Work Placement Portfolio

WORK PLACEMENT
PORTFOLIO
FOR
ANDREW MARSHALL
Third Year Work Placement Student
BA (Hons) in Business Studies
(Matric No: 200812384)
WORK PLACEMENT SPONSOR
Service Manager
UNIVERSITY PLACEMENT TUTOR
Alan Hutton
June 2009 to May 2010

1. Work Placement Report
2. Background to NHS Lothian
3. Learning Objective Statement
4. Appendices
Table of Contents

LEARNING OBJECTIVE STATEMENT
FOR
ANDREW MARSHALL
BA (Hons) in Business Studies
Service Manager, NHS Lothian
Alan Hutton
Senior Lecturer in Economics

CONTENTS
Page
Induction 02
Projects/Tasks/Work Routine
Project 01 – Discharge Lounge Utilisation 03
Project 02 – Real Time Use of Trak System 04
Project 03 – Delayed Discharges (OT Financial Assessment) 05
Project 04 – Admission and Discharge Predictor Model 06
Project 05 – Streamline Emergency and Elective Flows 07
Project 06 – A&E Breach Analysis 08
Project 07 – Discharge Policy 10
Project 08 – General Practitioner (GP ) at the Front Door Pilot 11
Project 09 – Primary Assessment Area (PAA) Pilot 12
Project 10 – Patient Transport Project 13
Personal Development and/or Learning Incidental to the Job 15
Student: Andrew Marshall Time Period: June 2009 to May 2010
Work Sponsor: NHS Lothian Education Sponsor: Glasgow Caledonian University
- 1 -

Learning Objectives
Directly Related to the Job
Timescale Evidence/Description
Confirmation/Sign-off Signature
Student Tutor Supervisor
INDUCTION
Meet Capacity & Site
Management Team
Week 01 Induction sheet (Appendix 1)
Meet middle and senior
managers of the hospital
management team
Week 01 Induction sheet (Appendix 1)
Meet with Line-manager to
discuss job role and
description
Week 01 Overview of team, hospital & organisation, key
issues, organisational goals and my role in helping to
achieve these
• Job description (Appendix 2)
Discuss and formulate key
objectives for the placement
Week 02 SMART Objectives for Key Results (Appendix 3)
Attend Corporate Induction
package (three days)
Weeks 03
and 04
Overview of organisation, H&S and employee benefits
etc
• Training Passport (Appendix 4)
• Induction Handbook (Appendix 5)
• Fire training certificate (Appendix 6)
• Induction timetable (Appendix 7)
Complete online module
induction package
Within
first 03
months
Compulsory online modules for all employees
(though tailored to staff groups)
• Certificate of Achievement (Appendix 8)
• Module timescale (Appendix 9)
Set-up desk (working area and
IT systems)
Weeks 01
and 02
• Ensure relevant software installed on computer
and working
• Obtain passwords for computer and software
packages
Meet with University
Placement Tutor (student and
line-manager)
Within
first 03
months
• Aid successful transition from university to
working environment
• Ensure initial learning objectives, tasks and
projects are viable and conducive to the work
placement ethos
• Provide information on work diary and learning
objective statement
- 2 -

Learning Objectives
Project 01 – Discharge Lounge Utilisation
Gain overview of discharge
lounge and services provided,
and understand pressures
and key issues
Weeks 02
and 03
• Meetings with:
o Discharge lounge management team
o Discharge lounge staff
o Key users of discharge lounge services
• Induction sheet (Appendix 1)
Produce report ‘Review of
Discharge Lounge Service’
(Appendix 10)
Weeks 06
and 07
• Presented to Discharge Lounge Management
Team, Capacity & Site Management Team and
Director of Delivery
• Research for report helped gain understanding of
pressures/key issues
• Identified good practice and areas for Action Plan
Patient Satisfaction Survey
(Appendix 11)
Weeks 06
and 07
• Develop survey to gain feedback from patients
• Collation and analysis of findings
• Incorporation of findings and recommendations
into ‘Review of Discharge Lounge Service’ report
Progress Meetings Ongoing
through
project
Held update meetings, as required, to ensure
effective communication between project members
Comparator Organisation
(NHS Glasgow Visit)
Week 13 • Meeting with NHS Glasgow to see how they do
things, identify similar issues and exchange ideas
Action Plan (Appendix 12) Weeks 17
and 18
• Develop Action Plan to identify objectives and key
actions required
• Meeting with Discharge Lounge Management
Team to discuss Action Plan
• Take forward key actions
Awareness raising Weeks
18, 19
and 27
• Contact IT to develop intranet and internet
website to inform key users of the service
(Appendix 13)
• Develop poster to inform key users and distribute
to relevant areas (Appendix 14)
• Workshops to inform staff users of services
provide by Discharge Lounge
- 3 -

Learning Objectives
Project 02 – Real Time Use of Trak (Patient Management) System
Project outline Week 07 Meeting with Service Redesign Manager to gain
understanding of current situation and future
aspirations
Identify key areas and
pressures
Week 07
and 08
• Meetings with various staff to understand key
areas and pressures that affect the real time use
of the Trak system
• Collate data in easy to view informal format,
noting key points
Staff Survey Weeks
10-12,
17-20
and 22
• Identify questions to be asked in survey with
team members
• Develop and draft survey format using Microsoft
Word
• Discuss and feedback for survey with team
members
• Proofread and finalise survey with team members
• Disseminate survey to staff through email and
paper versions
• Awareness raising through:
o Everyone email
o Charge Nurse monthly forum
o Clinical Management Teams (CMT)
• Develop survey audit tool using Microsoft Excel
• Collation of survey returns using audit tool
• Produce report based on results of survey and
disseminate to Hospital Management Team
• Presentation of results to Hospital Management
Team using Microsoft PowerPoint
Project amalgamation Week 22 • At this point a decision was made to amalgamate
this project with the discharge policy and
predictor model projects
- 4 -

Learning Objectives
Project 03 – Delayed Discharges (OT Financial Assessment)
Project outline and
understanding of delayed
discharge issues
Week 11 • Meeting with service manager, delayed discharge
team
Meet key agency management
representatives
(During meeting 02 it was
decided this was not a viable
project)
Weeks 13
and 23
• Gain initial thoughts on project value and outline
key outcomes
• Meeting 01 with AHP Head of Service, NHS
Lothian
• Meeting 02 with; AHP Head of Service; General
Manager, Edinburgh Community Health
Partnership; & Area Manager, Social Services,
City of Edinburgh Council
- 5 -

Learning Objectives
Project 04 – Admission and Discharge Predictor Model
Gain overview of current
predictor model
Week 02
and 03
• Gain understanding of purpose of predictor model
• How/what information is gathered for predictor
model
• Presentation of data
• Interface between predictor model and Trak
(patient management) system
• Interface between predictor model and Business
Objects (patient data collation software)
Research and data collection Ongoing
through
project
• Identify and collate data collected now and how
• Identify and collate data required for updated
version
Other organisation Week 08
and 12
• Meet with another organisation to discuss how
they predict their patient flows
• Identify key points/issues
• Discuss advantages and disadvantages of various
prediction elements
• Discuss current methods used and why
Update Predictor Model Weeks
11-19,
22-24, 30
and 33
• Develop predictor template using Microsoft Excel
• Collate various predictor elements into one model
template
• Ensure functionality of template is fit for purpose
• Test and reassess predictor template as required
Roll-out and awareness
raising
Presentation (Appendix 15)
Help sheet (Appendix 16)
Updated BO Report (Appendix
17)
Workshop Flyer (Appendix 18)
Weeks 38
to 42
• Workshops for staff to:
o Discuss the purpose and role of the predictor
model
o How the predictor model is populated
o Outline how the predictor model works
o Areas that may impact on the predictor
model, how and why
• Extra sessions provided to interested parties (i.e.
waiting times team and other hospital sites)
- 6 -

Learning Objectives
Project 05 – Streamline Emergency and Elective Flows
Project outline and
understanding of delayed
discharge issues
Week Meeting with Head of Service, General Surgery
Background research Week 08 • Identify significant impacts and Impact points
matrix developed (Appendix 19)
• Develop flowchart of current process
Comparator organisations
(other tertiary/regional
referral centres)
Weeks
10, 11
and 12
• Contact other organisations to gain insight into
their processes
• Identify best practice and processes
Waiting list management Week 11 • Meeting with Waiting List Manager to discuss:
o Purpose of waiting list and how it fits in with
the elective workloads
o Waiting list process and allocation
o Clinic and theatre allocation
o Interface between Waiting List Team and
Capacity & Site Management Team
Data collection Weeks
11, 12
and 13
• Research other organisations, using:
o Email and internet systems, telephone and
fax
• Identify relevant data for task (using flowchart
and feedback from Head of Service, general
Surgery))
• Use Trak system(patient management software)
• Use business objects (data collation and reporting
software for Trak system)
Produce report ‘Review of
General Surgery Flows’
Weeks
14, 15
and 16
• Collate information required for report
• Draft report
• Proofread report and finalise
• Present report to General Surgery Management
Team
- 7 -

Learning Objectives
Project 06 – A&E Breach Analysis
Project outline Week 18 Initial outline and purpose of project and my
potential role, meeting with:
• Service Manager, Capacity & Site Management
• Service Manager, General Medicine
• Clinical Nurse Manager, A&E
Development of audit tool Weeks
18, 19
and 25
A mechanism for collating data and subsequent
reports/presentations
• Identify data required
• Develop draft audit tool using Microsoft Excel
• Proofread and finalise form
Development of data capture
form
Weeks 18
and 19
A mechanism for capturing data required for the
breach analysis
• Identify data required
• Develop draft form using Microsoft Word
(Appendix 20)
• Proofread and finalise form
Liaise with A&E Kaizen Team Week 22 The Kaizen Team facilitates organisational change
and liaison was important to ensure I did not
duplicate work already carried out
• Liaise on an as required basis using:
o Email and telephone systems
Liaise with Clinical Nurse
Manager, A&E
Weeks 18
to 25
Liaison as required with Clinical Nurse Manager,
A&E, for data collection and upkeep of good working
relations using:
o Email and telephone systems and face-to-face
Data collection and research Weeks
18, 19
and 25
Carried out data collection and research using the
following:
• Trak system (Patient management system)
• Business Objects (data collation and reporting
• Microsoft Excel audit tool and data capture form
- 8 -

Collate audit data/findings Weeks
18, 19
and 25
Collated audit data/findings using the following:
• Trak system (Patient management system)
• Business Objects (data collation and reporting
• Microsoft Excel audit tool, PowerPoint and Word
Produce report on audit
data/findings
Week 25 • Identify data required for report
• Draft a report using Microsoft Word
• Proofread and finalise report
• Disseminate report to hospital management team
and other relevant parties using email system
Presentation of audit findings
at Kaizen Event
Week 25 • Produce a presentation using Microsoft
PowerPoint (Appendix 21)
• Disseminate presentation to hospital
management team and other relevant parties
using email system
• Present at Kaizen Event
Participation in Kaizen Event Week 26 • Be an active participant in the Kaizen Event
• Kaizen timetable
Other projects Week 26 Asked to participate in another project as a result of
work conducted for the A&E Kaizen Event (Project 09
– Primary Assessment Area (PAA) Pilot)
- 9 -

Learning Objectives
Project 07 – Discharge Policy
Project outline Week 11 Gain overview of current discharge philosophy
through meeting with Service Manager, Capacity &
Site Management Team
Discharge Survey (Appendix
22)
Weeks 11
to 15
• Develop survey using Microsoft Word
• Re-draft after feedback from team
• Distribute survey via email, post and restroom
• Develop audit tool using Microsoft Excel
• Collate and analyse survey data
Action Plan (Appendix 23) Week 15 Develop Action plan with team members to identify
actions and objectives for the discharge policy
Review current version of
discharge policy
Week 15 Review of current discharge policy to gain
understanding of areas for inclusion, editing and
deletion (as appropriate)
Policy meetings Ongoing
through
project
(monthly)
Monthly meetings to:
• Update staff on policy progression
• Provide a forum for feedback
• Discuss ideas
Patient Journey Form
(Appendix 24)
Weeks 16
to 20
• Develop Patient Journey form using Microsoft
Word
• Collate using data from survey and team
• Promulgate for feedback
• After discussion it was decided to discontinue
this line of development
Discharge Toolkit (Appendix
25)
Weeks 16
to 26
• Develop discharge toolkit using Microsoft Word
• Promulgate for feedback
• Re-draft as required
• Preparation for pilot
Policy/Procedure (Appendix
26)
Week 30 • Develop discharge policy/procedure based on
staff consultation, survey data and best practice.
• Feedback on policy/procedure and re-draft as
required
• Submit to Clinical Policy Group
- 10 -

Learning Objectives
Project 08 – General Practitioner (GP) at the Front Door
Project outline Week 23 Initial outline and purpose of project and my
potential role
Meeting with Project Lead Week 24 Meet with Project Lead to gain better understating of
project and discussed potential role
• Aid with evaluation of project
Development of data capture
form
Week 27 Create data capture form (Appendix 27) using
Microsoft Word
Development of evaluation
tool
Week 27 • Identify headings from data capture form
• Develop evaluation tool using Microsoft Excel
Collation of data capture
forms (as submitted)
Duration
of pilot
Collate data using evaluation tool
GP Service Report (Appendix
28)
Week 32 • Produce report based on results of evaluation
tool, using Microsoft Word
• Present report to Edinburgh CHP and General
Medicine Management Teams
- 11 -

Learning Objectives
Project 09 – Primary Assessment Area (PAA) Pilot
Project outline Week 26 General outline for the project was discussed during
the A&E Kaizen (Project 06)
Project meetings Ongoing
through
project
Meetings held on a regular, as required, basis to:
• Discuss purpose and role of the project
• Objectives of the project
• Allow comments/feedback for team members
• Identify issues that may impact on success of the
project
• Allocate team member roles
• Identify/prepare equipment required
• Draft and review operational policy
Project audit Weeks 29
and 33
• Identify prior work that may help with project
• Contact medical staff member who has carried
out an audit which links with the project
• Discuss with staff member the results of their
audit
• Staff member to present their findings to the
project team
- 12 -

Learning Objectives
Project 10 – Patient Transport Project
Project outline Week 26 Meeting with Associate Director, General Medicine,
to gain overview of project (role and purpose)
Project meetings (team) Monthly Project team meetings to:
• Provide a point of liaison between NHS Lothian
and the Scottish Ambulance Service (SAS)
• Discuss purpose and expectations of project
• Allocate team member roles
• Identify areas required for project
Data collection Weeks 26
through
38
• Identify data/information required
• Develop audit tool using Microsoft Excel
Project meetings (information
gathering)
Weeks
27-34
• Identify areas that use transport
• Identify and contact appropriate staff members
• Discuss role and purpose of project
• Discuss/introduce audit tool
Produce a Business Case
(Appendix 29)
Weeks 39
to 41
• Produce business case based on results of
evaluation tool and data collation, using
Microsoft Word
• Develop viable and cost-effective options for
transport provision
• Present report to Director of Delivery
Liaise with Transport Lead As
required
• Inform transport lead of purpose and aims of the
project
• Arrange meeting to discuss progress
Liaise with Operational
Working Group
Bi-
monthly
• Discuss roles and responsibilities
• Discuss/identify key objectives and outcomes
• Report on current progress
• Development of ideas/options
• Resource identification
- 13 -

Liaise with alternative (private)
transport providers
Week 43 • Inform providers of purpose and aims of the
project (business letter format)
• Provide information to providers on the tendering
process
• Feedback from providers regarding current and
future transport aspects
Patient Transport Booking
and Authorisation Process
Survey (Appendix 30)
Weeks 44
to 47
• Develop survey using Microsoft Word
• Develop data collation tool for survey using
Microsoft Excel
• Collate data from survey (as submitted)
Process mapping Weeks 44
to 47
• Develop (current state) process map from analysis
of survey data
• Develop (future state) process map for transport
project, in conjunction with survey data
- 14 -

Personal Development and/or
Learning Incidental to the Job
PERSONAL DEVELOPMENT/ LEARNING INCIDENTAL TO THE JOB
Business Objects (software
which interfaces with Trak
system)
Ongoing Developed, streamlined and produced more
accurate/new reports due to self-developed
knowledge of software (Appendix 17)
Trak System (patient
management system)
Ongoing • Initial training course provided a foundation level
of knowledge.
• Continued use of Trak and a good working
relationship with Trak Manager helped to
increase knowledge of system, identifying
anomalies to improve Trak.
Microsoft Office package Ongoing • Had a basic understanding of Excel before
placement.
• Use of Excel to update predictor model required
development of skills to facilitate this.
Diary management Ongoing • Employer sponsor allowed me to manage my own
diary.
• Forward planning of work was required to ensure
best use of time
• Effective diary management ameliorated the
effects of project time pressures and, subject to
tutor priorities, allowed each project to have
sufficient time allocated
Communication skills Ongoing • Communication with staff was by the following
methods: Email, PPT, excel, word and/or
telephone
• Effective communication with staff was required
to ensure parties understood objectives,
priorities, roles, responsibilities and timelines
Relationship building Ongoing • Relationship building within the organisation was
essential.
• Builds trust, confidence and improves working
relationships.
• Allowed easier access to information, both ways
- 15 -

Report writing As
required
• Report writing is essential to allow the effective
transmission of information in an appropriate
manner.
• Further developed the skill of writing objective
and neutral reports.
• Proofreading reports to ensure the content,
language and information is apt and appropriate
to the topic of the report.
Language (medical
terminology)
Ongoing • Use of appropriate language was essential for
building credibility within the organisation.
• Due to the nature of Healthcare, understanding
and using medical terminology was expected and
poor use/grasp reduced face value.
• Greater use allowed better interactions,
relationship building and general
communications
Diplomacy and tact Ongoing • Ability to keep a confidence and speak in an
appropriate manner to individuals/groups
regardless of their level within the organisation.
• Tactful conversations build confidence in the
other party and subsequent interactions.
Learning and Training As
required
• Provide informal training to team members and
other staff to develop knowledge and
understanding of:
o Business Objects software
o Trak (Patient Management) software
o Microsoft Excel
- 16 -

BACKGROUND TO NHS LOTHIAN
Organisation Overview
NHS Lothian serves a population covering the City of Edinburgh, West
Lothian, East Lothian and Mid-Lothian and is still a relatively young
organisation. It was established in 2001 as the ‘umbrella’ organisation for
all Lothian health services, with strategic planning and leadership provided
by Lothian NHS Board.
NHS Lothian’s principal health organisations are the Lothian NHS Board,
University Hospitals Division (UHD) and Community Health Partnerships
(CHP). The Royal Infirmary of Edinburgh (RIE), the Western General
Hospital (WGH) and St John’s Hospital (SJH) are the three main hospitals
within the UHD.
The RIE, located at Little France, is a major acute teaching hospital. With a
24-hour Accident and Emergency (A&E) department, it provides a full range
of medical and surgical services for patients from across Lothian and
specialist services for people from across the South East of Scotland and
beyond.
The £190 million hospital officially opened in 2003 as a modern, purpose
built replacement for the old and out-dated Victorian building at Lauriston
Place, and has more than 900 inpatient beds. It is home to Scotland’s
biggest maternity unit – some 6000 babies are born at the RIE’s Simpson
Centre for Reproductive Health each year – and Scotland’s busiest A&E
department.
Specialist services include cardiac surgery, kidney, liver, pancreatic and
bone marrow transplants. The RIE is home to the Scottish Liver Transplant
Unit.
The organisation is structured into several directorates to aid service
delivery, with ‘similar’ clinical services grouped together under these
directorate banners. These directorates include:
• Cancer, Clinical, Head & Neck (e.g. laboratory support)
• Medical and Associated Services
• Surgical and Associated Services
• Women’s, Children’s and Neurosciences
• Corporate Services (i.e. the Executive board and support services)
• Capacity and Site Directorate
My department, The Capacity and Site Directorate, is discussed further in
the next section.
- 1 -

Department Overview
The purpose of the Capacity and Site Directorate (CSD) is to ensure there are
enough beds, or capacity, for the patients utilising NHS Lothian’s services –
patients with certain medical conditions can only use certain types of bed
which is driven by the specialty the bed falls under – and the adequate
staffing, by suitably qualified staff, relating to those beds.
The CSD has a strategic as well as an operational remit for the oversight of
NHS Lothian’s bed capacity, with responsibility for staffing issues relating to
this ‘bed capacity’.
Strategic management control is through a, below board level, Director of
Service Delivery, with operational control provided by a Service Manager.
This arrangement is unique within NHS Lothian, as other directorates have
at least two other levels of management in-between.
The CSD team does not directly control bed capacity or the associated staff.
It operates within a regulatory/partnership framework, providing strategic
and operational oversight. Another integral element is supporting the ‘flow’
of patients into and out of the various hospital sites within, and outwith,
NHS Lothian. These flows include:
• Emergency admissions: acute type patients, typically presenting to
the A&E department;
• Elective admissions: patients requiring an interventional operation or
procedure that requires a stay in hospital; and
• Discharges or transfers: the timely and safe movement of patients
either to:
o Their home or permanent place of residence
o Further care facility (i.e. nursing home)
o Another hospital within or without NHS Lothian
Personal Overview
As part of my role I was co-located with, and collaborated very closely with,
the Service Manager within the RIE. Although my job
description (Appendix 2) was very comprehensive, it was also flexible. This
dynamic aspect allowed and I to adapt to changing organisational
needs and concentrate on high impact strategies – negating the need for
iterative role change negotiations.
- 2 -

WORK PLACEMENT REPORT
FOR
ANDREW MARSHALL
BA (Hons) Business Studies
Service Manager, NHS Lothian
Alan Hutton
Senior Lecturer in Economics

Contents
Page
1.0 Introduction 2
1.1 This Report 2
1.2 The Organisation (NHS Lothian) 2
2.0 Workplace Experience Description 2
2.1 Event 1: The Discharge Lounge Service 3
2.2 Event 2: NHS Lothian Discharge Policy 4
3.0 Evaluation 5
3.1 What Did I Get Out Of It? 5
3.2 How Does It Link In With The Degree? 5
3.3 Career Aspirations 7
3.4 Positive Points To Note 7
3.5 Problem Areas That Arose 8
4.0 Summary 9
5.0 Appendices
Appendix A: Skills Development during Work Placement 10
- 1 -

1.0 Introduction
1.1 This Report
This report is a both a description of my work placement experiences and a
critical reflection of those experiences. It is designed to provide you [the
reader] with an understanding of what work I [Andrew Marshall] carried out
during my twelve months with NHS Lothian (NHSL), and how those
experiences:
• Link with my first and second year university learning
• Have impacted upon myself, within a professional context
• May change my future performance in the workplace
1.2 The Organisation (NHS Lothian)
NHS Lothian is still a relatively young organisation and was established in
2001 as the ‘umbrella’ organisation for all Lothian health services, with
strategic planning and leadership provided by Lothian NHS Board.
NHS Lothian’s principal health organisations are the Lothian NHS Board,
University Hospitals Division (UHD) and Community Health Partnerships
(CHP). The Royal Infirmary of Edinburgh (RIE), the Western General
Hospital (WGH) and St John’s Hospital (SJH) are the three main hospitals
within the UHD.
The RIE, located within the South East area of Edinburgh, was my primary
location for the duration of my work placement, with regular travel to the
other sites. My sponsor department, the Capacity and Site Directorate, was
headquartered at the RIE.
Director of Delivery, was my initial work placement sponsor
with line management provided by Service Manager of the
Capacity and Site Team (CST). A detailed description of NHS Lothian is
provided in Section Two of the Work Placement Portfolio.
2.0 Workplace Experience Description
The work provided for me by the CST ranged from data collection and
analysis to policy formulation and drafting. I worked closely with
on a daily basis, from which we formed a close working relationship.
I also worked with other senior managers within NHSL due to the strategic
nature of the CST, and this provided me with exposure to all areas of the
business.
This work placement opportunity provided me with many varied projects1;
with two of these significant events described in further detail below.
1 Please refer to the Learning Objective Statement
- 2 -

2.1 Event 01: The Discharge Lounge Service
The first major piece of work I contributed to was a comprehensive review of
the Discharge Lounge Service2. This involved:
• Data collection (staff interviews, patient audit, and statistics);
• Liaison with staff (managers and shop-floor); and
• Report writing with recommendations and ways forward.
The idea behind the work was to increase the use of this service to improve
patient discharge from the hospital, which would aid the legally binding:
• 4-hour emergency access target for the A&E department; and
• 18 week referral to treatment (RTT) targets.
Although I authored this piece on my own, the Discharge Lounge Manager
( helped significantly with background knowledge and future
ideas. This developed a close bond between us which would prove useful for
future projects and work in general. As the operational manager
was very supportive of my ideas and plans, however the strategic manager,
was less enamoured.
This caused some friction between us but I worked in professional manner
to ameliorate this. Fortunately was a strong advocate for me and this
also helped to get past barriers with . It could be extremely difficult,
and frustrating, at times to get Paul to see ‘reason’ on certain matters –
significantly testing my diplomatic skills.
In January 2010 left NHSL and became the
strategic manager for this service. After an update and review,
bestowed and I carte blanche with regards to re-designing the
Discharge Lounge Service.
As this was the first piece of work I performed and at the start of the work
placement, I needed to build my credibility within NHSL in order to achieve
my objectives. I also used the initial interviews to gain a general
understanding of the organisation and the perception of staff, which differed
from the management cadre.
Understanding the perceptions of staff, managers and gaining an insightful
perspective on the organisation enabled me to tailor and realise appropriate
service re-design goals that would be sustainable and realistic.
Using this approach, in all my projects, enabled to me quickly gain the trust
and respect of my colleagues in NHSL, leading to further opportunities and
other networking events.
2 Learning Objective Statement, page 03
- 3 -

2.2 Event 2: NHS Lothian Discharge Policy
In November 2009 I was asked by if I wished to collaborate on
another piece of work3. Policy formulation and writing is an important skill
for senior managers, and I envisaged that this project would provide me with
skills and experience crucial to the future jobs market.
In short this policy was looking at how, when and where patients should be
discharged to, ensuring it was carried out in a consistent, dignified and
timeous manner.
Initial agreement was to look at the various discharge pathways used by
each area, such as:
• Which staff members were involved in the discharge, and their role;
• Patient involvement in their own discharge, including relatives and
carers;
• Purpose and perception of discharge by staff and patients (through
interviews and audit)
• Identifying best practice and differences in practice
It was decided to form a committee of appropriate staff to aid the formulation
of the policy and provide expert advice and opinion relevant to their area.
The idea was to meet monthly to discuss ideas and update the group on
progress to date.
However, this would prove to be problematic. Initially members appeared
enthusiastic but after the first two sessions we found that different
representatives would attend. Although we sent out information prior to the
meetings, reps would invariably not read these or were last minute
replacements. As a result everyone would need to be re-briefed on progress
reducing the value of the meeting. Also, different team members (of the
same team) would present different departmental aspirations – group and
individual consensus was often difficult to obtain.
What at first (to me) appeared to be straight forward quickly became a
Sisyphean task. The sheer number staff who wanted ‘their say’ became
inflated and it was decided to cease the monthly meetings in order to move
the project forward.
As a result we progressed quickly to a final draft which was promulgated for
consultation with relevant staff members. After amendments, the policy was
presented to the Clinical Policy Group (they oversee all new policies and
procedures in NHSL). This was the policy situation when my work
placement came to an end.
3 Learning Objective Statement, page 10
- 4 -

3.0 Evaluation
3.1 What Did I Get Out Of It?
After 16 years in the Army it was beneficial to bestow my CV with
commercial knowledge and practice. It can be difficult to illustrate military
workplace experiences and this work placement has provided prospective
employers with an identifiable benchmark. Appendix A provides an
illustration of the skills development achieved throughout this work
placement.
I have further developed my influencing and negotiation skills, which were in
considerable use throughout the work placement. Although the NHS works
in a collaborative manner, it has many ‘departments’ and this can make co-
ordination and communication problematic. Having effective organisation
and time management skills was extremely important in order to facilitate
work commitments and meetings.
Not withstanding patient safety, compromise was a watch word during my
time at NHSL. This is where effective negotiation with, and influencing of,
managers and staff became crucial. As a student within NHSL I had no
authority to compel or push ideas through, and so, I realised very quickly
that in order to ‘get things done’ I would need to understand the key
personalities and groups so that I could achieve, or at least in part achieve,
my objectives.
As a result of my networking, and close working with several senior
managers, I was subsequently asked to help on projects I otherwise would
not have had access to, or been asked to partake in.
3.2 How Does It Link In With The Degree?
There were several elements of my degree course that proved helpful or
crucial in my time with NHSL.
Practical use of the Quantitative Business Modelling (QBM) module helped
me work through the Predictor Model project4; I probably would have
struggled to complete this project without this prior knowledge. Essay and
exam writing aided me in the preparation and drafting of reports and
policies. Understanding of the question (problem), identifying the problem
and finding information (interviews and data collection), drafting and
developing the main body of the report, and identifying recommendations
(viable solutions) where integral to achieving these objectives.
Although I have previous presentation experience, the presentations
required in years one and two (at university) would have laid a solid
foundation for the presentations within the work placement year. Coherent,
planned and well-produced presentations are crucial for the effective
transfer of knowledge and information in a timely manner – especially in
time sensitive environments.
4 Appendices 15 to 18 and Learning Objective Statement page 6.
- 5 -

The team-working elements of the coursework and seminars, in year two,
also helped; in my time with NHSL I was required to work with a multitude
of different internal and external individuals and groups. I believe it is
important for future employees to identify that team-working is not just
about face-to-face interactions. For example, some elements of my projects
involved contact with team members via email only. Therefore, the careful
construction and drafting of emails (either queries or responses) should be
considered given the possibility for misinterpretation or misconstruing of
meaning. This can obviously impact on working relationships and the work
produced.
Some people believe the Army is very autocratic and involves a lot of
shouting, and on occasion this would be correct. However, there are many
occasions where the Army is democratic and very supportive – more so than
public and private entities. It was interesting to see how similar, and
exceedingly dissimilar, the NHS and the Army were at times.
The managing people at work module provided useful insights into some of
the aspects of NHS management and potential ways to ameliorate them.
Managers and staff were surprised when I mentioned the above. For
example, the NHS is very hierarchal just like the Army and staff always have
an eye on the next promotion, again like the Army. Therefore staff can rise
very quickly without the experience to back it up and, in some cases, it
shows.
NHS ‘committee’ meetings can also be quite arduous to attend as there is too
much debating, occasionally to little debating, and not enough action – it
was not unusual to have 2 or 3 meetings on the same thing without actually
moving forward. In contrast, the Army would meet, discuss, decide and then
act, reporting back only to update or notify of changes.
When I chaired meetings I kept to stringent meeting criteria, allowing staff to
put forward their views without monopolising time and achieving actions to
complete for the next meeting. With other individuals it could be difficult to
see where the meeting was going or time would be consumed debating issues
not overly relevant to the purpose of the meeting.
I obviously have experience of structured meetings from my Army career and
realise the importance of a structured versus unstructured meeting – i.e. the
effect on flow and outcomes. If I did not have this prior experience my
meetings may have been different and some preparation work during years
one and two at university may assist other students to ensure they are
effective in this important, but often overlooked, area.
- 6 -

3.3 Career Aspirations
My original career aspiration when joining this degree programme envisaged
the field of Human Resources (HR). With the then jobs market in mind, I
‘chose’ a work placement in the NHS because I believed this would provide
me with a rounded and challenging twelve months; a well founded belief.
I would still like to take a career in HR, within the NHS, as they also provide
candidates with Masters level qualifications; one of my future objectives.
This is a contributing reason, given the cost, but not the sole reason. A
career in the NHS would be rewarding but very challenging, especially given
the recent announcements regarding funding streams. HR would be at the
heart of any organisational change and/or development, and effective
communication and negotiation skills would be required to facilitate this.
3.4 Positive Points to Note
The work placement provided me with a variety of projects to work on and as
a consequence I developed my skills and experience. The work I was given
had real value to the organisation and contributed to savings and improved
service. Once I had proved myself, there was an expectation by my
managers that I would ‘get the job done’.
Although staff mentioned that they were open to new ways of working
and/or new ideas, it could be quite a challenge to convince said staff of
looking at problem/issues in a different manner and alternative solutions.
Again, once I had ‘proved’ myself to staff – it was not unusual to have to
convince each individual group involved in a project – it became somewhat
easier to put forward alternative ideas/solutions without being shouted
down.
Having worked in managerial positions in the Army and being involved in
projects, I already had a foundation for my work placement. Once my line-
manager gauged my work/skill set she managed me at arm’s length.
Although I prefer to work autonomously, it was nice that had the
confidence to allow me to do this. NHSL also had the confidence to let me
visit other organisations unescorted and I vouched to repay this confidence
with high quality work.
NHSL has also stated that they would be prepared to accommodate future
work placement students as a result of the positive experience during my
placement.
- 7 -

3.5 Problem Areas That Arose
Like any other job there are ups and downs. Fortunately I mainly had ups
but certain personalities were obdurate with everyone not just me. In these
instances the professionalism gauge was tweaked up. I always had in the
back of my mind, in difficult or potentially difficult situations, that I was
representing NHSL and not myself. Therefore, I should move forward in a
professional and somewhat conciliatory manner.
One particular manager could be very obdurate and tested my diplomacy
and tact on several occasions. This manager’s words contradicted their
actions and personal motivations were difficult to identify. Co-operation was
one-sided and innovative means were needed in order to bypass these
artificial barriers.
I am a proponent of the 6 P’s (Prior Preparation and Planning Prevents Poor
Performance) and this is an artefact of my military career. However, my line-
manager did not, in the main, follow this tenet. As a result in several
meetings my line-manager was presented with ‘new’ information on the day,
which had been disseminated days prior.
This often reflected on me and I felt embarrassed and annoyed. I
diplomatically approached my line-manager in our weekly one-to-one
meetings about the relevance of meeting up five minutes before meetings to
discuss the agenda and revisit important elements.
This was agreed but fell by the wayside at the first hurdle and subsequently
I responded by ‘stage managing’ future meetings to ameliorate this dilemma.
Currently business research methods (BRM) is taught to students during
their fourth year, mainly for the purposes of their dissertation. Most of my
work with NHSL involved data collection (primary and secondary) and some
knowledge of BRM prior to the work placement, I believe, would aid
students. Again my previous career provided me with the BRM skills
required during this work placement but most students may not have this
luxury.
- 8 -

4.0 Summary
I can say with conviction that I enjoyed and benefited from my time with
NHSL, I developed new skills and further refined existing ones.
The NHS is a difficult environment due to push/pull factors from a plethora
of groups, organisations and government. For me, this provided a
challenging and exciting work environment with a variety of demanding and
diverse projects.
University modules provided me with the foundation skills required for the
various projects I was engaged in. I was also provided with the opportunity
to further develop existing skills. The work placement has provided me with
real skills and experience which will be useful when applying for jobs in the
near future – the main reason for applying to Glasgow Caledonian
University.
Compromise is something everyone has to do at some stage in their lives
and, naturally, impacts upon the NHS. The development of influencing and
negotiating skills is required for a successful career in the NHS so that one
knows when to compromise and by how much; without diluting your
objectives too much.
Overall this was a successful and very useful twelve months, helping to
achieve the aims I set myself when first applying for the business studies
course.
- 9 -

5.0 Appendices
Appendix A
SKILLS DEVELOPMENT DURING WORK PLACEMENT
• Relationship building: creating positive relationships, first impressions,
personality traits, initiating dialogue, building rapport, credibility and trust and
barriers to effective self-presentation
• Information gathering and collection: primary and secondary sources
• Interviewing: structured, semi-structured, telephone and email, information
required, question base, purpose and length
• Meetings: agenda, purpose, length, who to invite, how to invite, minute taking
and trouble shooting
• Influencing:
• Negotiating: Negotiation is a method by which people settle differences. It is a
process by which compromise or agreement is reached while avoiding argument.
• Verbal communications: one-to-one, telephone, group and presentations and
cross cultural communication
• Written communications: letter, email, report, leaflets, posters and cross
cultural communication
• Report writing: presentation, language, diagrams and pictures, data analysis,
summary, introduction, main theme, logical flow and recommendations
• Presentation: using PowerPoint, Word, blackboard, flipcharts and other visual
devices
• Data analysis: data to gather, how to gather, source, relevance, interpretation of
results and presentation of results
• Group working: listening to others, team roles, group dynamics, conflicts,
collaboration, purpose of team and social skills
• Listening to others: tone, pitch, wording, body language and understanding
other viewpoints. A good listener will listen not only to what is being said, but to
what is left unsaid or only partially said. Listening involves observing body
language and noticing inconsistencies between verbal and non-verbal messages.
• Assertiveness: passive and aggressive and purpose
• Confidentiality: patients, data protection and co-workers
• Problem solving: identify problem, why problem, solutions, all information
available and other options
• Decision-making: decision making is the act of choosing between two or more
courses of action
• Reflection: what did you do and what could you do differently
• Interpersonal: Interpersonal communication is the process by which people
exchange information, feelings and meaning through verbal and non-verbal
messages.
• Time management: workload, diary management, smart objectives, self-
motivation, time-wasting, prioritising, action planning, travel to different sites
and personal effectiveness
• Emotional intelligence: empathy, responding to others and understanding other
viewpoints
• Managing change: why change, who does it affect, implementing change,
sustaining change, project management and identifying show stoppers
• Information technology (IT): Microsoft packages and in-house software
• Receiving feedback: line-manager, colleagues, workshop attendees,
interviewees, other organisations, policy groups & review boards
• Budget control: understanding financial governance, finance sources and
allocations
- 10 -

Work Placement Portfolio

More Related Content

What's hot

Viewers also liked

Similar to Work Placement Portfolio

Work Placement Portfolio