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Challenges for Medical Managers in the NHSDr Imran Waheed22 May 2014

+Introduction The familiar challenges faced by mental health trusts

have intensified in the face of considerable financial constraints.

The need for innovation and increased levels of productivity has probably never been greater.

All healthcare staff will need to contribute significantly to this effort.

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Clinical Engagement

The challenge is to nurture a positively committed and engaged medical workforce

The recent Francis and Keogh reports, both identified a lack of strong clinical leadership as a fundamental contributor to the failures of some NHS Trusts

The need to challenge the perception that doctors who become managers go to the “dark side”

The crucial question is whether the organisational culture and structure facilitate or inhibit this.

“Good management is the art of making problems so interesting and their solutions so constructive that everyone wants to get to work and deal with them.” - Paul Hawken

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Clinical Engagement

Organisations with engaged staff deliver:

Better patient experience

Fewer errors

Stronger financial management

Higher staff morale and motivation and less absenteeism and stress.

“An unduly casual attitude towards sudden death [and] inadequate systems for reporting incidents”

“Incident reporting systems were criticised by many staff”

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The Quality Challenge: lessons from Mid Staffs

Setting up proper systems of supervision

Understanding what pressures staff are experiencing

Taking action when things go a bit wrong rather than waiting until they are very wrong

Patient feedback to be a key indicator of performance

Taking seriously the ‘gold dust’ of complaints

Prioritising patient care over organisational needs

“We must put patients at the heart of everything we do”

[Prof Sue Bailey, RCPsych]

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The Innovation Challenge

Harnessing transformational technologies

Exploiting the potential of data

Moving away from the ‘one size fits all’ model of healthcare

A health service, not an illness service – the NHS has helped many quit smoking but what else can we do...?

“Insanity: doing the same thing over and over again and expecting different results.” [Albert Einstein]

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Conclusion

Financial constraints will persist for at least a decade but cannot be allowed to dominate management

Challenge of ensuring quality – putting patients first and prioritising patient safety and well-being

Innovation challenge – trying to increase productivity through innovation

Meeting these challenges is dependent on the clinical engagement challenge – ensuring that senior medical staff are playing leadership roles in their clinical teams