Project Management

NHS Rotherham

Mohammed Fazlur Rahman

Aim: Study of a completed project.

Learning Styles

Experimental Conceptual Modeller(Trial and Error) (Theory) (Copy)High Risk Moderate Risk Low Risk

Preferred Path:

Conceptual ExperimentalModeller

National Health Service (NHS) UK.

Started in 1948, 60 years old.Covers 60 million people.Treats 1 million patients / 36 hours or 8/second.Employs 1.5 million staff.Budget of £90 billion for 2007/2008 (60% staff

pay, 20% for drugs and supplies, 20% building, equipment, training, catering and cleaning).

80% of total budget with local NHS Trusts.Income from Taxation and N.I.(approx

£1500/a/person). Source: www.nhs.uk/aboutnhs/pages/about.aspx

NHS Structurehttp://www.nhs.uk/aboutnhs/HowtheNHSworks/Pages/NHSstructure.aspx

NHS Rotherham

Sir Gerry thinks doctors need closer managing www.news.bbc.co.uk/1/hi/health/6234919.stm

Author, has observed the programme (Can Gerry Robinson Fix the NHS?)on BBC 2 at 2100GMT on Mon 8, Tue 9 and Wed 10 January, 2007.

The chief executive of Rotherham General Hospital, Mr. Brian James admitted: “If 5% of our patients choose to have operations elsewhere, we could be in trouble. It is a question of survival”. “(BBC 2007, OU 2007)”,

Sir Gerry is a Management Consultant who consults NHS Rotherham management in diagnosing the problem.

Objectives:

Reducing waiting lists of patients.

Explore ways to improve efficiency of staff.

Improve patient services.

Maintain a consistent and upward growth in Trust funding.

TasksActivityActivity DescriptionDescription DependencyDependency Duration in Duration in

weeksweeks

AA Improve communication between the hierarchy.Improve communication between the hierarchy. ------ 22

BB Maximum utilisation of consultant schedule.Maximum utilisation of consultant schedule. AA 22

CC Consultants see more patients.Consultants see more patients. BB 11

DD Maximum utilisation of Surgeon schedule.Maximum utilisation of Surgeon schedule. CC 22

EE Surgeons perform more surgeries.Surgeons perform more surgeries. DD 11

FF Replacing general anaesthesia with local anaesthesia.Replacing general anaesthesia with local anaesthesia. ------ 44

GG Space allocation for Splitting up O/T into 2 divisions.Space allocation for Splitting up O/T into 2 divisions. AA 22

HH Approval from Ministry of Health.Approval from Ministry of Health. GG 22

II Approval from Infection control department.Approval from Infection control department. HH 22

JJ Fund allocation from NHS Trust for the division.Fund allocation from NHS Trust for the division. II 44

KK Planning and Execution of Operation theatre division.Planning and Execution of Operation theatre division. GG 11

LL Surgery staff schedule for simultaneous operations. Surgery staff schedule for simultaneous operations. KK 11

MM Staff feedback system to improve patient services.Staff feedback system to improve patient services. AA 11

NN

Monthly schedule system regarding meetings between Monthly schedule system regarding meetings between management and floor staff to resolve issues and improve management and floor staff to resolve issues and improve efficiency.efficiency. AA 11

ES EF LS LF LS-ES

On Critical path

A 0 2 0 2 0 Yes

B 0 2 3 5 3 No

C 2 3 5 6 3 No

D 3 5 6 8 3 No

E 5 6 8 9 3 No

F 6 10 9 13 3 No

G 2 4 2 4 0 Yes

H 4 6 4 6 0 Yes

I 6 8 6 8 0 Yes

J 8 12 8 12 0 Yes

K 12 13 12 13 0 Yes

L 10 11 13 11 0 Yes

M 11 12 11 12 0 Yes

N 11 12 11 12 0 Yes

Spare Time

Week Activity

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

AA

BB

CC

DD

EE

FF

GG

HH

II

JJ

KK

LL

MM

NN

Gantt Chart

Importance of

project to organizat

ion

HighHigh

LowLow

HighHigh LowLow Risk

Reducing Reducing

waiting listwaiting list

H I / L R H I / L R

Managed Managed

CarefullyCarefully

RejectReject Routine Routine

Risk Assessment

Balances between costs involved and benefits offered.

Positive if benefits higher than costs and vice versa.

NHS benefits are higher than costs as survival is challenged with no other option remaining rather than invest in efforts towards reducing waiting lists.

(a = 12 weeks/Earliest, b = 15 weeks/Latest, c = 26 weeks/Actual).

Expected weeks = 16 weeks.

Boardman A E (2004)

Cost Benefit Analysis (CBA)

Beta Probability.

Group DevelopmentForming:

Uncertainty about group Members more assertive. Output low. Self conscious.

Storming:

Members more assertive. Aggressive/personal attack. Leadership change. Membership turnover.

Norming:

Closed relations formed. Structure emerges.

Performing:

Fully operational. Solidarity.

Adjourning:

Over.

Consultant has utilized group development tools to extract work from NHS staff & mgmt.

Group ThinkConcerns.

• Over confidence in terms of uncalculated risks.

• Ethics are compromised in decision making.

• Self Censorship or reserve rights to discuss different aspects and directions.

• Majority rules with no space for objections.

• Negative and closed vision about competitors

Diagnosis.

• Calculated risks with pros and cons.

• Ethical concerns are addressed and taken into consideration.

• Leader encourages criticism, 2 groups with optimistic critical analysis.

• Devil’s advocate and adjudicator process.

• Broad minded study about competitors activities, e.g..SWOT analysis.

Source: http://www.cedu.niu.edu/~fulmer/groupthink.htm

Individuals at work

NHS ChiefExecutive

NHS floor staff

Skills

Time

H R DTechnical

Admin

Patient services

Innovation

Source: www.NHSLeadershipQualities.nhs.uk

Leadership

Manager is a Manager is a Good Good Employee Employee ((GEGE).).

Consultant is Consultant is a a Great Great Solution Solution Provider Provider ((GSPGSP).).

Leader is a Leader is a Great Actor Great Actor ((GA)GA)..

CultureRole Culture (NHS Bureaucracy)Senior Management Pillars (Surgeons & Consultants)Operative (Floor staff) Transformation of NHS Culture from Role to

Power.Power Culture (Centralised Power, Rapid

decision making)

Spider and the Web.

• Study of symptom as well as the core problem.Symptom is high waiting list, problem is ineffective chief executive.

• Application of tools like Task building, Spare time and Gantt chart to draw a road map for implementation, execution and control. (26 weeks : 15-12 weeks).

• Risk assessment, CBA and Beta probabilities for better financial management (Calculated Risk Management).

……….

Conclusion:

•Important Management issues like Group development, Group think concerns, Individuals at work, Leadership and culture change in relativity to the subject of presentation.

•Improving patient services by max.utilization of operational time, resources and staff motivation, ensures consistent/upward growth in local NHS Trust funding.