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Case Study – ‘Newlands’
Newlands is a hospital in the middle of Ireland and has always held the reputation
for being one of the most innovative and advanced in the field of mental health
and community health.
Key facts:
? The hospital itself employs 867 staff, and also has seven residential
establishments which employ a further 184 staff.
? While the hospital deals with acute care medical cases, the residential homes
provide care for up to 86 elderly patients and social care services back in the
community or approximately 300,000 patients across a large geographical
area.
? Newlands has a long standing reputation in the community and offers great
opportunities to provide an extensive range of excellent health and social
care services designed to meet users’ needs, both now and in the future.
There are plans for changes to the way health and social care is organised, and
therefore Newlands needs to review and improve its working practices, procedures
and policies to ensure that it is able to retain its independent status.
This, however, is in doubt and many of its staff have become very used to their own
ways of doing things and are reluctant to change their behaviour. If this is not
addressed, it could be its downfall unless all roles are reviewed and adapted to
meet the changing demands.
In addition to this, the Regional Health Board (RHB) recently introduced a
requirement for all administrators to attain a new level 4 qualification in office
administration by the end of 2016. This is to better support the clinicians and
managers in their busy roles and also to raise the standard of professionalism
amongst all administrative staff. Raising professional standards in quality, cost and
time management are essential elements for running a cost effective service whilst
also building patient confidence in the range of health and social care provided.
RHB have also issued targets for reducing patient complaints and to ensure that
those received are brought to completion within 30 days.
Newlands has made a commitment to raising the standard of professionalism
amongst its entire workforce, including the clinical and managerial staff, and as
such Newlands CEO and Executive Board wants the HR department to start
delivering a series of professional training courses on a wide range of subjects to
further support this message.
Internally, there is already a huge online library of information available to staff on
the hospital intranet. This includes all the hospital policies and procedural
documents, minutes from meetings and Board reports.
The quantity of information is extensive, however, the resource is poorly used and
many clinicians and managers cite lack of time to use these as well as they might.
© 2015-16 http://jfi.training | Strictly Confidential – not for distribution
Appraisal and personal development courses are run within the hospital but not in
the residential homes, however, attendance is low and take up of the appraisals
themselves by managers is very poor. In 2015 Newlands carried out a review of their
appraisal processes, and discovered that:
? Only 15% of staff had been offered an appraisal during 2014/2015
? Inconsistent approaches by managers and clinicians towards appraisal with
some senior clinical staff receiving this but junior staff being ignored
? Concerns about the high level of absence and sickness amongst the
managers
? Staff lacked a true understanding of how they were being supported and
developed in their roles and many said they didn’t see their managers on a
regular basis
At present there is no formal system for monitoring appraisal or for managing support
to managers and clinicians therefore, to improve the take up, a new policy has
been developed by HR and sent round to all for reading and compliance. The
target is to increase the current number of appraisals being undertaken by 60%
within the next 12 months.
In April, a new Clinical Director came into post and promptly started to review the
approach to clinical development alongside introducing a new competency matrix
aligned to the expected performance and skill levels of the clinicians.
A key issue highlighted by his initial scoping was the lack of a structured career
progression as often when reaching the top of their professional area, clinicians are
moved into a managerial role resulting in less clinical time and more managerial
admin time (80/20) – many resent this shift and Newlands are starting to lose good
people externally to other parts of the healthcare system.
This conclusion was supported by both poor scores (and poor returns) on the annual
‘Reaching Your Potential’ employee satisfaction survey, and perceived lack of
fairness around existing development opportunities for clinicians, managers and
other administrative staff.
The Clinical Director feels that career management needs to be more structured
and transparent, and would be perceived more positively if it could be brought to
life as part of a whole coaching culture aligned to career development. He would
like to put in place a training course that better identified and developed staff
(clinical and non-clinical).
The CEO and the Board would like to better safeguard the future of Newlands and
its independent status; however they recognise there is much to be done and
unclear about where to start to make quality improvements and change.
The board asks you to make some recommendations about
how learning and development could improve the qual i ty of
thei r processes and encourage the demotivated workforce
to bet ter embrace the changes that are coming. You need
to suppor t your recommendations wi th academic reading
and ci tations to give your suggestions some strength.