Medical Directorate

ANNUAL REPORT 2010-2011

Annual Report 2010/2011

ANNUAL REPORT 2010 2011

EXECUTIVE SUMMARY

KEY THEMES

Major activity for 2010-2011

What we are:

The medical directorate offers strategic vision, leadership and management of processes to support doctors across NHS Grampian.

What we do:

The medical directorate provides transformational leadership with respect to clinical governance, appraisal, revalidation, performance management, educational development/training, medical workforce and other relevant issues.

Strategic leadership

Secondary care appraisal

  • Set up systems to support revalidation
  • Collate form 4
  • National appraisal leads group
  • Support national database implementation
  • National training initiatives- local and national

Primary care appraisal

  • Set up systems to support revalidation
  • Collate form 4
  • National appraisal leads group
  • Support national database implementation
  • Maintain establishment of primary care appraisers

Performance support practitioner

  • Case management
  • Support for performance reference group
  • Facilitation

Postgraduate medical education

  • Development of secondary care education supervisors
  • Foundation doctors – can their experience be improved?
  • Patient safety initiative in relation to training
  • Induction of doctors

Medical workforce

  • National/regional work on workforce planning
  • Efficiency, productivity and sustainability of medical staff
  • Expertise on workforce planning, development and re-design
  • Support the medical directorate team

Deputy medical directors

  • Support for deputy medical directors
  • Clinical governance
  • Critical incidents and HEI
  • Staff governance

Development aims in 2011-2012

Deliver integrated appraisal & job planning systems to NHS Grampian

Develop appraisal & job planning database

Strategic leadership on developing a formative culture to support appraisal and job planning

National Appraisal training

Support national, regional and local work on supplementary medical staffing

Continue to develop a multi-skilled 24/7 trained clinician workforce across NHS Grampian (including the introduction of physician assistants)

FOREWORD:

Roelf Dijkhuizen Medical Director

Welcome to this summary of the purpose and activity of NHS Grampian Medical Directorate over the period 2010-2011. You will see from the activity data that the directorate continues to support a wide range of core functions as well as responds to new initiatives, both local and national.

The purpose of this and subsequent annual reports is to inform NHS Grampian to whom the directorate is accountable.

AIM OF MEDICAL DIRECTORATE

NHS Grampian corporate objective of learning and growth is supported by the medical directorate. This is through ensuring effective staff involvement in achieving a healthy and positive work experience.

This support is based on excellent clinical skills and systems enabling adherence to Staff Governance/Clinical Governance Standards.

Quantitative data regarding activity for the period 1 April 2010 to 31 March 2011 is presented.

NEW INITIATIVES

Appointment of Director for Postgraduate Medical Education and the development of supporting team (including training quality leads)

Appointment of Secondary care Appraisal Lead

Development of the electronic systems and processes

Introduction of physician assistant to a multi-skilled 24/7 trained clinician workforce

OVERVIEW

NHS Grampian medical directorate comprises a multidisciplinary team working across organisational boundaries

Staff members include:

Name / Contact
Medical Director / Roelf Dijkhuizen /
Secondary Care appraisal lead / Elizabeth Murphy /
Primary Care appraisal lead / Alan Carr /
Director Postgraduate medical education / Richard Coleman /
Director Undergraduate medical education / Kim Ah-See /
Performance Practitioner / Fiona McKay /
Medical workforce manager / Simon Shemilt /
Personal assistant / Lyndsay Cassie /
Data inputting form 4- secondary care / Jo Leele /
Data inputting /SOAR management primary care / Anne Murray /
Medical staffing support officer / Jennifer Christie /
Systems development and improvement manager / Chris Lawrie /

ACTIVITY OF NHS GRAMPIAN MEDICAL DIRECTORATE

Secondary Care Appraisal- Elizabeth Murphy

Number of consultants and other non training grade staff / Form 4 uploaded
(or notified of exemption) / %
2010- 2011 / 580 / 494 / 85
Consultants / 426 / 387 / 90
Honorary Consultant / 55** / 41 / 75
Other doctor including GP with sessions / 90 / 60 / 67
Dentists / 4* / 3 / 75

* numbers based on payroll upload at September 2011 includes maternity leave , sickness absence and new starts within the appraisal period

Number of secondary care appraisers / National trained / %
2010- 2011 / 147 / 24 / 16

147 current appraisers in NHSG 487 appraisees The mean is 487/147 = 3.3 appraisees allotted to each appraiser. The median is 3. The mode is 1. This is from 1 to 18 so the Range is 17.

National training in NHS Grampian dates-11th November 2011, 7th September 2012 ,9th May 2013

To date the process for internal audit and use of summarised and anonymous feedback forms from appraisers and appraisee has been implemented using survey monkey short form questionnaire. Full details are yet to be reviewed.

Primary care Appraisal- Alan Carr

Key development aims

  • To offer appraisal to every GP on Grampian Performers List.
  • To account for completion or reason for non-completion of every GP appraisal.
  • To advise and support GP appraisees in requirements for revalidation.
  • To maintain an adequate establishment of GP appraisers.
  • To support GP appraiser development.
  • To liase with Medical Director and Perfomance Practitioner regarding support for GPs not engaging with GP appraisal.
  • To liaise with Secondary Care Appraisal Lead to support secondary care appraisers through joint educational activity with GP appraisers.
  • To support NHS Orkney and NHS Shetland in offering all the above activities.

Activity

Number of GPs / Form 4 uploaded
(or notified of exemption) / %
2010- 2011 / 606 / 523 / 86.3
GP Scot 5b / 83 / 13.7
- ill health /mat leave / 18 / 3.0
- moved away / appraised elsewhere / 24 / 4.0
- Retired / 13 / 2.1
- Other / 25 / 4.1
Non-engagement referred to medical director / 3 / 0.5

Director of Postgraduate Medical Education- Richard Coleman

Key development aims

To maintain a register of all educational supervisors in Grampian.

To ensure that all educational supervisors have recognised time in their job plans for their educational role.

Activity

Preparation of job planning guidelines.

E-mail contact with all educational supervisor's (NES and DME working jointly) to maintain and update the NES-held database

Future areas for development

Review the quality of educational supervision in NHS Grampian (Dr Andy McPherson, Training Quality Lead)

Review patient safety issues in relation to training (Mr Pragnesh Bhatt, Training Quality Lead)

Review of foundation programme posts in NHS Grampian (Dr Ann Cadzow, seconded from NES)

Establish a mechanism to feed back educational governance data to individual trainers, departments and services (Dr Richard Coleman, DME)

Performance support practitioner- Fiona Mckay

  • Contact person for individual GPs/GP practices with performance concerns
  • Investigation of concerns and provision of support if contracting GPs
  • Liaison with CHPs if salaried GPs
  • Preparation of new cases/updates on hospital doctors, GPs and dentists for monthly performance review meeting
  • Liaison with GMC in all cases involving NHS Grampian doctors
  • Work with NHS Feedback in GP complaints not resolved at local level. Preparation of case reports and face to face meetings with patients/relatives
  • Maintaining case records of individual practitioners with performance issues and in 2010/11 helping develop a new computerised system on OPAS to record this
  • Work with the Medical Director to approve new applicants for the Performers List. Interviewing applicants from the EEA to ensure appropriate language skills and arranging work experience for them in Grampian.

Number of consultants and other non training grade staff NHS Grampian / Number of consultants and other non training grade staff NHS Orkney
2010- 2011
New referrals
Consultants / 4 (1 retired) / 1
Honorary Consultant
GP / 3 ( partners)
1 ( salaried)
Other doctor / 1 staff grade
1 ST 2
Locum doctors / 2 Consultant
1 GP
1 Staff grade
1 ST1
Dentists / 2

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