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Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
Nottingham University Hospitals NHS Trust
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Nottingham University Hospitals NHS Trust

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  • 1. Nottingham University Hospitals Proposal for new NUH structure Peter Homa Chief Executive January 2007
  • 2. Nottingham University Hospitals Purpose Output of consultation Proposed changes to Director posts and Portfolios Proposed new NUH structure Next steps and supporting work
  • 3. Nottingham University Hospitals Purpose • To update colleagues on the output of the structure consultation • To outline and discuss the final proposal for a new NUH structure • To outline and discuss proposed changes to director portfolios • Next steps
  • 4. Nottingham University Hospitals Output of consultation • Through consultation, principles for grouping the specialties were derived • 3 potential groupings of specialties were created via OME and circulated within NUH for comment • The responses received were categorised, summarised into a document and used as the basis for a final proposal for a new NUH structure
  • 5. Nottingham University Hospitals Proposed new structure • The new structure is proposed to have 10 clinical directorates. • Each directorate will be led by a Clinical Director (not necessarily a Doctor). They will be supported by a Business Manager and a Lead Doctor/Nurse/Midwife/Allied Healthcare Professional. • The Clinical Director will report to the Director of Operations but maintain professional accountability to the relevant Executive Director. • The 10 directorates are proposed not to be grouped into 3 divisions, nor will they be linked to 3 Medical Directors. • It is proposed that there will be a Medical Director and 2 Assistant Medical Director posts, as opposed to 3 Medical Director Posts.
  • 6. Nottingham University Hospitals Proposed new structure • It is proposed that there will be 4 pathway lead clinicians. • It is proposed to create a Director of Operations post (5th voting Executive Director). This post will have line management accountability for the 10 Clinical Directors and will also have corporate performance responsibility.
  • 7. Nottingham University Hospitals Director Portfolios Agreed at Trust Board on 7 Sept 2006 Director of Nursing, Midwifery & Service Improvement Medical Director Director of Finance and Procurement Director of Estates and Facilities Director of Human Resources Medical Director Medical Director Director of Corporate and Legal Affairs Director of Communications and Marketing Director of Strategy Director of Health Informatics Chief Executive
  • 8. Nottingham University Hospitals Proposal for Revised Director Portfolios Director of Nursing, Midwifery & Service Improvement * Medical Director* Director of Finance and Procurement* Director of Estates and Facilities Director of Human Resources Assistant MD Assistant MD Director of Operations* Director of Communications and Marketing Director of Strategy Director of Health Informatics Chief Executive* Trust Secretary *Voting Executive Directors Pathway Lead Clinicians
  • 9. Nottingham University Hospitals Update on Director Appointments Appointments made: Director of Nursing, Midwifery and Service Improvement – Jenny Leggott Director of Estates and Facilities – John Simpson Director of Health Informatics – Andrew Fearn Director of Communications and Marketing – Cath Lovatt Director of Strategy – Julia Hickling Posts yet to be Filled: Medical Director Director of Operations (Proposed) Director of Finance and Procurement Director of Human Resources
  • 10. Nottingham University Hospitals Medical Director Portfolio of Trust Wide Responsibilities Assistant Medical Director Assistant Medical Director Portfolio of Trust Wide Responsibilities Portfolio of Trust Wide Responsibilities
  • 11. Nottingham University Hospitals Director for Nursing Midwifery service Improvement 4 Pathway Lead Clinicians: Scheduled Care Unscheduled Care Children and Young people Older People
  • 12. Nottingham University Hospitals Theatre utilisation Scheduling Pre op Efficiency & effectiveness indicators Ambulatory Care Day cases; Out-patients High level scope of the role Choose and Book 18 weeks Cancer 2ww; 31; 62 days Scheduled Care Supported by: Project lead clinicians Redesign project manager
  • 13. Nottingham University Hospitals Hospital at Night Efficiency & effectiveness Indicators Discharge Admissions High level scope of the role Unscheduled Care Supported by: Project lead clinicians Redesign project manager
  • 14. Nottingham University Hospitals Efficiency & effectiveness Indicators Discharges Admissions Efficiency & effectiveness Indicators Discharge Admissions Older People Children and Young People High level scope of the role Supported by: Project lead clinicians Redesign project manager Supported by: Project lead clinicians Redesign project manager
  • 15. Nottingham University Hospitals Director of Finance Financial Turnaround SLA Contract including Nations Procurement Performance Management
  • 16. Nottingham University Hospitals Director of Operations Performance Management Line Management Responsibility for 10 Directorate Clinical Directors
  • 17. Nottingham University Hospitals Proposed Directorates Acute Medical Directorate •Acute Medicine •Adult Emergency Department •Burns •Stroke •Rheumatology •Healthcare of Older People Musculoskeletal and Neurosciences Directorate •Orthopaedic Trauma •Elective Orthopaedics •Sports Medicine •Spinal •Neurosurgery •Neurology •Neuro-rehab (Linden Lodge) •Clinical Psychology General Support Service and Ambulatory Care Directorate •Physiotherapy •Occupational Therapy •Disablement Services •Pharmacy •Dietetics •Speech and Language Therapy •Medical Photography •Spiritual and Pastoral Care •Outpatient Departments •Patient Appliances •Patient HotelDiabetic, Renal and Cardiovascular Directorate •Renal Transplant •Renal •Diabetes and Endocrinology •Endocrine Surgery •Vascular Surgery •Cardiac Surgery •Cardiology •Chiropody Thoracic and Digestive Diseases Directorate •General Surgery •Upper GI and HPB Surgery •Thoracic Surgery •Endoscopy •Gastroenterology •Colorectal Surgery NB – The specialties below are not currently included in the groupings: Clinical Immunology + Allergy: ID: Respiratory medicine: Sexual health:
  • 18. Nottingham University Hospitals Proposed Directorates Family Health Directorate •Obstetrics/Maternity/Gynaecology •Neonatal unit •Children and Young People •Adolescent/Paed Emergency Department •Genetics Cancer and Associated Specialties Directorate •Oncology and Radiotherapy •Clinical Haematology •Palliative Care •Cancer Centre •Breast Services •Plastic Surgery •Dermatology •Urology Clinical Support Directorate •Pathology •Radiology •Medical Physics, Clinical Engineering, Clinical Neurophysiology Head and Neck Directorate •Ophthalmology •ENT •Maxillofacial Specialist Support Directorate •Theatres and Sterile Services •Critical Care •Anaesthesia •Pain Management NB – The specialties below are not currently included in the groupings: Clinical Immunology + Allergy: ID: Respiratory medicine: Sexual health:
  • 19. Nottingham University Hospitals Proposed Directorates Acute Medical Directorate •Staffing (WTE) 974.31 •Forecast Expenditure £44.4m •Non-elective activity 165,000 •Elective activity1,100.00 •Outpatient activity 73,500 Musculoskeletal and Neurosciences Directorate •Staffing (WTE) 671.92 •Forecast Expenditure £31.5m •Non-elective activity 5,750 •Elective activity12,000 •Outpatient activity 107,000 General Support Service and Ambulatory Care Directorate •Staffing (WTE) 784.26 •Forecast Expenditure £27.0m •Non-elective activity 0 •Elective activity0 •Outpatient activity 0 Diabetic, Renal and Cardiovascular Directorate •Staffing (WTE) 767.10 •Forecast Expenditure £37.7m •Non-elective activity 2,900 •Elective activity5,000 •Outpatient activity 48,000 Thoracic and Digestive Diseases Directorate •Staffing (WTE) 538.51 •Forecast Expenditure £23.5m •Non-elective activity 6,250 •Elective activity18,500 •Outpatient activity 43,000 NB – The specialties below are not currently included in the figures above: Clinical Immunology + Allergy: Staffing: 5.6 Forecast Expenditure: £0.65m NEL: 20 EL: 1,000 OPD: 2,300 ID: Staffing: 43.78 Forecast Expenditure: £2.9m NEL: 15 EL: 0 OPD: 1,300 Respiratory medicine: Staffing: 202.31 Forecast Expenditure: £7.9m NEL: n/a* EL: 500 OPD: 9,750 Sexual health: Staffing: 44.8 Forecast Expenditure: £3.3m NEL: 0 EL: 0 OPD: 23,500 * = Part of Acute Medicine NEL data.
  • 20. Nottingham University Hospitals Proposed Directorates Family Health Directorate •Staffing (WTE) 1314.00 •Forecast Expenditure £60.5m •Non-elective activity 27,900 •Elective activity9,900 •Outpatient activity 110,000 Cancer and Associated Specialties Directorate •Staffing (WTE) 672.20 •Forecast Income £42.3m •Forecast Expenditure £39.8m •Non-elective activity 6,000 •Elective activity29,100.00 •Outpatient activity 125,000 Clinical Support Directorate Staffing (WTE) 999.43 •Forecast Income £57.5m •Forecast Expenditure £67.1m •Non-elective activity 0 •Elective activity0 •Outpatient activity 0 Head and Neck Directorate •Staffing (WTE) 437.33 •Forecast Expenditure £22.0m •Non-elective activity 20,000 •Elective activity12,250 •Outpatient activity 131,500 Specialist Support Directorate •Staffing (WTE) 1155.07 •Forecast Expenditure £64.5m •Non-elective activity 0 •Elective activity5,600 •Outpatient activity 7,900 NB – The specialties below are not currently included in the figures above: Clinical Immunology + Allergy: Staffing: 5.6 Forecast Expenditure: £0.65m NEL: 20 EL: 1,000 OPD: 2,300 ID: Staffing: 43.78 Forecast Expenditure: £2.9m NEL: 15 EL: 0 OPD: 1,300 Respiratory medicine: Staffing: 202.31 Forecast Expenditure: £7.9m NEL: n/a* EL: 500 OPD: 9,750 Sexual health: Staffing: 44.8 Forecast Expenditure: £3.3m NEL: 0 EL: 0 OPD: 23,500 * = Part of Acute Medicine NEL data.
  • 21. Nottingham University Hospitals Proposed next steps • 24/1/07 – Presentations on QMC and NCH campuses to CDs, Divisional and Directorate managers and Heads of Department. • 24/1/07 (after presentations) – circulation of proposed structure to wider Trust. • 24/1/07 – ask 4 remaining specialties which grouping they feel they are most suited to be linked with.
  • 22. Nottingham University Hospitals Proposed Timescales • Communicating Proposals – 8th January – 28th January • Final comments on proposals by Friday 2nd February • Developing Job Descriptions – 22nd January – 26th February • Agree Banding – 5th March • Agree Recruitment Process – By 26th February • Agree Recruitment Pools – By 5th March • Consult with affected staff – 12th March – 26th March • Advertise Posts – Medical Director and Director of Operations - 26th February • Advertise Remaining Posts – 2nd April • Interviews Commencing – 13th March and will complete by 11th May
  • 23. Nottingham University Hospitals Supporting work • Clarify proposed number of supporting posts in the groupings. E.g. Clinical Leads, operational managers, modern matrons etc. • Confirm the cost of the proposed structure and remuneration for all posts. • Clarify HR, Finance, ICT and Estates proposed structures and how they would interface with the 10 directorates • Understand the optimal links with all other Corporate Departments • Clarify the required HR process to implement the proposal • Finalise a proposal for an underpinning leadership development programme • Clarify future arrangements for meetings e.g. OME – Clarify how strategy will be managed – Clarify how performance will be managed

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