National Improvement Advisor

Unscheduled Care Improvement Programme

Directoratefor Performance and Delivery, The Scottish Government

£40,833 to 49,000(Band 8A)- Full time preferred

Fixed term/Service Level Agreement (SLA) to March 2019

Based Edinburgh/Glasgow

An exciting opportunity exists for a National Improvement Advisor to support the development of National 6 Essential Actions to Improve Unscheduled Care Improvement Programme and lead improvement projects within dynamic health and social care systems in Scotland.

The Unscheduled Care Improvement Programme will aim to improve staff, patient and carer experience of Unscheduled Care by working with local staff within the NHS to build capacity and capability in improvement methodologies to sustainably improve performance, patient safety and flow through the unscheduled care pathway.

The improvement programme focuses on six Essential Actions: Developing empowered, clinically focused management; a capacity management realignment process; a focus on patient management rather than bed management; establishing medical and surgical processes arranged for optimal care; 7 day services to support in hour, weekend and out of hours; and, ultimately patients being cared for in their own home.

This is a high profile area of work that requires passionate and experienced individuals who will confidently lead, manage, develop and implement improvement projects leading to sustainable performance improvements across a whole health and social care system. If you like a challenge and are committed to delivering innovative and complex programs to a wide variety of stakeholders within the health and social care sector then we want to hear from you. You will work as part of an expert team and have the opportunity to develop your skills in improvement science at a national level across NHSScotland, and learning from initiatives across the UK and internationally.

The successful candidate should possess excellent communication and interpersonal skills to secure clinical and operational engagement and drive safe, effective and person centred improvements in care. Be able to demonstrable understanding of unscheduled care; an in depth understanding of improvement methodologies, with recognised expertise in improvement science and its practical application in a range of health and social care settings. The ability to work within a highly political agenda, manage to deadlines and respond tochanging priorities is essential.

Closing date: 25/10/2017

For an application pack:

Visit:

Informal discussion arranged through:

Syed Kerbalai - Tel: 0131 244 2394 or by email:

JOB DESCRIPTION

1. JOB DETAILS
Job Title: / National Improvement Advisor – Unscheduled Care Improvement Programme
Immediate Senior Officer/Line Manager: / Unscheduled Care Director, Helen Maitland
Department(s): / The Scottish Government - Directorate for Performance and Delivery
Division: / Unscheduled Care National Programme
Job Reference: / UC/NIA
2. JOB PURPOSE
To contribute to the scoping and delivery across NHSScotland of the work streams outlined in the National 6 Essential Actions to improve Unscheduled Care Improvement Programme in the Directorate of Performance and Delivery, the post holder will bring expertise in NHS systems improvement, (including the use of data) to contribute to the design and delivery of effective programme and projects relating to the national policy context of both the quality strategy and the efficiency and productivity framework.
  • This highly complex, multifacetedwork will impact on the delivery of all health and relevant partner services in Scotland, and is key to ensuring that identified national performance targets are met. Using knowledge of national and local NHS datasets and an understanding of how to improve processes and systems, the post holder will work with NHS and SG staff to identify, investigate and develop solutions to system problems that improve quality, productivity and efficiency. This will involve analysing and presenting data in ways that support staff to understand, improve and manage their systems and processes.
  • In undertaking this role, the postholder will work in a corporate manner in a politically sensitive and sometimes highly contentious environment, contributing to Unscheduled Care Improvement Programme ability to respond quickly to relevant changes in health policy and ministerial priorities, together with the emergent needs within NHSScotland.

3a. DIMENSIONS
  • The Performance and Delivery Directorate drives the delivery of the Productivity and Efficiency Framework within the NHS and has a significant bearing on how the NHS configures its care and business processes
  • Using international best practice in NHS systems improvement, the directorate manages a portfolio of change programmes and projects that support NHSScotland in the delivery of key organisational objectives to achieve sustainable improvements in quality, efficiency and productivity.

3b. SPECIFIC DIMENSIONS OF CURRENT WORK
  • The Performance and Delivery Directorate at The Scottish Government is supporting work which will help to increase productivity and improve quality and effectiveness supporting redesign and transformation across NHSScotland. It primarily fulfils these functions through:
  • Scanning to identify opportunities for improving efficiency whilst maintaining or improving quality
  • Working with NHS Boards and other partners to test new ideas and/or evaluate the impact of applying existing ideas within the Scottish context, as well as supporting implementation of new ideas.
  • Spreading knowledge and practical experience of releasing productive opportunities
  • Championing the use of continuous quality improvement approaches, innovation and wider service redesign techniques as a way of meeting the current financial challenges whilst maintaining or improving quality
  • Ensure all improvement activity leads to delivery of National Emergency Access target and standard
  • The Directorate is also responsible for identifying and implementing any national support required to support NHS Boards to sustainably deliver targets and standards
  • The post holder will contribute NHS systems improvement expertise (including the use of data) to the Unscheduled Care Programme, applying this expertise across a range of NHS specialties and systems as required.
  • The post holder will monitor and influence the planning and financial management by each Health Board of any allocated Unscheduled Care funds to ensure delivery of agreed outputs from all improvement activity.
  • The post holder will work closely with all levels of NHS staff, including executive staff, clinicians and senior managers.
  • The post holder will work with SG and NHS staff to identify where to focus to achieve the biggest gains in performance, quality, efficiency and productivity. This will involve an ability to apply system improvement expertise, including the knowledge and skills to support teams to use data to improve the quality and efficiency of systems and processes.
  • The Unscheduled Care Programme will operate with close links to other Directorates within the Scottish Government.
  • The post holder will work in partnership with other national agencies and stakeholders across NHSScotland e.g. Integration Joint Board (IJB) Information Services Division (ISD), Healthcare Improvement Scotland (HIS), NHS Education for Scotland (NES) and Quality Improvement Hub, to ensure areas of crossover are identified and effectively managed.

4. ORGANISATION CHART
5. ROLE OF THE DEPARTMENT
The Performance and Delivery Directorate is the performance management & improvement function of the Scottish Government Health Directorates and brings together performance management and continuous improvement/support aspects of performance improvement. The Directorate is responsible for the NHS Performance Framework and the implementation of the productivity and efficiency framework. Supporting this. The Unscheduled Care Improvement Programme sets the framework for continuous improvement, designs and leads a portfolio of programmes and projects (applying improvement science) working with every NHS Board and other stakeholders and specific packages of intervention. The role of the Directorate is therefore outward facing to the NHS.
6. KEY RESULT AREAS
SCOPING, EVALUATING & RESEARCHING
  • Take a high level view of NHSScotland as a system and be involved in making informed and explicit choices about how to go forward with national work streams based on an awareness, understanding and experience of applying the full range of improvement and performance philosophies, approaches, methods and tools.
  • Contribute to the adaptation of these approaches to fit the context of the particular problems and identify and take account of the many interdependencies within the healthcare system. This will include:
  • Identification of the key methodologies that will deliver identified national outcomes, including:
  • the use of data such as demand, capacity, activity queue data,
  • identifying, analysing and interpreting key systems metrics
  • Leading the way within the improvement field in adapting improvement methodologies and data interpretation for use within different healthcare contexts to facilitate the improvement of services.
  • This will include the development of novel analytical tools which enable staff to understand and improve healthcare processes and systems.
  • Facilitating knowledge transfer to individuals within NHS Boards improving capability locally
  • Developing spread and sustainability strategies for the changes proposed
  • Assimilate information from a range of sources to contribute to the development of High Impact Changes/Primary Drivers that inform the focus of activities within Health Boards to improve efficiency and productivity.
  • Contribute to the review and evaluation of developments, emergent thinking and evidence base in
health care improvement and design of relevant health services to ensure that work streams reflect current thinking.
  • Contribute to the development of toolkit material and case studies to support boards in the implementation of improvement methodologies and hence redesign of services
  • Contribute to the overall development and evaluation of work.
NEGOTIATING
  • Support Boards to secure broad stakeholder agreement to the approach and methodology. This will include working with senior clinicians, senior managers and other key opinion formers within NHS Boards/IJBs to enable full engagement and commitment in the use of improvement techniques within frontline services.
  • Monitor, influence and approve the use of allocated programme funding, where applicable
  • Work with National Leads and other Improvement Advisors to ensure consistency of approach, whilst ensuring that specific needs of any individual projects are also met.
  • Ability and desire to work as part of a team; listening and learning from others regardless of hierarchies, sharing ideas, engaging in open and honest debate and adapting plans, direction and focus of work based on relevant information and knowledge.
  • Work with other relevant Scottish Government Departments (ie Quality Division, Health & Social Care Integration, Primary Care) to ensure consistency of messages to boards re achievement of Quality and Efficiency goals and HEAT targets.
  • Negotiate with other national and regional staff from National Programmes (i.e. NES, HIS) to ensure effective integration of work with regards to common priorities, so as to present a joined up approach to NHS Boards/IJBs and minimise duplication and conflicting messages.
  • Work with local teams to ensure that improvement is delivered through clinical and managerial teams to support sustainability.
  • Support local improvement teams to actively engage frontline staff, service users and carers in improvement work across relevant health and social care providers.
MANAGING
  • Develop a work plan for the programme/project that takes cognisance of the following:
  • the support required by Boards to enable them to develop programme plans that will deliver required outcomes on time
  • the implementation and adaptation of the plan in response to Boards’ progress
  • the need to prioritise the deployment of resources to Boards which present highest risks
  • Contribute to ensuring clinical redesign used by UC Programme adheres to current knowledge with regards to best practice and patient safety
  • Coaching and mentoring local staff to enable their management of improvement work and their personal development
  • Establishing networks to enable and facilitate cross organisational support and learning
  • Deputise for the Unscheduled Care Director as required
LEADING
  • Work with NHS Boards and IJBs etc, to develop a spread and sustainability strategy for the key phases of the implementation of the Efficiency and Productivity Framework.
  • Provide on-going support to local teams, in particular to overcome any blockages that are hindering teams from making progress.
  • Represent the specific National programmes and projects as agreed with the Lead e.g. Patient Safety Programme, Better Together Programme
  • Acts as a role model and advocate for Unscheduled Care Programme and the Scottish Government.
  • Self aware and authentic – understands and can articulate own strengths, motivations, patterns, needs and limitations. Able to engage in open and honest discussions of own performance and to use feedback constructively to improve performance.
MEASURING
  • Review local performance improvement in line with agreed trajectories to identify sites in need of additional support.
  • Support sites in the development of local measures, robust data and information for improvement, including the collection, analysis, interpretation and use of demand, capacity, activity and queue data to enable system and process improvement that results in the delivery of efficient, high quality healthcare services.
  • Direct and work with the information analysts in Performance and Delivery Directorate to develop measures, systems and processes for use within UC Programme and within NHS Boards/IJBs to inform the improvement of healthcare performance.
COMMUNICATING
  • Support and advises key stakeholders and engage them throughout the lifetime of the implementation of the Unscheduled Care Improvement Programme.
  • Communicate widely with key stakeholders, regularly with a variety of different sized groups.
  • Regularly deliver presentations to a range of stakeholder groups (regionally, locally and nationally when the latter is required).
  • Communicates appropriately contentious performance information to NHS Boards to ensure improvement activity is appropriately directed.
  • Where appropriate, establish networks for local staff involved in the delivery of front line services both regionally and nationally to focus on the implementation of Unscheduled Care Improvement Programme priorities. Develop the meetings into action learning sets some of which need to be held nationally.
  • Produce written and verbal reports for the programme.
  • Supports and advises National Clinical Leads on the challenges individual boards face around making changes to clinical practice to deliver sustainable and transformational redesign of services.
EDUCATING
  • Contribute to the development and delivery of national & regional learning events.
  • Provide ongoing training and development to local NHS teams in redesign tools and techniques and the use of data for improvement.

7. ASSIGNMENT AND REVIEW OF WORK and DECISIONS AND JUDGEMENTS
  • Guidelines for the work programme of the Improvement Advisor will be agreed with the Unscheduled Care Programme but day-to-day prioritisation and planning of work will be largely self-directed, in line with Scottish Government strategic priorities and the overall portfolio office plan.
  • The post holder has a high degree of autonomy and responsibility for anticipating problems for which there is no precedent, and proposing and implementing solutions in line with the overall programme plan.
  • Performance will be reviewed formally by the Unscheduled Care Director, in line with agreed objectives and Personal Development Plan
Typical judgements includes:
  • How a particular project resulting from Essential Action of the Unscheduled Care Improvement Programme should be implemented across NHS Boards.
  • Which stakeholders should be involved in any particular project.
  • How to ensure ongoing engagement of identified stakeholders.
  • What risks to the achievement of outcomes (in relation to Unscheduled Care Improvement Programme) exist within Health Boards and when these are such that they need to be escalated within the Scottish Government structures.
  • Measure the impact on delivery of Emergency Access target/standard

8. COMMUNICATIONS AND RELATIONSHIPS
The post holder will liaise with a wide range of partners to encourage, promote and ensure compliance and cooperation with the implementation of the Unscheduled Care programme:
Internal
  • Frequently with the Unscheduled Care Director to ensure compliance with particular work streams and the policy direction of the Performance and Delivery directorate.
  • Frequently with other members of the wider directorate and Scottish Government.
External
  • Frequently to support the local improvement teams, working with NHS Board and Health and Social Care representatives.
  • Frequently with Senior Clinicians and managers throughout NHSScotland.
  • Occasionally with NHS Chief Executives and Heads of Operating Divisions.
  • As appropriate with Local Authority representatives, Patient Groups, Voluntary sector organisations
  • Regularly with other national bodies and key stakeholders e.g. NES, HIS, ISD

9. MOST CHALLENGING PARTS OF THE JOB
  • Securing and maintaining complex stakeholder commitment and relationships which people or organisations that may be hostile or threatened by change.
  • Delivering measurable improvements within a complex system, in the midst of ambiguity and conflicting evidence with regards to appropriate ways forward. This includes ensuring that local teams use the overall approach and methodology, whilst facilitating local developments to support the diverse needs of different geographical areas.
  • To influence change at all levels without having direct management responsibility for service delivery. This includes working in a facilitative capacity to overcome blockages that inhibit progress.
  • Keeping up to date with innovations in care processes and systems.
  • Supporting teams to scope out the implementation of various projects and programmes of work arising from the Unscheduled Care Improvement Programme and mapping the relevance of previous work.
  • Communicating theories and models of change to multiple stakeholders.
  • As a result of the complexity of the work and the need to prioritise sites most in need of support, the post demands flexible working, careful time management and involves significant travel with considerable time spent away from home and office base.