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V1.9 Final 23.8.13 PF 1

CONSULTATION DOCUMENT – MANAGEMENT, NURSING AND

ADMINISTRATIVE WORKFORCE EFFICIENCY

27 AUGUST 2013

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CONSULTATION DOCUMENT – MANAGEMENT, NURSING AND ADMINISTRATIVE WORKFORCE EFFICIENCY

Contents List

Page No.

1. Introduction 3 2. Proposals 4 3. Rationale 6 4. Proposed Changes and Impact on Staff 9

4.10 Table of Proposed Establishment Changes 14 5. Process for Filling Posts 15 6. Summary of Points for Consultation 16 7. Method of Calculating Redundancy 16 8. Consultation Process and Timeline 17

Appendices 1: Summary of PwC Benchmarking Work 19 2: Summary of McKinsey Benchmarking Work 20 3: Healthcare Support Worker Job Description B2 21 4: Senior Healthcare Support Worker Job Description B3 32 5: ECAM ‘As Is’ Management Structure 44 6: ECAM ‘To Be’ Management Structure 46 7: W&C ‘As Is’ Management Structure 48 8: W&C ‘To Be’ Management Structure 49 9: Surgery ‘As Is’ Management Structure 50 10: Surgery ‘To be’ Management Structure 52 11: Cancer ‘As Is’ Management Structure 54 11a Cardio ‘As Is’ Management Structure 55 12 Cancer/Cardio ‘To be’ Management Structure 56 13 I & I Admin Structure ‘As Is’ 59 14 I & I Admin Structure ‘To Be’ 60 15 Receptionist B2 Job Description 62 16 Senior Receptionist B3 Job Description 67 17 Patient Care Co-ordinator B4 Job Description 72 18 Senior Nurse B8b Job Description 78 19 Governance B7 Job description 86 20 Service Manager Job description 99 21 Change Management Policy 100 22 Band 6 Ward Nurse Job Description 124 23 Band 8C Head of Service Job Description 125 24 Band 8C Head of Midwifery Job Description 126 25Equality Impact Analysis 127 26 Employee Assistance Programme from CiC 140 27 Band 6 Senior Staff Nurse Job Description 141 28 Clinical Site Management Revised Structure Chart 154

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CONSULTATION DOCUMENT – MANAGEMENT, NURSING AND ADMINISTRATIVE WORKFORCE EFFICIENCY PROPOSED CHANGES TO WORKFORCE STRUCTURES ACROSS THE TRUST TO IMPROVE EFFICIENCY AND SUPPORT FINANCIAL EFFECTIVENESS 1. INTRODUCTION 1.1 The NHS must provide the best possible care to its patients and as such

needs to change to meet altered needs and advances in practice, technologies and facilities. At Barts Health NHS Trust every department must continuously review its structures and processes to maintain a skilled, adaptable and efficient workforce that is able to deliver excellent clinical and non-clinical services and fulfil the Trust’s commitment to research and education.

1.2 We are in the business of providing high-quality safe care and just like all

businesses, whether in the public or private sector, we need to be a financially stable organisation.

1.3 The Trust Board is clear that our mission is to change lives in east London

through delivering excellent healthcare, reducing health inequalities and improving health in our local populations. It is equally as clear that we will stay true to the values that the board and the organisation have committed to and that there is no room for deviation from our mission or our values.

1.4 The Trust recently launched it’s ‘#becausewecare’ campaign, which is a call

to action for all staff to commit to improving compassionate care and improving patient experience. There are 13 key areas, of which 3 have been prioritised:

the environment and cleanliness;

welcoming and listening to patient and staff feedback;

ensuring everyone matters through team meetings, appraisals and supervision.

Our teams will work together to agree actions, monitor progress and provide evidence.

1.5 A significant piece of workforce configuration has been underway for some time, which will lead to a re-shaping of the management, nursing and administrative & clerical workforces, to better align our workforce structure to that of comparable peers. We are now in a position to consult on this work.

1.6 Due to the size of Barts Health, the proposed changes represent a substantial

change project involving staff across the whole organisation. A pre-consultation meeting between Michael Pantlin, Director of HR & OD, Len Richards, Chief Operating Officer and members of the recognised trade unions/staff side took place on 16th August 2013 as part of the pre-consultation process.

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1.7 When we merged as an organisation, we went through a consultation process

with corporate departments to standardise the service across the legacy sites. We now need to establish consistency across our clinical areas so that we have the same commonly applied standards.

2. PROPOSALS 2.1 This paper outlines proposed changes to workforce structures across the

organisation in management, nursing and administrative staff groups. 2.2 There are a number of benefits to the Nursing models proposed in this

consultation exercise:

the ‘Safe Staffing Alliance’ study and recommendations regarding safety on wards found that patient safety is compromised at a ratio of Registered Nurse to patient of 1:8 and therefore Barts Health has chosen to staff at a 1:7 average ratio across non specialist adult areas;

the RCN (2012) Guidance on safe nurse staffing levels in the UK recommended a registered to unregistered ratio of 65:35 and we will continue to remain slightly above this ratio; the acuity and speciality of areas have been taken into consideration, for example children’s wards, to comply 2013 RCN guidance for children and young people’s nursing;

more supervisory time for band 7s will be facilitated as part of this staffing model;

a flatter hierarchy between Chief Nurse and Ward Manager will be delivered, which will enhance clarification of roles and accountability;

the logistics of each Ward have been recognised in the staffing lay-out proposed;

Since the merger, nursing establishments beneath band 7 have not been reviewed so we have inherited three legacy staffing structures and this review gives us the opportunity to ensure a consistent approach;

we are addressing unacceptably low staffing levels in some wards;

we are using benchmarking work from PwC and McKinsey to deliver more effective staffing models;

we have an opportunity to invest in some areas such as older peoples services and surgery;

we can define the band 6 ward role1 - deputy to Ward Sister/Charge Nurse and a position with a quality focus;

we can establish site based senior leaders, allowing for increased visible clinical leadership.

2.3 In summary the proposals are:

To review the tier 2 and 3 structure2 across the Women’s and Children’s Health, ECAM, Surgery, Cardiac and Cancer CAGs. The review includes the roles of Heads of Nursing/Midwifery and Matrons, General Managers, Service Managers and Service Delivery Manager. Proposals include

1 See appendix 27 for revised job description 2 See appendices 6 to 12 for the ‘as is’ and ‘to be’ structure charts

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increasing the span of control of management posts within CAGs and delivering a headcount reduction and cost improvement across each CAG (see table below for scope);

In Women’s & Children’s Health and Cancer & Cardio CAGs, to review the Governance team which will allow Governance to be closely aligned with the Tier 2 and 3 clinical teams;

To implement the ward based nursing review, following work from McKinsey and PwC on benchmarking3;

To propose combining the role of Deputy Group Director and the role of Director of Midwifery in the Women’s and Children’s Health, thus removing one post;

To review the arrangements for site management across the Trust to ensure consistency, but tailored locally for optimum performance and efficiency;

To review the administrative and clerical grades in Cancer & Cardio, Community Health Services (CHS), Health Records, Women’s and Children’s Health and the Emergency Department and Immunisation and Infectious Diseases (I&I) department (ECAM);

To review the circa 600 non-ward based nursing posts across the Trust;

To review all vacancies within the Trust to see whether it is essential that these roles are filled or not.

2.3 It is currently estimated that approximately 323.14 whole time equivalent posts will be removed from the Barts Health establishment overall. There will be increases in establishment at some levels. The number of staff affected will be higher than this, as it is an overall figure which doesn’t take into account which CAG or department the post sits in, what pay band it is and which staff group.

2.4 It is important to note that the CAGs, services and posts that are noted as ‘out

of scope’ are all subject to separate review processes. Where appropriate CAGs will work together to ensure consistent principles are applied to these review s. For example, Surgery, ECAM and CSS are applying consistent principles to the review of services that provide a cross Trust/CAG function i.e. Theatres, Critical Care, Emergency Department, Diagnostics. The Director of CHS also intends to adopt consistent principles in reviewing the management structure of the service. Midwifery Matrons (Band 8a & 8b) are subject to a consultation that has already commenced in Maternity Services.

2.5 New job descriptions for band 2 and 3 ward based nursing posts have been

evaluated and are attached at appendices 3 and 4. 2.6 The changes, if approved, will be implemented in accordance with the Trust’s

Managing Change Policy unless agreed otherwise with staff side. It is the Trust’s intention to achieve the above changes without redundancies but in any programme of substantial change, there is a risk of redundancy. Because the Trust is so large, we have triggered a 45 day consultation and will,

3 A summary of this work is at appendices 1 and 2

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wherever possible, seek to effect the changes through re-deployment and removal of vacancies.

2.7 Given the large scale change that the Trust faces, management teams will be exploring opportunities to deploy staff flexibly to meet fluctuations in healthcare activity across the trust’s sites. Where wards/services are over staffed against activity at a particular site, managers will be looking to flexibly deploy staff resources to areas where they are under staffed in order to ensure appropriate cover without incurring additional bank and agency costs.

In Scope Out of Scope Ward based nursing & support

Non Ward based nursing

CHS Admin and Clerical

Women’s and Children’s Health Admin and Clerical

Women’s and Children’s Health senior management

Women’s and Children’s Health Governance Team

Cancer & Cardio Governance Team

Cancer & Cardio Admin and Clerical

Immunology and Infectious Diseases Admin and Clerical

Health Records

Emergency Department Admin and Clerical

Clinical Site management

Medical Productivity Programme

Trust-wide Admin and Clerical review

CAGs: Women’s & Children’s Health (WCH)

ECAM

Surgery

Cardiac

Cancer

CAGs: Clinical Support Services (CSS)

Community Health Services (CHS) – Clinical and management

Emergency Department nursing

Tier 2 and 3 posts including:- General Managers (Band 8c)

Heads of Nursing/Midwifery (Band 8c)

Matrons (Band 8a)

Service Managers (Band 8a)

Service Delivery Managers (Band 7)

The following Tier 2 & 3 posts are excluded and subject to separate review

Midwifery Matrons (8b and 8a)

General Managers, Service Managers and Service Delivery Managers in the Emergency & Acute Medicine CAG (ECAM)

Tier 2 & 3 in Theatres (Surgery)

Tier 2 & 3 in Critical Care (Surgery)

3. RATIONALE 3.1 The Trust has worked with PwC and McKinsey to benchmark against relevant

and comparable NHS providers. This comparison has shown differences in our skill mix and gaps between us and our peers as follows:

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in bands 2 & 3 and 5 & 6 in ward based nursing (leading to a high nursing cost per bed);

in the senior nurse structure (higher proportion of band 7 and above nurses);

in the proportion of registered nurses;

in the proportion of patients per nurse;

in the proportion of administrative and clerical posts in the Trust;

In all staff groups except medical and dental, relative to the peers, Barts appears to have a higher proportion of senior staff.

3.2 There are opportunities to:

reduce the cost of ward-based nursing whilst maintaining the quality and safety of our services by changing the skill mix in terms of both bandings and ratio of registered and unregistered nurses. The Trust has been working on this for some months to ascertain the optimum skill mix;

apply an average ratio of 1:7 registered nurse to patient in non-specialist adult areas (see paragraph 4.1);

retain some specialist band 3 Healthcare Support Worker roles to ensure some career progression opportunities;

reduce administrative costs by reviewing the proportion of admin posts;

reduce both nurse management and general management costs by revising the management structure in the Clinical Academic Groups (CAGs) across the Trust at tiers 2 and 3;

review Site management arrangements with a view to making the service more effective4.

3.3 A bottom-up assessment of nurse productivity staffing ratios and costs on

each ward across the Trust was undertaken by the Directors of Nursing within each CAG. This analysis was compared against the case-mix adjusted benchmarking undertaken by PwC against the peer group, and assessed against Royal College of Nursing guidelines and professional principles established by the Professional Council and recommended to the Trust Board. The Nursing Quality and Productivity Benchmarking Programme with McKinsey was launched by NHS London in 2012 and provides very similar results to that of the PwC benchmarking. A range of scenarios were modelled and the Trust Executive established a preferred implementation scenario which is described in section 4.1 of this paper.

3.4 The CAG leadership teams have reviewed Tier 2 and 3 posts across

Women’s and Children’s Health, ECAM, Surgery, Cardiac and Cancer CAGs with a view to increasing the span of control of management posts, ensuring

consistent principles across CAGs and delivering a headcount reduction and

cost improvement. The review will ensure CAG management structures support a sustainable model of service delivery and create the capacity & capability to consistently deliver Trust priorities. The new CAG structures will bring front line service delivery closer to the CAG Tier 1 management teams

4 A revised structure chart is provided at appendix 28

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ensuring that we create a stronger clinical leadership structure that supports a patient centred culture, openness, transparency and compassion. By bringing the CAG leadership teams closer to the front line we aim to improve our ability to listen to and learn from our patients and our staff. Benchmarking from PwC demonstrates that against a peer group of NHS providers, the Trust has a proportionately higher number of staff in the higher pay bands.

3.5 The proposals also include changes to the Governance Team who support

the Children’s Health and Neonatal Service lines and the Cancer & Cardio service lines. As the new CAG management structure will allow for governance to be closely integrated with the Tier 2/3 clinical teams, the requirement for a separate governance team will be diminished. This change will enable the CAGs to fully implement the recommendations of the Francis review in listening to the concerns of patients, carers and families and placing quality improvement at the heart of care delivery.

The new senior nurse structure for the CAG permits capacity for governance responsibility within the clinical teams. The new Band 8b senior nurse role will inherently carry greater governance responsibility.

The appointment of a Director of Nursing and Governance formally places accountability for governance within Tier 1

The appointment into the posts described above reduces the requirement for a band 8a governance role within the CAG

The integration of governance into clinical teams will ensure that patient safety and quality issues are identified at source and that these are addressed in a timely manner. Engagement in this process from clinical teams has been inconsistent leading to a backlog of overdue SI investigations and overdue complaints.

The Francis report has outlined the importance of listening to patient feedback and acting upon this, with evidence to demonstrate the commitment to service improvement. The current structure whereby governance is placed outside the clinical team does not encourage the integration of quality and safety improvement with clinical care.

3.6 Women’s and Children’s Health have also reviewed their Tier 1 management

structure and propose to amalgamate the roles & responsibilities of Group Deputy Director and Director of Nursing, Midwifery & Governance. This will provide consistency with the structures of other CAGs and ensure that accountability and responsibility for professional nursing, midwifery and governance are vested in one role rather than split across two.

3.7 Theatre Band 6 establishments were reviewed earlier this year due to

differences in establishments across the sites – two of the sites had considerably higher establishments of Band 6 staff. A review was therefore completed with the Matrons to establish what level of B6 cover was necessary. The review has provided an equitable approach in terms of staffing ratios towards ensuring a more consistent establishment. As some sites have higher establishments of Band 6’s, it may therefore be necessary to move staff to

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achieve consistency and to ensure appropriate and safe levels of staff at all sites.

4. PROPOSED CHANGES AND IMPACT ON STAFF 4.1. Following a review of the information presented by PwC and a discussion of

the various options, it was agreed by the Trust Executive to operate a Registered Nurse: Patient ratio of 1:7 for non-specialist adult nursing in 2013/14, as an average across the organisation. This means that there will be some wards and departments that are above and some below, appropriate to the care they provide, and each CAG should work to maintain this ratio as an average. The PwC work also reviewed the skill mix of the nursing staff group and indicated a higher than average proportion of band 6 and band 3 nursing staff. It is important that the staffing models are cost effective and deliver the right band of staff for the work required.

Nursing and Management

4.2. The Clinical Academic Groups (CAGs) have developed plans at ward, service and department level to deliver the following: Reduction of band 3 Healthcare Assistant posts and a growth of Band 2 posts;

Reduction of band 6 registered Nurse posts and a growth of Band 5 posts;

Implementation of a ratio of 1:7 nurse as described above;

Reduction in the number of Administrative and Clerical posts;

Removal of Heads of Nursing ( band 8C) and Matron (band 8A) posts, to be replaced by a new Senior Nurse role, band 8B – see appendix 18 for job description and appendices 6 to 12 for the structure charts;

Implementation of Head of Services roles, band 8C, in ECAM and Surgery CAGs and Head of Midwifery band 8C in Women’s and Children’s CAG - see appendices 6 to 12 for structure charts;

Reduction in non-ward based nursing posts. 4.3 The site management review covers clinical site management and Hospital. at

Night at Whipps Cross, Newham General, Royal London and Barts sites. In order to ensure consistency, staff members will be required to work on all sites within Barts Health, although they will have a natural base. Some sites have more than one 8A site manager on duty at a time; this will not be the case in the future. On the two larger sites, the role of Band 5 floor co-ordinator covering one or more specialties has been trialled and is considered a success and this will be expanded by adding a further band 5 to each site. Some sites have had Band 4 and 3 staff in the teams. This has been reviewed and they have been removed in preference for a different skill mix.

4.4 In addition, consistent grades will be applied to General Managers (band 8C),

Service Managers (band 8A) and Service Delivery Managers (band 7) across all CAGs.

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4.5 This will enable the Trust to deliver cost effective patient services, in line with our peers, and should protect those services from the effects of financial deficit.

4.6 At a Trust-wide level, the impact on staff will be as follows:

a) The removal of vacant posts where appropriate; b) Band 3 nursing posts removed (although some specialist posts will remain at band 3 level) and incumbent staff redeployed to band 2 posts; c) Band 6 nursing posts reduced in number and incumbent staff redeployed to band 5 posts; d) Heads of Nursing posts and Matron posts removed, with the creation instead of Senior Nurse posts at Band 8b and Heads of Service in ECAM and Surgery at band 8c; these band 8B and 8c posts to be filled and unsuccessful staff to be redeployed elsewhere in the Trust; e) Alignment of gradings across General Managers, Service Managers and Service Delivery Managers; f) Combining of Deputy Group Director and Director of Nursing, Midwifery and Governance post in Women’s and Children’s CAG will mean that two post holders will be in competition for one post; g) Governance changes in Women’s & Children’s and Cancer & Cardio CAGs: The resource requirement to support these roles in the designated governance teams are changing and the bandings will also change. The impact on staff is that three individuals would be placed at risk.

4.7 Administrative and Clerical Reviews

ECAM 4.7.1 Infectious Diseases and Immunology (I&I) ECAM is proposing changes to the current provision within the Infectious Diseases and Immunology (I&I) Admin and Clerical (A&C) staffing group.

The proposed structure5 aims to consider the standardisation of administrative provision across all sites and ensure that all the clinical requirements of service provision are accommodated. The A&C groups within I&I fall into several different administrative functions and are as follows:

System Management (GUM/HIV – PreView standalone system)

Reception Services–including scheduling outpatient appointments

Medical Secretary/Typing

Scheduling of Inpatient/Day case Activity

Reception services The BLT legacy model of a Band 3 Reception Supervisor6 at each site will be implemented across all sites and all Band 2 Reception staff will be moved on to the BLT legacy Reception job description7. The structure also reflects the

5 See appendices 13 and 14 for ‘as is’ and ‘to be’ structure charts 6 See appendix 16 7 See appendix 17

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move to Electronic Patient Records (EPR) and implementation of a single patient system across all sites (PreView).

Medical Secretaries/Typing This service is currently provided across 3 sites using a variety of dictation methods. The legacy BLT sites and Newham have a similar staffing ratio in terms of Consultants/medical staff to Medical Secretaries; Whipps Cross has a significantly higher ratio of Medical Secretarial support to Consultant. The consultation aims to address this variance and standardise across all sites providing clinical typing. TH CASH has a Secretarial post which will be reviewed as part of this consultation as the service no longer generates clinical typing. However the post currently completes other appropriate administrative functions still required by the service. It is therefore proposed that the role will be reconfigured to reflect current duties.

At Newham no changes will be made to the establishment, however it is proposed that the existing post holder will be moved onto the generic job description for Patient Care Co-ordinator; Band 4.

At Whipps Cross the proposed establishment will be reduced to reflect the staffing levels at other sites. For example at Newham 1.0 WTE Medical Secretary provides clinical typing provision for 5 WTE Consultants. The current provision at Whipps is 1.89 WTE for 3.15 WTE Consultants. The proposed new establishment will be 1.0 WTE and the post will be moved onto the generic job description for Patient Pathway Co-ordinator; Band 4.

At TH CASH the proposed changes will slot across the existing Secretary to the generic job description for Patient Pathway Co-ordinator; Band 4. Currently this post completes minimal clinical typing and the post holder completes a range of administrative functions that are more accurately encompassed by the proposed job description, including the scheduling of in-patient and day case activity for the departments Termination of Pregnancy, Religious Circumcision and Young Person Services. This will include scheduling of Inpatient/Day case activity for the Grahame Hayton Unit and Ward 13F.

No changes are proposed to the Patient Care Co-ordinator roles at the Ambrose King, Grahame Hayton and Barts Sexual Health Centres.

Scheduling of Inpatient/Day case Activity To standardise the banding of members of staff providing this function the Patient Care Co-ordinator job description8 will be introduced. The current establishment is as follows 1.0 WTE Band 7 Service Manager, 1.0 WTE Band 6 Support Service Manger, 1.0 WTE Band 4 Secretary (as above) and NHSP (Temporary) 1.0 WTE Band 3 Administrative Assistant. The proposed structure will be 2.0 WTE Band 4 Patient Care Co-ordinator and 1.0 WTE Band 3 Administrator.

4.7.2 Community Health Services (CHS) The proposals for the administrative posts in CHS have been developed in the context of the strategic vision for CHS following the transfer from Tower

8 See appendix 16

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Hamlets PCT in supporting an integrated care approach and the challenges facing CHS services. The strategic vision includes ; improving the quality of our services in line with the Barts Health vision; improving productivity and efficiency; reducing costs; improving care pathways across our own organisation and supporting the emerging strategy and vision of Clinical Commissioners seeking increasing integration of Tower Hamlets Community Services. We have worked jointly with Tower Hamlets Clinical Commissioning Group in developing several proposals set out for services in the recent Management and Operational Services Consultation held during May and June 2013 and in part the proposals set out in this administration services consultation have been developed to support the implementation of those changes. Where possible these proposals have taken into consideration the requirements to improve our cost effectiveness. The current establishment of 94 WTE across Bands 2-7 will be reduced by 10.86 WTE.

4.7.3 Trust Health Records It is proposed that 6 vacant posts are removed from the band 2 layer in Health Records.

4.7.4 Women’s and Children’s Health The proposals are for administrative reshaping/resizing which will impact on the entire Women’s & Children CAG through implementation of a new administration service designed around the clinical needs of the CAG and services provided to patients. Women’s CAG has an enormous challenge of delivering £6m in efficiency savings this financial year. The challenge has provided an excellent opportunity for the CAG to improve its services, streamline processes and ensure standardised approach is operational across all its sites as well as optimising income via robust data capture and quality process/systems. It is expected that the Cost Improvement Plan (CIP) schemes would identify, put processes in place to deliver and achieve its target. Taking this into context, the A&C overall budget is required to deliver circa £115k full year effect through the repositioning of roles and reducing 12.7 WTE posts from the overall headcount in parts of the CAG A&C administration structure.

4.7.5 Emergency Department (ECAM) The Emergency Department (ED) in ECAM has reviewed its administrative and clerical structure in order to:

align the workforce into similar models across ED, given needs of service and pattern of patient;

align the banding of front line administration staff in the ED across Barts Health;

standardise rotas across sites, build in cross site working, develop a POD system and a uniform data collection process.

To effect this it is proposed to remove band 3 Receptionist posts at Whipps Cross and Newham and increase the band 2 Receptionist posts at both sites. A new band 3 team leader role will be created at Newham and there will be a slight reduction to the band 4 posts at Newham.

4.7.6 Cancer and Cardio

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PA Consultation – Cancer and Cardiovascular CAGs It is proposed that the PA support is no longer provided per CAG, but will mirror the structure of the tier 1 leadership team. It is proposed that a similar set up across the four other CAGs in the Trust, who are each supported by one PA, is applied.

To meet the needs of the role, the post holder will be required to work core hours of 9-5. Elements of flexibility will of course be maintained and expected on both sides to meet the needs of the role and individual ad hoc requests.

It is not anticipated that any redundancies will result from this change.

MDT Coordinator Consultation – Cancer CAG Cancer CAG is proposing making changes to the banding of the MDT coordinator role across Barts Health. The MDT coordinator is a pivotal role across all cancer specialties. It provides each speciality with the administrative support to ensure patient’s pathways are smooth and delays are identified and reduced. The MDT coordinator plays a key role in helping the Trust achieve the cancer access standards. Currently, there is not a consistent job description across all legacy sites, and it is proposed to create one agreed job description for the MDT Coordinator role. This Job Description will be rolled out to the existing staff in this role. It is proposed to make this a band 4 role, which will be no change to staff at Newham and Whipps Cross, but will mean a change in banding for staff at Barts, who carry out this role on a band 5 job description. The changes will ensure that all staff are working to the same job description and being remunerated consistently. This will result in pay protection being applied but it is not anticipated that any redundancies will result in this change.

4.8. There is a relatively high proportion of staff that are non-clinical, indicating

potential for greater savings to come from non-clinical support to corporate, clinical and other functions. Barts Health has approximately 7.5% more A&C staff than the comparator group and a Trust wide administrative and clerical review will be undertaken. Proposals for CHS, Health Records, Emergency Department and Women’s and Children’s CAG administrative and clerical post are included in this document, as outlined above. Further work is likely to come under a second wave of consultation proposals.

Pay Protection 4.9 Staff redeployed into posts at a lower band will be eligible for pay protection. Proposed Changes 4.10 The proposed changes to establishments and the effect on staff in post are

summarised in the table below. It should be noted that data has been provided by the CAGs and is subject to refinement over the course of the next week.

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Banding

Current Budgeted Establishment WTE

Proposed establishment WTE

Proposed Establishment minus Staff in Post

Staff in post

Proposed (Increase/decrease) in Establishment

Non Nursing 591.11 529.4 -10.88 540.28 -61.71

Band 2 246.23 272.92 55.36 217.56 26.69

Band 3 144.61 107.22 -32.62 139.84 -37.39

Band 4 88.98 69.72 -12.37 82.09 -19.26

Band 5 37 16 -19 35 -21

Band 6 15.8 17.4 1.6 15.8 1.6

Band 7 18.31 14.5 -2.81 17.31 -3.81

Band 8A 20.53 20.64 0.11 20.53 0.11

Band 8B 5.15 2 -1.15 3.15 -3.15

Band 8C 11 9 1 8 -2

Band 8D 1.5 0 -1 1 -1.5

Vacancies Unbanded

2 0 0 0 -2

Nursing 2809.07 2660.41 360.86 2299.55 -148.66

Band 2 293.25 497.9 241.66 256.24 204.65

Band 3 302.5 62.8 -209.98 272.78 -239.7

Band 4 50.69 26 -11.53 37.53 -24.69

Band 5 1168.52 1349.74 356.47 993.27 181.22

Band 6 724.37 514.2 23.01 491.19 -210.17

Band 7 174.93 165.77 5.24 160.53 -9.16

Band 8A 68.31 19 -46.51 65.51 -49.31

Band 8B 9 21 16 5 12

Band 8C 17.5 4 -13.5 17.5 -13.5

NWBN(Various Band)

497.76 384.99 -107.77 492.76 -112.77

Grand Total 3897.94 3574.8 242.21 3332.59 -323.14

5. PROCESS FOR FILLING POSTS 5.1 The general process for filling posts is described in the Change Management

policy. The policy does not describe the pooling arrangements when large numbers of staff are affected and therefore proposals for this are outlined below.

5.2 Selection pools are used to identify which staff are eligible for which posts.

Pools are proposed as follows:

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Nursing and Midwifery 5.3 Band 8A Matrons and Band 8C Heads of Nursing and other Band 8A to 8C

non-ward based Nurses will be pooled together across all sites and CAGs to be competitively selected for the new Band 8B Senior Nurse posts and 8C Heads of Service posts (the latter in ECAM and Surgery only). The rationale for this is:

o the Matron posts and the Heads of Nursing posts are being removed, to be replaced by the Senior Nurse posts and Head of Service posts (the latter in ECAM and Surgery only);

o some of the 8A Matrons are on protection from former 8B posts (as a result of the merger)

o it provides the non-ward based senior nurses with an opportunity to apply for the new posts

5.4 The site management team will be pooled together as this change relates to

consistency across the service rather than reduction of posts. 5.5 Non specialist band 6 Nurses will be pooled together across the CAGs. Band

6 Nurses in specialist areas (such as Paediatrics and Critical Care) will form separate specialist pools. Specialists at band 6 will be identified as either those that qualify on a specialist part of the register or those that require a post-graduate qualification.

5.6. Pooling is not deemed necessary for the Band 3 posts as the proposal is that

all would be appointed to Band 2 posts. Administrative and Clerical 5.7 Administrative and clerical staff will be pooled by service within the CAG.

Within that process, they will be pooled on job type and pay band. 5.8 The principles under-pinning the pooling described in this section will be

discussed with staff side as part of the consultation process. Managers at a local level will be tasked with defining the appropriate pools based on the principles established.

Appointment Process 5.9 The selection process will follow the general process outlined in the Managing

Change policy. 5.10 Due to the volume of band 6 Nurses, selection will be through an agreed

common group process. We are in discussion regarding the choice of group assessment or on-line testing and a proposal to include paper-based selection criteria covering absence records (excluding disability or pregnancy related absence), performance, skills and capability, disciplinary record and values and behaviours in relation to patient care (e.g. written evidence of compliments/thanks from patients, specific work on patient safety or

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experience, delivery of developments in patient care or nominations for awards including ‘Barts Health Heroes’ awards) is being considered.

5.11 Staff who are unsuccessful in securing a post in the revised structure will have

their skills and experience assessed for redeployment opportunities within the Trust, at any of the Trusts’ sites. They will be registered for redeployment and the redeployment process will be co-ordinated centrally through the Recruitment team to optimise access to vacancies across the organisation. Information on suitable external NHS vacancies will also be provided. Staff redeployed to a lower banded post will be eligible for pay protection.

5.12 The designated redeployment team will keep a register of vacancies to be

filled and a register of staff to be redeployed and will work with the CAG Service Managers (supported by CAG HR Managers) to match people to suitable posts.

5.13 The Trust is committed to avoiding redundancies as far as possible, but

cannot guarantee that they will not occur. We acknowledge that for the more senior or specialist posts, redeployment will provide more of a challenge but we are committed to working with neighbouring Trusts to maximise redeployment opportunities.

6. SUMMARY OF POINTS FOR CONSULTATION 6.1 This document describes proposed changes to establishments and proposes

new staffing models based on a review of volume and skill mix of posts across management, nursing and administrative services. It includes information on the background to the changes and principles for managing such change.

6.2 The paper specifically seeks to consult on:

o Revised staffing models as outlined in sections 3 and 4 of the paper; o Selection pools as outlined in section 5 of the paper; o The use of paper based selection criteria to support the common group

assessment process as outlined in section 5 of the paper. 7. METHOD OF CALCULATING REDUNDANCY PAYMENTS

Redundancy payments will be calculated in line with the Trust’s Managing Change Policy, which is in line with Section 16 of the Agenda for Change Terms and Conditions of Service Handbook. Other appropriate NHS policy and procedures will be used for staff not on an Agenda for Change contract.

8. CONSULTATION PROCESS AND TIMETABLE 8.1 We have listened to staff feedback about the cost of paper copies. Whilst a

paper copy of this document will be available to affected staff members from their line manager if requested, staff are encouraged to access it on the

V1.9 Final 23.8.13 PF 17

Trust’s intranet site at http://bartshealthintranet/About-Us/Corporate-Directorates/Human-Resources/Consultations/Index.aspx

Staff on long term leave, such as sickness, maternity and career breaks, will receive this information via the post, with an invitation to attend collective and one to one meetings.

8.2 A copy has also been given to the Chair of Staff side together with an

invitation to attend the scheduled open staff meetings. The meetings will be held to launch and close the consultation process and staff affected, Staff side Chair and local trade union representatives are invited to attend. Please note the timetable in paragraph 8.5. A dedicated consultation sub-group has also been set up to have oversight of this consultation and will meet weekly.

8.3 Staff affected will also be able to request an individual meeting with their

manager if they wish to discuss the proposed changes to the establishment, grading structure and work pattern, and which roles may be suitable for them in the new structure. The manager will make a time table available and staff can choose a convenient appointment. Staff have the right to bring a trade union representative or colleague not acting in an official capacity to accompany them to this meeting.

8.4 Written comments regarding these proposals should be sent to me by letter or

via a dedicated email address: [email protected] by 30 September 2013.

8.5 Following closure of the discussion period of the consultation I will consider all

comments received and confirm the final decision in writing by 4 October 2013. If implemented, I anticipate the process for filling posts will commence on 7 October 2013 and new arrangements will come in to operation between from 11 October 2013 onwards. The timetable for the consultation process is in the table below.

Event Timetable

Preliminary discussion with staff side IPB 8 August 2013

Pre consultation meeting with recognised Trade Union representatives/Staff side

16 August 2013

Approval by dedicated Consultation sub-group To be confirmed

Consultation paper circulated 27 August 2013

Consultation formally commences 27 August 2013

First open staff meetings at CAG level (NB: CAGs will provide a summary of how the changes affect the staff at a local level, in readiness for staff meetings)

By 30 August 2013

Individual staff meetings and regular briefings (by CAG)

2 September to 20 September 2013

Final open staff meeting (by CAG) 23 September 2013

Consultation comments received by 30 September 2013

http://bartshealthintranet/About-Us/Corporate-Directorates/Human-Resources/Consultations/Index.aspx

http://bartshealthintranet/About-Us/Corporate-Directorates/Human-Resources/Consultations/Index.aspx

mailto:[email protected]

V1.9 Final 23.8.13 PF 18

Decision communicated via outcome paper 4 October 2013

Process for filling posts (where applicable) From 7 October onwards

New structure begins From 11 October onwards

8.6 In the meantime, I appreciate that this is an anxious time so please feel free to

contact me if you require any further clarification. Our Employee Assistance Programme is also available to you. It is provided by an external company, CiC and if you wish to access the free confidential advice and counselling service, they can be contacted on 0800 085 1376 (Freephone). More information is provided in appendix 26.

Len Richards Chief Operating Officer Aneurin Bevan House, 81 Commercial Road, E1 1RD 0207 092 5375 27 August 2013 Dedicated consultation email address: [email protected]


V1.9 Final 23.8.13 PF 19

Appendix 1 - Summary of PwC benchmarking work Background

• Barts Health commissioned PwC to undertake benchmarking and analysis across key workforce metrics to provide an assessment of where potential improvement opportunities exist.

• PwC undertook the benchmarking exercise in February and March 2013 with the resulting analysis presented to the Trust’s CIP Steering Group.

• Following this analysis a number of work streams were created to look at the findings in more detail and to determine whether improvements could be made to the workforce profile as a result.

• A weekly CAG Director of Nurse Steering Group has been meeting each week to consider the findings and develop options for the nurse programme

Process • The analysis looked at the following staff groups: •

Nursing & Midwifery Admin & Clerical

Medical & Dental Additional Clinical Services

Healthcare Scientists Additional Professional, Scientific and Technical

Allied Health Professionals

• These staff groups were benchmarked against a peer group that had

characteristics as close to Barts Health as possible. Whilst there is not another Trust the size or complexity of Barts Health it was possible to identify 10 comparator trusts based on common specialties from HED.

• In addition to the 10 Trusts, comparison was also made against the average data for all Acute Teaching Trusts and all Acute Teaching FTs.

Conclusions • The benchmarking showed that there are opportunities across all staff groups. • ‘Right size’ opportunities exist where Barts has a bigger workforce than its

peers – pro rata there are more staff than at other Trusts. • ‘Right shaping’ opportunities were identified where Barts has a richer skill mix

than its peers – its banding of staff is higher on average than other Trusts. • Many of the key messages from PwC’s benchmarking align closely with the

recent analysis undertaken by The Nursing Quality and Productivity Benchmarking Programme which was launched by NHS London in summer 2012, including:

• The Trust has a high nursing cost per bed, • The Trust has a larger senior nurse structure than its peers; • The Trust has a notably higher proportion of registered nurses to its

peers; • There is a significantly higher proportion of qualified nurses, with only

two other trusts, Chelsea and Westminster and Whittington, at the same level, and only Imperial with a higher skill mix.

• There is also a higher skill mix within the qualified nurse population, with a higher proportion at band 7.

V1.9 Final 23.8.13 PF 20

Appendix 2 – Summary of McKinsey work (pan London)

1. The Nursing Quality and Productivity Benchmarking Programme was launched by NHS London in the summer 2012 to compare nursing services within 15 Trusts and Foundation Trusts and to assist directors of nursing in identifying specific improvement opportunities within their organisations.

2. This benchmarking study had the full support of participating Trust Chief

Nurses and was co-designed and sponsored by them, and uses trusts’ own data on quality, activity, staffing and cost to ensure balanced benchmarking of nursing on a service by service basis.

3. For all trusts involved in this programme potential value improvements were

identified, both in terms of quality and productivity.

4. The strong positioning of quality throughout the programme was to ensure trusts are able to consider the relative quality of nursing in each trust and department when identifying which peer organisations they may best learn from. This report looks at individual ward areas as when examining the cost and productivity of the workforce it is important to be cognisant of the acuity, dependency and turnover of patients.

5. In benchmarking Barts Health against other participating London Trusts

McKinsey identified a number of nursing quality and productivity strengths and improvement opportunities. The main opportunities identified were:

Skill mix comparison to peers shows a high proportion of band 7 and 8 nurses, resulting in a high average pay cost per attendance relative to peers;

Patient wards have amongst the highest cost per occupied bed day when compared to peers

Financial gap to peers is fairly even among patient wards and non-ward settings of care

Hourly bank and agency cost is slightly greater than the peer group median in the in-patient setting

Cost of acute senior nurses as a percentage of total hospital nurse spend is 2% greater than the peer group median

V1.9 Final 23.8.13 PF 21

Appendix 3

HEALTH CARE SUPPORT

WORKER Band 2

Job description Date: May, 2013

V1.9 Final 23.8.13 PF 22

Context Barts Health NHS Trust is one of Britain’s leading healthcare providers and the largest trust in the NHS. It was created on 1 April 2012 by bringing together three trusts: Barts and The London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust. The new trust has a turnover of approximately £1.1 billion and approximately 15,000 employees. Together our hospitals - Newham University Hospital in Plaistow, St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel, The London Chest in Bethnal Green and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield. The hospitals offer a full portfolio of services that serve the needs of the local community, and are home to some of Britain’s leading specialist centres including cancer, cardiac, trauma and emergency care. Barts Health also has one of the UK’s busiest children’s hospitals and internationally renowned surgical facilities. Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve – one dedicated to ending the historic health inequalities in east London. We will build an international reputation for excellence in patient care, research and education. And as members of UCLPartners, the largest academic health sciences system in the world, we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments. We are looking for the best talent to lead our ambitious new healthcare organisation. In return, the Barts Health will provide unsurpassed professional development opportunities, enabling investment in a range of new initiatives that would mean: • doctors and nurses in training will be able to gain experience in different hospitals

along the whole patient pathway; • there would be greater opportunity for career progression – we could retain good

staff who might otherwise leave to gain promotion; • becoming world-class will enable us to recruit some of the best doctors and

researchers in the world – who can share their knowledge and experience; • joining forces with other partners in an Academic Health Science System will

mean that staff would be better able to secure funds and pool their talents to develop new technology, techniques and treatments.

V1.9 Final 23.8.13 PF 23

Manager

This Job ColleagueColleague ColleagueColleague

Report No 3Report No 2 Report No 4Report No 1

Job description

Job title: Healthcare Support Worker

Clinical academic group: Trust Wide

Board/corporate function:

Enter the board/ corporate function the post sits in

Salary band: 2

Responsible to: Charge Nurse, Ward Manger/Team Leader

Accountable to: Modern Matron

Hours per week: State total hours a week the role requires

37.5

Location: Barts Health NHS Trust (base to be determined, travel between sites will be required)

Budgetary responsibility:

Nil

Manages: Direct reports: Nil

Indirect reports: Nil

Aim of the role

The Health Care Assistant is a member of the ward / department team who implements prescribed care and undertakes administrative activities as directed by a registered nurse.

Key working relationships

Ward Manager/Team Leader/Charge Nurse

Matron

Registered Nurses

Learners working within the clinical environment

Multi-professional team supporting the delivery of patient care within the clinical environment

V1.9 Final 23.8.13 PF 24

Key result areas The post holder will be an integral part of the nursing team actively taking part in meeting the needs of patients and of the service in accordance with agreed standards under direct supervision of the registered nurse. The post holder will develop essential competencies though training and practice to ensure safety and quality are the priority

Main duties and responsibilities Under the direct supervision of the registered nurse the post holder will: Participate as a member of the team providing the highest standard of patient care,

ensuring their comfort and safety.

Assist patients, with activites of daily living, respecting individual needs, dignity

and privacy in all necessary activities.

Assist the trained nurses in undertaking basic observations such as temperature,

pulse, blood pressure, oxygen saturations, and urine analysis.

Assist and support trained nurses in obtaining specimens such as stool, urine

and MRSA screens.

Assist patients with their nutritional requirements, which includes ensuring menus are completed, handing out drinks & food to patients (ensuring they can reach everything they need, and are sat in a good eating position), and where appropriate feed patients.

Undertake height and weight measurements to assist in the calculation of patient

body mass index.

Assist in ensuring that patients are screened for MRSA.

Support patients undergoing clinical procedures ensuring their comfort and

safety.

Communicate using appropriate verbal and nonverbal methods, in a variety of

situations that may involve overcoming physical and psychological barriers.

Under the supervision of a qualified nurse, organise own workload and assist

patients in all activities of daily living.

Provide direct technical assistance to registered nursing staff when required,

safely, utilising electronic and mechanical/ manual equipment.

Undertake and record clinical activities and observations, such as obtain

specimens following training and assessment, as directed by the Registered

Nurse.

V1.9 Final 23.8.13 PF 25

Enter and update patient documentation and records, utilising computerised

information systems where required.

Observe for and report any change in the condition of patients to the nurse in

charge.

Report all accidents/incidents to the nurse in charge.

Contribute to the maintenance of work area, e.g.: disposal of linen, cleaning and

tidying equipment, effective use of resources.

To deal with patient property in accordance with Trust procedure.

To escort patients to other departments such as directed by the nurse in Charge.

To help reinforce health education advice to patients.

To protect and maintain patient confidentiality at all times.

To carry out all duties in a professional manner, adhering to the policies and

procedures of the Trust and conforming to current legislation concerning Health &

Safety at Work.

Be aware of and work in accordance with the policies and procedures of the Department and the Trust.

Maintain the confidentiality of information concerning patients, staff and other health care professionals.

Be aware of minimising risk for patients, visitors and staff.

Understand and adhere to the procedure for handling complaints and ensure that they are dealt with promptly and sympathetically.

Be aware of and work in accordance with Trust infection control standards.

Be able to report clinical incidents and be familiar with DATIX to report incidences.

To undertake any relevant training and to be active in developing knowledge and skills to support practice, under the guidance of the ward sister

Deal with telephone enquiries sensitively and initiate appropriate action.

Receive and direct patients and their relatives in a helpful and friendly manner.

Maintain the clinical area in an organised and professional manner – clean and tidy, well

stocked and in good order.

Keep patient and clerical areas pleasant, safe, clean and tidy.

Clean and clear equipment as required.

Keep storage areas in good order.

Keep waste to a minimum.

V1.9 Final 23.8.13 PF 26

Financial responsibilities

Demonstrates adherence to policy in the safe care, use and storage of medical and other equipment in the clinical environment

Reports faulty equipment in a timely and appropriate manner

Ensures that patient valuables are handled in accordance with hospital and department policies and procedures

Information Management Under the supervision of the Registered Practitioner:-

Understands the importance of data collection and supports the team whenever necessary to ensure data accuracy.

Is clear about the safeguarding of confidential information in accordance with legislation, policies and procedures, encouraging good practice in others

Records personally generated information and contributes to updating and maintaining patients records

Service Development

Demonstrates an awareness and participates in strategies to improve clinical practice

Offers a questioning approach to all aspects of health care.

Guides others in maintaining acceptable standards of cleanliness and hygiene, taking pride in the environment and services provided

Participates in audits, surveys and research and development activities under supervision

Demonstrates own duties to new starters, agency or bank staff Education and Professional Development

Engages with Barts Health Development Programme for Healthcare Support Workers

Together with a more Senior Member of the Team, engage with the appraisal process. Ensuring your own continuing professional development

Maintain statutory and mandatory training requirements Equality and Diversity

Recognises that all people are different and require individual care.

Treats everyone with dignity and respect

V1.9 Final 23.8.13 PF 27

Acts in a professional manner at all times in what they do and say when interacting with patients, colleagues, other service users and visitors.

Identifies and takes action when own or others behaviour undermines equality and diversity

The job description is not intended to be exhaustive and it is likely that duties may be altered from time to time in the light of changing circumstances and after consultation with the post holder.

The post holder might be required to work across the Trust at any time throughout

the duration of his/her contract, which may entail travel and working at different hospital.

Effort, skills and working conditions Physical skills

Ability to use hoists and engage in other physical activity related to patient care e.g. bathing, feeding.

Physical effort

Patient care e.g. turning, bathing, cleaning. Preparing instruments for surgery under the supervision of the Registered Professional.

Mental effort Concentration required for personal care duties which are routine within the Community or Hospital environment.

Emotional effort

Required to be involved with looking after the terminally ill patient. Maybe required to be involved in the care of a patient with challenging behaviour.

Working conditions

Maybe exposed to bodily fluids, or patients with challenging behaviour.

Performance management and appraisal

All staff are expected to participate in individual performance management process and reviews.

Personal development and training

Barts Health NHS Trust actively encourage development within the workforce and employees are required to comply with trust mandatory training. Barts Health’s education academy aims to support high quality training to NHS staff through various services. The trust is committed to offering learning and development opportunities for all full-time and part-time employees. No matter where you start within the NHS, you will have access to extra training and be given every chance to progress within the organisation. You will receive an annual personal review and development plan to support your career progression and you will be encouraged to develop your skills and experience.

V1.9 Final 23.8.13 PF 28

Health and safety at work

The post holder has a duty of care and personal obligation to act to reduce healthcare-associated infections (HCAIs). They must attend mandatory training in infection prevention and control (IP&C) and be compliant with all measures required by the trust to reduce HCAIs. All post holders must comply with trust infection screening and immunisation policies as well as be familiar with the trust's IP&C policies, including those that apply to their duties, such as hand decontamination, personal protective equipment, aseptic techniques and safe disposal of sharps. All staff must challenge noncompliance with infection, prevention and control policies immediately and feedback through the appropriate line managers if required.

Confidentiality and data protection

All employees are expected to comply with all trust policies and procedures related to confidentiality and data protection and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary).

Conflict of interest

The trust is responsible for ensuring that the service provided for patients in its care meets the highest standard. Equally it is responsible for ensuring that staff do not abuse their official position for personal gain or to benefit their family or friends. The trust’s standing orders require any officer to declare any interest, direct or indirect with contracts involving the trust. Staff are not allowed to further their private interests in the course of their NHS duties.

Equality and diversity

The trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust will aim to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job. You are responsible for ensuring that the trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services.

NHS Health Care Support Worker Code of Conduct

As a Healthcare Support Worker, you make a valuable and important contribution to the delivery of high quality healthcare, care and support. The NHS health care

V1.9 Final 23.8.13 PF 29

support worker code of conduct outlines your responsibilities and the expectations of the role. You are expected to follow the code of conduct at all times. www.skillsforhealth.org.uk

Budgetary management

If you have responsibility for a budget you are expected to operate within this and under the trust’s standing financial instructions (available in the intranet’s policies section) at all times.

Barts Health values based leadership

Our leaders ensure a focus on health where patients are at the centre of all we do. They work to create a culture where innovation is promoted and encouraged. They lead by example and demonstrate value based decision making as being integral to the ways of working within the Trust. Barts Health leaders are role models who demonstrate those attitudes and behaviours which will make us unique. Our leaders are passionate about delivering high quality patient care, take pride in the work that they do to and are committed to the delivering the Barts Health NHS Trust 10 pledges of: 1. Patients will be at the heart of all we do. 2. We will provide consistently high quality health care. 3. We will continuously improve patient safety standards. 4. We will sustain and develop excellence in research, development and innovation. 5. We will sustain and develop excellence in education and training. 6. We will promote human rights and equalities. 7. We will work with health partners to improve health and reduce health inequalities. 8. We will work with social care partners to provide care for those who are most

vulnerable. 9. We will make the best use of public resources. 10. We will provide and support the leadership to achieve these pledges. Our leaders are visible leaders who believe in spending time listening and talking our staff, patients and partners about the things that are important to them and the changes they would like to make to continuously improve patient care. Barts Health leaders work with their teams to develop organisational values, embed them in our ways of working and create the cultural changes required to ensure that we consistently provide an excellent patient experience, regardless of the point of delivery, in an environment where people want to work, regardless of where they work or what they do.

V1.9 Final 23.8.13 PF 30

Person specification

Essential defines the minimum criteria needed to carry out the job and the job cannot be done without these. Desirable refers to criteria which are not essential and which successful applicants would be expected to acquire during their time in post. The desirable requirements are not taken into consideration in a job evaluation panel.

Essential = E Desirable = D

E or D

Application form

Interview

Qualifications and knowledge

NVQ Level 2 or Equivalent or willing to work towards Diploma Level 2 or equivalent. Basic Numeracy and Literacy Understanding of some of the special needs of people during illness

E

Experience Experience of working in a patient

care setting or customer facing

environment

E

Skills Patient focused

Good communication and interpersonal skills

Capable of dealing with sensitive and distressing situations

Able to use initiative

Caring and Compassionate

E

Personal and people development

To be enthusiastic, flexible and co-operative Respect all people and treat everyone with dignity Ability to form good interpersonal relationships and able to work effectively in a team

E

Post Healthcare Support Worker Band 2 To be confirmed

Dept/ward Trust Wide

V1.9 Final 23.8.13 PF 31


E or D

Application form

Interview

Communication

Ability to communicate effectively, and demonstrate excellent communication skills: verbal, listening & written

Legible handwriting.

Be able to demonstrate an understanding of the concept of confidentiality

E

Specific requirements

To be able to work a 24 hour rotation. This will include, week-ends and public holidays To be involved with an on-call system where required. (Trust policy for flexible working) To be able to engage with manual handling using manual handling aids e.g. hoists following training. To be physically fit

E E

Initial and date of preparation Initial and date as required by the Line Manager

V1.9 Final 23.8.13 PF 32

Appendix 4

SENIOR HEALTH CARE SUPPORT WORKER

Band 3

Job description Date: May, 2013

V1.9 Final 23.8.13 PF 33

Context Barts Health NHS Trust is one of Britain’s leading healthcare providers and the largest trust in the NHS. It was created on 1 April 2012 by bringing together three trusts: Barts and The London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust. The new trust has a turnover of approximately £1.1 billion and approximately 15,000 employees. Together our hospitals - Newham University Hospital in Plaistow, St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel, The London Chest in Bethnal Green and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield. The hospitals offer a full portfolio of services that serve the needs of the local community, and are home to some of Britain’s leading specialist centres including cancer, cardiac, trauma and emergency care. Barts Health also has one of the UK’s busiest children’s hospitals and internationally renowned surgical facilities. Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve – one dedicated to ending the historic health inequalities in east London. We will build an international reputation for excellence in patient care, research and education. And as members of UCLPartners, the largest academic health sciences system in the world, we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments. We are looking for the best talent to lead our ambitious new healthcare organisation. In return, the Barts Health will provide unsurpassed professional development opportunities, enabling investment in a range of new initiatives that would mean: • doctors and nurses in training will be able to gain experience in different hospitals

along the whole patient pathway; • there would be greater opportunity for career progression – we could retain good

staff who might otherwise leave to gain promotion; • becoming world-class will enable us to recruit some of the best doctors and

researchers in the world – who can share their knowledge and experience; • joining forces with other partners in an Academic Health Science System will

mean that staff would be better able to secure funds and pool their talents to develop new technology, techniques and treatments.

V1.9 Final 23.8.13 PF 34

Manager



Job description

Job title: Senior Healthcare Support Worker (HCA)

Clinical academic group: Trust Wide


Enter the board/ corporate function the post sits in

Salary band: 3

Responsible to: Ward Manager/Charge Nurse/Team Leader

Accountable to: Modern Matron


37.5

Location: Barts Health NHS Trust (base to be determined, travel between sites will be required)


Nil

Manages: Direct reports: Nil

Indirect reports: Nil

Aim of the role

To be an integral member of the nursing team. The post holder will be responsible for administrative and nursing duties as directed by the registered nursing staff. Clinical tasks to be undertaken by HCA’s will be ratified by the Nursing Clinical Academic Group. The Senior HCA and Unit/Ward manager are responsible for ensuring competency. Clinical tasks to be undertaken will therefore be specific to the clinical area.


Ward Manager/Team Leader/Charge Nurse

Matron

Registered Nurses

Learners working within the clinical environment

Multi-professional team supporting the delivery of patient care within the clinical environment

V1.9 Final 23.8.13 PF 35

Key result areas Undertakes a range of delegated patient care duties across Barts Health NHS Trust and records patient information. To report the patient’s condition to Registered Staff (NMC/HPC)

Main duties and responsibilities Clinical Responsibilities These responsibilities will be carried out under the guidance of the shift coordinator/ registered nurse.

Monitor and record patients’ vital signs (including blood pressure, pulse, temperature, oxygen saturation) and report any abnormal results to registered nursing staff.

Measure and record patients’ height and weight.

Perform venepuncture and venous blood sampling.

Undertake clinical tasks relevant to the specific clinical area following competency sign off. For example: ECG, urinalysis, MRSA screening swabs, recording of allergies and other clinical tasks where training/competency sign off has been deemed appropriate for HCA and has been ratified through the Nursing CAG.

To assist the nursing staff in the admission of patients to the ward where applicable and demonstrate an understanding of discharge planning at this time.

Direct or escort patients with their belongings between departments and clinical areas.

To demonstrate an understanding of infection control issues by attending mandatory training; understand infection control policy and procedure, accept responsibility for own infection control practice and be willing to challenge others’ practice.

Demonstrate an understanding of nursing care plans and utilize them in line with trust policy and procedure.

Understand the dietary needs of patients and utilize diet charts and fluid balance charts appropriately, working alongside the ward host/hostess and housekeeper and liaising with member of the MDT as appropriate.

Liaise with the trusts MDT as appropriate to ensure complete holistic care is provided.

Collects blood products from the laboratory in accordance with the hospital transfusion policy (The post holder will only perform this task after training and assessment of competency as per trust policy).

Assist in the provision of basic care to patients so as to ensure their comfort, cleanliness and well-being (e.g. assist with mouth care, hygiene and eye care).

Report to registered nurses any problems arising during observation of or conversation with patients and careers.

Cooperate with all colleagues to maintain a presentable and safe environment.

To ensure that all patient/public areas including bedside, where applicable, and

V1.9 Final 23.8.13 PF 36

utility rooms are clean and tidy at all times, and to inform an appropriate member of staff when the required standard is not maintained.

To prepare dressing/procedure trolleys (e.g. for central venous catheter insertion/tracheostomy insertion); initially under the guidance of registered staff and then independently following completion of competency.

To clean equipment on a daily basis, including trolleys and drip stands. To inform the nurse in charge when repairs are needed.

To assist nursing and medical staff with various clinical procedures when delegated appropriately by a registered nurse (e.g. for central venous catheter insertion; tracheostomy insertion).

To monitor ward equipment service/calibration history and in conjunction with the ward sister/ charge nurse ensure all equipment is maintained as per trust policy.

To undertake daily checks and document compliance or report repairs/faulty equipment as necessary, e.g. resuscitation trolley, oxygen and suction equipment, fridge temperatures, bed pan washers and emergency equipment plugged in plus other checks delegated by the Ward/Department Sister/ Charge Nurse.

To report faulty equipment to the relevant department for repair.

Ensure stock levels of clinical and non-clinical supplies are maintained through ordering, storing and rotating stick and safely disposing of out of date stock.

Prepare patients for discharge and ensure that rooms/bed areas are ready for the prompt reception of a patient at any time. This may involve appropriate cleaning of the bed, bed table, and locker and any other moveable item of furniture, as a bed is vacated in the course of the day/evening. To clean floors, walls, bathrooms, showers and toilets in rooms, between patients.

Assisting with daily bed making as required.

To provide quality therapeutic care through the delivery of specified treatment programmes to particular patient groups, as directed by the senior therapist. At times this will involve working unsupervised reporting back patient progress and informing the physiotherapist of any problems.

Following appropriate training and demonstration of competence to a specified level to provide individual therapeutic treatments to a specified patient group identified by the ward manager.

To assess and deliver specified treatments under the direction but not direct supervision of a physiotherapist using exercise and electrotherapy techniques.

To use accurate and precise sensory and physical skills in the therapeutic handling of patients including specialist handling of patients immediately following trauma or surgery if appropriate to clinical area

Financial responsibilities

Demonstrates adherence to policy in the safe use and storage of medical and other equipment in the clinical environment

Reports faulty equipment in a timely and appropriate manner

V1.9 Final 23.8.13 PF 37

Ensures that patient valuables are handled in accordance with hospital and department policies and procedures

Maintains stock levels Information Management Under the supervision of the Registered Practitioner:-

Understands the importance of data collection and supports the team whenever necessary to ensure data accuracy.

Is clear about the safeguarding of confidential information in accordance with legislation, policies and procedures, encouraging good practice in others

Contributes to updating patients records

Service Development

Demonstrates an awareness and participates in strategies to improve clinical practice

Offers a questioning approach to all aspects of health care.

Guides others in maintaining acceptable standards of cleanliness and hygiene, taking pride in the environment and services provided.

Handles and patient/service user/visitor complaints courteously and objectively

Reports any complaints immediately to an appropriate Manager/Supervisor.

Following training acts as mentor/assessor for less experienced staff enabling learning through instruction and demonstration

Displays knowledge and skill in the care and related procedures and clinical observations

Follows policies, may contribute to in discussions on proposed changes to ward procedures

Education and Professional Development

To undertake regular statutory and mandatory training in accordance with trust policy.

To continuously work to develop skills within the trust policy.

Management and Leadership Responsibility

It is the post holder’s responsibility to know the correct methods of communication to report issues to.

To act as an advocate for staff, patients and relatives at all times.

To ensure the benefits of patients are maximized through careful, economical and appropriate use of NHS resources including equipment, property, money, time etc.

To assist nursing staff and to supervise more junior Health Care Assistants.

V1.9 Final 23.8.13 PF 38

Equality and Diversity

Recognises that all people are different and require individual care.

Treats everyone with dignity and respect

Acts in a professional manner at all times in what they do and say when interacting with patients, colleagues, other service users and visitors.

Identifies and takes action when own or others behaviour undermines equality and diversity





Ability to use hoists and engage in other physical activity related to patient care e.g. bathing, feeding.

Physical effort

Patient care e.g. turning, bathing, cleaning. Preparing instruments for surgery under the supervision of the Registered Professional.

Mental effort Concentration required for personal care duties which are routine within the Community or Hospital environment. Concentration required when assessing more junior staff.

Emotional effort

Required to be involved with looking after the terminally ill patient. Maybe required to be involved in the care of a patient with challenging behaviour.

Working conditions

Maybe exposed to bodily fluids, or patients with challenging behaviour.




Barts Health NHS Trust actively encourage development within the workforce and employees are required to comply with trust mandatory training. Barts Health’s education academy aims to support high quality training to NHS staff through various services. The trust is committed to offering learning and development opportunities for all full-time and part-time employees.

V1.9 Final 23.8.13 PF 39

No matter where you start within the NHS, you will have access to extra training and be given every chance to progress within the organisation. You will receive an annual personal review and development plan to support your career progression and you will be encouraged to develop your skills and experience.




All employees are expected to comply with all trust policies and procedures related to confidentiality and data protection and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary).




The trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust will aim to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job.

V1.9 Final 23.8.13 PF 40

You are responsible for ensuring that the trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services.

NHS Health Care Support Worker Code of Conduct

As a Healthcare Support Worker, you make a valuable and important contribution to the delivery of high quality healthcare, care and support. The NHS health care support worker code of conduct outlines your responsibilities and the expectations of the role. You are expected to follow the code of conduct at all times.

www.skillsforhealth.org.uk

Budgetary management If you have responsibility for a budget you are expected to operate within this and under the trust’s standing financial instructions (available in the intranet’s policies section) at all times.




V1.9 Final 23.8.13 PF 41




E or D

Application form

Interview


Basic literacy and numeracy skills (English and Maths GCSEs or equivalent) NVQ in Health and Social Care Level 2 NVQ Level 3 (or willingness to undertake training to level 3) Basic computer skills

E

Experience Experience of working in a healthcare

setting for a duration long enough to

have obtained relevant competencies

for a Band 3 post.

Experience of dealing with the

general public

E

Post Senior Healthcare Support Worker Band 3 To be confirmed

Dept/ward Trust Wide

V1.9 Final 23.8.13 PF 42


E or D

Application form

Interview

Skills Clinical skills (e.g. phlebotomy

simple wound dressings

Evidence of effective

interpersonal skills Evidence of

good organisational skills

Self-motivated to work under

minimal supervision

Ability to work as part of a team

Good communication skills,

written and verbal

Patience and understanding of

patient’s needs

Ability to remain calm and

demonstrate tact and diplomacy

whilst under pressure

Evidence of commitment to

customer care initiatives

Awareness of the importance of

patient confidentiality

Ability to use own initiative

Awareness of health and safety at

work, e.g. Manual Handling Skills,

infection control measures

Understanding of working with

patients who are critically and

chronically ill B

basic keyboard/computer skills

(e.g. ability to enter patient data

onto computer records)

prepared to undertake further

training to develop the necessary

competencies and skills

E


To be able to assess more junior staff Under the supervision of the Registered Professional be able to engage with the appraisal process of more junior staff. Enthusiastic member of the ward team

V1.9 Final 23.8.13 PF 43


E or D

Application form

Interview

Communication The ability to work within a team. Ability to exchange factual information to patients or their families using tact, reassurance, persuasion and empathy. Ability to exchange factual information to the multidisciplinary team. To be able to document in patient notes.

E


To be able to work a 24 hour rotation. This will include, week-ends and public holidays To be involved with an on-call system where required. (Trust policy for flexible working) To be able to engage with manual handling using manual handling aids e.g. hoists following training. To be physically fit

E E

Initial and date of preparation Initial and date as required by the Line Manager

V1.9 Final 23.8.13 PF 44

Appendix 5 – ECAM ‘As Is’ Chart

V1.1.9 Final 23.8.13 PF 45

V1.1.9 Final 23.8.13 PF 46

Appendix 6 – ECAM ‘to be’ Chart

V1.1.9 Final 23.8.13 PF 47

V1.1.9 Final 23.8.13 PF 48

Appendix 7 – Women’s and Children’s ‘As is’ Chart

V1.1.9 Final 23.8.13 PF 49

Appendix 8 – Women and Children’s ‘To be’ Chart

V1.1.9 Final 23.8.13 PF 50

Appendix 9 – Surgery ‘As is’ Chart

V1.1.9 Final 23.8.13 PF 51

V1.1.9 Final 23.8.13 PF 52

Appendix 10 – Surgery ‘To be’ Chart

V1.1.9 Final 23.8.13 PF 53

V1.1.9 Final 23.8.13 PF 54

Appendix 11 – Cancer ‘As is’ Chart

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V1.1.9 Final 23.8.13 PF 56

Appendix 11 a – Cardio ‘As Is’ Chart

V1.1.9 Final 23.8.13 PF 57

V1.1.9 Final 23.8.13 PF 58

Appendix 12 – Cancer & Cardio ‘To Be’ Chart

V1.1.9 Final 23.8.13 PF 59

Appendix 13

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Appendix 14

V1.1.9 Final 23.8.13 PF 61

V1.1.9 Final 23.8.13 PF 62

Appendix 15

JOB DESCRIPTION

POST: Receptionist CLINICAL/CORPORATE GROUP: GRADE: Band 2 HOURS OF WORK: 37.5 hours per week LOCATION: REPORTS TO: Senior Receptionist ACCOUNTABLE TO: Service Management KEY WORKING RELATIONSHPS: Receptionist, Nurses, Therapists, Health

Records staff, Clinicians and other administrative staff throughout the Trust.

JOB PURPOSE

To provide professional receptionist support to the Trust’s clinics ensuring the provision of an excellent “front

of house” service. In conjunction with the medical and nursing team provide seamless outpatient care for The

Trust’s patients ensuring that all patients, relatives and visitors to the Department are dealt with in a courteous

manner at all times.

MAIN DUTIES AND RESPONSIBILITIES

To provide professional receptionist support to designated clinics.

To ensure that patients are correctly identified on arrival at clinic.

To check patient information i.e. address and general practitioner and make any necessary alterations to the patient’s health record and to CRS (Care Record System)

Assess patient eligibility for NHS treatment in accordance with Department of Health and Trust policies and procedures.

V1.1.9 Final 23.8.13 PF 63

To record accurately the patient’s attendance at clinic, ensuring that the data relating to time of arrival, time seen, seen by whom and any outpatient procedure codes are accurately recorded on CRS.

To log all outcomes promptly for every patient.

To make follow-up appointments as requested by the clinician within appropriate

timeframes.

To inform clinical staff if appointments cannot be made in accordance with

their request.

To work closely with the nursing teams to keep them informed of any problems with the clinic i.e. late arriving patients.

To direct patients to diagnostic and support departments i.e. Phlebotomy, Pharmacy.

To process patients who Do Not Attend (DNA) inline with Departmental policy and complete

clinic ‘cash up” promptly.

To assist with clinic telephone calls and enquires.

To assist with the booking of transport for patients who fulfil The Trust’s criteria for eligibility to non-emergency transport.

To ensure that all interpreters are booked in a timely manner.

To ensure that all patients investigation request forms are distributed to the relevant department immediately.

To ensure that any note that require collection or delivery are stacked and labelled appropriately at the end of each clinic.

To open and distribute incoming and outgoing mail.

To undertake any other duties which are commensurate to the grade.

OTHER DUTIES

To assist, where appropriate supervisory staff in the training of new or

temporary staff.

To be aware of, understand and work within the legislation, Department of Health guidelines and Trust policies and procedures relating to the safeguarding of confidential information relating to the Trust and its patients.

V1.1.9 Final 23.8.13 PF 64

To ensure that work is conducted within the legislation, Department of Health guidelines and Trust policies and procedures relating to health and safety at work.

FURTHER INFORMATION

The post holder is expected to actively promote and implement the Trust’s equal opportunities policies and procedures.

The post holder must ensure that personal information for patients, members of staff and all other individuals is accurate, up-to-date, kept secure and confidential at all times in compliance with the Data Protection Act 1998, the Caldicott principles and the common law duty of confidentiality.

The post holder must follow the record keeping guidelines established by the Trust to ensure compliance with the Freedom of Information Act 2000.

The post holder is expected to take responsibility for self-development on a continuous basis, undertaking on-the-job and other training as required.

The post holder is required to familiarise him/herself with and comply with the Trust’s policies and procedures.

The post holder must be aware of individual responsibilities under the Health and Safety at Work Act and identify and report, as necessary, any untoward accident, incident or potentially hazardous environment.

The post holder is expected to develop IT skills. The post holder may be required to undertake duties at any location within

the Trust, in order to meet service needs. This job description is intended as a guide to the main responsibilities of the

post and not as an exhaustive list of duties and tasks. The post holder may be required to undertake other duties appropriate to his/her grade, which are not listed above, at the direction of his/her manager. The job description may be amended from time to time after consultation with the post holder.

The Trust operates a No Smoking Policy. All staff must ensure that they comply with the Trust's Infection Control

policies and procedures and undertake relevant training for any deficit in their practice and knowledge. Staff must take personal responsibility for their own actions in relation to infection prevention and control practices during their day to day work.

The post holder will adopt the Trust Culture ‘Bringing excellence to life’:

We value professionalism, courtesy and respect We do not tolerate bullying and rudeness We value ‘nimbleness’ (responsiveness, creativity, flexibility) Our decision processes are open and inclusive We act collectively We coach and develop our staff We encourage learning from mistakes but poor performance will be

challenged.

V1.1.9 Final 23.8.13 PF 65

PERSON SPECIFICATION FORM

POST Receptionist GRAD

E Band 2

DEPT/WARD

Evidence sought from

(tick)


E or D

Applic’n form/CV

Interview

Test

EDUCATION/ QUALIFICATIONS

A minimum of GCSE level or equivalent E x x

Literate and numerate E x x

SKILLS/ ABILITIES

Excellent interpersonal skills with the ability to maintain a courteous approach at all times

E x x

Excellent, clear, and concise written communication skills

E x x x

Able to work as part of a team E x x

Able to communicate effectively face-to-face

E x x

Excellent IT skills including Microsoft Office

D x x

Able to organise own workload and prioritise appropriately

E x x x

Able to communicate effectively over the telephone

E x x

Able to work on own initiative E x x x

Able to work under pressure E x x

EXPERIENCE Previous clerical and/or administrative experience

D x x

An understanding of the importance of confidentiality

E x x

KNOWLEDGE Understanding of NHS and related services D x x

OTHER REQUIREMENTS

Flexibility and commitment to ensure accuracy and efficiency

E x x

Able to maintain high quality standards and customer service

E x x

Possesses a positive attitude towards change and process development

E x x

Understanding of Data Protection Act & Freedom of Information Act

D x x

V1.1.9 Final 23.8.13 PF 66

DRAWN UP BY (NAME)

TITLE DATE

V1.1.9 Final 23.8.13 PF 67

Appendix 16

Job Description

POST: Senior Receptionist BAND: 3 CLINICAL/CORPORATE GROUP: HOURS OF WORK: 37.5 hours per week LOCATION: REPORTS TO: Service Management ACCOUNTABLE TO: Service Management KEY WORKING RELATIONSHPS: Receptionist, Nurses, Therapists, Health

Records staff, Clinicians and other administrative staff throughout the Trust.

JOB PURPOSE To provide professional receptionist support to the Trust’s clinics ensuring the provision of an excellent “front of house” service. In conjunction with the medical and nursing team provide seamless care for The Trust’s patients ensuring that all patients, relatives and visitors to the Department are dealt with in a courteous manner at all times. The post holder will be expected to rotate to various clinics areas. MAIN DUTIES AND RESPONSIBILITIES

To provide professional receptionist support to designated clinics.

To act appropriately to resolve all ad hoc problems that arise including problems with patient records and appointments, liaising with the appropriate staff members and Supervisors as necessary.

To ensure that patients are correctly identified on arrival at clinic.

To ensure patient demographic details including ethnic coding are correct and updated the information onto CRS immediately.

Assess patient eligibility for NHS treatment in accordance with Department of Health and Trust policies and procedures.

To record accurately the patient’s attendance at clinic, ensuring that the data relating to time of arrival, time seen, seen by whom and any outpatient procedure codes are accurately recorded on CRS.

V1.1.9 Final 23.8.13 PF 68

To log all outpatient outcomes promptly for every patient.

To make follow-up appointments as requested by the clinician within appropriate timeframes.

To inform clinical staff if appointments cannot be made in accordance with their request.

To work closely with the nursing teams to keep them informed of any problems with the clinic i.e. late arriving patients.

To direct patients to diagnostic and support departments i.e. Phlebotomy, Pharmacy.

To process patients who Do Not Attend (DNA) inline with Departmental policy and complete clinic ‘sign off’ promptly.

To assist with clinic telephone calls and enquires.

To assist with the booking of transport for patients who fulfil The Trust’s criteria for eligibility to non-emergency transport.

To ensure that all interpreters are booked in a timely manner.

To ensure that all patients investigation request forms are distributed to the relevant department immediately.

To ensure that any note that require collection or delivery are stacked and labelled appropriately at the end of each clinic.

To open and distribute incoming and outgoing mail.

To undertake any other duties which are commensurate to the grade.

OTHER DUTIES

To record staff absence or sickness

To undertake training of new or temporary staff.

To be aware of, understand and work within the legislation, Department of Health guidelines and Trust policies and procedures relating to the safeguarding of confidential information relating to the Trust and it’s patients.

To ensure that work is conducted within the legislation, Department of Health guidelines and Trust policies and procedures relating to health and safety at work.

FURTHER INFORMATION

V1.1.9 Final 23.8.13 PF 69

The post holder is expected to actively promote and implement the Trust’s equal

opportunities policies and procedures. The post holder must ensure that personal information for patients, members of staff

and all other individuals is accurate, up-to-date, kept secure and confidential at all times in compliance with the Data Protection Act 1998, the Caldicott principles and the common law duty of confidentiality.

The post holder must follow the record keeping guidelines established by the Trust to ensure compliance with the Freedom of Information Act 2000.

The post holder is expected to take responsibility for self-development on a continuous basis, undertaking on-the-job and other training as required.

The post holder is required to familiarise him/herself with and comply with the Trust’s policies and procedures.

The post holder must be aware of individual responsibilities under the Health and Safety at Work Act and identify and report, as necessary, any untoward accident, incident or potentially hazardous environment.

The post holder is expected to develop IT skills. The post holder may be required to undertake duties at any location within the Trust,

in order to meet service needs. This job description is intended as a guide to the main responsibilities of the post and

not as an exhaustive list of duties and tasks. The post holder may be required to undertake other duties appropriate to his/her grade, which are not listed above, at the direction of his/her manager. The job description may be amended from time to time after consultation with the post holder.

The Trust operates a No Smoking Policy. All staff must ensure that they comply with the Trust's Infection Control policies and

procedures and undertake relevant training for any deficit in their practice and knowledge. Staff must take personal responsibility for their own actions in relation to infection prevention and control practices during their day to day work.

The post holder will adopt the Trust Culture ‘Bringing excellence to life’:

We value professionalism, courtesy and respect We do not tolerate bullying and rudeness We value ‘nimbleness’ (responsiveness, creativity, flexibility) Our decision processes are open and inclusive We act collectively We coach and develop our staff We encourage learning from mistakes but poor performance will be challenged.

V1.1.9 Final 23.8.13 PF 70

PERSON SPECIFICATION FORM

POST Senior Receptionist GRADE Band 3

DEPT/WARD

Evidence sought from (tick)


E or D

Applic’n form/CV

Interview

Test

EDUCATION/ QUALIFICATIONS

A minimum of GCSE level or equivalent, including English grade A-C

E x x

Literate and numerate E x x

SKILLS/ ABILITIES

Excellent interpersonal skills with the ability to maintain a courteous approach at all times

E x x

Excellent, clear, and concise written communication skills

E x x x

Able to work as part of a team E x x

Able to communicate effectively face-to-face, including with people where there may be barriers to understanding

E x x

Excellent IT skills including Microsoft Office and thorough knowledge of CRS and other hospital information systems

E x x

Able to organise own workload and prioritise appropriately, delegating to other staff if necessary

E x x x

Able to communicate effectively over the telephone and in person

E x x

Able to work on own initiative to solve problems

E x x x

Able to work under pressure E x x

EXPERIENCE 2 years’ experience working in a reception or clinic preparation role

E x x

An understanding of the importance of confidentiality

E x x

KNOWLEDGE Knowledge of local and national targets relating to own work area

E x x

OTHER REQUIREMENTS

Flexibility and commitment to ensure accuracy and efficiency

E x x

Able to maintain high quality standards and customer service

E x x

Possesses a positive attitude towards change and process development

E x x

Understanding of Data Protection Act & Freedom of Information Act

E x x

DRAWN UP BY (NAME)

V1.1.9 Final 23.8.13 PF 71

TITLE DATE

V1.1.9 Final 23.8.13 PF 72

Appendix 17

Barts Health NHS Trust JOB DESCRIPTION Job Title: Patient Care Coordinator Grade: Band 4 Hours: 37.5 Reports to: Service/ Delivery Manager or Senior Patient Care Coordinator Accountable to: CAU General Manager Liaises with: Patients, relatives, carers, GPs, community teams, patient services, consultants, junior doctors, nurse specialists, other clinicians, schedulers, ward clerks, inpatient admissions schedulers, patient validation teams and other members of the Directorate. Location: Based at The Royal London, Barts or The London Chest Job Purpose: The purpose of this post is to actively manage the administrative processes of patient pathways, ensuring a smooth and efficient service for patients throughout their treatment by the Trust. Also to ensure and participate in providing an effective administration service to the multidisciplinary team. In summary the post holder will:

Actively manage the administrative processes associated with patient pathways and the functioning and effectiveness of clinical teams. This includes ensuring that 18 week access and other quality targets are met.

Be a key contact in providing patients with access to healthcare professionals, information on appointments and assisting with other queries.

Manage clinic profiles to ensure capacity is used efficiently, including regular monitoring of clinic utilisation and use of corrective actions on CRS (the Trust’s patient information system) when required.

Be responsible for the provision of an efficient and effective secretarial/PA service to a multidisciplinary team, including implementation of digital dictation/voice recognition services and quality assurance of the documents and their distribution. Work closely with the multidisciplinary team to ensure all correspondence is dealt with quickly and efficiently.

Undertake small amounts of typing when letters fall outside of the remit of Dictate IT or voice recognition.

Implement Standard Operating Procedures (SOPs) and contribute to the development of SOPs

Line manage some other administrative staff if required to do so.

V1.1.9 Final 23.8.13 PF 73

Whilst it is likely the post holder will be linked to specific multidisciplinary teams s/he will also be required to work across the department and the Trust’s multiple sites to ensure cross-cover is provided. DUTIES AND RESPONSIBILITIES 1. Work with the Service Manager/Delivery Manager or Senior Patient Care Coordinator (line manager) to ensure that administrative processes for the patient pathway meet the quality standards required both nationally and within the directorate and are adhered to. 2. Implement the Trust’s digital dictation/voice recognition system for the service area. Ensure that all incoming and outgoing communication, including urgent matters are dealt with efficiently (including vetting correspondence and ensuring that appropriate action is taken before passing on). 3. Implement improvements to the administrative element of the pathway. Also proactively identifying emerging issues that may cause delays at any point in patient pathways and make suggestions to improve administration or any other aspect of the total pathway. 4. Ensure administration SOPs are implemented and make suggestions to support changes in service delivery. 5. Work closely with line manager and multidisciplinary team to ensure all patients with allocated slot issues (ASIs) are given appointment dates within the time period specified and within the correct clinic specification. 6. Use the Trust information systems to monitor patients’ pathway progression, monitoring appointments and attendance through the use of IT systems such as DMS/EPR/CRS. Observe legal and Trust data confidentiality, security and quality requirements. 7. Send all referrals to Central Appointments in line with the correct departmental procedure. 8. Input and retrieve information from the departmental and/or Trust computer systems in accordance with departmental guidelines. 9. Forward patients’ corrected/updated details to Central Appointments. 10. Use the CRS System booking when required, including moving and creating new slots for patients. 11. Maintain a regular “forward look” of upcoming clinics, ensuring all diagnostics are present and correct, and under or over-booking issues are proactively dealt with. 12. Supply clinicians and others with information on the 18 weeks status of the patients when required. 13. Assist in booking diagnostics when required 14. Maintain Waiting/TCI Lists. 15. When clinics are cancelled at short notice inform patients of cancellation. 16. Deal proactively with all enquiries from patients, carers, GPs and other service users, ensuring where possible that the caller’s needs are met or they are transferred to the most appropriate person. Respond to all informal concerns/complaints coming into the department both on the telephone and in writing and escalate where necessary. 17. Keep a record of the movement of medical records passing through the administrative office, and maintain the notes, and track to the appropriate department, enabling continuity of care.

V1.1.9 Final 23.8.13 PF 74

18. Maintain a central record of doctors/consultants annual leave/study days. Reporting and actioning any clinic/theatre cancellations and annual leave requests from your clinical team. 19. Ensure that stationery and office equipment is used efficiently and that any specific unmet needs are brought to the attention of the line manager. Undertake stock control as appropriate. 20. Collect and deliver post and occasional reception duties. 21. Be aware of changes in NHS waiting time targets and associated government policy and use this information to propose improvements. 22. Organise meetings including support material, refreshments, the production and distribution of agendas and minutes etc. Organise and provide cover for other staff within the pathway team and cover for colleagues as and when required regardless of site and the Directorate. FURTHER INFORMATION _ The post holder is expected to actively promote and implement the Trust’s Experience of Human Rights, Equality & Diversity policies and procedures _ The post holder must ensure that personal information for patients, members of staff and all other individuals is accurate, up-to-date, kept secure and confidential at all times in compliance with the Data Protection Act 1998, the Caldicott principles and the common law duty of confidentiality. _ The post holder must follow the record keeping guidelines established by the Trust to ensure compliance with the Freedom of Information Act 2000. _ The post holder is expected to take responsibility for self-development on a continuous basis, undertaking on-the-job and other training as required. _ The post holder is required to familiarise him/herself with and comply with the Trust’s policies and procedures. _ The post holder must be aware of individual responsibilities under the Health and Safety at Work Act and identify and report, as necessary, any untoward accident, incident or potentially hazardous environment. _ The post holder is expected to develop IT skills. _ The post holder may be required to undertake duties at any location within the Trust, in order to meet service needs. _ This job description is intended as a guide to the main responsibilities of the post and not as an exhaustive list of duties and tasks. The post holder may be required to undertake other duties appropriate to his/her grade, which are not listed above, at the direction of his/her manager. The job description may be amended from time to time after consultation with the post holder. _ The Trust operates a No Smoking Policy. _ To adhere to Trust policy and infection control principles and standards to minimise patient risk and ensure high quality patient care. _ Undertake appropriate training and practice to ensure you (and your teams) have the right skills and are competent. _ Are responsible for keeping the environment clutter free, clean and raising issues of concern in the interest of staff and patient safety. _ Ensure high cleaning standards to prevent infection and increase patient’s confidence.

V1.1.9 Final 23.8.13 PF 75

PERSON SPECIFICATION POST Patient Care Coordinator GRADE Band 4 DEPT/WARD Trust template job description and person specification Evidence sought from ( Essential = E Desirable = D E or D Applic’n form/CV Interview w Test GCSE A Level or equivalent standard of education E _ A good level of medical terminology acquired through education, training or work experience E _ ECDL or equivalent experience i.e. experience of a range of IT packages such as word, excel, outlook and power point E _ _ Education/ Requirements Supervisory or office management skills equivalent to certificate level D _ _ Highly developed communication skills, with experience of dealing with patient’s anxiety in a reassuring manner. An ability to communicate professionally at all levels. E _ _ _ Proactive with the ability to use own initiative E _ _ _ Able to present a positive image of her/himself and the service E _ _ Minimum of 3 years administration/ medical secretarial/ pathway experience or equivalent non NHS E _ _ Ability to self-reflect, carry out tasks of own job and identify what s/he needs to learn to able to do current job better

V1.1.9 Final 23.8.13 PF 76

E _ _ Ability to take an active role in agreed learning activities and keep a record E _ _ Communication Knowledge of national targets with respect to the patient pathway. A sound knowledge and demonstrable competence re 18 week referral to treatment rules E _ _ _ Acts in a way that is consistent with legislation, policies and procedures and promotes the Trust Health and Safety policies E _ _ Health, Safety and Security Experience of assisting in maintaining a healthy, safe and secure working environment for self and other E _ _ Ability to assess risks and report any issues that may put Health and Safety at risk. E _ _ Have a sound understanding of NHS wide initiatives and experience of responding positively to ensure local implementation. D _ _ Service Improvement Ability to provide constructive opinions and views on ideas for service improvement E _ _ A proven record of being able to work within set timeframes working to priorities and deadlines. E _ _ Able to recognise own limits and work within those limits of competence E _ _ Acts responsibly as a team member and seeks help if necessary E _ _ Ability to use and maintain resources efficiently and effectively and

V1.1.9 Final 23.8.13 PF 77

encourage others to do so E _ _ Quality Able to monitor quality of own work and others and initiate improvements E _ _ Ability to treat everyone with whom s/he comes into contact with dignity and respect E _ _ Human Rights, Equality & Diversity Experience of Experience of Human Rights, Equality & Diversity policies and procedures D _ _ Keyboard skills to access and input to data systems; Competent in Microsoft Office products. E _ _ Competence with a range of IT packages, e.g. CRS and EPR E _ _ Ability to use information to monitor processes, plan and initiate action D _ _ Information Processing Understanding of Data Protection Act and Freedom of Information Act E _ _ The ability to plan and co-ordinate activities and changes to systems or standards E _ _ Flexible approach to the planning and co-ordination of patient pathways to ensure maximum use of clinical time. E _ _ Project and Service Management Methodical and logical approach to work prioritisation and planning E _ _ _

V1.1.9 Final 23.8.13 PF 78

Appendix 18 – Senior Nurse Band 8B Job Description

Title: Senior Nurse Clinical Academic Group *Insert as appropriate Band: 8b (to be confirmed) Responsible to: General Manager Accountable to: CAG Director of Nursing & Governance Hours: 37.5 per week Location: *Insert as appropriate

BARTS HEALTH NHS TRUST

Insert standard text

CLINICAL ACADEMIC GROUP

*Insert as appropriate

SERVICE GROUP

* Insert as appropriate

JOB PURPOSE

The post holder provides forward-thinking clinical and professional leadership to nursing staff at all levels within their service group, ensuring that nursing care is delivered to a high standard and that the nursing resource is managed effectively. She/he contributes to the ongoing implementation of the nursing and midwifery strategy, ensuring achievement of its objectives and proactively modernising nursing roles in accordance with the needs of patients. She/he will also undertake the key functions of the Modern Matron role ensuring the patient experience in wards/ departments is of the highest possible standard at all times with particular emphasis on dignity and compassion and the delivery of the Care Campaign objectives. The post holder will work in partnership with the Service Clinical Director and Service General Manager in developing the service’s strategic direction and policy framework, ensuring that the service contributes significantly to the achievement of corporate objectives and that effective governance arrangements are implemented and maintained.

CORE JOB DESCRIPTION

V1.1.9 Final 23.8.13 PF 79

** Additional contents of this section must be approved by DoN/General Manager

DIMENSIONS

Responsible for the first line management of Ward/Departmental Sisters and specialist nurses and the clinical and professional leadership of nursing staff working across the service/site. Key Working Relationships with: Director of Nursing & Governance, Operations Director, Corporate Nurses, Senior Nurses from alternate services, Service General Manager, Service Clinical Director, Service Managers, Lead Clinicians, Human Resource Managers, Finance Managers, Ward Sisters, Clinical Nurse Specialists/Practitioners, Practice Development Nurses, HEIs, Community Matrons, referring hospitals

KEY RESULT AREAS

Communication Maintain effective communication links with ward sisters, specialist nurses, general

managers and other services or departmental teams as appropriate

Represent the service and the General Manager/DoN at meetings as required and promote effective communications

Represent the service at meetings with partner agencies as required

Arrange and chair service meetings and trust-wide as required

Assist the Trust’s press officer in the formulation of press statements as required

Ensure that all direct reports are briefed and appraised of service, CAG and Trust issues

Establish communication and meeting arrangements with the Clinical Lead and the General Manger for the service

Meet with patients and their families as required in order to resolve their concerns

Ensure staff respect people’s dignity, involve them in shared decision-making and obtain consent before undertaking nursing procedures

Personal and People Development Be appraised at least annually and contribute to own personal development plan (PDP)

Be responsible for developing and sustaining own knowledge, management & clinical skills (as appropriate) and professional awareness in accordance with CPD requirements and maintain a professional profile

Provide constructive feedback to staff on their performance, taking remedial action when performance falls below the required standard to assist them in addressing deficits

Identify opportunities to develop the role of the nurse beyond traditional boundaries in order to positively impact on the patient experience and maximise the potential of individual staff members or teams

Provide mentorship, coaching, supervision and shadowing opportunities to individuals in order to support their development

Be accountable for and ensure own competence in practice

Take part in reflection and appropriate learning from practice, in order to maintain and develop competence and performance

Health, Safety and Security

V1.1.9 Final 23.8.13 PF 80

Ensure maintenance of clean and safe clinical environments within the service

Maintain high standards of infection prevention and control practice across the service, actively minimising incidents

Ensure nursing practice and care delivery is in accordance with relevant research and evidence base and trust policies and guidelines

Ensure potential risks for all staff, patients and visitors are identified, action taken as required and relevant incident reporting procedures adhered to

Take a lead role in the implementation and monitoring of the Trust’s risk and governance strategy at service level

Coordinate the collation and maintenance of the service risk register

Contribute to drawing up action plans to minimise and manage risks

Conduct investigations into complaints and adverse incidents

Provide written responses to formal complaints when required by the Director of Nursing and Governance

Identify and address opportunities for shared learning resulting from incidents and complaints

Service Improvement Support the General Manager and Clinical Lead in developing and implementing the

service development strategy for the service with specific reference to the nursing contribution to service improvement objectives

Support the General Manager in delivery of key performance targets by assessing the operational processes and ensuring the nursing and wider team work efficiently and effectively to maintain performance.

Ensure the delivery of effective and efficient discharge processes.

Undertake workforce planning activities in order to reconfigure nursing establishments in line with service changes

Identify staffing and skill mix requirements using information provided

Ensure service human resource performance monitoring reports are comprehensive and submitted on time (IPR, vacancy report)

Monitor trends in incidents and complaints and promote service improvements which are responsive to patient feedback

Encourage and promote nursing research activity

Engage with patients and their families in order to establish their views on services

Promote patient and public involvement in the evaluation and improvement of services

Review the results of patient satisfaction surveys and utilise findings to improve services

Contribute to the development of clinical protocols in accordance with valid evidence

Quality Monitor progress towards achievement of Nursing and Midwifery Strategy objectives

within the service

Be responsible for monitoring the quality of environmental services within the care area and lead that aspect of the modernisation agenda

Ensure that audit programmes are consistent with service objectives

Ensure that a Quality Monitoring Programme is fully implemented across the service and that action is taken to achieve and maintain quality standards in all areas

Undertake audit as required to support the service development strategy, e.g. Benchmarking; take appropriate actions in response to audit findings

Undertake investigations into issues raised by patients or their families and take action to resolve their concerns in liaison with the PAL service as appropriate

V1.1.9 Final 23.8.13 PF 81

Ensure that incidents are investigated and action taken to improve patient safety and quality of care

Ensure a patient focused multidisciplinary approach to care in collaboration with carers, health care professionals and other agencies

Maintain a high clinical presence and visibility within the service

Work in the clinical setting each Friday and support the Trust model of first and third clinical Fridays.

Equality and Diversity Carry out duties and responsibilities with regard to the Trust’s Equal Opportunity policy

Recognise the importance of peoples’ rights and act in accordance with legislation, policies and procedures

Ensure that staff acknowledge and recognise peoples’ expressed beliefs, preferences and choices; respecting diversity and valuing people as individuals

Take account of own behaviour and its effect on others

Information collection and analysis Ensure that staff records are correctly maintained and that their confidentiality is

Protected

Ensure that the registration status of registered nurses is verified and updated in a timely manner

Take appropriate action in accordance with professional standards and Trust policy when staff fail to maintain effective registration

Produce notes, minutes, agendas for meetings and a range of correspondence (simple and complex)

Identify and interpret information as required and apply it appropriately to support the delivery and development of services

Financial management Responsible for appropriate/allocated nursing budgets (as identified by the General

Manager); identify anticipated pressures and potential efficiency savings

Ensure that the nursing resource is deployed efficiently and minimise spending on bank or agency staff

Ensure continuous review of the service recruitment strategy actively minimising vacancy and turnover factors to develop quality and efficiency

Contribute to ensuring that the service achieves a balanced budget

Ensure that the results for the CQC audits are discussed and acted upon

Support the General Manager in identifying the service CIP and implementing financial recovery plans where necessary

Contribute to the development of business cases

People management Line manage senior members of nursing staff including ward/departmental sisters and

specialist nurses, undertaking regular performance review and overseeing personal development plans

Develop job descriptions and actively recruit to new or vacant posts in accordance with Trust policy

V1.1.9 Final 23.8.13 PF 82

Chair or sit on interview panels for all Ward Sister posts and other nursing and non- nursing posts as required

Manage the service’s post-registration education contract

Consider requests for funding for courses and conferences and make fair and equitable decisions regarding allocation

Actively promote partnership working with staff and their representatives

Produce consultation papers, in collaboration with HR manager and undertake the consultation process with staff affected by proposed service changes

Assist individual members of staff in resolving conflicts that arise in the workplace

Participate in and lead all aspects of the Disciplinary process as required; including decision to suspend, chairing hearings and making decisions on disciplinary action up to and including final written warning

Act as nurse advisor to the General Manager on disciplinary panels in cases of alleged gross misconduct, providing professional advice in cases of potential dismissal

Ensure that appropriate action is taken in cases of professional misconduct by informing the Director of Nursing & Governance

Capacity and capability Undertake on-call duty manager responsibilities

Act in the absence of the General Manger Manager and the Director of Nursing as required

Provide cross cover for other Senior Nurses with the CAG as required for professional issues

Lead the training needs analysis for nursing within the division; support staff in identifying and meeting their own training needs

Contribute to the development of in-house education and training programmes

GENERAL

Adhere to the Bart’s Health Values & Vision and adopt a professional approach to customer care at all times

Comply with the Trust’s Equal Opportunities Policy and treat staff, patients, colleagues and potential employees with dignity and respect at all times

Take personal responsibility for promoting a safe environment and safe patient care by identifying areas of risk and following the Incident, Serious Incidents and Near Misses reporting policy and procedure

Take personal responsibility for ensuring that Barts Health resources are used efficiently and with minimum wastage, and to comply with the Trust's Standing Financial Instructions (SFIs)

Comply with Trust policies for personal and patient safety and for prevention of healthcare-associated infection (HCAI); this includes a requirement for rigorous and consistent compliance with Trust policies for hand hygiene, use of personal protective equipment and safe disposal of sharps

In accordance with the Trust's responsibilities under the Civil Contingencies Act 2004 to undertake work and alternative duties as reasonably directed at variable locations in the event of and for the duration of a significant internal incident, major incident or pandemic

Be aware of and adhere to all Trust policies and procedures, the Health and Safety at Work Act and the Data Protection Act.

Maintain confidentiality at all times Other

V1.1.9 Final 23.8.13 PF 83

These guidelines are provided to assist in the performance of the contract but are not a condition of the contract. The job description is not intended to be exhaustive and it is likely that duties may be altered from time to time in the light of changing circumstances and after consultation with the post-holder. All staff will be regularly assessed on their knowledge, skills and behaviour, and application of all aspects of the job description, in line with the Trust’s Personal Development Review (PDR) process. Staff will also be expected to work according to the Nursing and Midwifery Council and code of professional practice and relevant professional guidelines.

V1.1.9 Final 23.8.13 PF 84

Person Specification

Post:

Band 8b Senior Nurse

Candidate’s Name:

*Essential / Desirable – E/D

HOW WILL CRITERIA BE ASSESSED? (A)APPLICATION / (T) TEST / (I) INTERVIEW / (R) REFERENCES

REQUIREMENTS *E / D How assessed

Met Not Met

EVIDENCE TO SUPPORT ASSESSMENT

1. Knowledge & Qualifications a. First level registered nurse with specialist qualification in Neonatal Nursing (NNU posts) Children’s Nursing (Children’s posts) b. Educated to Masters level or for completion within 12 months of appointment c. Leadership Qualification d. Management qualification

E E

E D D D

A A

A A

2. Experience a. Operational management experience in acute hospital setting b. Teaching c. Manager on-call

E

E E

A

A A/I

3. Communication a. Excellent written and verbal communication skills b. Formal presentation skills

E

E

A/I

I

4. Personal And People Development a. Human Resource skills b. Organisational skills c. Decision-making skills d. Professional Nursing issues e. Able to manage time effectively f. Able to prioritise objectives and workload g. Practice Development

E E E E E E E

A/I A/I A/I A/I A/I A/I A/I

5. Health, Safety And Security a. Monitors and maintains health, safety and security of self and others b. Promotes, monitors and maintains best practice in health, safety and security c. Clinical risk management techniques and skills d. Clinical Governance and Risk Management

E

E

E

E

I I I I

6. Service Improvement a. Thorough understanding of NHS improvement agenda b. Skill-mix and Workforce planning c. Business planning Skills

E

E D

I

A/I A/I

7. Quality a. Quality assurance and improvement

E

A/I

V1.1.9 Final 23.8.13 PF 85

b. Developing policies and protocols

E A/I

8. Equality and Diversity a. Respects the privacy and dignity of the individual b. Understands the implications of Equal Opportunities in practice

E

E

I I

9. Information processing a. Able to utilise ICT to full potential b. Data collection and interpretation as required

E E

A/I I

10. Financial Management a. Budgetary management skills

E

A/I

11. People management a. Able to delegate appropriately b. Highly professional role model c. Managing organisational change d. Managing a range of staff groups

E E E E

I I

A/I A/I

12. Capacity and Capability a. Able to participate in on Call rota

E

I

Shortlist: Yes / No Reason: Signatures: Offer Post: Yes / No Reason: Signatures:

V1.1.9 Final 23.8.13 PF 86

Appendix 19 – Band 7 Governance Job Description

GOVERNANCE STANDARDS & RISK SYSTEMS COORDINATOR

Job Description Version 0.1 JB/LA 24/4/12

V1.1.9 Final 23.8.13 PF 87

Context

Barts Health NHS Trust is one of Britain’s leading healthcare providers and the largest trust in the NHS. It was created on 1 April 2012 by bringing together three trusts: Barts and The London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust. The new trust has a turnover of approximately £1.1 billion and approximately 15,000 employees. Together our hospitals - Newham University Hospital in Plaistow, St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel, The London Chest in Bethnal Green and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield. The hospitals offer a full portfolio of services that serve the needs of the local community, and are home to some of Britain’s leading specialist centres including cancer, cardiac, trauma and emergency care. Barts Health also has one of the UK’s busiest children’s hospitals and internationally renowned surgical facilities. Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve – one dedicated to ending the historic health inequalities in east London. We will build an international reputation for excellence in patient care, research and education. And as members of UCL Partners, the largest academic health sciences system in the world, we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments. We are looking for the best talent to lead our ambitious new healthcare organisation. In return, the Barts Health will provide unsurpassed professional development opportunities, enabling investment in a range of new initiatives that would mean:

• doctors and nurses in training will be able to gain experience in different hospitals along

the whole patient pathway;

• there would be greater opportunity for career progression – we could retain good staff

who might otherwise leave to gain promotion;

• becoming world-class will enable us to recruit some of the best doctors and researchers

in the world – who can share their knowledge and experience;

• joining forces with other partners in an Academic Health Science System will mean that

staff would be better able to secure funds and pool their talents to develop new technology, techniques and treatments.

V1.1.9 Final 23.8.13 PF 88

JOB DESCRIPTION Job title: Governance, Standards’ and Risk Systems Coordinator

Clinical academic group: Nursing and Governance


Governance and Risk Management

Salary band: Agenda for Change Band 7

Responsible to: Director of Nursing and Governance

Accountable to: Director of Nursing and Governance


37.5hrs

Location: The Post Holder will have a primary base but will be expected to work between sites.


Delegated management of relevant elements of the budget

JOB PURPOSE To coordinate activity and provide system support in the operation of the Trust’s governance, standards and risk systems and databases so that they are fully integrated and utilized across the organization and support the delivery of effective Quality Governance and Risk Management processes.

AIM OF THE ROLE The post holder will be the in-house expert for the Risk Management Database (Datix) and the other governance systems procured or operated currently within the Trust such as the Governance warehouse. The post holder will lead and coordinate new system set up or design change, coordinate implementation, provide user training and ensure on going product usage and support. The role will be responsible for system quality assurance, including data entry accuracy and security.

KEY WOKING RELATIONSHIPS

Internal: Other Governance Standards Coordinator (s)

Governance, Standards and Risk Manager

Head of Governance Standards and Risk

Head of Patient Safety

All members of the Governance Standards/Risk and Patient Safety and Legal Teams

CAG Governance Leads and Teams throughout Barts Health

Corporate and CAG Directors/Deputy Directors where appropriate

V1.1.9 Final 23.8.13 PF 89

Corporate Information Technology & Systems Leads and Information Governance Managers

Senior Nurses/ Professional Leads in all areas,

Other NHS

& Non NHS NHS organisations and stakeholders, NHSLA, CQC and other regulatory bodies, commercial companies e.g. Datix, Allocate Software, CHKS

KEY RESULT AREAS Strategic Development To lead the development of project documentation (PID) and action plans for new risk or governance IT system implementation in the organisation or when changes to existing systems or processes are required. In conjunction with the Governance Standards and Risk Manager and NHSLA and CQC Coordinators ensure a continuous and sustainable improvement programme in relation to statutory compliance and its impact on risk to the organisation, including benchmarking, audit and learning from experience. Responsible for the CAS alert database system ensuring an effective receipt, dissemination, monitoring and assurance of compliance process. To ensure comprehensive IT and data collection systems are in place as part of the Trust’s preparation and response to external reviews/recommendations including those undertaken by the Care Quality Commission and the NHS Litigation Authority, working closely with the Governance Standards and Risk Coordinators and colleagues at all levels of the organisation, both within the Trust and with external agencies Work with the Governance Standards Coordinators and Facilitators to collate, evaluate and maintain contemporaneous evidence of compliance within the appropriate systems and databases identifying gaps and producing reports and updates in respect of the Trust’s position for relevant committees and corporate and CAG teams, including Governance Leads. Expert Practice With the Governance and Risk System Facilitators provide system support and training to ensure the effective design and operation of the Risk Management Database (Datix), Health Assure and Governance Warehouse by all users - addressing problems, troubleshooting any technical issues and escalating unsolvable and serious problems to the external Datix support team or ICT System support/help desk The post holder will be plan and coordinate SI meetings and support the development of action plans within the CAG. Maintain the security of the Risk Management Database (Datix) and other systems, by managing user accounts and profiles.

V1.1.9 Final 23.8.13 PF 90

Ensure there is a process in place for the audit of Electronic Incident forms to ensure their completeness anonymity and accuracy, in line with the 14 day escalation policy on Incident Management Liaise with the information provider of an incident form, other members of the team and Trust staff to clarify any discrepancies or gaps in the information provided, and provide guidance to the appropriateness of data for inputting. The post holder will coordinate the receipt, acknowledgement and response to complaints, working closely with the CAG Tier 2 and Tier 3 teams. Manage all DATIXWEB projects and be the responsible person and contact in all related queries/issues. Review the use of the DATIXWEB products in light of user feedback. Ensure the Risk Management Database (DATIX) and other systems capture all information required by external agencies (NPSA, HCL, MHRA, and HSE). Ensure data submissions internally and externally via the Risk Management Database as required. Design effective reports for corporate teams and CAG Governance Managers and leads to monitor incidents and complaints occurring and to enable monitoring of trends for action. Produce high level reports as required or requested from the Risk Management Database and other governance systems, e.g. Health Assure, Governance Warehouse to inform Trust Committees and reports. Ensure there is a process to monitor outstanding actions noted within the Risk Management Database (Datix) and Health Assure , informing the relevant managers to attend to this with a tight deadline and where required escalate if compliance is not achieved. Leadership and Professional Development Motivate and support corporate and CAG teams to recognise their role in complying with all external assessments

Provide training in respect of statutory compliance at all levels across the organisation, using a range of media

To engage in an agreed programme of personal/professional development that contributes to service improvement

Management

Actively contribute to the management of performance and monitoring of standards within the team, taking remedial action where necessary

Develop the capability of the team to offer appropriate advice in relation to governance standards and risk management systems and compliance ensuring effectiveness and service flexibility

To undertake the role across all units and sites of the organisation

V1.1.9 Final 23.8.13 PF 91

Communication and Relationships Develop and maintain collaborative and effective team working with colleagues from corporate and CAG teams, including Governance Leads to provide advice and to increase understanding and therefore compliance with all governance standards Education, Research and Development

Participate in an annual performance review


The post holder might be required to work across the Trust at any time throughout the

duration of his/her contract, which may entail travel and working at different hospital.

EFFORT, SKILLS AND WORKING CONDITIONS

Physical skills

Standard keyboard skills required High levels of accuracy required in handling large volume of data

Physical effort

The role will not normally involve the post holder in a high level of physical activity The post holder may be sat at a computer station for prolonged lengths of time The post holder is required to travel between 3 Trust sites and to relevant local meetings The post holder will regularly be required to sit and need to walk between locations

Mental effort The post holder requires high levels of concentration as they deal with heavy demands for a variety of sources The post holder may be frequently interrupted due to the operational nature of the job The work may be unpredictable and the post holder may have to adapt to change in a short time frames and be able to deliver outcomes Frequent requirement for concentration when analysing and interpreting data/information from internal and external sources Frequent concentration when preparing for meetings and report writing

Emotional effort

The post holder has to be able to work successfully under pressure of time and resources Some exposure associated with learning from adverse events

Working conditions

Frequent VDU use involving exposure to VDU screens whilst inputting data. The post holder works across sites in acceptable working

V1.1.9 Final 23.8.13 PF 92

conditions. Office based but may need to visit a range of clinical and non-clinical settings

PERFORMANCE MANAGEMENT AND APPRAISAL


PERSONAL DEVELOPMENT AND TRANING

Barts Health NHS Trust actively encourage development within the workforce and employees are required to comply with trust mandatory training. Barts Health’s education academy aims to support high quality training to NHS staff through various services. The trust is committed to offering learning and development opportunities for all full-time and part-time employees. No matter where you start within the NHS, you will have access to extra training and be given every chance to progress within the organisation. You will receive an annual personal review and development plan to support your career progression and you will be encouraged to develop your skills and experience.

HEALTH AND SAFETY AT WORK

The post holder is required to: • Take reasonable care for the health and safety of him/her and other persons who may be

affected by their actions or omissions at work. • Co-operate with the employer in ensuring that all statutory and other requirements are

complied with. • Comply with Trust policy and procedures regarding infection control and to adhere to good

practice guidance in relation to infection control precautions.

CONFIDENTIALITY AND DATA PROTECTION

The post holder has a responsibility to comply with the Data Protection Act 1998 and maintain confidentiality of staff, patients and Trust business. If you are required to process information, you should do so in a fair and lawful way, ensuring accuracy is maintained. You should hold information only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose. You should disclose information only to authorised persons or organisations as instructed. Breaches of confidentiality in relation to information will result in disciplinary action, which may include dismissal. Employees are expected to comply with all Trust policies and procedures and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that

V1.1.9 Final 23.8.13 PF 93

employee to ensure that their staff receive appropriate training (e.g. HISS induction, organizing refresher sessions for staff when necessary).

CONFLICT OF INTEREST

The Trust is responsible for ensuring that the services for patients in its care meet the highest standards. Equally, it is responsible for ensuring that staff do not abuse their official position, to gain or benefit themselves, their family or friends.

EQUALITY AND DIVERSITY

The Trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust will aim to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job. You are responsible for ensuring that the Trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services. NHS MANAGERS’ CODE OF CONDUCT As an NHS Manager, you are expected to follow the code of Conduct for NHS Managers (October 2002), observing the following principles: • Making the care and safety of patients your first concern and to act to protect them from

risk. • Respecting the public, patients, relatives, carers, NHS staff and partners in other agencies. • Being honest and acting with integrity. • Accept responsibility for your own work and the proper performance of the people you

manage. • Showing your commitment to working as a team member by working with your colleagues

in the NHS and wider community. • Taking responsibility for your own learning and development.

BUDEGETARY MANAGEMENT

If you have responsibility for a budget you are expected to operate within this and under the Trust’s Standing Financial Instructions (available from the Finance Director) at all times.

SAFEGUARDING ADULTS AND CHILDREN

Employees must be aware of the responsibilities placed on them to maintain the wellbeing and protection of vulnerable children and adults. If employees have reason for concern that a patient is 'at risk' they should escalate this to an appropriate person i.e. line manager, safeguarding children's lead, matron, ward sister/change nurse, site manager, consultant.

OTHER

V1.1.9 Final 23.8.13 PF 94

The post holder is required to conform to both Barts Health NHS Trust and to the University’s policies and procedures, including attendance at any training sessions required. The post holder will adhere to the Data Protection Act and Health and Safety Act. This job description is intended as a guide to the main duties and responsibilities of the post and may be subject to change. Such change will only take place following consultation between the post holder and the Chief Nurse.

TRAINING NEEDS

From 6 April 2010, employees in organisations with 250 or more employees in England and Wales have the statutory right to request time off for training. This was extended to all organisations on 6 April 2011 and the Barts Health NHS Trust actively encourage development within our workforce, and it is in the greatest interest of our employees that they fully comply with Trust mandatory training as it is an integral part of our culture The Trust is committed to offering learning and development opportunities for all full-time and part-time employees. No matter where you start within the NHS, you will have access to extra training and be given every chance to progress within the organisation. The Training Quality Improvement programme aims to support training services in delivering high quality training to NHS staff through various services You will receive an annual personal review and development plan to support your career progression, and you'll be encouraged to progress through the Knowledge and Skills Framework.

BARTS HEALTH VALUES BASED LEADERSHIP

Our leaders ensure a focus on health where patients are at the centre of all we do. They work to create a culture where innovation is promoted and encouraged. They lead by example and demonstrate value based decision making as being integral to the ways of working within the Trust. Barts Health leaders are role models who demonstrate those attitudes and behaviours which will make us unique. Our leaders are passionate about delivering high quality patient care, take pride in the work that they do to and are committed to the delivering the Barts Health NHS Trust Ten Pledges of: 1. Patients will be at the heart of all we do 2. We will provide consistently high quality health care 3. We will continuously improve patient safety standards 4. We will sustain and develop excellence in research, development and innovation 5. We will sustain and develop excellence in education and training 6. We will promote human rights and equalities 7. We will work with health partners to improve health and reduce health inequalities 8. We will work with social care partners to provide care for those who are most vulnerable 9. We will make the best use of public resources 10. We will provide and support the leadership to achieve these pledges Our leaders are visible leaders who believe in spending time listening and talking our staff, patients and partners about the things that are important to them and the changes they would like to make to continuously improve patient care.

Barts Health leaders work with their teams to develop organisational values, embed them in our ways of working and create the cultural changes required to ensure that we consistently

provide an excellent patient experience, regardless of the point of delivery, in an environment where people want to work, regardless of where they work or what they do

V1.1.9 Final 23.8.13 PF 95


Essential = E

Desirable = D

E or D Application form

Interview


IT knowledge and expertise acquired through degree level or equivalent qualification/training /experience

Intermediate qualification or

experience in the use of Microsoft

Office applications

Completion of a management

qualification or equivalent experience

E E D

√ √

√

Post Governance Standards and Risk Systems

Coordinator

Band 7

Dept/ward Governance, Standards and Risk

V1.1.9 Final 23.8.13 PF 96

Essential = E

Desirable = D


Interview

Experience

Experience of preparing and

delivering organisational compliance

with regulatory/statutory governance

standards

Experience of collating/evaluating evidence against statutory standards and of maintaining effective monitoring systems to assess compliance

Evidence of training experience and presentation skills, using a range of media to support compliance and the managment of risk

E E E

√ √

√

V1.1.9 Final 23.8.13 PF 97

Essential = E

Desirable = D


Interview

Skills and Knowledge

Ability to make adjustments to plans due to variable workload Good organisational skills; able to work effectively within tight time scales in order to meet deadlines Logical, with analytical skills to assess and interpret complex qualitative and quantitative clinical/non clinical data and information. Comprehensive knowledge of Microsoft Office and the use of Powerpoint to support the analysis of data, present information and develop training programmes Be a positive role model for the Department, Directorate and organisation

E E E

√ √ √ √


Experience of managing staff and the professional and/ or personal development of self and team

D √

Communication

Able to maintain effective relationships and develop networks both internally and with external organisations to ensure effective governance Ability to present complex issues clearly and concisely at all levels of the organisation, including to senior colleagues

E E

√ √


Able to pay attention to detail where necessary Assertive but polite and professional Able to maintain discretion regarding sensitive issues Self-motivated, proactive and resourceful

E

√

V1.1.9 Final 23.8.13 PF 98

24/4/2012 LA/JB

V1.1.9 Final 23.8.13 PF 99

Appendix 20 – Service Manager Job Description

V1.1.9 Final 23.8.13 PF 100

Appendix 21 – Change Management Policy

APPROVAL Director of Human

Resources

Date approved:

TBC

EFFECTIVE FROM TBC

DISTRIBUTION All Wards and Departments via Trust Bulletin

RELATED DOCUMENTS

Pay Protection

Agenda for Change Terms and Conditions of Service

Handbook

NHS Constitution

Trust Recognition Agreement

OWNER Director of HR and CEO

AUTHOR/FURTHER INFORMATION

Author: HR Policy Development Workforce Specialist

EXTERNAL REFERENCES -

SUPERSEDED DOCUMENTS

Managing and Supporting Staff Through Change Trust Core Policy (Barts and The London NHS Trust); Policy and Procedure for Staff Affected By Change and Staff Consultation Policy and Procedure (Whipps Cross University Hospital NHS Trust); Change Management Policy (Newham University Hospital NHS Trust); A

Partnership Approach to Managing Change (CHS)

REVIEW DUE Three years from the date of approval shown, or earlier subject to legislative or national policy changes

or organisational need.

KEYWORDS Policy, change, organisation, consultation, TUPE, redeployment, at risk, redundancy, slotting in, suitable

alternative employment; early retirement,

INTRANET LOCATION(S) http://bartshealthintranet/Policies/Policies.aspx

CO

NS

ULT

AT

ION

Barts Health Working Groups

Policy Development Working Group Interim Partnership Board Trust Policy Committee

External Partners Capital Hospitals via the New Hospital Programme Control Team.

Sco

pe

For the groups listed below, failure to comply with this policy may result in investigation and management action which may include formal action in line with the Trust's disciplinary or capability procedures for Trust employees, and other

TRUST CORPORATE POLICY : MANAGING CHANGE

V1.1.9 Final 23.8.13 PF 101

action in relation to organisations contracted to the Trust, which may result in the termination of a contract, assignment, placement, secondment or honorary arrangement. Application: All Trust staff employed on a contract of employment

Exclusions: Individuals working within the Trust who are not on a contract of employment e.g. students, agency workers, Bank (only) staff, honorary contracts, junior doctors on training and contractors working within the Trust

V1.1.9 Final 23.8.13 PF 102

TABLE OF CONTENTS

1 INTRODUCTION AND AIMS OF POLICY 103

2 DEFINITIONS 103

3 DUTIES AND RESPONSIBILITIES 109

4 PLANNING AND CONSULTING ON CHANGES 112

5 REDUNDANCY PROCESS 114

6 FILLING POSTS IN THE NEW STRUCTURE AND REDEPLOYMENT 115

7 TUPE 118

8 RIGHT OF APPEAL 119

9 IMPACT AND EQUALITY ANALYSIS 119

10 MONITORING THE EFFECTIVENESS OF THIS POLICY 119

APPENDIX 1: GLOSSARY OF TERMS 120

APPENDIX 2: OTHER LINKED TRUST POLICIES AND GUIDELINES 122

APPENDIX 3: EXTRA SOURCES OF INFORMATION AND SUPPORT 123

Please note that where words/phrases are inside square brackets [ ], this indicates that you can click on the word/phrase when and it will send you to the relevant area

of the policy or (if you are using a Trust PC) the relevant supporting document/template.

This Policy is available in Braille, large print, Easy-Read and alternative languages by

request. It is a manager’s responsibility to ensure employees are aware of these options.

V1.1.9 Final 23.8.13 PF 103

MANAGEMENT OF CHANGE

1 INTRODUCTION AND AIMS OF policy

1.1 The Trust is committed to supporting its employees whilst also ensuring that it delivers and

maintains an efficient and consistently high standard of care to its patients and service users.

1.2 In order to achieve this, the Trust recognises that organisational changes will need to take place

and recognises its responsibility to provide security for its employees as far as is reasonable

practicable. Therefore, in order to minimise redundancies or early retirement as a result of

redundancy ([s.16.10 AfC]) employees may need to be redeployed to [suitable alternative

employment].

1.3 However, this may not always be possible and therefore a clear process needs to be in place so

that employees know what support they can expect from the Trust when they are affected by

organisational changes.

1.4 The Trust is committed to engaging and consulting with its employees and representatives of the

recognised Trade Unions, in line with the Trust’s Recognition Agreement throughout the process

and will maintain open channels of communication at all stages of the process and at all levels.

1.5 The aim of this policy is:

to ensure that there is an agreed approach across the Trust to consultation about organisational changes and how to redeploy staff who are displaced as a result of that change

to ensure this approach is fair and consistent and without discrimination in relation to any of the [protected characteristics]

to ensure employees are aware of the support that they can expect from the Trust

to ensure that organisational change is undertaken in line with the [Equality Act 2010]

to ensure efficient and high quality care for our patients

to monitor to ensure effectiveness of implementation

1.6 This policy contains the process and principles for managing organisational change and

consulting with employees to ensure best patient care only. For further details please read the

supporting [Management Guide].

2 Definitions

2.1 The following definitions are used in this policy:

Consultation Involves seeking acceptable solutions to problems through a genuine exchange of views and information. Consultation does not remove the right of managers to manage – they must still make the final decision – but it does impose an obligation that the views of employees will be sought and considered before decisions are taken.

Continuous Full or part time employment with the Trust or any previous NHS

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Service employer. If there is more than one NHS employer, there must not have been a break of more than one week (Sunday to Saturday) between employments or a redundancy payment taken from previous NHS employment.

This reflects the provisions of the Employment Rights Act 1996 and Agenda for Change handbook (where applicable) on continuous employment.

Early retirement on the grounds of redundancy

Members of the NHS Pension Scheme who are made redundant and meet the conditions of continuous/reckonable service, may choose to retire early without reduction in the value of pension benefits, as an alternative to receiving the full lump sum redundancy benefit (as above). To qualify for early retirement the employee must: be a member of the NHS Pension Scheme;

have at least 2 years’ Continuous Service and 2 years’ pensionable membership; and,

have reached the minimum pension age in accordance with the relevant NHS Pension Scheme arrangements.

Equality Analysis

An analysis of the effect on equality for all of the [protected characteristics] and all of the aims of the general equality duty. The Trust needs to demonstrate that due regard has been given to the aims set out in the general equality duty (see [Equality Act 2010], Appendix 1).

The analysis is done before the change is developed or during the early stages of development and poses the question ‘what would happen in relation to equality and good relations as a result of this change?’ This is not limited to identifying and removing negative effects or discrimination, but also to identify ways to advance equality of opportunity and to foster good relations. It is also not limited to the impact to employees but also the community the Trust serves.

Major organisational change

Includes: reorganisation, relocation of a service, merger, expansion or closure of a service, competitive tendering or outsourcing, a major change in working practice or a significant change in terms and conditions of service. This list is not exhaustive.

Minor organisational change

May be implemented without the need to go through formal processes within the policy but will require reasonable consultation.

No posts are at risk of redundancy and may or may not impact employees e.g. change in practice or change in line management.

New Post Normally a new job title, new or substantially changed job description or new pay band will be proposed (see Management Guide for indicative proportions).

Open Meeting A group meeting that is held by the manager leading the change.

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All employees affected by the change will be invited as well as recognised Trade Union/Staffside representatives. It may also be appropriate to invite relevant stakeholders.

Prior to the open meeting the consultation paper should be given to all employees affected and their Staffside representatives. A minimum of 7 calendar days’ notice of the meeting should be provided. At the open meeting the proposed changes will be introduced and employees/representatives can raise initial comments and questions.

Organisational Change

Any structural or managerial change in the organisation of the Trust’s service provision. This may or may not have an impact on employees.

Pool The pool is the group of employees who are potentially at risk of redundancy. The pool will normally consist of employees who carry out the same, or similar work and perform jobs that are interchangeable, which may or may not be in the same department or location, or on the same shifts according to the scope of the change. Managers must think carefully when considering the choice of pool. The starting point is usually to consider which particular kind of work is ceasing or reducing. Other factors that are likely to be relevant to identifying a pool are:

What type of work is ceasing or reducing The extent to which employees are doing similar work The extent to which employees' jobs are interchangeable Whether there are employees doing similar work at other

locations where appropriate

Whether the selection pool was agreed with the Staffside/Trade Union [Representatives]

Employee preferences, where considered appropriate Where two posts are the same but have been banded differently (e.g. where there has been a TUPE transfer of employees) both jobs will be re-evaluated to determine whether they are the same job and if they should be included in the pool.

Reckonable Service

[Continuous Service] plus:

any service with a previous NHS employer where there has been a break of 12 months or less

periods of employment as a trainee with a general medical practitioner

at the Trust’s discretion, any period of employment outside the NHS which is relevant to NHS employment may be counted as Reckonable Service.

Redeployment The transferring or recruitment of staff at risk into a suitable alternative post within Barts Health or a partner NHS body.

Redundancy - Compulsory

Redundancy is when the Trust dismisses an employee because the Trust no longer:

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and Voluntary carries out/expects to carry out the business for which they are employed

carries out/expects to carry out the business in the place where they are employed

requires them/expects them to carry out work of a particular kind

Or where the above has reduced or is expected to reduce to such an extent that the Trust will need fewer posts. For a redundancy to be genuine, the Trust must demonstrate that the employee's job will no longer exist.

An employee will have their contract of employment terminated on the grounds of (compulsory) redundancy if there is a mutual agreement that no suitable alternative employment can be found prior to the end of their notice period or if a trial period is unsuccessful.

If the [trial period] is unsuccessful, as determined by the individual and/or the manager concerned, redundancy arrangements will apply as from the date when the original contract of employment will terminate.

In order to avoid making compulsory redundancies (as above), the Trust may ask for volunteers for redundancy or early retirement. If a member of staff volunteers for redundancy/early retirement, approval of the request will be subject to the needs of the service and the cost implications. Care must be taken to ensure that decisions are based on sound organisational reasons and do not breach equality legislation. The Trust reserves the right to decline a request for voluntary redundancy. To qualify for a redundancy payment/early retirement benefit the individual must have:

a contract of employment with the Trust; and at least 2 years’ (104 weeks) [Continuous Service] within the

NHS The redundancy payment is calculated on the basis of one month’s pay for each complete year of Reckonable Service, subject to a minimum of 2 years’ Continuous Service and a maximum of 24 years [Reckonable Service] (i.e. the maximum payable is 24 months). If following a redundancy payment the individual secures employment within the National Health Service with a break in employment of less than 4 weeks, they will be required to repay the sum in full. Employees will not be entitled to redundancy payments/early retirement on the grounds of redundancy if they:

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are dismissed for reasons of misconduct; or

at the date of the termination of the contract have obtained without a break, or with a break not exceeding four weeks, suitable alternative employment with the Trust or other NHS employer; or

unreasonably refuse to accept suitable alternative employment with the Trust or another NHS employer; or

leave their employment before expiry of notice, except if they are being released early; or

are offered a renewal of contract with the substitution of a new employer for the Trust; or

where their employment is transferred to another public service employer who is not an NHS employer.

Representative A representative of a recognised Trade Union, an accredited Staffside representative or an Employee of the Trust.

Employees are not permitted to bring legal representation to internal formal or informal meetings.

Ring-fencing The process by which staff at risk will be considered for a post in a new staffing or management structure which is similar to their current post and where there is more than one individual in the pool for that post.

Selection Criteria

These describe how employees will be identified as being at risk of redundancy following consultation (where applicable) and are included in the consultation paper (see [section 4]). n.b. This is not appropriate where there is only 1 employee whose post is at risk. These criteria should be fair, objective, clearly defined, measurable, non-discriminatory, based on the skills and competency requirements of the post and capable of being applied in an independent way. The Selection Criteria must be applied fairly, reasonably and consistently and in accordance with the [Equality Act 2010]. This is to ensure employees are not selected unfairly. Basing any selection on skills or qualification will help to keep a balanced workforce appropriate to the Trust's future needs. Managers must seek advice from HR on the selection criteria to be used. Selection criteria will be discussed, with a view to reach agreement with Trade Unions.

Examples of such criteria (also see Management Guide) include: attendance record (ensuring this is fully accurate and that reasons for and extent of absence are known, discounting absences listed in the Managing Sickness Absence Policy)

disciplinary record (you should ensure this is fully accurate) skills or experience standard of work performance aptitude for work

Formal qualifications and advance skills should be considered, but not in isolation.

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The manager will have a [‘pool’] of employees who are potentially redundant as a result of the change. These are the employees who will be subject to the selection criteria which will identify ‘at risk’ employees. The manager will discuss the constitution of the [pool] with the relevant Staffside/Trade Union [Representatives] at the pre-consultation meeting (see Management Guide)

Slotting In The process by which staff who would otherwise be at risk, are confirmed into a post in a new staffing or management structure which is similar to their current post and where that individual is the only contender for that post. Options for slotting in should be reviewed at the pre-consultation stage (see [section 4]) Slotting in may occur where a post is in the same band as the individual’s current post or where it remains substantially the same with regard to factors such as job content, responsibility, grade/band, status and requirements for skills, knowledge and experience as identified by comparing the Job Description and Person Specification for each post (please see Management Guide for a suggested template matrix). Consideration should also be given to hours and location.

Staff at Risk Staff whose posts are at risk of redundancy as a result of organisational change. The member of staff is issued with notice of redundancy and remains ‘at risk’ until suitable alternative employment is offered (and therefore redundancy would not be applicable) or they are made redundant.

Suitable Alternative Employment (SAE)

Work within the Trust that is on broadly similar terms and within the same range of skills required as the current employment where the individual meets the essential criteria of the person specification. It may be on any site operated by the Trust subject to consideration of the individual’s personal circumstances such as travel, caring responsibilities or mutually agreed flexible working arrangements that are in place or that could facilitate SAE. A post may be considered as suitable alternative employment if it is banded/graded on the same band/grade as the staff member’s current post, or the next lower band/grade (see also [section 5.3] and supporting Management Guide). Posts on reduced hours are not considered SAE, except where this is acceptable to the employee. Where this is the case, it should be confirmed in writing/electronically by the employee. Where an employee is able to be offered their ‘old’/original post in the new structure after being declared ‘at risk’ (see below), this will be considered an offer of suitable alternative employment and therefore redundancy would not be applicable. This does not stop employees applying for jobs at other bands by the normal means. In which case, pay protection would not apply (see [Appendix 2]).

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If, as a result of organisational change, there is a requirement to move employees from their normal place of work to another location within the Trust and this results in increased travel costs to and from work, employees may be reimbursed their extra daily travelling expenses for a fixed period of time in accordance with the Trust’s Expenses Policy (see [Appendix 2]).

Trial Period The purpose of a trial period(s) is for both the manager and the individual to assess the suitability of the post as alternative employment. This will normally be for a period of 4 weeks, but may be extended up to 12 weeks by mutual agreement or longer where a period of retraining is needed (max. 6 months). A Trial Period applies to employees at risk and where a formal offer of suitable alternative employment has been made. Where employees have the potential ability but not the immediate experience to undertake full duties of the role, they will be provided with appropriate skills development/training. This will be provided when it is reasonable, practical and cost effective and where the member of staff demonstrates a willingness to learn and can apply the new skills within an agreed timeframe. A robust review (appropriate for the post) will take place at the end of the trial period to assess whether it has been a success or not. This will include an assessment on whether a ‘good faith’ approach has been taken to the process (e.g. whether the employee has made a genuine attempt to settle into and adapt to the new role with necessary support). Where a trial period is unsuccessful the employee will return to their previous ‘at risk’ status and redundancy arrangements will apply as from the date when the original contract of employment will terminate.

TUPE Transfer of Undertaking (Protection of Employment) Regulations 2006 (see management toolkit for further details).

This refers to the transfer of services from one organisation to another and the employment of the staff who are assigned to those services will also transfer to the new organisation.

All the terms and conditions within the transferring employee’s contract of employment will transfer with them unless declared in the measures letter and should not be changed as a consequence of the transfer.

3 DUTIES and Responsibilities

Employee Where possible, be involved in the planning stages of organisational changes

Engage in the consultation process, helping to develop the change to achieve the best outcome for the patients, service and employees

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Raise concerns and discuss improvements and where possible proposing alternatives/developments based on own research, observations or innovation

Engage in the process of filling posts following the change and any subsequent redeployment process

Play an active role in the implementation of the changes

Understand that if they do not engage by applying for suitable alternative employment or notifying their manager that none is available in writing or unreasonably refuse an offer of suitable alternative employment they will no longer be eligible for redundancy pay

Where a representative is unavailable on a proposed one to one meeting date, the employee will provide their manager with an alternative within 7 calendar days of the original date or an extension to this by mutual agreement to take place within a reasonable timeframe

Respect confidentiality at each stage of the process

Manager Ensure employees are aware of and understand the policy and their responsibilities (this may include supporting employees by providing [reasonable adjustment] e.g. providing the Policy in Braille/large print/Easy-Read or in a language other than English, or reading it to them)

Develop services to achieve the best outcomes for the patients and service with due regard to the welfare and rights of employees (these may be mutually exclusive)

Base changes on national guidance, best practice research and innovation

Be sensitive to individual employee needs and discreet and consistent in their approach

Involve employees in the design of the proposed change and have due regard for their input (except in exceptional circumstances) and consult with affected employees and their Representatives

Ensure there is a continuous effective communication loop where employees receive information about the change and can feed back their thoughts and opinions and make meaningful contributions

Engage with Staffside/Trade Union colleagues as early as possible in the whole process (see [section 4])

Send Staffside/Trade Union representatives a copy of the consultation paper (including the change programme sponsor and lead) at least 7 calendar days before the [Open Meeting]

Carry out an [Equality Analysis] and obtain review sign-off from Human Rights, Equality and Diversity Manager prior to launch of the consultation and include in the consultation documents. Review following any changes to the proposed change ensuring that there are no adverse effects or discrimination against any of the protected characteristics

Where there is potential for redundancy, set [selection criteria] to identify [at risk employees] and include these in the consultation paper

Consider changes/improvements/concerns that employees may have about

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the changes

Support employees to find suitable alternative employment where they are displaced following the change as part of the redeployment process

Regularly liaise with HR and finance regarding the change/modifications to the change

Inform employees of support and training/development that is available to them

Make staff aware of suitable alternative posts in writing/electronically and liaise with HR where none is available

Inform employees of their right to representation (Trade Union/Staffside representatives or an employee of the Trust) at formal meetings in writing

Consult with absent employees e.g. those on Maternity/Adoption/Paternity leave, Long Term Sickness etc. to ensure that they are not put at a disadvantage due to their pregnancy/maternity status or absence


Human Resources

Provide advice, support and training to managers about the application of this policy

Highlight possible suitable alternative employment to the employee and their manager in writing/electronically

Advise on the application of this policy to employees


Notify the Secretary of State in writing of proposed redundancies in line with statutory notice periods for redundancy (i.e. 20-99 redundancies, 30 days before first dismissal and 100 or more redundancies 45 days before first dismissal)

Staffside/ Trade Union representative

Work with the manager to develop the early plans for the change, helping to develop the change to achieve the best outcome for the patients, service and employees

Advise on the application of this policy to employees

Represent members at consultation [open meetings]

Represent members at formal one to one meetings

Facilitate and support employees in collating and presenting issues, concerns and responses including alternative proposals


3.1 If the employee feels that this policy is being applied unreasonably or not followed they should

follow the process laid out in the [Grievance Policy].

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4 PLANNING AND CONSULTING ON CHANGES

The flowchart below sets out the process for the development of the change. If there is a possibility of

redundancy, read in conjunction with the [Redundancy Process]

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Management of Change – Planning and Consultation StageP

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e Manager discuss draft proposal with HR & Finance

Draft proposal to include:

Current situation analysis including current structure

Rationale for & aim of change

Impact on patient care & any risk assessment

Options considered for achieving aim

Proposed change(s) including proposed structure

Finance/staffing/workload impacts

Numbers & bands of staff affected

Method of selection for posts in new structure

Selection criteria for redundancy (see redundancy process) & steps

taken to avoid compulsory redundancies

How information will be shared

Consultation process & subsequent steps

Identify who is leading the change programme lead & the sponsor

Finalise proposal & produce a consultation paper

Hold pre-consultation meeting with Staffside/Trade

Union Representatives to discuss the proposed

change & agree further dates to meet

Begin consultation with timing proportionate to the

degree of change

30 calendar days where there are no proposed redundancies or

shorter by mutual agreement;

30 calendar days before first dismissal where there may be 99 or

fewer redundancies;

45 calendar days before first dismissal where there may be 100 or

more redundancies.

Duration may be shortened or lengthened where there is

agreement for this.

Where there may be 100 or more redundancies a dedicated

consultation sub group will be formed.Hold Open Meeting for team consultation with

Staffside/Trade Union representation

Give employees & Staffside/Trade Union

Representatives reasonable notice (min. 7 calendar

days) of the Open Meeting & provide with a copy of

consultation document.

Carry out Equality Analysis & relevant Health &

Safety assessment on the proposed changes &

amend plans to minimise adverse effects such as

voluntary redundancy

Invite (in writing) to a minimum of 1 1:1 meeting with right to

representation.

Discuss how the changes impact the employee, answer any

questions or concerns & discuss possible options

Employees & Staffside/Trade Union

Representatives give ideas for improvements/

development of the plans/concerns

Hold individual consultation meetings

Consultation ends

No

Meet with Staffside representative as a mid-

consultation meeting to review feedback received

Need for a change is identified

Consultation Paper to include:

All details listed for draft proposal plus:

Any supporting documents/evidence (e.g. benchmarking)

Job Descriptions for new posts in the structure (where available)

Equality Impact Assessment (& Health & Safety Assessment

where applicable)

Discuss:

Quality & sufficiency of information/the process

Staff questions/issues/concerns

Hold post-consultation meeting with Staffside/Trade

Union Representatives

Start to implement changes/give at

least reasonable notice where relating

to change in terms or conditionsFollow process for filling positions

Should contain:

Give response to feedback submitted by employees/Staffside

Details of any changes made, their impact & reason for change

Revised Equality Impact Assessment (& Health & Safety

Assessment where applicable)

Update on information included in original consultation paper

including JDs where applicable

Change involves

displacement of

employees?

Hold final employee open meetingHold no more than 7 calendar days before consultation ends

Summarise feedback received & when they will receive

outcome

Produce outcome paper & circulate to employees &

Staffside representatives

Discuss:

Process, responses received & issues

Attempt to resolve outstanding issues

Attempt to reach agreement

Yes

See redundancy process where redundancies likely

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5 Redundancy process

5.1 Where there may be redundancies, the following process should be read in addition to the

[Planning and Consulting on Changes]:

Redundancy Process

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Genuine redundancy

situation (see section 2)

Consider Pool, selection criteria and list any

possibly suitable alternative vacancies in the

proposed structure

Notify HR where more than 20 staff are likely to

be made redundant. HR notify Secretary of

State

Carry out consultation process

(section 4)

At Open Meeting also explain:

Reasons for potential redundancies

How many jobs are potentially at risk

Ways of avoiding redundancy that are being explored

Invite suggestions for ways to avoid redundancies

Selection criteria and ‘pools’

Right to take time off to seek suitable alternative employmentConfirm information given at Open

Meeting in writing Include:

Selection criteria

Scoring guidelines

Apply selection process to each

potentially redundant employee

Write to those employees

provisionally selected for redundancy

and invite them to a meeting to

discuss their selection

Invite in writing with 7 calendar days notice.

Include right to representation.

Meet with employees individually

+/- representative

Employee is declared ‘at risk’ &

confirmed in writing

Move to section 6 – Filling positions

and Redeployment

Discuss:

The employee’s outcome from the selection

Consider comments from employee

Details of alternative roles

Inform of right to appeal selection (see section 7)

Hold individual consultation meetings Hold as per planning & consulting stage, but discuss which

roles might be suitable for them in the new structure

Consideration should be given to reducing overtime,

temporary staffing, contractors & freezing of vacancies where

appropriate before making redundancies

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6 FILLING POSTS IN THE NEW STRUCTURE AND REDEPLOYMENT

6.1 Following the consultation, the following process will be applied to fill positions in the new

structure and redeploy

employees:

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Management of Change – Filling Positions and Redeployment

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Is the post substantially

different to the previous post?

Manager will identify

which posts the

existing members of

staff will be ‘slotted-in’

to the revised structure

Employees are declared ‘At Risk’ of

redundancy. These employees

should have priority applications/

manager should invite them to apply

for new posts in the new structure

before they are advertised for open

competition outside the department

Are there sufficient

posts for the number of

staff?

Employees to fill the limited posts

will be selected on a ‘ring fenced’

basis by competative interview

No

Yes

YesNo

Staff are slotted into

the new structure

All employees

selected?

End process

All employees

selected?

Those not selected for the new

posts will be formally given notice

of redundancy.

Staff will be registered for

redeployment within the Trust (or

elsewhere in the NHS) on NHS

Jobs as an ‘At Risk’ candidate to

seek suitable alternative

employment

See Redeployment

Process

Yes

No

No

Employee meets with line manager & completes the

[Redeployment Registration Form]

State:

Reason for Redeployment

Skills & Knowledge

Experience

Preferences for types of post

Manager sends form to HR & their details are added to

the redeployment register. Employees who are ‘At Risk’

will be flagged as such

HR will notify the

employee & their

manager of any suitable

vacancies

Employee & their manager

continue to look for any

suitable vacancies on NHS

Jobs/Intranet

Employee notifies their line manager

Line manager contacts the recruiting

manager. If employee meets essential

criteria for the post they will be given

priority for interview

Employee attends interviewEmployee

successful?

Trial period can be

extended by mutual

agreement for up to 12

weeks

Yes

No

This is considered SAE.

Manager confirms in

writing

Yes

Has notice

ended?

Contract is

terminated

No

Yes

Employee is

appointed

subject to a 4-

week trial period

Trial period

successful?

Yes

No

This is considered

SAE. Manager

confirms in writing

End process

SAE found?

Yes

No

Employee is:

At Risk of Redundancy or

Needs redeployment due to ill health/capability problems

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6.2 Please note that the redeployment process outline above will also apply for ill health/capability

redeployment.

6.3 SAE must be brought to the employee’s notice in writing or by electronic means before the date

of termination of contract and with reasonable time for the employee to consider it. The

employment should be available no later than 4 weeks from that date. Where this is done, but

the employee fails to make any necessary application, the employee will be deemed to have

refused SAE.

6.4 When an employee is declared ‘At Risk’ of redundancy, their line manager will write (see

supporting Management Guide) to them informing them of their at risk status and confirming

the following:

Number of weeks contractual/statutory notice

Effective date of redundancy, which will also be the last day of service

Amount of outstanding annual leave

Amount of redundancy payment which will be paid (where applicable)

What help will be provided to help the employee find suitable alternative employment

during their notice period

What support is available during their notice period

What work the employee will be expected to do whilst working their notice

Confirm that reasonable time off with pay will be given to seek and prepare for alternative

work

That early release will normally be given, unless there are compelling service reasons

against this, where the employee successfully obtains suitable alternative employment.

Where agreed, this will be the new date of redundancy for the purposes of calculating

redundancy pay

Right of appeal against redundancy

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7 TUPE

7.1 The flow chart below sets out the process for TUPEing staff out of the Trust

TUPE Out

TU

PE

Proposal to transfer services

to different employer

Inform Staffside of the proposed transfer & liaise

where necessary at a pre-consultation meeting

Begin consultation with timing proportionate to

number of staff affected by transfer

Manager will write to employees affected &

Staffside informing them of the intention to

transfer staff

Include:

Services, posts & individual staff who will

transfer or be affected by the transfer

Implications of the transfer

Any measures which will be taken in connection

with the transfer

Normally 30 days (unless this is not feasible) or

90 days where 100 or more staff are affected

Hold individual consultation meetings (on

request)

Invite (in writing) to any one to one meetings with right

to representation.

Discuss how the changes impact the employee,

answer any questions or concerns & discuss possible

options

Confirm discussion in writing & remind of

support available

Manager gives formal notice of the transfer as

early as possible.

This will be 3 months notice where possible .

Where this is not possible, a shorter notice period will

be provided after consultation with the Partnership

Board.

Employees transfer

to new organisation

Manager continues to communicate progress &

changes to employees throughout process up to

transfer

Inform HR of the proposed transfer

Identify affected employees & create measures

letter & due diligence

Invite new employer & Staffside to an open

meeting to meet employees & answer questions

7.2 Where an employee refuses to TUPE transfer they should state this in writing to their manager.

This will be understood to be a resignation from their post with no entitlement to redundancy

payments.

7.3 If individuals are TUPE tranferring into the Trust, the manager should notify HR so that the

necessary [due diligence] and review can be undertaken. The manager should make efforts to

meet with the transferring individuals (possibly at a consultation meeting) before they TUPE

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transfer in order to welcome them to the Trust and answer any questions the individuals may

have regarding the transfer.

8 RIGHT OF APPEAL

8.1 Employees may appeal against their selection for redundancy. This should be made in writing to

the manager of the person who notifies the employee of their ‘at risk’ status within 14 calendar

days of receipt of the letter confirming their ‘at risk’ status and confirm the reason for making

the appeal.

8.2 All employees who are dismissed by way of redundancy as a result of organisational change have

a right of appeal. This should be made in writing to the Director of HR within 14 calendar days

of the letter confirming the dismissal and confirm the reason for making the appeal.

8.3 Reasons for appeal should be based on the following areas:

Unfairness by comparison to how the policy has been applied to others (including selection) or bias of the manager;

Incorrect decision based on the evidence provided to the manager;

Did not follow the procedure detailed in the policy;

New evidence has come to light since the dismissal that would have affected the decision.

9 Impact and Equality analysis

9.1 An Equality Analysis has been carried out for this policy and has concluded that there are no

detrimental effects and some positive effects of this policy. The analysis has been included here:

23 03 12 Managing Change Policy EqAnalysis.doc

10 Monitoring the effectiveness of this policy

Issue being monitored

Monitoring method

Responsibility Frequency Reviewed and followed up by

Overall policy

compliance

Review of work of Corporate Policy Review Group and related policy bodies

Chair of Corporate Policy Review Group

Annual Trust Management Executive

Compliance

with duties

within

Equality Act

Report on demographics of displaced employees

Human Resources

Bi-Annually (every 6 months)

Partnership Board CAG Local Consultation and Engagement Board

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Meaningful

consultation

with

employees

Feedback from employees/Staffside representatives Review grievances raised in relation to organisational change

Staffside Human Resources

Bi-Annually (every 6 months) Bi-Annually (every 6 months)

Partnership Board CAG Local Consultation and Engagement Board Partnership Board CAG Local Consultation and Engagement Board

END

Appendix 1: Glossary of terms

Equality Act 2010

Replaces previous discrimination law (e.g. Disability Discrimination Act 1995) and includes the following: Extends the groups protected (protected characteristics)

Removal of health questionnaires Bans discrimination by association Bans direct and indirect discrimination Bans harassment, victimisation and failure to make

reasonable adjustments

Replaces all previous discrimination law Introduces harassment by third parties

Also relates to provision of services to patients, not just employment

Protected Characteristics (part of the Equality Act 2010)

Age Disability Gender Reassignment Marriage and Civil Partnership Race

Religion or Belief Sex Sexual Orientation (Pregnancy and Maternity – only some elements apply)

Reasonable Adjustments (part of the Equality Act 2010)

An ‘adjustment’ is a change. This can be a physical change or a change in the way something is done.

‘Reasonable’ will depend on a number of circumstances but the tests include:

How much will a reasonable adjustment reduce the disadvantage?

The practicality of the change.

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The financial and other costs and the extent of any disruption caused.

The extent of the Trust’s financial & other resources.

Although the Trust must consider reasonable adjustments for employees who have a disability or are pregnant, it is best practice for them to be considered for all employees to facilitate attendance and implemented where service delivery allows.

Due Diligence A process of information sharing and investigation undertaken prior to agreeing a TUPE transfer.

The organisation that is transferring a service (the ‘undertaking’ in the Act) out will provide certain information to the organisation that is receiving the transferred service. Some of this information will relate to the staff who will transfer with the service; this part will be done between the two HR departments. The rest of the information (e.g. finance information, service details etc.) will be provided to the new organisation by the manager.

Flowchart Colour Key

In order to assist reading the flowcharts, please note that specific information has been colour coded. Orange hexagons = Start of process/specific milestones Green rectangles = the process to be followed Yellow diamonds = a decision to indicate which part of the process to follow Blue rectangles = provide further information (e.g. topics to be discussed, required information in written correspondence etc) Purple oval = end of process

Orange rectangles = possible outcomes

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Appendix 2: other linked trust policies and guidelines

Title differences where policies have not been amalgamated

Barts and The London (& CHS)

Newham University

Whipps Cross University

Pay Protection n/a n/a n/a

Stress Management

Managing Work Related Stress Policy and Guidance (CHS equivalent)

Policy for the Prevention and Management of Stress at Work

Stress Management Policy

Expenses Policy

Relocation of Normal Work Base: Excess Travel Arrangements

Flexible Working Policy

Flexible Working Policy (CHS equivalent)

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Appendix 3: Extra sources of information and Support

Employee Assistant

Programme provided by

CiC

A free service to all employees provided 24 hours 7 days a week which includes advice on

debt, legal issues, caring and childcare and offers face to face counselling services.

Tel. 0800 085 1376

Or access them via www.well-online.co.uk

Management Advice Line

provided by CiC

A dedicated helpline for managers, offering guidance and support on dealing with the

interpersonal aspects of their role as a line manager, such as how best to manage a

difficult situation or sensitive subject with an employee.

If you are a Manager please call 0800 085 3805 to access the Managerial Advice Line.

Or access them via www.well-online.co.uk

http://www.well-online.co.uk/


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Appendix 22 – Band 6 Ward Nurse Job Description To be provided

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Appendix 23 – Band 8C Head of Service Job Description To be provided

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Appendix 24 Band 8C Head of Midwifery Job Description To be provided

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Appendix 25

Preliminary Equality Analysis Tool

Name of Service, Policy or Function: CONSULTATION DOCUMENT – MANAGEMENT, NURSING AND ADMINISTRATIVE WORKFORCE EFFICIENCY

Name and contact details of individual / team completing analysis: Hardev Malhi, Equality & Diversity Advisor

Date of completion: 22 August 2013 Review Manager’s Signature:

This form has been devised to enable you to analyse how your service, policy or function may affect equality and human rights. Additional supporting documents may be found on the Trust’s Intranet.

For support and advice please contact the Inclusion Team:

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Banji Adewumi [email protected] Khasruz Zaman

[email protected]

Dilwar Hussian [email protected] Hardev Malhi [email protected]

Also consult the ‘Equality Analysis Completed Forms’ (supporting documents) to assist you.





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You need to consider how your Service, Policy or Function meets the 3 aims of the Public Sector Equality Duty (Equality Act 2010) to:

1. Eliminate unlawful discrimination. 2. Advance Equality of Opportunity. 3. Promote Good Relations between communities.

The consideration of all 3 aims must be made in reference to the following Protected Characteristics and Human Rights Articles. If no relevance is found for a specific Human Rights Article – just state that this is so.

Protected Characteristics: Human Rights Articles

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Age

Race

Disability

Gender Reassignment

Religion or Belief

Pregnancy & Maternity

Sexual Orientation

Sex

Marriage & Civil Partnership

A2 Right to Life

A3 Prohibition of torture, inhuman or degrading treatment

A4 prohibition of slavery & forced labour

A5 Right to liberty & security

A6 Right to a Fair Trial

A7 No punishment without law

A8 Right to respect for private and family life

A9 Freedom of thought conscience and religion

A10 Freedom of expression

A11 Freedom of assembly and association

A12 Right to marry and found a family

A14 prohibition on discrimination

Think about the affect your service, policy or function may have on the protected characteristics and human rights articles i.e. what benefits and disadvantages could there be in light of the 3 aims of the duty. To help you identify the potential for benefits or disadvantages it’s useful to consider the list below:

1. Communication and information: Can this protected characteristic access communication and information

appropriate to their specific needs? e.g. if a matter has to be ‘put in writing’ is it also recognised that ‘reasonable adjustment’ for patients and staff with disabilities will be made and that translation services are available for those whose first language is not English? How do you ensure informed consent in the context of disability?

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2. Health Inequalities: is a particular protected characteristic affected by a particular health inequality which this

service, policy or function relates to? How does this influence the content of the policy and delivery of the service or function?

3. Involvement & Access: does the service, policy or function enable each protected characteristic to fully participate

and have equal access? Will their dignity be respected and how will you ensure that it is?

4. Representing diverse communities: does the way that communication and information is delivered / provided

reflect diversity e.g. do leaflets reflect diverse images; same sex couples, different religion & beliefs, different ages etc. Is information available in different formats? e.g. Easy Read, Braille, Large Print, Different Languages etc.

5. Proportionate means to a legitimate aim: the law recognises that sometimes a particular disadvantage is

unavoidable e.g. a carer with a heart pacemaker cannot enter the imaging room to provide support during an x-ray procedure, this may be viewed as disadvantageous to the carer but it is actually legally ‘a proportionate means to a legitimate aim’ to ensure the health & safety of carers.

6. Disease or condition profile: is a particular protected characteristic particularly affected by the disease or

condition being addressed by this service, policy or function? How will this influence the content of the policy and how the service or function should be delivered?

7. Diverse & Specific needs: does the service, policy or function recognise the specific needs of each of the

protected characteristics and take them into account? How do you ensure this?

This list can easily be remembered as C.H.I.R.P.D.D. Consider all the questions above as you complete the Equality Analysis Form.

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Completing the Equality Analysis Table

Completing the Equality Analysis Table is no more difficult than completing any type of risk assessment. The intention is that the task is completed collaboratively with support and advice from others. The Inclusion Team are available to assist you.

Equality Area

(Refer Page 2)

Positive Impact

Negative Impact

Neutral Evidence

Age

X This consultation does not negatively affect staff from different age groups.

Race X This consultation has no negative impact in reference race. Staff from all

backgrounds will be treated equally and fairly consultation and redeployment.

Sex X This consultation does not negatively affect staff from different age groups.

Disability

X Staffs that are currently on sick leave should not in any way be

disenfranchised by this consultation. Staff on sick leave should be notified in

writing of the consultation and how they can take part in the process. Where

changes to jobs/posts do occur those staff on sick leave should be notified

about the changes and the process of redeployment etc. should be explained

by line managers.

It is important that staff who have disabilities are not negatively affected by

the redeployment process. Any reasonable adjustments that are currently in

place in the present job should also be made available in the new posts.

Information in different formats should be available if needed.

V1.1.9 Final 23.8.13 PF 134

Equality Area

(Refer Page 2)

Positive Impact

Negative Impact

Neutral Evidence

Sexual Orientation

X This document has no impact on reference to Sexual Orientation

Gender Reassignment

X This document has no impact on reference to Gender reassignment

Marriage & Civil Partnership

X This consultation has no negative impact on reference to marriage and civil partnership.

Religion or Belief

X This consultation has no impact on reference to Religion or belief.

Pregnancy & Maternity

X This consultation makes reference to staff on Maternity and or Paternity

Rights. Staff who are affected by the changes and are currently on Maternity

or Paternity leave should not be disadvantaged in any way. staff affected

should be notified of the consultation in writing and have the means to take

part in the consultation. Any changes affecting their jobs/posts as a result of

the consultation should be discussed with the staff member, if needs be with

a home visit or on a one to one basis.

Human Rights (Dignity & Respect)

X This consultation does not contravene any of the articles of the human rights act.

Consultation/contribution Consultation is an important element of all Equality Analysis. Please list the groups/stakeholders (i.e. Staff Diversity Network, Patient Groups, Trade Union/Staff Side, Community Groups, etc.) who have been consulted about the Equality Analysis and what contribution they have made.

V1.1.9 Final 23.8.13 PF 135

A copy of the Equality Analysis has been sent to Staff side for their consideration.

Summary

Please provide an overview of key findings as a result of completing this exercise including any measures to eliminate discrimination and promote equality of opportunity. Also, as part of the evaluation and monitoring process, to include the diversity monitoring of staff who retire as part of workforce information reporting

V1.1.9 Final 23.8.13 PF 136

Action Plan Please complete the table below outlining agreed actions to mitigate against any identified Negative affects / impacts. Actions must be S.M.A.R.T: Specific, Measurable, Achievable, Realistic, and Time-bound.

Identified negative affects / impacts e.g. in reference to:

S.M.A.R.T (mitigating) action Lead Timescale Measures for success

Comments

1 Staff, Patient, and Stakeholder involvement:

2 Equality Monitoring: E.A results are to be monitored in an accessible way ensuring stakeholders are informed of how their views have informed the process.

3 A

4

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5

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Appendix 26 – Employee Assistance Programme CiC provides a free and confidential information, support and counselling service – ‘Confidential Care’ - to all Barts Health staff. This service can be accessed 24 hours a day, 7 days a week, 365 days a year. It is accessible in the following ways:

Telephone: 0800 085 1376

Text Relay: 18001 0800 085 1376

Website: www.well-online.co.uk Confidential Care is independent, free and completely confidential. The service is staffed by a range of highly experienced consultants, including counsellors, psychotherapists, solicitors and financial experts, all qualified to provide clear, relevant guidance on the challenges you face. You can get practical advice and information on a range of issues including debt legal (excluding employment law), financial and tax advice. There is also a service called ‘Family Care’ for support with all child, elder and disability care issues, including finding a care home for an elderly relative to locating a play group or after school club in your area. The ‘Everyday Matters’ service is a valuable, time-saving tool that can help locate any service, activity or supplier in your area, including GP surgeries, health and fitness facilities, adult education and specialist retailers. Travel advice is also available. If counselling is the most helpful way forward, you can be referred for a limited number of sessions with a fully qualified counsellor.


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Appendix 27

Senior Staff Nurse for Quality

Job description

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Date: 21 August 2013

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Context

Barts Health NHS Trust is one of Britain’s leading healthcare providers and the largest trust in the NHS. It was created on 1 April 2012 by bringing together three trusts: Barts and The London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust. The new trust has a turnover of approximately £1.1 billion and approximately 15,000 employees. Together our hospitals - Newham University Hospital in Plaistow, St Bartholomew’s (Barts) in the City, The Royal London in Whitechapel, The London Chest in Bethnal Green and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield. The hospitals offer a full portfolio of services that serve the needs of the local community, and are home to some of Britain’s leading specialist centres including cancer, cardiac, trauma and emergency care. Barts Health also has one of the UK’s busiest children’s hospitals and internationally renowned surgical facilities. Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve – one dedicated to ending the historic health inequalities in east London. We will build an international reputation for excellence in patient care, research and education. And as members of UCLPartners, the largest academic health sciences system in the world, we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments. We are looking for the best talent to lead our ambitious new healthcare organisation. In return, the Barts Health will provide unsurpassed professional development opportunities, enabling investment in a range of new initiatives that would mean:

• doctors and nurses in training will be able to gain experience in different hospitals along

the whole patient pathway;

• there would be greater opportunity for career progression – we could retain good staff

who might otherwise leave to gain promotion;

• becoming world-class will enable us to recruit some of the best doctors and researchers

in the world – who can share their knowledge and experience;

• joining forces with other partners in an Academic Health Science System will mean that

staff would be better able to secure funds and pool their talents to develop new technology, techniques and treatments.

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Job description

Job title: Senior Staff Nurse for Quality

Clinical academic group:


Salary band: Band 6 to be confirmed

Responsible to: CAG Director of Nursing Senior Nurse Corporate Nursing Human Resources Multi-disciplinary team

Accountable to: Ward Sister/Charge Nurse

Hours per week: State total hours a week the role require 37.5

Location: Relevant CAG


Yes

Manages: Direct reports: Band 5 staff nurses

Indirect reports:

Aim of the role

The Senior Staff Nurse has delegated responsibility for the management of the clinical areas including assessment of care needs, the development, implementation and evaluation of programmes of care and the setting of standards on a shift basis. The Senior Staff Nurse will participate in innovation and evidence based nursing practice through professional leadership and supporting the clinical team in close liaison with the Sister/Charge Nurse and Junior Sister/Charge Nurse. The Senior Staff Nurse will act as a credible and professional role model and encourage and empower other staff to develop both personally and professionally to achieve their maximum potential. The Senior Staff Nurse will lead on the implementation and development of care standards to reflect the ‘becausewecare’ initiative and will ensure that nursing practice is evidenced based according to Professional and National guidelines.

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Manager



The Senior Staff Nurse will lead on the implementation of education and development plans which involve the induction, mentoring, preceptorship and the on-going professional development of all staff on the Unit. This will also include ensuring robust systems are in place to record and monitor ward performance against agreed targets for Mandatory training


Key Relationships: Ward Manager

Senior Nurses CAG Director of Nursing Corporate Nursing Human Resources Multi-disciplinary team

It is usually best to draw the organisation chart with the manager in the centre at the top, the job in question immediately below with peers on either side. Jobs that report to the post holder should then be shown below.

Main duties and responsibilities Communication & Relationships Skills

Facilitate communication, which results in clear responsibilities being identified within the multi-professional team

There is a requirement to exchange verbal and written information with patients, staff and carers requiring tact and diplomacy. The post holder needs

V1.1.9 Final 23.8.13 PF 146

to ensure that all barriers to understanding are overcome by using differing strategies to meet individual need,

Deputise for the Sister/Charge Nurse at Directorate/ Divisional meetings and working groups in relation to improvement in patient care

Ensure that patient concerns are addressed on the ward/department and work with the Patient Advisory and Liaison Service (PALS) and patient forums. Participate in the resolution of complaints / adverse incidents and support the Sister / Charge Nurse in the development and implementation of action plans to prevent re-occurrence.

Will liaise with clinical experts in aspects of critical care to ensure clinical practice reflects the current deficit base.

It is expected that ALL employees of the Trust will take part in the appraisal process each year with the first appraisal taking place within the first 6 months from appointment

Cascading information relating to clinical standards to promote ownership amongst the clinical team

Use excellent presentation skills to deliver training and education sessions and be able to manage varying levels of understanding. The education sessions will range from one to one, small or large groups.

Participate and co-ordinate activities in the ward area to gain feedback on patient experience

To support the ward manager in the leadership and objective setting of the ‘#becausewecare’ initiative.

Lead on audits i.e. CQC, safety thermometer.

To be the safety link nurse for the ward. Knowledge, Training & Experience

Current NMC registration

Evidence of study at degree level in Health/Nursing Related Studies

ENB 998/ Mentorship module or have experience of teaching and assessing

Formal leadership and management training

Minimum of 3 years post registration experience to include 1 year experience of taking charge of a ward on a shift basis.

Ability to lead change and lead new ways of working

Analytical & Judgemental Skills

The post holder will be responsible for the assessment of needs, development, implementation and evaluation of programmes of care in line with the Nursing and Midwifery Council (NMC) and reflect the Trust’s policies, procedures standards and guidelines.

The post holder will demonstrate the skills for assessing and interpreting specialist acute and other patient conditions, initiating actions as appropriate.

Planning & Organisational Skills

The post holder will prioritise, plan workload and organise own time.

V1.1.9 Final 23.8.13 PF 147

Contribute to the principles of clinical governance ensuring that quality standards are set and monitored. Ensure that clinical risk management and clinical audit are an integral part of the ward function.

The post holder will be responsible for planning and facilitating education development programmes for clinical staff, liaising with link nurses within the ward area to influence a learning environment within the clinical area

Supports the Sister / charge Nurse in the planning and organisation of staff delegation and activity for patients, making short term adjustments to electronic duty rosters.

Required to co-ordinate activities with other professional agencies. Physical Skills

The post holder will be required to have the dexterity and accuracy required for procedure such as venepuncture, cannulation and administration of intravenous drugs and is able to demonstrate clinical skills

The post holder will be required to have standard keyboard skills, use of presentation, projection/multimedia equipment and e-learning resources.

Responsibility for Patient/Client Care

To act in accordance with the NMC Code of Professional Conduct for Nurses, Midwives and Health Visitors and to be accountable for own clinical practice and professional actions at all times. Ensure continued and effective registration with the NMC.

Develop specialised programmes of care / care packages providing specialised advice concerning care.

Provide specialist advice relating to nursing care for the speciality of patient Responsibility for Policy/Service Development

Implements policies and procedures, and proposes changes to practices for own area, contributing to the development of specialist protocols.

Assist in the delivery of education to support staff in the adoption of new policies and procedures.

Maintain accurate registers of staff training and development Responsibility for Financial and Physical Resources

Demonstrate safe working practices in the use of equipment in the clinical areas, and maintain equipment training records for all staff

Regularly required to handle patient valuables Responsibility for Human Resources

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Working with the Sister / Charge Nurse, provide leadership to the clinical team and identify innovation in clinical practice

To effectively manage the Ward / Department on a shift by shift basis.

Support the Sister/Charge Nurse in the performance review of all ward staff which will include annual appraisal and individual personal development plans to monitor staff performance against objectives set with them.

Manage sickness and absence on a shift basis in line with the sickness and absence policy and the principles of safe staffing document.

Participate in the recruitment and selection of staff for the ward/department.

Contribute to the formal induction of all new staff.

Facilitate and participate in the preceptorship of newly appointed staff and the education of learners and clinical support workers

Responsibility for Information Resources

Updates and maintains patient records

Maintains comprehensive records of training undertaken Responsibility for Research and Development

Participate as an individual in surveys.

May participate in clinical research, audit and trials

To lead the audit programmes for the ward in monitoring the effectiveness of Proud to Care and other areas requiring monitoring

Freedom to Act

Accountable for own professional actions: not directly supervised.

Leads in the development of training programmes and implementation of the training

Personal/Professional Development

To take every reasonable opportunity to maintain and improve your professional knowledge and competence

To participate in personal objective setting and review, including the creation of a personal development plan

Standards of Behaviour

Managers who have responsibility for supervising/managing people must comply with the guidelines that can be found in the “Code of Conduct for NHS Managers”

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The principles of “Improving Working Lives” must be upheld at all times

The job description is not intended to be exhaustive and it is likely that duties may be

altered from time to time in the light of changing circumstances and after consultation with the post holder.




Physical effort

The post requires a combination of physical effort including sitting, standing, walking which equates to moderate physical effort over short periods i.e. hoisting patients and manoeuvring patients in wheelchairs

Mental effort The post requires frequent concentration with an often unpredictable work pattern

Emotional effort

Deals with distressed relatives, care of the terminally ill and deals with the consequences of terminal illness.

Working conditions

The post holder will have exposure to bodily fluids. The post holder may have exposure to aggressive patients.




Barts Health NHS Trust actively encourage development within the workforce and employees are required to comply with trust mandatory training.

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Barts Health’s education academy aims to support high quality training to NHS staff through various services. The trust is committed to offering learning and development opportunities for all full-time and part-time employees. No matter where you start within the NHS, you will have access to extra training and be given every chance to progress within the organisation. You will receive an annual personal review and development plan to support your career progression and you will be encouraged to develop your skills and experience.




All employees are expected to comply with all trust policies and procedures related to confidentiality and data protection and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receives appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary).




The trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised. The Trust will aim to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job.

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You are responsible for ensuring that the trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services.

NHS managers’ code of conduct

As an NHS manager, you are expected to follow the code of conduct for NHS managers (October 2002). www.nmc-uk.org/

Budgetary management

If you have responsibility for a budget you are expected to operate within this and under the trust’s standing financial instructions (available in the intranet’s policies section) at all times.




http://www.nmc-uk.org/

V1.1.9 Final 23.8.13 PF 152



Essential = E

Desirable = D E or D Application

form Interview


Registered Nurse on NMC Register

Diploma in Nursing

Evidence of degree level study in health/nursing related studies

On-going personal / professional development

Certificates / portfolio of evidence

post grad qualification in the clinical speciality or related speciality

E E D D E D

Experience Minimum of 3 years post registration experience to include 1 years of management/leadership experience

Experience in a leadership role

Good communication skills.

Formal teaching to groups of staff

E E D

Application Form/Interview Interview

Post Senior Staff Nurse for Quality Band 6 Confirmed

Dept/ward Relevant Division

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Essential = E

Desirable = D E or D Application

form Interview

Skills ENB 998 or equivalent or experience of teaching the clinical areas

Evidence of no-going professional education in a specialist area

E E

Interview


Reliability

Effective interpersonal skills

Clinical reasoning

Problem solving and independent decision making

Proven Leadership skills

References Interviews / portfolio of evidence

Communication

Able to use own initiative.

Ability to work as part of a team.

Effective communication skills

Interview


Reliability

Effective interpersonal skills

Clinical reasoning

Problem solving and independent decision making

Proven leadership skills

E E E E E

21 August 2013 Tracey Carter Deputy Chief Nurse

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Appendix 28

consultation document management, nursing and ... · v1.9 final 23.8.13 pf 1 consultation document...

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