People, Planning, Politics and Prioritising

1
People, Planning, Politics andPrioritising

• Melanie Jones
• Consultant Anaesthetist
• BroMorgannwg NHS Trust

2
What do you feel as CD?

• Top of the World, Ma - James Cagney
• Nobody likes me, everybody hates me, I think
  Ill go and eat worms - Trad.
• All in one day

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Background

• Appointed Consultant, Bridgend 1990
• College Tutor, 1990 - 1996
• WCSC - 1995 - present
• Post-Graduate Organiser, 1999 - 2004
• Secretary, MSAC, 1993 - 5
• Secretary, LNC, 1995 - 1998
• MWF, S Wales and Council, 1992 - present

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Clinical Director

• Bridgend NHS Trust, 1998 - 1999, appointed by
  interview, CE and MD.
• BroMorgannwg NHS Trust, 1999 - 2003
• appointed by panel, inc. external assessor.
• Responsible to CE and MD.
• By open invite to all consultants in Directorate

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Remuneration

• What are you worth?
• Time or money?
• Salary regular review
• Superannuable
• Reduced fixed sessions
• Performance related pay

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The Directorate

• Theatres - x6 at POW, x2 at NPT, (x2 LW)
• DSU x2 - POW and NPT
• Anaesthetic Dept x2 - 20 consultants, 8 trainees
  and 8.5 staff grades
• ITU and HDU in Bridgend
• Sterile Supplies Service
• Acute and chronic pain services

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Staff

• 39 Doctors
• 200 Nurses
• 30 Technical
• 40 others
• 5 administrative staff

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Budget

• 1999 - 6.2 million
• 2001/2 - 10.4 million
• (projected overspend - 30K)
• 2002/3 - 12.8 million
• (acceptable overspend 0 )

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Directorate Core Team

• Clinical Director
• Directorate Manager now shared with surgery
• Head of Nursing and Clinical Services
• Directorate Finance Manager
• Directorate Personnel Manager
• Sterile Supplies Manager

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Directorate Meetings

• Core team x2 per month
• Core team H grades x1 per month
• Core team H grades others for Clinical
  Governance x1 per month
• Consultants x1 per month
• Staff grades and Trainees - (if asked)

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Other Meetings

• Management Executive
• Operational Services Group
• Medical Workforce Planning Group
• Clinical Audit and Effectiveness Committee
• Clinical Risk Steering Group
• Financial Audit Committee
• Theatre Users Committees x2

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Other Meetings

• Equality Steering Group
• Clinical Directors Group
• Day Surgery Strategy Group
• Clinical Model Task Team
• Elective Surgery Sub Group
• etc etc etc .

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Workload Planning

• Daily contact with DM and HoN
• Daily contact with Consultant Colleagues
• Weekly contact with Director of Surgery
• Weekly contact with Medical Director
• Loss of Clinical Activity - inevitable
• Time Management - electronic

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Directorate Planning

• Top 5 - for this year and beyond
• Ready to go - prepared, finance, business case -
  HDU beds, ITU nurses, Sat and Sun a.m. lists,
  Chronic Pain, HSDU, medical staffing
• Other Directorates plans
• External Drivers
• we need this by Friday

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External Drivers

• WAG, Regional offices,
• Specialist commissioning
• LHB
• DoH
• EWTD, New Deal,
• PMETB
• NICE, CHAI, NSF

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Priorities For Directorate

• Changeable from week to week
• Promote the Top 5 at every opportunity
• Watch other Directorates, WAG, LHB
• Contact with Planning Directorate
• Contact with MD/CE
• Capital Planning

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Priorities for Me

• Changes day to day
• Strategic Planning and Clinical Governance
• Operational Issues - delegate, unavoidable
• Complaints Management - Patients, Internal
  customers, Staff, Medico-legals.
• Conflict Resolution
• Succession Planning
• Keep colleagues informed, consulted, (supportive)

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The Life Cycle of a Clinical Director

• Year 1 - what have I got myself into?
• Year 2 - this is alright, really
• Year 3 onwards I wish Id known this last year,
  now were really moving, I have a cunning plan
• Finally - megalomania, palace revolts, oh that
  again, new pastures over the horizon

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People

• Learn to say No, cannot please everyone
• Always make time for listening
• Keep it short, ask them to go
• Open door
• Keep smiling, be positive, take action
• Nothing is a problem or too much trouble
• Share, consult, red book, feedback

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Personal development

• Self awareness
• What drives you
• What you avoid and why
• Your style
• Emotional intelligence / awareness of others
• Keep the organisation informed
• Ask for help

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The Rest

• You cannot be prepared for everything
• Speak up, you may not get another chance
• Accept mistakes by yourself and others
• Do not reply in writing and in haste to anything
• Dont make enemies
• Avoid constant alliances
• ENJOY IT!!!!!!