SCTS Consultant Job Planning
Regional Representative Meeting
RCSEng: 10th Nov 2010 Graham Venn
Chairman of Job Planning Cardiothoracic Surgery
Consultant Job Plans
• Current Process• Provisional job plan prepared by source Trust• Trust send to College for Approval• College send to Regional College
Representative for approval – now ‘new’ RSPA
• Following approval back to source Trust who then constitute the AAC
Secondary Approval
• Three Specialities currently have a secondary centralised approval process – usually the Society President.• Cardiothoracic, Neurosurgery, Transplantation
• SCTS present process serendipitous• London RSA at the time• Bruce Keogh’s proxy – increasingly busy• Large number of JDs reviewed – problems apparent.
Problems
• Problems with the primary JD structure
• Problems with the primary JD approval
• Problems with the secondary approval process
• Problems constituting the AAC
Problems with JD Process
• Produced by junior member of HR or business staff with little experience.
• Few have clinician input. (Only two correct in last 65 reviewed)
• Old, pre 2003, contract format; half days – sessions etc• No times of work specified – am or pm only• On-call forgotten• Travel to and from outlying hospitals forgotten• Simple maths errors the norm, unable to summate PAs• Remarkably little medical involvement at any time• Usually try to cram 12PA job into 10PAs• School-leaver level errors in most JDs
Problems with Primary approval
• Sent to Regional College Representative (RSPA) for approval
• Variable input and understanding from the regional reps. No homogeneity of advice. (Not surprising-Regional Reps have no training in this)
• Lack of consistency increases confusion back at host Trust
• Different rules for each job, specialty and College
Problems with Secondary Approval
• President usually too busy for detailed review
• Introduces further variable and unhelpful delay
• JD usually nodded through
Problems with AAC
• Back to Trust following central approval• Trust approach College for AAC representative
with tentative date for interview• College struggle to find AAC rep who is free and
from correct (sub)discipline• Trust finally constitute appointment committee
following identification of AAC representative
Overview
• Cumbersome and time consuming• Inconsistent
• Same job countrywide- variable job descriptions • Same job trustwide – variable structure and pay
• Difficult for a new and vulnerable Consultant to change an inappropriate job plan at inception of new post
SCTS Pilot
• SCTS form JD subcommittee• Small cohort of individuals to review all new
JDs• Combine regional and secondary process• Homogenous advice using pre-agreed BMA
type JD format (usually very well received)• Quick turnaround
Provide Consistent Template
• A modified BMA template serves well
Daily Work Plan
Day Time Location Work CategoryNo. of
DCC PAsNo. of
SPA PAs
Wednesday 0800 to 1200
City Hospital
OPD (Inc review, clinic and letters)
DCC 1.00 embedded teaching
1200 to 1400
County Hospital(alternate weeks + travel)
Aortic Surgery MDM
DCC 0.25
1400 to 1700
City Hospital
Ward Round
DCC 0.75 embedded teaching
Thursday 0800 to 1800
City Hospital
Operating DCC 2.5
Weekend Work
Day Time Location Work CategoryNo. of DCC
PAsNo. of SPA
PAs
Saturday 0900 to 1200
City Hospital(1 in 4)
On Call Ward Round (includes travel)
DCC 0.25
1200 to 1500
City Hospital(alternate weeks)
Waiting List Initiative
DCC 0.5
Sunday
Predictable On Call Work(Saturday)
1200 to 1800(1 in 4)
City Hospital
Post Take Surgery + WRs
0.5
Annualised Activity?
Work Location Weekly Hours
Category Weekly DCC PAs
Weekly SPA PAs
Teaching Students
City Hospital
2 SPA 0.5
Audit City Hospital
2 SPA 0.5
Service Lead
City Hospital
4 SPA 1.0
Post G Super
City Hospital
2 SPA 0.5
CPD and Research
City Hospital
2 SPA 0.5
Patient Admin
Variable 6 DCC 1.5
Total 1.5 3.0
SPA Activity
• Training: CS, AES etc. S1• CPD S2• Teaching S3
• Postgraduate• Undergraduate• External
• Audit and Clinical Governance S4• Job Planning / Appraisal S5• Research (negotiable with Trust) S6• Clinical Management - Service Lead etc S7
On Call
On Call Allocation
Availability Category Immediate ‘A’ – 8%Delayed ‘B’ – 5%
8%
On Call Rota 1 in 4
Unpredictable On Call Work
4 hours 1 PA
Clear Summary
Programmed Activities Number
Direct CareOptional and Funded
7.5 2.0
Supporting Activities 2.5
Total PAs 12.0(9.5 + 2.5)
Fundamental Steps
• Engage in constructive dialogue• Provide useful and consistent proforma (BMA)• Ensure that Clinical Director has signed off JD• Liaise with Clinical Lead, not HR / Business staff• Use annualised activity for irregular activity,
particularly for SPAs• Be consistent - small core group• Be efficient, quick turnaround, facilitate AAC
How are we doing?
• Highly successful - but lots of work
• Virtually every job changed and improved
• Usually better remuneration• Up to 3 PAs – Optional funded PAs
• Greater clarity and transparency and consistency
• Useful service for job plan reviews - staff
• Supporting the Surgeon in the Workplace
Next Steps -
• Provide concise advice to RSPAs and DPAs• Provide advice to specialty membership
• Advice Document
• Coordinate advice nationally – small core group – be consistent
Summary
• Not Rocket Science!
• Current process needs to be more professional and consistent
• Consistency of New JDs protects new appointees – Very positive service to the membership
• Surprisingly well received by (most) Trusts due to inexperience of HR staff / business managers
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