Consul Tant Manager Relationship

8/6/2019 Consul Tant Manager Relationship

1/6

DRAFT

Clinicians in Management

Charter of Rights and ResponsibilitiesFor hospital Managers and Consultants

July 2004

Draft Document for Consultation Purposes


2/6

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.


3/6

DRAFT


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.


4/6

DRAFT


Hospital Managers

RIGHTS OF HOSPITAL MANAGERS RESPONSIBILITIES OF HOSPITAL MANAGERS


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


5/6

DRAFT


Clinical Directors(in addition to Rights and Responsibil ities of H ospital Consultants)

RIGHTS OF CLINICAL DIRECTORS RESPONSI BILITIES OF CLINICAL DIRECTORS


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.


6/6

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

Consul Tant Manager Relationship

Documents

Transcript of Consul Tant Manager Relationship