| Listed below are recent projects and
publications delivered or in the process of delivery
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Case for Investment - Innovation in Social Care
Five projects started out, and 4 projects lasted all four months
of the programme. With Skills for Care New Types of Worker I took
four third-sector (voluntary) organisations through a programme
of workshops and coaching, culminating in them meeting the commissioners
to ask form money (in sample format).
Both the third sector organisations and the commissioners found
the process extremely useful and Skills for Care are due to provide
the educational materials amongst their resources. The programme
will be re-run with more time given to coaching commissioners as
well as innovators.
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Social Enterprise development
The climate in the delivery of care to users has moved in the
direction of independent, voluntary, and disaggregated public sector
providers. We set up Urgent Care Ltd (Social Enterprise) in July
2007 as a result of clinical front-line staff wanting to deliver
a service, and commissioners wanting to buy it. One year on the
organisation has proved its success. As chair I am responsible for
inviting and engaging with trustees, ensuring governance, demonstrating
performance and the case for investment, and searching out sources
of grant funding. We're registered with the Inland Revenue as a
society with charitable aims (and enjoy the tax advantages of this).
see www.urgentcarelimited.com
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Research, Audit, Publication: Case for investment
in Emergency Care Practitioners
Initially involved with the 17 pilot sites which determined the
direction Emergency Care Practitioners would develop, my work was
used to justify investment by PCTs and Ambulance Trusts in 800 of
these advanced practitioners. ECPs continue to remain a distinct
and homogeneous new profession, one of very few widely adopted new
professionals in 15 years, and I continue to serve on the national
panel steering the profession to registration. See also Contributions
to publications (at end page) including ‘Measuring the Benefits
of the Emergency Care Practitioner’ (a review of the literature)
2007.
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Knowledge Capture: ISIP Local Health Community
Demonstrator Sites
With the Knowledge Management team I designed the template used
for reporting each LHC Demonstrator Site’s impacts and to
evaluate benefits using the ISIP approach, and then reformatted,
gained approval from the sites and published the inspirational cases
studies aimed at encouraging others.
I also developed the Practical Guide to Benefits Driven Change and
the Benefits Approach to Service Transformation, branded for the
ISIP LHC Demonstrator Programme.
I provided benefits planning and evaluation expertise for projects
to reduce attendance at hospital for Urgent Care and Long term Conditions,
and to deliver the 18 week Referral to Treatment (RTT) target.
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Initiating joint working: Cross-sector forum
With New Ways of Working I have initiated a core planning group
to identify cross-sector issues (health, social services, childrens
incorporating commissioners and providers from public, independent
and voluntary sector) and share knowledge. Decisions on the funding
and types of care in one sector often impact on others, and many
staff and users want seamless care delivery and transferability
of skills and qualifications.
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Project management: New Ways of Working National
Governance Group
This group has representatives from SHAs and national agencies
and is set up to identify the issues relating to the introduction
of new, enhanced and extended roles in healthcare and in particular
those issues which need national support. Within this role I prepared
the Baseline Report (below) and begun work developing the communications
strategy ,which includes designing a web site to share information,
interviewing potential users about their needs and preferred mode
of communication, and reviewing the styles of similar web sites.
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Research: Baseline Report on New Ways of Working,
Warehouse of Roles and Transferable roles
Before planning new projects, the National Governance Group needed
to know what was currently happening. Reconfiguration in NHS meant
that a lot of corporate memory had moved on or left, but I managed
to identify 700+ projects and interview 41 stakeholders to identify
both the current state of New Ways of Working and the support which
would offer most value.
The baseline report and its conclusions were accepted and the examples,
new and existing roles and workforce innovation tools are now being
collated for sharing.
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Audit: Fitness for Purpose Audit of reconfigured
PCT
Determining the commissioning capability of the PCT with the largest
in-year deficit in England as it copes post-merger, and with stakeholder
and provider changes.
The audit both highlighted areas for improvement and triggered some
of the required cultural change within the PCT
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Consultancy: Workforce Reprofiling in Acute and
Mental Health Environments
Research and analysis to determine the workforce across a provider
organisation which delivers optimum quality outcomes for optimum
activity cost – currently part of Productivity/ Efficiency
streams in Foundation Trusts locally. Managers, workforce planners
and clinicians used the profiles generated to plan and implement
projects to deliver the changes and realise the benefits
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Consultancy: Long-Term conditions (Diabetes) –
Value for Money.
Review of a diabetes Locally Enhanced Service which identified
the cost-benefit and likely reasons (patients continue to attend
annual reviews at hospital even though they have already had their
review with their GP); the report was presented to community providers
and resulted in a concerted effort by clinicians to change the behaviour
of the patients to realise the benefits more completely.
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Process Redesign: Reception and Appointments booking
for Community Clinics
A PCT requested myself and a colleague to run a programme to redesign
the process of booking patients in for community services eg long-term
conditions management (it covered all services delivered in PCT
buildings). Involving staff, stakeholders and service users revealed
that the overall community service could be run more cost-effectively,
and more appropriately for service users at the same time supporting
healthcare staff, by devolving administration to the community buildings
rather than centralising. The PCT was extremely pleased with the
result.
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Consultancy: developing a case for investment for
Community Matrons
Community Matrons were asked to report on activity levels as a
way of justifying their costs, but they wanted a more outcomes-based
way of reporting. We developed a balanced scorecard aligned to the
employing provider organisation and commissioning organisation’s
own key priorities.
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Evaluation and Reporting: Payment by Results after
18 months
South Yorkshire was the pilot for Payment by Results (PbR), and
commissioned me to discover the hidden impacts of PbR and what should
be done to encourage beneficial behaviours and reduce destructive
behaviours (after a series of audits of activity had proved inconclusive).
Based on interviews with over 40 stakeholders, my report “Shared
Responsibility – an answer to Payment by Results” (Dec
2006) highlighted the importance of leadership and focus on shared
values in delivering benefits from a mechanistic system.
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Economic & workforce modelling: Resource and
economic analysis of urgent and emergency care in London
As part of the wider project examining options for redesign of
emergency and unscheduled care for NHS across London, I prepared
the detailed modelling (workforce, financial, business change).
I’m now helping to set up a Social Enterprise to deliver urgent
care
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Economic & workforce modelling: Resource and
economic analysis of urgent and emergency care in London
As part of the wider project examining options for redesign of
emergency and unscheduled care for NHS across London, I prepared
the detailed modelling (workforce, financial, business change).
I’m now helping to set up a Social Enterprise to deliver urgent
care
Research: Staffing from overseas – feasibility for a commercial
provider
Just before joining NHS, my last project was to examine the options
for an international agency provider of service staff to enter NHS
market and provide temporary staffing from suitable countries. My
report predicted that numbers of newly trained practitioners (especially
of generic staff eg Junior doctors, Nurses) would increase over
the following two years. The report allowed the company to focus
on more sustainably profitable economic sectors.
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Training and Conferences: School Health Workforce
This project by NHS Employers Large Scale Workforce Change group
commissioned me to train sites in development of an evaluation and
benefits realisation methodology and use it for the delivery of
projects
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Course Delivery
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Developing the Evidence Based Business Case
A 1½ day workshop for people who need to prepare business
cases, need more practice, or whose track record at having business
cases approved is not all they would like. It helps delegates to
gather the evidence and identify the impacts which contribute to
a compelling business case; and explores alternative sources of
funding
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Gaining Clinical Engagement for Change
The people who deliver care to patients are clinicians, so to create
change we (service improvers) need to engage. Clinicians often know
the problems, and with the right help will both develop solutions
and implement them. Facilitated session supporting clinicians to
talk about the engagement they require
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