Why waste a good crisis?

Transcription

1 Why waste a good crisis? A framework for performance and talent management delivering revalidation Dr Jonathan Fielden Chief Medical Officer Royal Berkshire NHS Foundation Trust Challenges & opportunities 2010: Responding to concerns about practitioner performance NCAS Annual Conference Tuesday 30 March 2010 London Summary Where we are Components of talent management Tools available Challenges and opportunities 1

2 Rule No 1 Never allow a crisis to go to waste They are opportunities to deliver key changes Rahm Emmanuel Starter for 10 view of the journey Some key outcomes key illnesses throughput capacity health priorities waiting times financial stability quality, safety patient experience 18 weeks credibility health & well-being equity joined up care Self-sustaining Health Transforming care system SERVICE Journey Growth, Expansion & Delivering the Basics Reconfiguring Service Delivery Financial Stabilisation Local Capability & Self-improvement Breakthrough & Innovation Social Movements Co-creation REFORM Journey Centre s LEADERSHIP Journey Targets & Performance Management Target setter + Performance manager + Delivery leader Technical Leadership SHA/PCT/Trusts Choice & Providers Commissioning Connecting for Health Adaptive Leadership Regulator + National Standards + System leader 2

3 Some potential mechanisms to promote quality improvement Patient choice Information for choice Commissioning esp PBC & pathway redesign Quality requirements in contracts NICE guidance + NSFs providing advice for commissioners DEMAND SIDE REFORM More choice and a much stronger voice for patients TRANSACTIONAL REFORM Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve Better quality Better patient experience Better value for money Reduced inequality Payment by Results Developments in PbR eg normative pricing Quality bonus/discount scheme in model contract Other incentives in secondary care eg CGST QOF Frequency and type of clinical & patient experience information SUPPLY SIDE REFORM More diverse providers, with more freedom to innovate and improve services Licensing against core standards of safety and quality Clinical failure regime Performance assessment of providers and commissioners Organisational assessment Professional regulation Clinical networks across commissioners and providers A framework of system management, regulation and decision making which guarantees safety and quality, fairness, equity and value for money SYSTEM MANAGEMENT AND REGULATION Benchmarking and audit Empowering clinical teams Lean thinking & reliability science Provider support eg NIII, CGST Voluntary accreditation Workforce development Professional education/cpd New providers, eg IS, 3rd sector Service reconfiguration Patients trust Traditional social deference is being challenged Public expectations rising Work becoming more complex and demanding greater risk of error Greater emphasis on remediation, rehabilitation and support High profile cases No hiding place Risk based regulation Need for a new system which is able to detect problems early, provide open assurance of competence and good conduct and deal fairly and independently with poor practice and poor behaviour 3

4 Assessment Specialty Doctor Productivity 4

5 Public spending squeezed Percentage real increase Institute for Fiscal Studies Real increase, LH axis Level, RH axis Financial year Percentage of national income Next stage review SHA visions in place Enabling report: High quality Care for all Education, Workforce and Training Leadership Quality NHS constitution Principles and values Legal rights, Pledges and Responsibilities 5

6 Embedding quality Key purposes Example product National Improvement against national priorities Accountability to taxpayers International benchmarking NQB Quality Report Regional Local Team Co production at all levels of the system Subsidiarity Local clinical ownership of indicators Improvement in quality within the region and progress against the regional vision Enable benchmarking Service improvement Board accountability Provider benchmarking Service improvement Team benchmarking for improvement Regional quality measures Services from Quality Observatory Provider quality account Clinical Team quality measure and dashboards Sources of evidence based indicators include Royal Colleges, specialist societies, NHS Information Centre, universities, commercial sector Successful organisations Patient focused Have vision Align their vision with their (senior) staff Value and develop in partnership Have/develop inspirational leadership Forecast and adapt Learn, innovate and improve Know their market Put quality results as their goal 6

7 What is performance management? A process which contributes to the effective management of individuals and teams in order to achieve high levels of organisational performance. As such, it establishes shared understanding about what is to be achieved and an approach to leading and developing people which will ensure that it is achieved'. They go on to stress that it is 'a strategy which relates to every activity of the organisation set in the context of its human resource policies, culture, style and communications systems. The nature of the strategy depends on the organisational context and can vary from organisation to organisation. ARMSTRONG, M. and BARON, A. (2004) Managing performance: performance management in action. London: Chartered Institute of Personnel and Development. What is performance management? A effective management of individuals and teams in order to achieve high levels of organisational performance Establishes shared understanding Developing people which will ensure that it is achieved Relates to every activity of the organisation: policies culture style, and communication. ARMSTRONG, M. and BARON, A. (2004) Managing performance: performance management in action. London: Chartered Institute of Personnel and Development. 7

8 What is performance management? A tool to ensure that managers manage effectively know and understand what is expected of them have the skills and ability to deliver on these expectations are supported by the organisation to develop the capacity to meet these expectations are given feedback on their performance have the opportunity to discuss and contribute to individual and team aims and objectives. It is also about ensuring that managers themselves are aware of the impact of their own behaviour on the people they manage and are encouraged to identify and exhibit positive behaviours Talent management The concept of talent management has evolved into a common and essential management practice and what was once solely attached to recruitment now covers a multitude of areas including organisational capability, individual development, performance enhancement and succession planning CANNON, J.A. and MCGEE, R. (2007) Talent management and succession planning. CIPD toolkit. London: Chartered Institute of Personnel and Development 8

9 Why talent manage? Talent management The systematic attraction, identification, development, engagement/ retention and deployment of those individuals who are of particular value to an organisation, either in view of their high potential for the future or because they are fulfilling business/ operationcritical roles Benefits of talent management A successful approach is based on an agreed, organisationwide definition of talent and talent management An agreed narrative is a strong component A proactive, strategic approach to talent management offers considerable organisational benefits in terms of developing a pool of talent as a resource to meet identified needs Support for talent management must flow from those at the very top of an organisation and cascade throughout Engaging line managers from an early stage is critical Talent management can enhance an organisation s image and supports employer branding enhancing employee engagement to improve retention. Processes must be developed to track the performance and progress 9

10 Elements to performance management Performance management 10

11 Appraisal Attribute 1: Maintain your professional performance Attribute 2: Apply knowledge and experience to practice Attribute 3: Knowledge, Skills Keep clear, accurate Performance and legible records Attribute 1: Communicate Communication, effectively Partnership Attribute 2: Teamwork Work constructively with colleagues and delegate Attribute 3: Establish and maintain partnerships with patients Attribute 1: Put into effect systems to protect patients and improve care Attribute 2: Respond to risks to safety Attribute 3: Safety and Quality Protects patients from any risk posed by your health Attribute 1: Show respect Maintaining for patientstrust Attribute 2: Treat patients and colleagues fairly and without discrimination Attribute 3: Act with honesty and integrity 11

12 Job planning and appraisal cycle Clinical excellence awards Appraisal meeting Agreement of personal objectives Local Delivery Plan Annual pay progression Job plan review meeting Business planning and service development Agreement of service objectives (team or individual) 12

13 13

14 Talent management 14

15 ACCEA ADVISORY COMMITTEE on CLINICAL EXCELLENCE AWARDS Guides Applicants eligibility, how to apply Assessors scoring, details on criteria Employers committees & annual reports Nominators ranking processes, citations Award holders reviews, changes of circumstance A competitive scheme All consultants eligible from the beginning of 2 nd year Peer majority on Local Employer based awards committee 2434 national applications for 576 new awards All applications considered by regional sub-committees Some also by national nominating bodies Shortlisted applications from either route considered by Chair and Medical Director 12:Platinum 11:gold 10: silver 9: Bronze Local awards

16 Distribution of CEAs Award Status of Consultants June % 4% 1% 8% 41% No CEA or DP L1-4 + DPs L5-8 L9 + B L A L12 + A+ 38% Talent management 16

17 Normal distribution moving the curve right Framework 17

18 Challenge and success Patient (customer) focused High quality Safe Value Driven Vision for the future 18