Post on 07-Apr-2018
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DRAFT
Clinicians in Management
Charter of Rights and ResponsibilitiesFor hospital Managers and Consultants
July 2004
Draft Document for Consultation Purposes
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DRAFT
CONSULTANT/MANAGER RELATIONSHIP:CHARTER OF RIGHTS AND RESPONSIBI LITIES
In 1998 the Department of Health and Children launched the Clinicians in
Management Initiative (CIM) which was designed to heighten the involvement ofkey health professionals in the planning and management of services. Therationale for this was primarily about improving the quality of clinical service bymoving decision making closer to the point of service delivery. A centralcomponent is to create and maintain effective working partnerships betweenclinicians and managers. Though notable progress under the initiative has been
made in a number of hospitals the CIM experience has been very varied. Fiveyears on from the launch of CIM, full clinician involvement in decision-makingand in the management of resources is not yet the norm across the healthservice.
In 2003 a small and informal discussion group of hospital managers andconsultants was convened, by the Office for Health Management, in an effort toprogress the initiative. The discussion group has focused on the goal ofincreasing cooperation between doctors and managers at both hospital andnational decision making levels. This will involve building a framework foreffective working partnerships between clinicians and managers designed todeliver the goal of achieving meaningful involvement of clinicians inmanagement. All agree that his is going to take time and it is probably wise tostart small and progress slowly at a pace the parties are comfortable with.Consultants and senior managers are the key players. Others have much to
contribute, much to gain and not a lot to lose.
During the past year the group has met on a number of occasions and hasdevised a draft charter of rights and responsibilities for Consultants, Managersand Clinical Directors. This document is intended to set out the principles onwhich understanding between clinicians and managers can develop and grow ina spirit of genuine partnership. We now consider it to be a consultationdocument and we are inviting clinicians and managers throughout the system toconsider the charter, reflect on the spirit as well as the letter of it and let us havethe benefit of their views.
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DRAFT
CONSULTANT/MANAGER RELATIONSHIP:CHARTER OF RIGHTS AND RESPONSIBI LITIES
Hospital Consultants
RIGHTS OF HOSPITAL CONSULTANTS RESPONSI BILITIES OF HOSPITAL CONSULTANTS
I have the right to:
Clinical autonomy, i.e. the right to makedecisions about the treatment of my patientswithout consulting anyone
Ongoing Continuing Professional Developmentto ensure my clinical practice continues to besafe and effective
Meet with other consultants/clinicians as partof my contracted working week
Make a case for my perceived view of theresources needed to safely and effectivelytreat patients under my care
Management information on the allocationand utilisation of resources to allow me tomake my case
Access the Hospital Management and theBoard of the hospital via an agreed process
Make my views known to the medicalrepresentative on the Management Teamand/or the Board of Management
Advocate for patients under my care Treat private patients within agreed
hospital/national norms and guidelines
Be supported in my management of HumanResources and Financial Resources
Influence national policy
I have the responsibility to:
Ensure my clinical practice is safe andeffective
Take account of the impact of my clinicaldecisions on others, both other clinicians andtheir patients
Contribute to the Clinical Audit process Contribute to the development of safe
hospital systems
Participate in hospital planning and decisionmaking
Organise my clinical practice to enable me toparticipate in hospital decision making withoutunduly impacting on hospital finances, level ofservice or patient care
In making public statements, consider theimpact of my actions on the standing of myhospital in the system
Practice safely and ethically as a clinicianthrough participation in the Medical CouncilCompetence Assurance Scheme
Act within agreed Service Plan provisions Take account of the multi-disciplinary nature
of care and to respect the contributions ofother disciplines to patient care
Take responsibility for the supervision andeducation of the NCHDs under my aegis.Promote safe clinical practice and becognisant of the budgetary implications oftheir practice
Communicate with patients and familiesrespectfully and fully and ensure my team
does also
Contribute to the hospitals ClinicalGovernance system
Maintain effective two-way communicationsystems with GPs
Communicate as appropriate with PublicHealth services, Mental Health services andCommunity Care services including thePrimary Care Team.
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CONSULTANT/MANAGER RELATIONSHIP:CHARTER OF RIGHTS AND RESPONSIBI LITIES
Hospital Managers
RIGHTS OF HOSPITAL MANAGERS RESPONSIBILITIES OF HOSPITAL MANAGERS
I have the right to:
Manage the hospital (in co-operation withconsultants and others)
Make decisions regarding requests foradditional resources in the context of overallresource availability and having consultedappropriately
Take the corporate view in making decisions Manage implementation of the Consultant
Contract
Information on patterns and outcomes ofclinical practice by consultants
Be informed by consultants about any publicstatements they intend to make about thehospital
Develop Hospital Strategic plan and ServicePlan
Seek to influence national policy A respectful relationship with consultants and
the consultants representative bodies
Expect an efficient use of hospital beds andother resources
Ask consultants to participate in hospitalplanning and decision making
Ask consultants to organise themselves toachieve a) medical representation and b)medical coordination of services
Advocate on behalf of my hospital
I have the responsibi lity to:
Meet with consultants, both individually andcollectively, on an agreed periodic basis
Take account of the views of consultants inmaking decisions on resource allocation
Ensure the hospital consultants operate safesystems and monitor their practice on aregular basis
Manage the whole hospital as an integratedunit serving a population
Measure performance of the whole hospital toensure it meets defined patient needs
Allocate resources efficiently and according toan agreed set of criteria
Facilitate consultant participation in hospitalplanning and decision making
Represent the interests of the hospital to thefunding system in order to access theresources necessary to deliver services
Provide data to hospital consultants to fullyinform their decision-making
Ensure that all staff have the skills necessaryto fulfil their roles within the hospital
Ensure hospital HR policies and proceduresare developed and implemented within goodpractice standards
Develop safe systems and ensure consultantscontribute to and observe the safety of thesystems within their own practice
Participate in Continuing ProfessionalDevelopment
Participate in audit of hospital management inrelation to efficiency, effectiveness andpatient safety
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CONSULTANT/MANAGER RELATIONSHIP:CHARTER OF RIGHTS AND RESPONSIBI LITIES
Clinical Directors(in addition to Rights and Responsibil ities of H ospital Consultants)
RIGHTS OF CLINICAL DIRECTORS RESPONSI BILITIES OF CLINICAL DIRECTORS
I have the right to:
Manage the Directorate (in co-operation withthe rest of the hospital)
Participate in the hospital CorporateManagement structure
Contribute to hospital/organisation StrategicPlan and Service Plan
Be given the authority and appropriateresources to meet the goals of the ServicePlan
Have the freedom to make decisions withinthe parameters of the organisation goals
Lead and manage the Directorate within theparameters of the hospital guidelines
Appropriate corporate support to enable meto fulfil my management role
Full and timely management information onthe allocation and utilisation of resources
within my Directorate and within the hospital
Information re clinical and planningoperations of other Directorates
Access to the Hospital Manager and Board ofthe hospital
Access to ongoing management training andcontinuing professional development as aClinical Director
Tap into a support network of other clinicaldirectors nationally
Meet with colleagues and other ClinicalDirectors as part of my contracted workingweek
Recognition of the time required to fulfil theClinical Director role
I have the responsibility to:
Contribute to the implementation of theStrategic Plan for the hospital/organisation
Consult with the multi-disciplinary team withinmy Directorate on the long term strategicdirection of the Directorate
Produce an annual Service Plan for theDirectorate
Engage the multi-disciplinary team within myDirectorate in discussions on the service planof the Directorate
Monitor, review and report on theimplementation of the annual service plan forthe Directorate
Manage within agreed resources for theDirectorate and take such action as may benecessary to meet Service Plan targets
Ensure work of the Directorate is in line withbest practice standards of care
Develop a multi-disciplinary team approach tothe management of all clinical issues arising inthe Directorate
Collaborate with the Business Manager andothers to ensure continuous qualityimprovement in patient services
Audit clinical services to ensure theDirectorate standards and performance arecomparable with national/internationalbenchmarks
Review case mix to identify decision drivers,implications, costs and impact on otherDirectorates
Provide clinical leadership across disciplineswithin the Directorate and across the hospitalwith other consultants
Note: it is assumed that the Clinical Director reports to the hospital Chief Executive.
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DRAFT
Members of the CIM Discussion Group
Chair
Mr Denis Doherty, CEO of Health Boards Executive and Director Office for HealthManagement
Group Members
Dr Luke Clancy, Clinical Director, CresT Directorate, St James Hospital
Ms Jackie Crinion, Management and Organisation Development Specialist, Officefor Health Management
Dr John Fennell, Consultant Physician, Loughlinstown Hospital
Dr Bairbre Golden, St. Bartholomews Hospital, London and Vice-President,Clinicians in Management Ireland
Dr Laraine Joyce, Deputy Director, Office for Health Management
Mr John Lamont, Registrar, Irish medical Council
Mr Michael Lyons, Chief Executive Officer, AMNCH, Tallagh
Mr Tony McNamara, General Manager, Cork University Hospital
Mr John OBrien, Chief Executive Officer, St James Hospital
Dr Christine OMalley, Medical Consultant, Nenagh Hospital
Dr Cillian Twomey, Consultant Geriatrician, Cork University Hospital