Masterclass

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Masterclass

• Robert Jones and Fiona Jenkins
• 14th November 2008

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and the issues we are facing

• Political drivers
• Economic issues
• Social issues
• Cultural issues
• Clinical governance issues
• Corporate governance
• Information use
• Demographic issues

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What are your 5 key priorities for your service
in the next 2 years?

• A
• B
• C
• D
• E

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Overview

• The importance of management structure
• Structure and AHPs
• Management
• 10 domains of AHP management
• Proposed assessment tool
• Assessing your service

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Why Management Structure is Important

• Service provision
• Operational management
• Service development
• Staff
• Organisations
• Strategic influence
• Development of the professions

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Factors Influencing Management Structure

• Local healthcare changes
• Financial, political, economic and social
• Decentralisation
• Multi-professional management

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Different AHP management models
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Management Models- why important?

• Patient care and management models
• Different models of management for AHPs
• Pros and cons of models
• Factors for effectiveness and efficiency
• Link between structure and function

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Why does this Matter?

• Changes in health service provision
• Increasingly complex organisations
• Frequent re-organisation of provider and
  purchaser services
• Where do AHPs fit?
• Evidence based management
• Directly impacts on the care we can give to
  patients

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What about you and your service?

• Q2 What elements are there in the services that
  you provide e.g. primary care, secondary care,
  tertiary/quaternary care ? please list
• Q3 Do you have management responsibility and
  authority for the whole of the service continuum
  listed above? Yes/ No
• Q4 Does your role include both management and
  professional advisory functions? Yes/ No

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Background and Evidence

• Williams 1980s
• Jones 1986 ongoing
• Berry early 1990s
• Øvretveit and Brunel 1970s- early 1990s
• Boyce 1990s ongoing
• Mueller 1990s ongoing
• Jenkins 2002 ongoing

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Roles, Responsibilities and Duties of
Physiotherapy Managers

• 8 Domains, 27 Elements
• Strategic Management
• Human Resource Management
• Operational Management
• Budget and Resource Management
• Information Management
• Education Pre and Post Graduate
• Research and Development
• Clinical and Professional Leadership and
  Consultancy

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Representation/Communication
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What level is your post in the organisation?

• Board level ( Level 1)
• Reporting to a Board level member e.g. Chief
  Operating Officer (COO) or a General Manager
  (Level 2)
• Level 3
• Level 4
• Level 5 or below

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Post holder Representing AHPs at Board Level
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Purchaser Involvement with service planning
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Thematic Analysis of AHP Manager views

• Non fragmented services are best
• Cross organisational working benefits patient
  care
• Maintain critical mass of staff
• AHPs lack good executive and strategic level
  representation

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Questions so far?
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Our Assessment Tool

• Developed from collaboration
• Evidence-based
• 10 Domains, with individual elements

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Our Assessment Tool -10 Domains

• 1. Strategic management
• 2. Clinical governance
• 3. Human resource management
• 4. Clinical professional requirements
• 5. Operational/service management
• 6. Resource management

• 7. Information management
• 8. Education and training
• 9. Commissioning (service purchasing)
• 10. Service improvement

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Domain 1 Strategic Management
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Domain 2 Clinical Governance
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Domain 3 Human Resource Management
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Domain 4 Clinical Professions Requirements
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Domain 5 Operational/Service Management
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Domain 6 Resource Management
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Domain 7 Information Management
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Domain 8 Education Training
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Domain 9 Service Purchasing
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Domain 10 Service Improvement
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10 Domains

• 1. Strategic management
• 2. Clinical governance
• 3. Human resource management
• 4. Clinical professional requirements
• 5. Operational/service management
• 6. Resource management

• 7. Information management
• 8. Education and training
• 9. Commissioning (service purchasing)
• 10. Service improvement

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Its Lunch time!
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Evaluation/Scoring

• Use Red/Amber/Green
• 1 score for each domain

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Heres one we prepared earlier!
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Prioritisation
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The Building Blocks

• High calibre management with relevant expertise
• Non fragmented service
• Equitable patient services
• Critical mass staff
• Take staff with you
• Structure that addresses our 10 domains
• Ability to influence upwards
• Effective and efficient

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Not Recommended!
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Quality Management
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When assessing your service..

• Maintain focus on patient-centred care
• Aim for non-fragmentation
• Management structures and collaboration
• Respect for individual professions
• Develop structures that support patient pathways
• The role and future of the professions
• Value for money
• Be pragmatic

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Any Questions?