OUR FUTURE. IN YOUR HANDS.

Transcription

1 OUR FUTURE. IN YOUR HANDS. DIVISIONAL DIRECTOR Clinical Scientific Services March 2015 Page 1 of 37

2 CANDIDATE PACK Divisional Director - Clinical Scientific Services Letter from our Chief Operating Officer, Julia Bridgewater Section 1 Job advertisement Section 2 CMFT Background Chief Operating Officer Organisational Structure Section 3 CMFT 5 Year Strategic Plan Section 4 Organisation Charts for Clinical Scientific Services Section 5 Business Plan for Clinical Scientific Services Section 6 Leading for Excellence Section 7 Job Description & Person Specification Section 8 Recruitment Timetable & Outline of Process How to Apply Page 2 of 37

3 Trust Headquarters Manchester Royal Infirmary Oxford Road Manchester M13 9WL Tel No: th March 2015 Dear Applicant Thank you for your interest in the Divisional Director position at CMFT. Let me introduce myself, I am the COO at CMFT having joined the organisation only some 18 months ago. It has been an exciting time for me, and I have found the size, pace and complexity of CMFT exhilarating and challenging in equal measure. From my personal experience, I can tell you that you will find the Board here to be supportive and passionate and I am committed to building a senior team that shares this ethos. Quite simply we have the scale and opportunity to achieve great things, and I want to create a team of Directors that can rise to any challenge, both for today and the future. As you will be gathering, these are all high profile appointments at a pivotal time for one of the largest and most successful organisations in the NHS. The newly appointed Divisional Director will harness the substantial experience, expertise and enthusiasm within these complex Divisions, helping to drive the Trust forward in playing an increasingly critical role in local and wider Greater Manchester healthcare. Exceptional team work, strong collaboration and continuous improvement will be at the forefront of your thinking and you will need to be confident enough to challenge in the search for truly innovative solutions. With an annual income of 950m we have a national and international reputation for service delivery, teaching, research, transformation and innovation. Joining CMFT will provide the opportunity to work in a well-established, high performing Foundation Trust, now operating in the context of the recently signed historic devolution agreement incorporating Health and Social Care across Greater Manchester. You will be part of a tight knit group of Divisional Directors reporting directly to the Chief Operating Officer, with responsibility for the day to day running of the organisation. You will work closely with your Clinical Head of Division and Head of Nursing to provide coordinated leadership across your Division. We are seeking exceptional individuals to master some of the most complex change programmes in the NHS. Torres & Partners have been appointed to help with the search for the right individual for the posts. You will find useful contact details under the How to Apply Section. I look forward to receiving your application. Yours sincerely, Julia Bridgewater Chief Operating Officer Page 3 of 37

4 Section One Job Advertisement Make the change. Make the difference. Divisional Director Clinical Scientific Services (CSS) Competitive salary & remuneration package Central Manchester &Trafford There s a real sense of change across the NHS in Greater Manchester, with a range of far reaching initiatives and collaborations between health and social care organisations as well as the added impact of the imminent devolution of 6bn of NHS Commissioning to the area. As one of the largest Foundation Trusts in England, with revenues in the region of 950m, we at Central Manchester University Hospitals NHS Foundation Trust are well regarded for our commitment to innovation and quality, so to be at the forefront of this change is genuinely exciting for us as an organisation. We are an integrated health, teaching, research & innovation hospitals group, responsible for running 8 hospitals and community services across Manchester and Trafford. We are a dynamic organisation working in an environment that is constantly changing and to support this, we re recruiting an innovative, shrewd and talented Divisional Director of Clinical Scientific Services to form part of the Senior Leadership team. Managing a budget in the region of 100m in a division of almost 1900 staff, you will be responsible to the Clinical Head of Division for the direct delivery of all services comprising 9 Clinical and Scientific Divisions that include: a new 40 bed Critical Care Unit, Anaesthesia, Pharmacy, Radiology, Allied Health Professionals, Laboratory Medicine, Nuclear Medicine, Neurophysiology and Medical Engineering. With a flair for driving through service improvement and transformational change, you ll have a natural ability to influence and communicate at all levels. Your strategic thinking along with your strength in leading others will be evident in all you do, acting as a role model and mentor for other key members of the senior team. You will need: To be educated ideally to Masters degree level or equivalent plus evidence of continuing professional and personal development Significant management and leadership experience at a senior level in the NHS Experience at Director level in an NHS Acute Trust Evidence of successfully leading significant organisational change in developing new models of healthcare delivery Demonstrable experience of building, maintaining and utilising successful relationships with all staff, especially clinicians within complex organisations You ll be working in a fast moving pressurised environment where experience, strength of character and co-operation really matter. But more than that, you ll be making a real difference to improving the health and wellbeing of our diverse population across our local communities. Quite simply, there could not be a better time to join us. For more information and to apply go to or your CV including salary details to our exclusively retained consultant Alison Diamond, at Torres and Partners; alison.diamond@torres.co.uk or contact her on Page 4 of 37

5 Section Two - CMFT Background 1. Introduction Central Manchester University Hospitals NHS Foundation Trust obtained Foundation Trust status in January, It had previously been formed in April, 2001, as the Central Manchester & Manchester Children s University Hospitals NHS Trust, following the merger of the Manchester Children s Hospital Trust and the former Central Manchester Healthcare Trust. It employs nearly 12,800 staff and has an income of approximately 950m. It has a close affiliation with Manchester University, as the largest undergraduate teaching centre in the North West and has built an enviable record in teaching, research and the provision of services to the populations of Greater Manchester and the North West and in certain specialties both nationally and internationally. 2. Divisional Structures The management structure is aimed at creating a balance between on the one hand, significant local autonomy and innovation with strong clinical involvement/leadership, and on the other a corporate style of working to address Trust wide operational issues and give a sense of strategic direction. In doing this, we have created a management structure around natural clinical groupings and hospitals but also have ensured that the units are not too large so as to be operationally unmanageable. On this basis, the following Clinical Directorates have been created: Children s Hospital Saint Mary s Hospital Royal Eye Hospital/Dental Hospital Clinical & Scientific Services (incorporating the Directorate of Critical Care Unit, Anaesthesia, Pharmacy, Radiology, Allied Health Professionals, Laboratory Medicine, Nuclear Medicine, Neurophysiology and Medical Engineering) Acute Medicine & Community Services Manchester Royal Infirmary Specialist Medicine Manchester Royal Infirmary Surgery Manchester Royal Infirmary Trafford Hospitals Research & Innovation Each Division is headed by a Clinical Head of Division drawn from a clinical background. As well as being accountable for the agenda within their own Division, each Clinical Head of Division joins with the Executive Director team to form a single Management Board for the Trust. Within the general parameters set by the Board of Directors, the Management Board is the prime body for determining the overall operational management of the Trust and influencing effectively our corporate strategic direction and programmes. Each Clinical Head of Division is accountable to the Chief Executive, although much of their day to day dealings is through members of the Executive Director team and Associate Directors. On an operational basis this is through the Director of Patient Services/Chief Nurse. Divisional Directors report managerially to their Clinical Head of Division and professionally as managers to the Director of Patient Services/Chief Nurse. Page 5 of 37

6 3. Executive Director Team The structure at Executive Director team level reflects an absolute commitment to place patient/clinical services at the heart of the Trust. The team is made up of four Executive Directors who play a major role in the overall corporate management of the Trust as well as discharging wider functional responsibilities. Given the breadth and complexity of the agenda each Executive Director is, in turn, supported by a number of Associated Directors. The following posts make up the Executive Director Team: Director of Patient Services/Chief Nurse (Deputy Chief Executive) This post has a crucial corporate role with the remit of aligning our patient partnership work, the professional nursing agenda, the overall day to day operational management of patient services, including the delivery of key targets and our work on service development and modernisation. This post also acts as the Deputy Chief Executive. Executive Director of Finance This post pulls together a wide range of work at corporate level around Finance, Contracting, Informatics, Planning and Capital development. Medical Director The Medical Director role is a full time managerial position and is corporately responsible for Clinical Governance, Research & Innovation and Medical Education. Director of Human & Corporate Resources This post plays a major role not only in human resources but also takes the lead responsibility for corporate support functions to include Board secretariat, Governors and membership, Communications and Legal services. Chief Operating Officer This post is a pivotal role in the corporate management and strategic development of the organisation, as well as providing professional leadership to the Divisional Directors. 4. Principles and Values The Board of Directors has established a clear vision for the future underpinned by five strategic aims. Our vision for CMFT is to become the leading integrated health, teaching, research and innovation campus in the NHS and to position the Trust on an international basis alongside the major Biomedical Research Centres, as part of the thriving city region of Manchester with it strong emphasis on economic regeneration, science and enterprise. Underpinning our vision of five strategic aims. To maintain and build upon our position as being: The leading provider of tertiary and specialist services across the NHS Prestigious internationally renowned Centre for translational research Excellent local hospitals providing integrated care for our resident population At the heart at the regeneration of the communities we serve The best place to train and work Page 6 of 37

7 Section Three - CMFT 5 Year Strategic Plan Page 7 of 37

8 Overview Central Manchester University Hospitals NHS Foundation Trust is a renowned healthcare and research organisation with a local, national and international reputation. We are responsible for running eight hospitals and community services across Manchester and Trafford and have a strong track-record of delivering excellent clinical care, and achieving NHS performance targets and financial balance. Our vision for the future is: To be recognised internationally as leading healthcare; excelling in quality, safety, patient experience, research, innovation and teaching; dedicated to improving health and wellbeing for our diverse population. We face a number of significant challenges over the next five years as we aim to deliver our vision at the same time as finances are tightening and costs are increasing. Our four key longer term initiatives that will help us to address the twin challenges of balancing the books and continually improving the quality of the services that we provide are: Specialised Services Developing specialised services, building on our strengths and our existing portfolio Healthier Together Actively supporting and delivering the programme to reconfigure health services across Greater Manchester Living Longer, Living Better Working with partners across Manchester to implement a new community-based model of care Research & Innovation and Technology Continuing to invest in research and new technology to remain at the leading edge of medicine and service delivery This document is our response to the requirement of Monitor, our regulator, to set out our high level plans for the next five years. It is important to remember that all that we do each day is underpinned by our continued focus on: Safety - delivering safe, harm-free care Quality - delivering personalised, responsive and compassionate care Productivity and efficiency delivering our services in a cost-effective way. Our Profile We are a large teaching hospital group providing local community and general hospital services to the population of Central Manchester and specialist services to patients from Greater Manchester, the North West, and further afield. We have eight hospitals, four of which are located on the main Oxford Road site, two miles south of Manchester city centre: Manchester Royal Infirmary (MRI) a large acute teaching hospital providing a wide range of complex secondary and specialist services. We are a specialist regional centre for kidney and pancreas transplants, cardiology and cardiothoracic surgery. The Accident & Emergency Department sees around 145,000 patients each year. We have pioneered many medical breakthroughs including being the first hospital in the UK to use a standalone 3D system for prostate cancer surgery. Page 8 of 37

9 Saint Mary s Hospital a regional centre of excellence providing a wide range of world class general and specialist services for women and babies, including maternity, gynaecology, newborn intensive care, clinical genetics, and a sexual assault referral centre. Manchester Royal Eye Hospital (MREH) one of the largest teaching eye hospitals in Europe and one of only two dedicated eye hospitals in the UK. Globally acknowledged as a centre of excellence, MREH is renowned for its pioneering work in all aspects of ophthalmology, including the emergency eye centre, acute referral centre, ophthalmologic imaging ultrasound unit, electrodiagnosis, laser unit, optometry, orthoptics, Manchester eye bank, ocular prosthetics, and the bionic eye implant unit. Royal Manchester Children s Hospital (RMCH) a specialist hospital that provides healthcare for children and young people from throughout the North West, as well as nationally and internationally. It has 200,000 patient visits each year across a range of specialties including oncology, haematology, bone marrow transplant, burns, genetics, and orthopaedics and is the largest single-site children s hospital in the UK. The Wellcome Trust Children s Clinical Research Facility based there is involved in research areas that include cancer, growth and endocrine disorders, mental health, inherited metabolic disease, and kidney disease. The University Dental Hospital of Manchester is one of the major dental teaching hospitals in the UK and is located within the nearby University of Manchester campus. Around 90,000 patients, both adults and children, are treated here every year. A team of around 300 staff provide general and highly specialised care for patients from the North West in areas such as complex medical problems, oral reconstruction and implantology following trauma or oncology, intravenous sedation for anxious patients, and cleft lip and palate services. Trafford Hospitals, which we acquired in April 2012, includes Trafford General Hospital in Davyhulme and two smaller out-patient facilities in Altrincham and Stretford. Services at Trafford General include an urgent care centre, in-patient medical facilities, daycase surgery, and a dedicated elective orthopaedic centre. Services at Altrincham Hospital will transfer to a new purpose-built 17 million development in spring They will include a 7-day minor injuries unit, a wide range of specialist out-patient clinics, physiotherapy, radiology, and a dedicated renal dialysis unit with an award-winning home care training unit. We also provide a wide range of community services for adults and children from facilities such as health centres, children s centres, schools, and in patients own homes. There are around 45 community services including adult services such as district nursing, continence, and podiatry in central Manchester, and specialist services including children s services, contraception and sexual health, community dentistry, and learning disabilities for the city of Manchester. For full details of our services, go to We are responsible for teaching undergraduate students from The University of Manchester Medical and Dental Schools and for providing postgraduate medical education for junior doctors. In addition, we provide training for twenty professional staff groups, in partnership with local higher education institutes. The Oxford Road site underwent major redevelopment which was completed in Manchester Royal Infirmary, Manchester Royal Eye Hospital, Saint Mary s Hospital, and Royal Manchester Children s Hospital are now located next to each other which gives patients easy access to a wide range of services and clinical expertise. Being able to provide specialist children s services with a range of adult services, maternity and neonatal care alongside high quality biomedical research space on one site puts us in a unique position to deliver the highest quality and most up-to-date healthcare for patients with the most complex conditions. Page 9 of 37

10 Further recent developments include: Critical Care - a 25m investment to expand and develop our critical care service and improve clinical safety was completed in June The new unit has 52 critical care beds with easy access to A&E, theatres, radiology, and wards. Hybrid Theatres - two new hybrid theatres that have the equipment needed to produce very detailed images, along with the necessary facilities for traditional surgery were completed in July This will enable us to develop our expertise in vascular and cardiac services. Citylabs 1 - a new commercial science and innovation centre to provide a base for companies to develop new healthcare solutions close to the clinical workplace was completed in August Research and Innovation Our focus on research and innovation differentiates us from other hospitals. It ensures that our patients have access to the latest high quality care and that we attract the best staff and get the best results for our patients. It also attracts investment and enables us to develop mutually beneficial relationships with industry. We have a large number of clinical academics who are recognised leaders in their field. Our main academic partner is The University of Manchester and we work closely with industry and private sector organisations such as Manchester Science Partnership (MSP). We are a founding partner of the Manchester Academic Health Science Centre, a major biomedical/health hub providing clinical and research leadership and helping healthcare organisations reap the benefits of research and innovation to drive improvements in care. Our campus and its proximity to the University enables us to work with our partners to develop new ideas and drive them though into clinical practice. Our Values, Vision and Strategic Aims Our vision has been updated to reflect recent developments, where we are now, and what our ambitions are for the future. Our vision is: To be recognised internationally as leading healthcare; excelling in quality, safety, patient experience, research, innovation and teaching; dedicated to improving health and wellbeing for our diverse population. This vision is underpinned by a series of more specific strategic aims: 1. Improve the safety and clinical quality of our services 2. Improve the experience for patients, carers and their families 3. Develop our specialist services and, in collaboration with our health and social care partners, lead on the development and implementation of co-ordinated care 4. Increase the quality and quantity of research and innovation across the organisation to improve patient health and wellbeing 5. Provide high quality education and training 6. Develop our organisation, support the wellbeing of our workforce and enable each member of our staff to reach their full potential 7. Remain financially stable and generate a surplus to invest in our services. Our organisational values underpin everything we do. We have developed a framework that sets out the core behaviours and attitudes that we expect of our staff, recognising how important the right attitude and behaviours are to delivering a positive patient and staff experience. Our values are: Pride showing pride by being the best in everything we do Respect showing regard for the feeling, rights and views of others Empathy showing empathy by understanding the emotions, feelings and views of others Consideration showing thoughtfulness and regard for others, showing consideration for their feelings and circumstances Compassion showing understanding, concern and contributing to providing a safe, secure and caring environment for everyone Dignity showing respect and valuing all individuals and their diverse needs. Page 10 of 37

11 Values and Behaviours Framework PRIDE RESPECT EMPATHY CONSIDERATION COMPASSION DIGNITY Expected Behaviours I will take pride in my own work and the contribution I make to others I will look for ways to do things better I will celebrate and share successes I will be a role model for others I will consider the effect of my actions on others I will get to know people and understand how they wish to be treated I will actively listen, showing that I value others input and opinions I will manage my reactions to situations professionally, appropriately and calmly I will involve patients, families, staff and others in decision making. I will listen carefully to others demonstrating my understanding and valuing other people s situations I will take into account the views, opinions, actions and feelings of others. I will adapt my communication style and behaviour appropriate to the situation. I will give relevant, timely and reliable information No decision about me without me. I will give Individualised care / service to patients, families and others. I will be collaborative and contribute to partnership and team working I will actively seek and respond constructively to feedback from others I will show compassion through kindness, understanding of others and respect for their privacy I will make the time to listen, showing sensitivity and offer emotional support as required I will care for others in a professional, safe and secure way I will show appreciation to others, recognising what they do I will show awareness and respect of people s rights, diversity, privacy and cultural needs I will deal sensitively with all personal information ensuring confidentiality I will raise any issues of concern and support others to do so I will Involve and enable others to make informed decisions Leadership Behaviours Foster a culture to enable teams and individuals to continually improve services Celebrate achievements Lead by example, sharing knowledge and promoting best practice Build on and promote the positive reputation of CMFT Demonstrate appreciation of the efforts of teams and individuals Encourage team members to recognise and value individual contributions Respect the diversity of others Address unacceptable behaviour Actively seek the views of others Support individuals and teams to ensure the needs of others are understood and addressed Take into account the feelings and views of others in decisions and actions Foster a supportive and caring culture Role model appropriate communication and behaviour Develop teams and individuals to ensure a personalised service. Ensure the involvement of individuals and teams in planning and decision making. Involve individuals and teams in changes which may affect them. Seek out opportunities for collaborative, team and partnership working. Lead with a positive attitude Develop a culture which is open, honest and caring Listen and understand the needs of others Lead and develop services so they are safe, secure and delivered to a high standard. Foster a culture where all individuals are able to contribute equally Proactively role model and promote equality, people s rights, diversity and inclusion Lead and develop individuals and teams to ensure that people are treated with dignity and respect. Support individuals and teams to understand and learn from any concerns raised Page 11 of 37

12 Health and Hospital Services in Our Area Our hospitals provide local health services for the populations of Central Manchester and Trafford. The population of Central Manchester is growing. 56% are under the age of 30 and 47% come from black and minority ethnic (BME) groups. There are significant levels of deprivation and, despite the relatively young population, there are high numbers of people living with long term conditions. Central Manchester is in the worst performing group nationally* for: - Potential years of life lost from causes considered amenable to healthcare - Health related quality of life for people with long term conditions - Proportion of people feeling supported to manage their condition - Unplanned hospitalisation for chronic ambulatory sensitive conditions and for asthma, diabetes and epilepsy in under 19s - Emergency admissions for acute conditions that should not usually require hospital admission. Generally health in Manchester is worse than the England average, with higher than average deprivation. Trafford has a population of c 235,000. Trafford fares better than Manchester, with general health better than the England average, lower than average deprivation, and life expectancy for men and women both above the England average. Trafford is better than the England median* for: - Potential years of life lost from causes considered amenable to healthcare - Health related quality of life for people with long term conditions - Proportion of people feeling supported to manage their condition but worse than the England median for unplanned hospitalisation for chronic ambulatory sensitive conditions and emergency admissions for acute conditions that should not usually require hospital admission. Both Trafford and Central Manchester sit in Greater Manchester. Health needs in the city region are variable, although general health in most of the local authorities in Greater Manchester is worse, deprivation is higher, and life expectancy is lower than the England average. Hospital services in the area are outdated. They were designed to meet the needs of the last century, not to deliver the type of care required today by people living with multiple long term conditions. The large spread of services across the region means that not all hospitals are able to provide senior doctors on site 24 hours a day, 7 days a week. As a result not all patients get the same level of service and this can result in variation in the quality of outcome for patients. An example of this variation in outcomes can be seen in mortality rates for emergency general surgery which vary from 23.1 to 51.7 per 1,000 spells across Greater Manchester. * (Outcomes Benchmarking Support Pack, NHS England 2013/14) Page 12 of 37

13 Our Strategic Plan Our strategic plan sets out the key programmes of work which will enable us to continue to improve the quality of our services and to live within our budget. It is based on four key strategic initiatives which are described below: Specialised Services Strategy developing our specialised services, building on our strengths and our existing portfolio CMFT is a major provider of specialised services nationally - we are currently the 7 th largest provider of specialised services in England. We have particular expertise in children s services, genetics, women s services, eye services, cancer surgery, vascular services, cardiac services and haematology. Our clinical campus is designed to enable us to treat those patients with the most complex conditions and our strategy is to develop our specialised services, building on our existing portfolio. Specific areas where we expect growth and development over the coming five year period include cancer surgery, vascular and cardiac services, and children s services. Healthier Together actively supporting and delivering the programme to reconfigure health services across Greater Manchester to improve health outcomes and reduce variation Healthier Together is a collaboration of health and social care organisations in Greater Manchester, including CMFT, working together on a programme that focuses on the redesign of hospital, community and primary care services with the aims of: Improving the health and wellbeing of people in Greater Manchester Improving equality of access to high quality services Improving people s experience of healthcare Making better use of healthcare resources. The proposed future model of hospital care is: Specialist hospitals providing care more the most seriously sick patients on a small number of sites (4 or 5) across Greater Manchester Local hospitals providing high quality care to the majority of patients, but not equipped to care for the small proportion of patients who are seriously ill and require highly specialised care. We expect to be a specialist hospital and will work together with a number of local hospitals to provide high quality care across our catchment area. Public consultation on the proposals started in July For more information, go to Page 13 of 37

14 Living Longer, Living Better - working with partners across Manchester to implement a new community-based model of care that is appropriate for patients today, in particular those living with multiple long term conditions Living Longer, Living Better - working with partners across Manchester to implement a new community-based model of care that is appropriate for patients today, in particular those living with multiple long term conditions. Living Longer, Living Better is a 10 year programme that aims to ensure that local people receive high quality, personalised and integrated services which support them to manage their own health and wellbeing, and live long, healthy lives. Key to this is developing and investing in our community services to deliver new models of care that keep people well and enable them to be cared for, as far as possible, in the community and without the need to be admitted to hospital. We are focusing on people who are: at the end of their lives with long term conditions frail and who may live with dementia in their early years living complex lives children with long-term conditions. Multi-agency teams will provide co-ordinated care to those most at risk of admission to hospital. Specialist teams working in hospital and in the community will support these teams. All beds, including those in hospital wards, nursing and residential homes and patients own homes, will be used to provide the highest quality of care, wherever people are. We have agreed a goal of 20% more care being provided in the community rather than in hospital by Research & Innovation and Technology Strategy continuing to invest in research and new technology to remain at the leading edge of medicine and service delivery. We aim to make the most of our state-of-the-art facilities to deliver ground-breaking research and world-class services. Our strategy is to build on our existing areas of strength by investing in new technology and in people to be at the leading edge in key areas such as: Genomics and personalised medicine - this is a new type of medicine that tailors medical decisions, practices and products to the individual patient, based on their genetic make-up. Our Centre for Genomic Medicine is one of the largest and most comprehensive in Europe. We expect the number of diseases that we treat using this approach to increase greatly over the next 5 years. Cardiac - we aim to develop a single Manchester cardiac service with the University Hospital of South Manchester that will enable us to become an internationally recognised centre for research and to increase the life expectancy for patients with cardiovascular disease. Inflammation and repair we already have internationally recognised research expertise in the area of musculo-skeletal disease. Areas for future development include the establishment of a Manchester Cartilage Centre where research will be undertaken and findings quickly brought into clinical practice, and the establishment of an academic department of orthopaedics. Page 14 of 37

15 What we will be... What we are doing... What drives us... Our Strategic Plan : Plan-on-a-Page OUR VISION To be recognised internationally as leading healthcare; excelling in quality, safety, patient experience, research, innovation and teaching; dedicated to improving health and wellbeing for our diverse population CHALLENGES STRATEGIES OUTCOMES Getting value for money from limited NHS resources Achieving and exceeding quality standards Delivering services that patients and commissioners want Improving hospital services across Greater Manchester Ensuring that we have the capacity to do all that we want to do Key Strategies Specialist services targeted development of services, building on our strengths and existing portfolio Healthier Together work with partners across Greater Manchester to redesign services to ensure equitable access to high quality services Living Longer, Living Better develop a new community based model of care between acute, community, primary and social care One of national centres for specialised care An accredited major trauma centre for adults and children One of major emergency centres nationally An accredited centre for specialised cancer surgery One of 4-5 designated specialist hospitals across Greater Manchester Improving the health and wellbeing of local people Responding to the NHS England specialised services strategy Building on the strengths of the Oxford Road site facilities, skills and colocation Building on our commercial, academic and research links Responding to the national procurement for genetics Remaining at the leading edge of technology Research, innovation and technology invest in key areas to remain at the leading edge of medicine Supporting strategies Quality IM&T Estates Organisational Development Workforce Communications Finance One of the top three integrated care systems in England A designated NIHR Biomedical Research Centre A nationally recognised Centre for Translational Research A recognised national leader in personalised medicine The Genomics hub for the North of England OUR VALUES PRIDE being the best RESPECT regard for the feelings, rights and views of others EMPATHY understanding the emotions, feelings and views of others DIGNITY respect and value all individuals and all their diverse needs CONSIDERATION thoughtfulness and regard for others, consideration of their feelings and circumstances COMPASSION understanding & concern and providing a safe, secure and caring environment for everyone Page 15 of 37

16 Section Four Organisation Charts for Clinical Scientific Services Clinical & Scientific Services Division Organisational Chart & Management Arrangements Clinical Head of Division Post Grad Education Lead Under Grad Education Lead Divisional Director Vacant Divisional Accountant HR Business Partner Divisional Clinical Effectiveness Manager Associate Director of Division Head of Nursing Business Analyst IT Analyst Procurement Manager Directorate Accountants Divisional Quality & Complaints Manager Divisional Research Mgr. Divisional Comms Lead Directorate of Laboratory Medicine Directorate of Radiology Directorate of Nuclear Medicine Directorate of Anaesthesia Directorate of Critical Care Directorate of Pharmacy Directorate of Allied Health Professionals Directorate of Neurophysiology Medical Engineering (MEAM) Clinical Director Clinical Directors Clinical Director Clinical Director Deputy CD s Clinical Director Director of Pharmacy Head of AHPs Clinical Lead Head of MEAM Directorate Manager Directorate Manager Directorate Manager Directorate Manager Deputy DM Anaesthetics / Critical Care AHP Professional Leads Adult / Paediatrics OT Physio Dietetics SALT MSK Directorate Manager Trust Medical Devices Coordinator Last Updated June 2014 Page 16 of 37

17 CSS GOVERNANCE ARRANGEMENTS Trust Management Board (TMB) Trust Risk Management Committee Trust Clinical Effectiveness Committee Operational Management Group (OMG) CSS DIVISIONAL BOARD CSS DIVISIONAL CLINICAL EFFECTIVENESS BOARD CSS OPERATIONAL GROUP (COG) CSS QUALITY GROUP CSS Divisional Infection Control Forum Corporate Meetings CSS Meetings CSS Directorate Meetings Directorate Management & Clinical Governance Meetings Page 17 of 37

18 Section Five - Business Plan for Clinical Scientific Services 1. KEY CHALLENGES Clinical & Scientific Services (CSS) Division Business Plan (DRAFT) 2016/ /20 Identify the key issues facing the Division over the coming 5 year period - these will include significant risks, threats, opportunities Key Clinical Challenges Meeting the need for clinical service reconfiguration across Greater Manchester through Healthier Together, Living Longer Living Better & Place Based Care Working with clinical divisions to support NHS Seven Day Service implementation Introduce a standalone vascular and non-vascular consultant on call rota to support vascular services development and complex EVAR Manage the final roll out of the CRIS communicator system for radiology reporting within the Trust. Improving overall clinical outcomes from medicines through individualising patient care Medicines Optimisation Key Operational Challenges Matching Anaesthetic capacity with demand through effective resource management and timely recruitment. Implementing a Post-Operative Care Unit (POCU) to facilitate improved CCU patient flow. Reducing the gap between radiology reporting capacity and demand to reduce reporting delays and outsourcing requirement The installation of a second MR scanner on the MRI site to reduce the need for outsourcing scans to the independent sector Implement a Managed Equipment service (MES) to provide the DLM with cutting edge and cost efficient automation platforms that streamline operations and workflow. Implement a substantive ESP service in the Emergency Department at MRI to support the achievement of the 4hr target. Key Strategic Challenges Continued harmonisation & integration of service at Trafford to deliver equitable services across sites and rationalise estate requirements. Responding to Seven Day Service delivery requirements whilst ensuring cost effective and sustainable services Pursuing opportunities for collaborative working with partner organisations to deliver high quality and sustainable services across Greater Manchester Continue to enhance the Trust s strong reputation for embracing clinical research through the installation of a PET-MR scanner within Neurophysiology in partnership with the University of Manchester Identify opportunities for partnership working with the Nuffield development to enhance service provision through innovative service models. Key Financial Challenges Identification and delivery of the divisional Trading Gap Continue to ensure premium payments are brought baseline. Implementation of Seven Day Services across key support services To lead on and support the implementation of Transformation schemes Ensuring sufficient capital funding is available to support the purchase of replacement, new and innovative clinical technologies. Page 18 of 37

19 2. PLANS 2.1 Quality Improvement Plans Clinical Effectiveness Plan milestones to be achieved by (enter in appropriate box) Key challenge(s) addressed Significant risks and mitigation (of plans) Resource requirements Name / Description Implement Trustwide Electronic Prescribing and Medicines Administration system. Roll out of Radiology communicator system Milestones 15/ 16 15/ 16 16/ 17 16/ 17 17/ 18 18/ 19 19/ 20 Q2 Q4 Q2 Q4 Q4 Q4 Q4 Pilot complete Improving safe Phase 1 roll-out medicines practice Phase 2 roll-out Phase 3 roll-out Improving clinical Full implementation outcomes from medicines Complete roll out across central site Operational productivity and efficiency Failsafe communication of diagnostic results IT challenges associated with a regional shared information system Scale of organisational change. Capital funding (total 4m) DH allocation ( 2m) CMFT allocation ( 2m) Project management team. 7 day working Full scoping exercise Prioritise areas and resource Reducing overall LoS for patients implications Agree funding for priority areas and initiate recruitment Equity in quality of services received Continue process of implementation Improvement in weekend mortality rates Significant funding implications Ability to link divisional priorities with the need to support plans of clinical divisions TBC Page 19 of 37

20 2.2 Quality Improvement Plans Patient Experience Plan milestones to be achieved by (enter in appropriate box) Key challenge(s) addressed Significant risks and mitigation (of plans) Resource requirements Name / Description Development of a Daycase Interventional Radiology unit. Milestones 15/ 16 15/ 16 16/ 17 16/ 17 17/ 18 18/ 19 19/ 20 Q2 Q4 Q2 Q4 Q4 Q4 Q4 Business Case approval Reducing day Execute Implementation plan before and on the Go live day cancellations due to lack of beds Improve overall patient experience Inability to effectively re-utilise released capacity within MRI Use of ICON facility for alternative services Physical space requirement Reduce failed daycase rate Lloyds outpatient dispensing contract achieving specification. Use patient feedback to improve service Assist patient flow across MRI Max OP wait < 30 minutes Extended waiting Average OP wait < 15 minutes times for out-patient Zero Complaints dispensing times? Dispensing errors Annual contract review Adult facility refurbishment Contract re-tendered Increase data collection compliance relating to patient experience Ensure data is displayed in both patient and staff areas across directorates Identify and implement improvement opportunities Utilise patient stories within key agendas to communicate real life experiences to drive change. Contract management. Refurbishment of adult facility to improve workflow and patient experience Page 20 of 37

21 Embed the Trust quality strategy in service delivery Deliver Cancer Survey Action Plan Identify quality improvement actions at directorate level Annual review of quality improvement actions Continue to utilise divisional theme of the month agenda Carry out review of patient information Review OP survey to capture areas for improvement Improve departmental environment through life cycling process 2.3 Quality Improvement Plans NHS Performance Targets Plan milestones to be achieved by (enter in appropriate box) Key target(s) addressed Significant risks and mitigation (of plans) Resource requirements Name / Description Anaesthetic capacity / demand Milestones 15/ 16 15/ 16 16/ 17 16/ 17 17/ 18 18/ 19 19/ 20 Q2 Q4 Q2 Q4 Q4 Q4 Q4 Advertisement and recruitment Financial Delivery Consultants start in post in line with project plan Development of Fellow Posts in Areas of Specific Interest Contribute to 18w RTT achievement Competition from other Trusts. Turnaround time of recruitment process (approval, recruitment etc) Availability of high quality candidates Robust and timely data Development of Solo lists for ST5+ trainees in hours Recruitment and training of locums as a potential source of Consultant recruitment Annual Availability Page 21 of 37

22 Installation of a second MR unit on the Manchester Royal Infirmary site Implementation of a POCU (Critical Care) Business Case submission & approval Commence Procurement process Estates enabling works Installation and commissioning Commence operational use Submit business case for approval Engage with commissioners Estates enablement works Operational implementation 6 Week diagnostic waits 18w RTT achievement Supports reduction in LoS Reduced unnecessary admissions to Critical Care Unit Reduced elective cancellations Ensuring appropriate physical location for new scanner Unable to support additional activity but will reduce need for outsourcing Capital funding Funding for capital and revenue requirements Implement Trustwide Electronic Prescribing and Medicines Administration system Improve 18w RTT performance Pilot complete Reduced LoS Phase 1 roll-out Phase 2 roll-out Reduced Phase 3 roll-out readmissions Full implementation Scale of organisational change. Capital funding (total 4m) DH allocation ( 2m) CMFT allocation ( 2m) Project management team. DLM Managed Equipment Service Release BAFO tender docs Project implementation plans Reduced Turnaround time in Complete enabling works DLM Impact of equipment installation on current service provision On-going system management and training team. Transfer from existing equipment following evaluation Integration of virology/ Immunology/serology service into a fully automated blood science laboratory Potential to reduce LoS due to reduced downtime and quicker turnaround of blood samples Page 22 of 37

23 AHP Support to ED/Urgent Care Review pilot scheme effectiveness Develop substantive business case Align staffing requirements & recruit if needed Improved achievement of ED 4hr target Reduced unnecessary admissions Ability to identify accurate demand profile to maximise impact Funding for additional substantive staffing Improved patient experience 2.4 Strategic Development Plans Plan milestones to be achieved by (enter in appropriate box) Key challenge(s) addressed Name / Milestones 15/ 15/ 16/ 16/ 17/ 18/ 19/ Description Q2 Q4 Q2 Q4 Q4 Q4 Q4 PET/MR Confirm estate refurb plans Improved access for scanner for Complete estates works NHS patients Dementia Scanner Installation research Commission equipment Reputational profile Collaboration Commence operations v of Trust for with University advancing research Translational research Developing services to align with the Living Longer, Living Better agenda Significant risks and mitigation (of plans) Timescales for implementation to align with spend requirements for grant to Manchester University Resource requirements Funding to contribute to estates refurbishment Centralisation of Pharmacy Aseptic Units at MRI Project feasibility and planning Submit case for implementation v v In line with trust TGH Estate Implementation v Rationalisation strategy Potential delivery of financial improvement Page 23 of 37 Impact on current service delivery. Various service model options to be considered Long term inability to respond to changes in clinical model for TGH TBC

24 2.5 Transformation Plans Plan milestones to be achieved by (enter in appropriate box) * Name / Milestones 15/ 15/ 15/ 15/ 16/ 16/ 16/ Description Q1 Q2 Q3 Q4 Q1 Q2 Q3 Blood Confirm project scope and v Management deliverables Identify required project v management requirements Confirm workstreams and v project plan Implementation v v Review impact and outcomes v Place Based Care (Pharmacy & AHP) EPP (anaesthetics) Measurable Benefits Reduced blood product wastage and associated costs Improved LoS Improved patient experience Identify Community Offer v Reduced inhospital Finalise service redesign models activity Implementation Reduced readmissions Confirm actions within overall project plan Confirm baseline data Improved patient experience Improved theatre utilisation Reduced ad-hoc anaesthetic sessions Risks and mitigation (of plans) Requires Trust wide buy in and implementation. Divisional project and clinical leads to be identified Cost implications for implementation of new service models Ability to meet 20% shift objectives Requires trust wide buy in and support Ability of Trust systems to capture baseline and improvement data Lead Clinician / Lead Operational Manager Dr Kate Pendry Leigh Hudson Leigh Hudson / Clinician TBC 7 Day Services (all services) Identify developments to achieve compliance Identify resource needs Project implementation Financial improvement Reduced LoS Improved clinical outcomes Potential for significant cost implications for weekend working *Please note different timescale Improved ED/UC 4 hr performance Page 24 of 37

25 3. WORKFORCE 3.1 Human Resources What are the key workforce issues/challenges over the next 5 years and how are they being addressed (eg recruitment, implementing new roles, productivity)? RECRUITMENT AND RETENTION Nursing recruitment and retention to be addressed via a rolling programme of recruitment, international recruitment, and retention plans including exit questionnaire review and staff engagement initiatives (Critical Care). Development of ESP (extended scope practitioner) roles in AHPs ( ) Lack of experienced paediatric AHP staff for specialist areas to continue to be addressed by a combination of external recruitment, internal training, Masters Level programme training and liaison with the NW workforce board. Neurophysiology - workforce development - 60% of the experienced band 7+8 staff will retire within the next 2 years. There is a local and national shortage of clinical physiologists. Plans to address this include the recent recruitment of a newly qualified Band 5, in house training and development of lower banded staff to support succession planning along with short term over-establishment at Band 7 to manage workload on retirements. Further recruitment and increased clinical placements for MMU students to assist with future staffing shortages. Consultant recruitment Neurophysiology for which Salford are the Hub. Support needed with capacity issues. Joint advert unsuccessful and requires further re-advertisement. Recent replacement at SpR level at Salford. Recruitment of sonographers to meeting service development and increasing demand. Review of internal training provision and recruitment and retention packages. WORKFORCE PRODUCTIVITY Impact of increased flow and acuity and expectation for greater productivity Anaesthetic capacity and demand ( ) and expansion of preoperative clinics, addressed via the implementation of the workforce plan for Consultants Anaesthetist appointments and increasing subspecialisation. 7 day working and staffing levels, addressed through service review, workforce planning and forecasting, recruitment to turnover e.g. Nursing, Pharmacy and ad-hoc utilisation of internal bank workers. Cycle of job plan review to determine the scope for Consultant APA s in delivering the one week referral to CPET test commitment ( ). Increasing demand for PST and CT scans addressed by workforce planning review. Workforce review and training needs analysis to be undertaken as POC tests and devices are identified as appropriate in line with the Urgent Care Plan. SKILL AND CAPABILTY MEAM - Professional rolling apprenticeship and staff development training programmes to address succession plans and ensure skilled available workforce. Ensure high quality appraisals take place for every member of staff. Achievement of appraisal and mandatory training targets by a scheduled rolling programme of planned completion dates. Page 25 of 37