Hybrid management in Rehabilitation the service impact of

Hybrid management in Rehabilitation: the service impact of a dual management/clinical role Jo Cartwright Access to Communication and Technology Service Lead

Plan • Traditional Head OT to Service Lead • Leadership Model • Clinicians Perspective • Project Management

Previous Traditional Model • Head OT in a Learning Disabilities Service • No clinical role • Focus on operational and assurance

Access to Communication and Technology National Context • Regional Service • 1 of 16 hubs across England • Deliver specialist service for – Alternative and Augmentative Communication – Environmental Control and Computer Access

Access to Communication and Technology My Role • Manage leads for OT, SLT, Clinical Scientists, Technicians, Stock, admin and clinical support. • Clinical input into mounting appointment clinics • Service Improvement through Project Steering • Operational Management

Access to Communication and Technology Journey • Service bid for funding from NHS England in 2014 to deliver new national specifications • 2 year convergence plan to meet the specifications • Originally there was a project manager • Service Lead appointed in April 2016 • Project Cycles

Access to Communication and Technology Leadership Model Service Lead 8 A Jo Cartwright Speech & Language Therapy Lead SLT 8 A Chris Sherlock Lead SLT 8 A Julie Atkinson SLT Band 7 Catriona SLT Band 7 x 0. 5 Siobhan Murphy Training support worker Band 3 Terri Kelly Healthcare Science Technical Services Access to Communication and Technology Clinical Scientist 8 A Mike Ryan Clinical Scientist Band 7 Ralph Palmer Technologist Band 7 Geoff Harbach Lead OT 8 A . 64 Lynne Allsopp Tech Services Manager B 6 Tony Petrou Lead OT 8 A . 64 Claire Hayward Band 6 Karen Posts Role Technician Band 5 x 3 Tony Mountford Kevin Mc. Grath Brian Darby Band 7 x 2 Stock Lead Band 4 Neelan Moodley Admin team lead Band 4 Marilyn O’Neill OT Band 7 x 3. 78 Lisa Price, Hannah Jeffery, Sue Scott, Nisha Mavji, Mary Groves OT Rotation Technician Band 4 x 3. 6 Vas Tsioumanis, Steve Aldridge, Paul Administration Occupational Therapy Stock Support Band 3 x 3 David Roden Jess Belm Vacancy Rehabilitation Assistant x 2 Band 4 Yas Anisuddin, Band 3 x 2. 5 Anita Higgins Laura Collins Vacancy Band 2 Vacancy OT Band 7 Vacancy

Hybrid Model Hybrid Manager- Professionals‘ Identity work: The Maintenance and Hybridization of Medical Professionalism in Managerial Contexts- Mcgivern et al • Combines clinical, professional, operational and project management • Management across professions • Pathway manager – integrated team

Focus on Project Management Major project work to move from 16 to 37 staff and meet two national service specification

Changing the job of the manager • UIMPROVE principles all improvement takes part project by project. • Workers work in the system. The job of the manager is to work on the system and improve it with their help – Myron Tribus • Manager needs to be project manager as well as clinical and operational

Project Steering Methodology

Project Workforce Planning This project group looked at the learning and development needs of new and existing ACT staff. The work included developing a competency framework. Referral to Provision Pathway This project group concentrated on improving the existing pathway, identifying delays and inefficiencies in order to deliver the pathway from referral to provision in 18 weeks Management of Equipment This project group worked on all areas of equipment management, including procurement, loan equipment, stock control, installation and innovation Planned Preventative Maintenance This project group was responsible for developing a programme of annual testing and maintenance for all equipment on issue Enabling Local Teams This project group was responsibility for engaging with local teams and other stakeholders; establishing their training and support needs and developing programmes to provide the necessary support

Clinically Lead Managerially Supported • • • Must do the day job as a clinician Keep it real know the day to day reality Contribute to activity as one of team Dedicated time to work on quality Link person to commissioners and suppliers

Experience of Clinicians • Knowledge that manager knows the day job not just management • Understands the patient perspective • Pick up the operational which enables clinical leads to focus on professional role

Key Messages • • • Integrated working across the pathway Focus on quality Clinically Lead Shared responsibility Balance understanding the business with compassion for the focus being on the patients needs

References • The Universal Improvement Company http: //www. theuic. com/ • Hybrid Manager- Professionals‘ Identity work: The Maintenance and Hybridization of Medical Professionalism in Managerial Contexts http: //wrap. warwick. ac. uk/67727/1/WRAP_MCGIVERN_ et_al-2015 -Public_Administration. pdf

NHS England Documentation • AAC Service Specification https: //www. england. nhs. uk/commissioning/wpcontent/uploads/sites/12/2016/03/aac-serv-spec-jan-2016. pdf • Guidance for commissioning AAC services and equipment: https: //www. england. nhs. uk/commissioning/wpcontent/uploads/sites/12/2016/03/guid-comms-aac. pdf • EC Service Specification https: //www. england. nhs. uk/wp-content/uploads/2013/06/d 01 -com -dis-equ-env-con. pdf

Any Questions? My Contact Details Jo Cartwright Access to Communication and Technology Service Lead Tel: 0121 466 3102 Email: joanne. cartwright@bhamcommunity. nhs. uk Web: www. bhamcommunity. nhs. uk and www. actwmids. nhs. uk