Agenda Item Description - NHSGGC Redesign of Allied Health Profession (AHP) Services

Transcription

1 (Paper No. 11/95) Renfrewshire Community Health Partnership Committee Date: 20 th January 2012 Author: Sylvia J Morrison Head of Primary Care & Community Services Agenda Item Description - NHSGGC Redesign of Allied Health Profession (AHP) Services 1. Introduction & Background 1.1 This paper provides a report to the Committee on the work of the NHSGGC AHP Review Steering Group which concluded in August 2011, the subsequent implementation of the redesign and finally the impact on Renfrewshire CHP. The detail of this review and associated work programmes are described in earlier papers and reports presented to the Steering Group and Directors therefore that content is not repeated here, but can be provided if required. 1.2 In August 2009, the CHP/CHCP Directors agreed an approach to expand and further develop early work initiated by the previous AHP Waiting Times Group. This was with the aim to build on the progress to date, bring the various AHP service work programmes together into a single process reporting to the Directors Group and to provide focus to our efficiency and financial performance closely linked to service redesign and effectiveness. The NHSGGC AHP Review and Redesign Steering Group was chaired by Keith Redpath (Director West Dunbartonshire CHCP) and included management, professional and staff partnership representatives. 1.3 The services included in the review were Community Paediatric Speech & Language Therapy ( SLT ) All Podiatry Services All Dietetic Services Occupational Therapy (OT, Glasgow City only therefore not discussed in this report) Musculo Skeletal ( MSK) Physiotherapy Community and Acute 1.4 David Leese, Director Renfrewshire CHP, led the work streams on Podiatry and Community Paediatric Speech & Language Therapy. Alex MacKenzie Director Glasgow City provided the lead role for OT, Keith Redpath led on Physiotherapy and Anne Harkness Director of Rehabilitation and Assessment Directorate provided the lead role for Dietetics. Each of these work streams was supported by a sub group which included a lead Head of Service, management, professional and staff partnership representatives. 2 Recommendations 2.1 The review programme sought to identify and address issues in the models of service management arrangements and support infrastructure which, if addressed, could increase efficiency (including cost savings), effectiveness, quality and equity of access. W:CHP Committee\General\Front cover sheet 1

2 2.2 The key conclusions arising from the review were; The steering group challenged the cost, cohesion and sustainability of the currently differing models of management across different AHP professions and recommended that changes to the management and structure of services was required; The adoption of a single service model for MSK physiotherapy, dietetics and podiatry services hosted by a nominated single CHCP/CHP was appraised as the most efficient and cost effective model. The service models for OT in Glasgow City and SLT will remain based within CHP / CHCP structures. That a quadrant model of service management for MSK physiotherapy, podiatry and dietetics offers opportunities for efficiencies that this will provide, balanced with a continuation of local service provision within partnerships. Professional leadership for AHPs was considered in the broader context of the NHS Board wide system and with accountability to the Board Director of Nursing. There remained a significant challenge of having an effective IM&T solution that enables these changes to progress, particularly in terms of the proposed call centre model with an integrated appointment system. NB Due to resource constraints this work has not been concluded and has been remitted to the NHSGGGC Health Information Technology Group. 3. Future Structure 3.1 Community Paediatric Speech & Language Therapy The review and redesign resulted in little change to the previous broad structure within Renfrewshire CHP, however has resulted in changes to roles, job descriptions and improved performance and governance arrangements. A new role of SLT Manager is now in place supported by 2 Locality Team Leaders namely Kirsty Gilbert, Grace Christie and Fiona Alexander. Workforce planning is progressing to increase the number of support worker and administration roles within the service to optomise the role of qualified staff. A consistent governance framework has been implemented on an NHSGGC basis this includes use of Triage, Care Aims, Clinical Supervision, Practice Development Networks and agreed Key Performance Indicators Historically Renfrewshire CHP has provided a service to East Renfrewshire CHCP. This continues through Fiona Forde Locality Team Leader until March As of April there will be a resource transfer to East Renfrewshore CHCP who will as of 1 April 2012 assume responsibility for their service. Transition plans are in place to ensure an effective handover. 3.2 Podiatry Services Diagram 1 below shows the future service structure. This single service will be managed by Renfrewshire CHP on behalf of NHSGGC and is comprised of 152 whole time equivalent staff (195 head count) and a budget of approximately 6m. David Wylie has been appointed as the NHSGGC Podiatry Service Manager and Professional Lead and will report to the Head of Primary Care & Community Services. Appointment of all Quadrant Managers and Team Leaders has now been concluded As a result of this redesign there will be a change to the local managers working in Renfrewshire. The current Podiatry Service Manager Mary McCulloch has been appointed to the post of Team Leader in the East Quadrant. Gail Beaton is the new Quadrant Manager for South Clyde and will be supported by 2 team leaders; Margaret Lamont covering Renfrewshire and Sharon Lafferty in Inverclyde. W:CHP Committee\General\Front cover sheet 2

3 Diagram MSK Physiotherapy Service The future structure of the MSK Physiotherapy Service mirrors that of Podiatry. There will be 4 quadrant MSK Physiotherapy managers each supported by Team Leaders who are responsible for all physiotherapy MSK services delivered within the CH(C)P and acute sites in each geographical quadrant. This service has a staff compliment of 154 whole time equivalents As a result of this redesign there will be a change to the local managers working in Renfrewshire. The current Physiotherapy Service Manager Elizabeth Lightbody has been appointed to the post of Team Leader in the East Quadrant. Caroline Horn and Helen Litte will job share the new Quadrant Manager for South Clyde and will be supported by 2 Team Leaders Karen Runciman and Bruce Coyle covering Renfrewshire and Inverclyde. 3.4 Dietetics Services Diagram 2 below shows the future service structure. The single Dietetics service will be managed on behalf of NHS GG&C by the Rehabilitation and Assessment Directorate within the Acute Services Division. W:CHP Committee\General\Front cover sheet 3

4 Diagram As a result of this redesign there will be a change to the local managers working in Renfrewshire. The current Dietetics Service Manager Michelle Wardrop has been appointed to the post of Community Manager. Michele Mackintosh has been appointed as Dietetics Service Manager, Fiona Clark is the Adult Acute Manager and Anne Maclean will manage Paediatric Services. 4. Transition 4.1 The management of the transition phase in each of these service areas is underway with implementation of the new structure as of 1 April The Head of Primary Care and Community Services in Renfrewshire CHP is leading the transition group and the associated plan for podiatry services. A shadow period will commence as of 1 February Our approach to both short and longer term redesign and continual improvement has been developed using the facing the future together framework and supported by a structured communication and engagement plan. 5. Governance 5.1 Redesign of these services results in significant changes to the management and governance arrangements within Renfrewshire CHP. As can be seen from section 3 above, as of April 2012 the CHP will no longer have responsibility for Physiotherapy or Dietetics services. The CHP will retain responsibility for the Community Paediatric Speech & Language Therapy Service as part of Children & Families services. The CHP will host all Podiatry Services on behalf of 8 CHP/ CHCPs and the Acute Division. 5.2 For hosted services, all Clinical Governance, Staff Governance and Financial Governance will be the responsibility of the host CHCP. Therefore Renfrewshire CHP will be responsible for the governance of all aspects of the Podiatry Service, West Dunbartonshire for the MSK Physiotherapy Service and Acute Division for the Dietetics Service. 6. Workforce Planning and Savings 6.1 Each of these service redesign programmes have undertaken detailed workforce planning, outlining the required changes in band and skill mix to meet the future needs of the population served. W:CHP Committee\General\Front cover sheet 4

5 6.2 These work force plans include the impact of the Resource Allocation Models for each service and are also supported by Board wide savings plans which at this stage cover a 4 year period starting in 2012/13. Indicative savings totals over the 4 year period are: Podiatry 546k Physiotherapy 450k Speech and Language 639k Dietetics To be confirmed by Acute Division 7. Current Service Management 7.1 The CHP would like to take this opportunity to recognise the significant and valued contribution that Michelle, Mary and Elizabeth have provided in recent years. In addition to contributing positively to these recent Board wide change programmes, our colleagues have also previously led CHP review and redesign processes achieving service improvements and benefits for our service users and staff. We wish each of them every success in their new roles. Recommendations The Committee is asked to note the content of the report. W:CHP Committee\General\Front cover sheet 5