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Posts Tagged ‘Management’

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Criticism as NHS Managers recruit Efficiency Expert

Thursday, October 20th, 2011

Hospital staff and unions today criticised managers at Lancashire Teaching Hospitals for taking on an “efficiency” consultant to help them achieve financial savings.

Steve Leivers, who is Director of Transformation at Aintree, has joined Lancashire Teaching Hospitals for six months to help them achieve their £21 million efficiency target. It has not been disclosed how much he will be paid for this period.

Workers and unions have however blasted the move and have branded it a waste of money. They assert that any further cuts will adversely affect patient care, and that spending more money on further employment in order to specify areas to target cuts to was counter-productive. They voiced their concerns that the role of efficiency directives should be the responsibility of their current managers and directors to find the most efficient ways of working and provide value for money.

George Dixon, central Lancashire Branch Secretary for UNISON, said that the move to appoint a specialist to make further savings indicates that management resources have been dramatically cut. “We have just been reported as being in the bottom 20 of hospital trusts by the Care Quality Commission when it comes to patient care. Further cuts will impact on staff’s ability to deliver patient care” he stated.

Karen Partington, Chief Executive of Lancashire Teaching Hospitals NHS Foundation Trust, said that the appointment of Mr Leivers as Director of Transformation is hoped to support them in achieving their efficiency target by 2012. He will collaborate with staff to review processes and working practices to identify more effective ways of delivering services.

Ms Partington said that Mr Leivers has a track record of delivering sustainable financial balance in challenging situations, and has previously supported other organisations to make significant savings. Mr Leivers is currently leading a £35m trust wide clinical transformation programme at Aintree.

Despite the best intentions of NHS Managers attempting to target areas for efficiency savings, Trusts may find that they could achieve better results by providing Heads of Service with the right tools to do their jobs. Trusts could seek to implement an Electronic Patient Record (EPR) system such as Therapy Manager, which provides managers with a robust suite of tools to enable on-demand monitoring of key performance measures. The system can report on the Costs of Care and where they are incurred, ensuring managers are supported in clinical decision making which could potentially reduce the financial costs incurred in patient care.

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Mapping resources and skills to case complexity

Saturday, October 1st, 2011

When allocating resources to a patient within Therapies, it may not be as simple as determining the availability of clinicians, but may also need to take into account the complexity of the patient journey. The challenges surrounding patient complexity can include:

  • Determining availability by NHS band and speciality
  • Performance Benchmarking
  • Analysing staff training needs

Determining availability by staff band and speciality

When scheduling Appointments for patients, the easiest option is to simply find the first available time slot with any clinician which does not discriminate based on NHS band or capabilities. This may mean that patient interventions may not occur with the most suitable clinician and potentially have a lesser effect on improving the patient experience. Therapy Manager however allows administrators and clinicians alike to undertake a search for the next available patient appointment using a number of different parameters including NHS Band, Clinic or Speciality group. This enables you to schedule more intelligently and ensure that patients are being supported by receiving the most appropriate care.

Performance Benchmarking

As a product of capturing all clinical activity, Therapy Manager allows you to measure the performance of your team and view it comparatively. The reporting functionality enables comparison of the actual duration of patient contacts across your team, and indicates the exact proportions of what types of interventions are being undertaken between different clinicians. You then have the ability to determine in which areas different clinicians excel and how long actual appointment durations take as an average. Identifying areas of superior performance can ensure that staff are given caseloads that cater to their individual interests and preferences, and that patients are provided with the best quality treatment as a result.

Analysing staff training needs

Using Therapy Manager as a management tool can ensure that you are informed as to the real-time performance of your teams and can assist you in identifying any discrepancies in clinical activity. The content of all Assessments and Clinical Notes can be viewed along with the exact time, date and clinician who completed them. Monitoring patient information can help you to ensure that clinicians are adhering to Trust guidelines with regards to time for completion and data quality, and highlight any areas where additional guidance or training may be required.

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Managing Annual Leave in Therapies

Monday, August 1st, 2011
During the summer months in particular, managing Annual Leave for clinicians in a manner that has the least impact on patient care can often prove challenging. The most common problems that Administrators and Managers encounter when attempting to co-ordinate Annual Leave are:

  • Arranging cover for Clinics and Classes
  • Cancelling and Rescheduling patient appointments
  • Managing Waiting Lists
  • Following a standard Annual Leave booking process

Arranging cover for Clinics and Classes

No matter how “in advance” Annual Leave is booked, it may be the case that patient appointments are already scheduled in the time a clinician is set to be absent. It may be the case that with enough available resources, you will be able to arrange for another clinician to assume these additional patient contacts. Current “paper diaries” are not conducive to this process, as information surrounding capacity is not immediately available.

All scheduled clinical activity within Therapy Manager is viewable on a timetable which indicates “Available” and “Clinical” time for every day a clinician is working. Users have the ability to view this information or search for available time to determine when another clinician will be able to take on scheduled patient contacts. Administrators can also modify timetables to extend clinical time if there is an additional demand placed upon capacity.

Furthermore, every aspect of the patient’s record, including Referral details, Waiting List data, appointment details, completed Assessments and Clinical Notes are viewable by every user of Therapy Manager. This will enable any clinician taking on another’s caseload to view all information about a patient to ensure that they are fully informed in their decision making processes. Clinicians undertaking planned Annual Leave will also be able to leave a Note in the patient’s record or send a Task or Message to the substitute clinician outlining any specific information or steps to be taken in their care.

Cancelling and Rescheduling patient appointments

If the resources are simply not available to take on the additional caseload, patient appointments can simply be set to “Cancelled”. This information will still be historically captured in the patient’s record, and an automatically populated document informing the patient of the details of any change can then be produced.

Therapy Manager also provides a mechanism to quickly change the clinician allocated to a patient appointment in just 4 clicks that will transfer the patient into the substitute clinicians diary.

Managing Waiting Lists

Ensuring that RTT targets are upheld in a period of potentially reduced capacity can be highly demanding. Therapy Manager enables a service-wide view of all patients waiting for an Initial Appointment which is colour-coded in accordance with Trust thresholds. Patients are not removed from the Waiting List until the point of treatment, so will persist in the event of a cancellation. Clinicians and Administrators can also book appointments straight from the Waiting List to ensure that all patients requiring treatment are seen within a Trust-approved time period.

Following a standard Annual Leave booking process

Problems can arise when attempting to adhere to standard Annual Leave booking processes and attempting to “block out” time on a rigid scheduling system (i.e. by cancelling clinics on a Patient Administration System).

Therapy Manager allows a simple mechanism to schedule Annual Leave into a clinicians timetable or diary, which is then viewable by all users. Any clinical time will then be automatically removed, and will not appear as bookable. The system can then be used to support a re-design of the way in which clinicians go about booking Annual Leave in an attempt to streamline the process.

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Posted in Operational Tips, Performance Management | No Comments »

How the NHS can follow the Unipart model of efficiency

Thursday, July 21st, 2011
John Neill, Chief Executive of the Unipart Group has outlined in his keynote address to the NHS Confederation conference what the NHS could stand to learn from the “lean thinking” mechanisms used to transform Unipart into a highly efficient logistics company.

Neill states that the drive for efficiencies started 25 years ago following the realisation that if Unipart couldn’t find a way of continuously improving quality at ever reducing levels of cost, that they may not survive within a competitive market. In order to do so, the company sought to rationalise factories, renegotiate employee terms and conditions and vastly improve investment in IT services.

Despite taking seemingly dramatic restructuring and watching efficiencies improve, Neill states then when benchmarking UK factories with their Japanese counterparts, those in Japan excelled in every key measure of performance. When taking into account quality metrics, they were “100 times better”.

In order to identify exactly how and where these efficiencies were being incurred, Neill sought advice from Japanese factory owners. Furthermore, after speaking to his employees, he discovered that “bottom up” approach towards efficiency was the most superior method.

Neill places the greatest emphasis on good leadership through efficiency drives, saying that management have a pivotal role in engaging staff members. “You have to lead them, you have to inspire them, you have to show them, you have to illuminate what is possible, you have to explain and you have to do it every hour of every day” he said. He explains that to achieve full employee engagement, he recommends a restructuring of working practices and attitudes towards work.

Setting deadlines demanding targets he says is extremely important, and stresses that managers must have the information to back up any changes they attempt to implement. Controversially, he states that any employees that consistently represent a barrier to change should simply be removed from the process.

Focus on IT is imperative he says, placing focus on an integrated system of tools that work together and on systems that deliver long-term results. He stresses that the expense both financially and of staff resources when implementing new systems may initially seem counter-intuitive, but the emphasis should be placed instead on the potential long term benefits.

Whilst Neill asserts that he understands the pressure within the NHS to deliver “quick wins”, he says that the focus should instead be on embedding the foundations for a culture of continuous improvement which creates genuine employee engagement and builds capability for problem solving. He says that if NHS managers are willing to make the commitment to implementing an operational excellence system and take on the demanding personal leadership challenge which that implies, he is extremely confident that cost saving targets and the productivity improvements which are necessary can be achieved.

In order that the NHS can align themselves within an increasingly competitive environments, managers need to be provided with the tools to be able to perform to the best of their ability. Trusts could therefore seek to implement an Electronic Patient Record (EPR) system such as Therapy Manager, which provides managers with a robust suite of management tools to enable on-demand monitoring of key performance measures. The system can report on the Costs of Care and where they are incurred, ensuring managers are supported in clinical decision making which could potentially reduce the financial costs incurred in patient care.

Original Source The Guardian

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Managers fears for the NHS

Wednesday, July 6th, 2011
The new Chief Executive of the NHS Confederation, Mike Farrar, has warned that if the NHS is to survive in the current climate then it is essential the government support large-scale restructuring of the service.

To highlight the issue, the NHS Confederation has published a survey of the opinions of NHS managers, which reflected their uncertainly surrounding the government’s health reforms and fears of the effects that the £20 billion health savings drive will have on clinicians and patients. The survey comes at a time when it has been reported that doctors at the British Medical Association’s annual representative meeting in Cardiff where 59% of delegates voted for the Health and Social Care Bill to be withdrawn.

Of the 287 NHS Chairs and Chief Executives polled, 89% predicted that the plateau in spending has led to “very serious” financial issues for the organisation, with 42% reporting that this was the worst environment ever experienced by NHS staff.

In excess of 50% of participants asserted their belief that waiting times will worsen as a result of the reforms despite the recent re-instation of the 18 week “referral-to-treatment” objective as a formal NHS target. Whilst the majority of managers felt they would manage to adhere to their budgets, one in five felt the quality of care would decline over the next year, with a third expecting it to decline over the next three years. In addition, there is widespread belief that NHS cuts will negatively impact council spending, and therefore the standards of social care.

Despite these fears, the savings must be made, and Farrar says this will only be achievable if politicians are able to back big service changes that are needed on quality and cost grounds. He adds that currently this cannot be achieved due to the unstable climate of the NHS and uncertainty surrounding whether the Bill will go ahead, and whether the contents will continue to be modified.

“We are concerned about excessive centralisation, bureaucratic restrictions on the freedom to act of local commissioning groups, the continued attack on management, and the lack of political courage when reconfiguration of services is justified on quality, safety, and, let’s name it, on cost grounds” he said.

Farrar asserts that it is not enough to cut financial overheads, but that services must be redesigned, ensuring that cuts are only made once the areas of excess are properly identified. He also called for the dissolution of the target of cutting a third of management costs, saying that such a large service needs adequate management to perform well. “We have got to value clinical and professional management and stop the endless attacks on it” he said.

One method to ensure efficiency savings without increasing cuts to provisions and staff numbers is the implementation of an Electronic Patient Record (EPR) system such as Therapy Manager.  The system provides not only a more streamlined and efficient working practise reducing administrative and clinical input, but has the capacity to report on exactly where costs are being incurred to ensure cuts are being directed towards the correct services. It also provides managers with a robust suite of management tools to enable on-demand monitoring of key performance measures.

Original Source Financial Times

About Pathway Software

Pathway Software (www.pathwaysoftware.com) specialises in the design and development of patient information systems for Allied Health professionals.

Its flagship product, Therapy Manager, is an Electronic Patient Record (EPR) system specifically designed for Therapy Services to provide decision makers with the ability to track and manage clinical activity and analyse cost of care by patient, episode or service. The system also demonstrably reduces administration time and the costs of managing Therapy Services.

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Posted in NHS | No Comments »

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