Workshops and Seminars 2014-15

The following Management in Medicine workshops and seminars were held at Green Templeton in the academic year 2014-15:

The structure and history of the NHS

Saturday 4 October 2014, 09:30

Speakers:

The NHS is one of the world’s largest organisations, comparable to the People’s Liberation Army of China, the Indian Railways and Wal-Mart. Understanding how this vast conglomerate came into being and how it works today is important for anyone interested in its leadership and management. This interactive workshop explored participants’ understanding of the current structure of the organisation and looked at how it came into being, how it was originally managed and operated and the series of significant structural changes that has been an important characteristic of its 66-year history. Since 1990, commissioning has formed an ever more important aspect of the work of the NHS. The workshop also explored how different services are commissioned and the role of doctors in the commissioning process.

Financial skills for healthcare

Saturday 8 October 2014, 09:30

Speaker: Dominic Tkaczyk, a senior financial professional with over 40 years practical experience of finance in the NHS.

Successful managers must plan the resources needed to carry out any particular task or function and measure how those resources are used. Accounting is the discipline, developed over centuries, that helps managers to measure resource allocation and use. It provides a standard language for reporting financial performance and is primarily a way of ‘keeping score’.

An understanding of NHS finance and accounting, including how hospital budgets are constructed, how activity is measured and how to put together a business case for a new activity is an invaluable skill for any manager. In this workshop, Dominic Tkaczyk described how NHS organisations report their financial position, explained how ‘Service Level’ accounting works and illustrated how to put together a business case. Working in small groups, participants got hands-on experience in these activities.

Dominic is a senior financial professional with over 40 years practical experience of finance in the NHS, having been Finance Director at a range of NHS organisations from Acute Trusts, to Community Trusts to Primary Care Trusts and more recently a Foundation Trust. He is familiar with the financial policies, practices and needs in Trusts as diverse as a large London Teaching Hospital and a Primary Care Trust. Dominic has also had wider management experience having managed IT, Estates and Performance Management directorates. He has also acted as Chief Executive of an Acute Trust. For the last 16 years he has run his own consultancy organisation providing interim financial management to NHS organisations brining a wealth of experience and insight to his clients.

Reflection and confessions of a Chief Medical Officer

Monday 17 November 2014, 18:45

Speaker: Dr Andrew Bishop, Chief Medical Officer, Hampshire Hospitals HNS Foundation Trust.

Challenges and lessons for doctors in leadership emerging from The Francis Enquiry

Monday 1 December 2014, 18:45

Speaker: Mary Agnew, Assistant Director, Standards and Guidance, General Medical Council.

“The system failed in its most essential duty, to protect patients.” Sir Robert Francis.

One year on from the Government’s response to the Mid Staffordshire NHS Foundation Trust Public Inquiry, what should we expect from medical leadership? How can doctors create cultures of openness, learning and high quality care?

This talk explored:

  • The role of the General Medical Council in setting standards and promoting professionalism. The GMC’s core guidance, good medical practice, sets out the principles that underpin the professional lives of all doctors, whatever their role and in whatever setting they work. The GMC publishes explanatory guidance and resources to expand on this, including specific guidance on leadership and management for doctors.
  • The professional duty of candour, on which the GMC and NMC are currently consulting.
  • Doctors’ roles in quality improvement, safer clinical systems and raising and acting on concerns.
  • The behaviours of medical leaders as individuals, as team players and across their organisations, drawing on the current Faculty of Medical Leadership and Management (FMLM) consultation on its Professional Standards for Medical Leadership and Management and Professor Michael West’s work on developing cultures of high quality care.

The session was interactive and exploratory – a chance to share thoughts on doctors as leaders, and the support participants would like from the GMC and others in meeting ‘the Francis challenge’.

Mary joined the GMC in June from the Department of Health, where her most recent role was as Deputy Director responsible for the Government’s response to the Mid Staffordshire NHS Foundation Trust Public Inquiry.

Creating flow in hospital processes and relationships: a case example

Saturday 24 January 2015, 09:30

Speaker: John Drew, Partner in McKinsey’s Healthcare Practice.

A&E is a hot topic at the moment, and is likely to remain that way with the NHS being a key election battleground. Performance against the four-hour target makes headlines, but what really lies beneath that is a complex and dynamic system, which depends as much on relationships as it does on processes. There are also societal trends at play, with ‘A&E’ being a trusted and convenient brand compared to alternative ways of accessing urgent care. So understanding it and solving the underlying problems – ‘cracking the code’ – is not straightforward, and the diversity of competing theories can get in the way of making progress.

At its heart, most people would agree that this is a ‘flow’ problem, which may manifest in the hospital Emergency Department but which starts upstream (e.g., primary care, prevention) and requires capacity downstream (e.g., MAU, Wards, intermediate care, social care) to create an end-to-end pathway which flows.

This interactive session used some simple frameworks and not-so-simple case examples to frame the issues and work through what needs to happen to improve flow along the pathway and engage staff in the process. This included short, practical exercises in small groups. We considered the core clinical and operational processes, as well as how performance is understood, measured and managed, and the human factors of how people work together within and between teams. The core principles and many of the tools are equally relevant to the elective pathway and other pathways of care.

John is a partner in McKinsey’s Healthcare Practice, leading its work with NHS hospitals. After studying Engineering, Economics and Management at Oxford he went into industry working as a manufacturing engineer, and then joined McKinsey’s Operations Practice. Since then he has worked intensively with hospitals for the last decade, and more recently has established the McKinsey Hospital Institute. In 2005 he wrote an award-winning book on operational improvement called Journey to Lean.

Making service improvements

Saturday 21 February 2015, 09:30

Speakers:

  • Dr Keith Ruddle, Fellow of Green Templeton College and Saïd Business School, University of Oxford.
  • Dr Ian Reckless, Consultant Physician and Clinical Director, Neurosciences at Oxford University Hospitals NHS Trust.

This workshop focused on implementing change in the clinical environment. Led by Dr Keith Ruddle and Dr Ian Reckless, the aim of the event was to develop and implement workable ideas for improving services in participants’ own departments and practices. This is the third year that this programme was run. Projects from the previous two workshops are already being implemented at OUH.

The day included briefings by Dr Ruddle and Dr Reckless on methodologies for changing practice and current priorities at OUH. The main time was spent working in small groups, on ideas for implementing service improvements. Participants got the most out of the morning if they came with specific ideas for improving services based on their current or recent clinical experience. It was anticipated that at least some of the service improvements should link with programmes at the OUHT or other parts of the health system.

Effecting change: an introduction to management and leadership skills in healthcare

Saturday 28 March 2015, 09:30

Speaker: Richard Canter, Visiting Professor of Surgical Education at the University of Oxford (2007 to date) and honorary consultant at Oxford University Hospitals since 2014.

The main objective of the workshop was to provide some simple but effective practical teamwork, management and leadership skills that participants could immediately start thinking about and using to effect change in complex situations at work, and for that matter in their personal life. These are simple enough to keep in your head to enable you to respond constructively and more effectively in a wide range of situations. For example, responding to an angry patient, understanding your own preferred working styles and that of your colleagues, becoming more effective when encountering difficulties and frustrations with management and healthcare colleagues, negotiating your work schedules, changing practice in your organisation, being more effective as a clinical leader, managing your own future career in the current difficult environment, and other situations. These skills can be harnessed to deliver service improvements in the working environment. It won’t solve all your problems, but it might lower your blood pressure by giving you insights into what is happening around you and lead to better ways of managing day to day difficulties and frustrations.

Building a high performing health workforce: lessons from the US

Saturday 16 May 2015, 09:30

Speaker: Professor Timothy Hoff. Professor of Management, Healthcare Systems, and Health Policy, Northeastern University, in Boston, Massachusetts, and Visiting Associate Fellow at Green Templeton College.

Using the U.S. case, this workshop reviewed the important workforce issues existing today in healthcare, provided an appreciation for how to think about and approach such issues as managers, and taught best practices for addressing the issues within the context of a typical health care organisational setting. Professor Hoff gave an overview of system trends driving workforce performance management issues in health care. He addressed some of the key issues such as appropriate talent management for health care professionals, employee motivation, job satisfaction, burnout in a high-pressure health system, and designing and implementing health care teams.

Contact

All enquiries about the Management in Medicine Programme should be addressed to:

Naomi Benson
naomi.benson@gtc.ox.ac.uk
Academic Projects Administrator
Green Templeton College
Woodstock Road
Oxford
OX2 6HG