2009 May » Hospital Dr

Archive for May, 2009

800 Britons are enrolled with Swiss suicide clinic

The Observer - 31st May 2009 10:56 pm

Record numbers of Britons, who are suffering from terminal illnesses, are queueing up for assisted suicide at the controversial Swiss clinic Dignitas.

Almost 800 have taken the first step to taking their lives by becoming members of Dignitas, and 34 men and women, who feel their suffering has become unbearable, are ready to travel to Zurich and take a lethal drug overdose.

The tenfold increase in the number of Britons who have joined Dignitas since 2002 raises questions about the law that bans assisted suicide in Britain.

We have to keep racism out of revalidation

Dr Raman Lakshman, BAPIO's vice chair of policy - 30th May 2009 5:52 pm

In July 2008, the Chief Medical Officer’s report acknowledged the existence of racism in the NHS, which has damaged individual careers and harmed patients. Now we have licensing to practise and revalidation will be introduced over the next few years. BAPIO understands that these processes are necessary to ensure quality care and patient safety.

However, we are concerned that there is scope for abuse and discrimination and careers and lives are at stake. A large number of ethnic minority doctors and international medical graduates already fear the worst over revalidation.

Revalidation will give a small number of individuals huge power to both support doctors but to also expose incompetencies. This by its very nature needs people, who in the main would be medical directors, to act fairly and in an evidence-based manner and without consideration to matters outside professional competence.

Much work and thought is necessary to make sure this works fairly and without prejudice. Equality and diversity training must be mandatory for all individuals involved in revalidation. The framework for revalidation must be transparent and robust and decisions must be based on multiple evidences rather than on the views of a few individuals.

The GMC, as the regulator, has the responsibility to ensure there is no discrimination by its members. It must ensure it is easy for individuals to complain to it about discriminatory matters, that the threshold for investigating such complaints is not inappropriately high and demonstrate that it takes such complaints seriously and will investigate them thoroughly.

Are we confident all this will be in place?

Tags: CMO, License to practise, Revalidation
Posted in Dr Blogs | 1 Comment »

CV writing and job interview advice for doctors

By Mike Broad - 29th May 2009 7:48 pm

The first step for a doctor to get a new job is to write a strong CV. A doctor’s CV will often have less than a minute to convince a recruiter of their suitability for a role in a competitive specialty. A doctor’s CV must be concise, well designed and easy to skim read in search of important information.

Application forms

Increasingly electronic application forms are requested for NHS job applications. These do not replace the well written CV and it is standard pratice for doctors applying for a role to send a CV in advance, or bring a CV with them when visiting the hospital prior to interview. Standardised application forms include all the usual sub-headings of a CV but will also include interview-type questions on leadership, management, personal strengths and weaknesses.

Medical CV structure

1. Title page: name and qualifications only.

2. Personal identity (full name, date of birth, nationality, sex).

3. Professional memberships (GMC, royal medical college, NTN, CCT date, indemnity number).

4. Contact details (postal address, telephone, email).

5. Qualifications (dates, institution, location).

6. Education (dates, institution, course, prizes, other achievements).

7. Prizes and presentations.

8. Current position.

9. Work history (date, position, employer, supervising consultant, duties and achievements – all in reverse chronology).

10. Summary of skills and achievements.

11. Courses and conferences attended.

12. Research.

13. Publications (original papers, reviews, chapters and abstracts in that order).

14. Teaching (training and experience).

15. Audit (training and experience).

16. Management (training and experience).

17. Leisure interests and activities.

18. Career intentions.

19. Referees – names and contact details of three people.

Common mistakes made by doctors in their CVs

At the top of the list of CV mistakes is poor spelling, grammar and typos. Doctors must spell check their CVs. They should also ask a friend, colleague or mentor to proof read the completed CV.

Doctors should also be careful not to make the CV too duty-oriented, at the expense of outlining the individual’s experience and achievements. Applicants should avoid long paragraphs and use concise bullet points instead.

Other problems include inaccurate or missing contact information, poor formatting, long-winded paragraphs and inappropriate personal information.

The doctor should ensure the CV is written in active language and competently printed on white paper. It is unnecessary to have the CV professionally printed on thick paper – the candidate is going to be judged on the words and how they’re presented.

A doctor’s covering letter

The doctor’s covering letter should be tailored to the role. It should convey the doctor’s interest in – and suitability for – the job. It must be both informed and enthusiastic about the role, team and employing organisation. The recruiter must be left in no doubt on what the applicant would bring to the role and how that separates them from others. It should be no longer than one side of A4 paper.

Job interview preparation for doctors

Medical interviews should not be taken lightly. They are demanding at all levels, seeking to assess a doctor’s character, attitudes and flexibility of thought as well as their medical expertise. The panel format (typically eight to 12 people) can also be intimidating for some. Many good doctors have failed to secure the role they wanted because of poor preparation and interview technique. Planning and preparation can significantly improve a doctor’s chances.

Interviewers’ objectives in a medical interview

They are seeking to appoint the right doctor for the role, and a colleague they can envisage working with. To do this they will examine a doctor’s motivations, career aspirations and potential, technical competence, team working abilities and professionalism.

For a consultant interview, the panel will also be looking for a doctor’s ability to work independently, work with managers, lead a team and move the service forward.

Getting prepared for the interview

The formal interview is not the chance to find out more about the job – the doctor should already have done this. Clarity is needed on the following issues:

1. Yourself: a doctor should be clear on their ambitions, priorities, and clinical and outside interests.

2. The role: review the person specification in depth and detail all of the key competencies, personality skills and clinical skills required.

3. The organisation: find out about the department, hospital and trust. Doctors should visit its website and read the annual report or executive summary. They should visit the team in person and ask lots of questions about the role and service, and talk to any contacts who have worked there. Doctors should understand the team’s and organisation’s history, activities, strengths and weaknesses and future direction.

4. The interview panel: the interviewee should find out, if possible, who will sit on the panel. For a consultant interview there will be at least seven members potentially including the trust chair, chief executive, medical director, lead clinician from the team, college representative, academic representative, patient representative and a member of the HR team. It is worth exploring the clinical interests of the medical members.

Candidates for consultant roles should ensure that they meet the chief executive, medical director, clinical director, as well as the current consultants in the relevant team in their visits to the trust. They may also wish to meet allied health professionals as well.

Commonly panel interviews take a structured approach, with each interviewer taking it in turn to ask questions.

5. Specialty issues: read relevant medical journals closely for three to six months preceding the interview, and are aware of any recent NICE or MHRA guidance.

6. Wider NHS issues: read non-clinical magazines, such as HospitalDr.co.uk and BMA News, to understand the current professional debates. Doctors should understand the current change agenda including the modernisation of services, Lord Darzi’s review, revalidation, changes to training and Foundation Trusts.

Practicalities of getting to the medical interview

It’s commonsense to check the employer’s location and travel details well in advance. Also find out where the interview is being held within the building beforehand. On the day of the interview travel early, or even consider the night before, and ensure that you don’t have to ‘cram up’ on information you should already have read.

Doctors’ presentations at interview

Doctors may be asked, in advance, to give a formal presentation as part of the interview process. Check what equipment will be available on the day and prepare appropriately. Make sure it is professional and formally delivered, but with pace and enthusiasm.

Answering questions at interview

There will be several candidates for the job. The applicant who is successful will be the one who is distinctive, enthusiastic, has something interesting to say and shows potential.

Doctors should not simply answer the question. They should also sell themselves. Doctors should populate their answers with real examples from their working life. They should also remember to demonstrate their understanding of the role, team and organisation in their answers.

Be positive wherever you can. Panels like positive people. So when a doctor is asked about changes in the NHS, they should start their answer by stressing why change can be good before being more critical.

Rehearse strong answers on your skills, strengths and weaknesses (finding a positive way to frame your answer), experience and motivations. Draw up a list of other potential questions and think through answers – but don’t sound too pre-rehearsed.

First impressions

Initial impact is important. Doctors should dress smartly and be well groomed – they will never regret buying a plain suit. They should take a deep breath and calm themselves before entering the interview room. Candidates need to be confident. Close the door behind them. Smile. Respond to offered handshakes firmly and sit quietly but alertly for the opening question.

Positive body language is also important. The doctor should be responsive, leaning slightly forward, open arms, nodding. They should listen attentively and keep eye contact.

Style of response

The interviewee should look at the person questioning them and direct answers to them. They should glance around to engage the whole panel. Speaking slightly slower than normal is a good technique, and their voice should show their enthusiasm for medicine and the role.

If they ask you whether you have any questions at the end, either ask a good one or don’t bother. Don’t ask one for the sake of it and avoid ones about terms and conditions. In a consultant interview, you should – from your previous visits – know the service ambitions of the chief executive or senior clinical representative and you could consider asking a more strategic question about those issues. At the end thank the panel for their time and leave in a smooth manner.

Practice makes perfect

Take time to practice. Try your ‘stock’ answers out in the mirror first and then on a colleague or mentor – preferably one involved in recruitment. If you’ve been asked to do a presentation, also run it past a friend or colleague as well. It’s the only way to still be able present yourself to the best of your abilities when you may be suffering from nerves.

Type of questions asked in a doctor’s interview

A search of the web will reveal lists of questions that typically get asked in medical interviews for both juniors and consultants.

Accepting failure and learning from it

If the doctor doesn’t get the job they should ask for feedback. However disappointed a doctor feels they need to learn from the experience and then try again.

Tags: Job interviews, Jobs, Overseas recruitment, Recruitment
Posted in Guidance | 1 Comment »

Trainees encouraged to lie about work hours

HSJ - 28th May 2009 4:48 pm

Trainees are being encouraged to lie about their hours to make trusts appear to be compliant with the Working Time Directive.

Out of 31,360 trainee doctors responding to a question by the Postgraduate Medical Education and Training Board, one in 10 whose hours were compliant on paper said they were being asked to lie.

HSJ recently revealed strategic health authorities were predicting that a third of hospital rotas risked missing the August deadline.

Exploitation risk for overseas trainees

By Francesca Robinson - 4:17 pm

Employers are being warned not to exploit overseas junior doctors taking up new training placements in the NHS through the new Medical Training Initiative (MTI).

The MTI, which provided 250 two-year placements for doctors from developing countries last year, is now being expanded in stages to provide up to 750 opportunities.

Dr Ramesh Mehta, president of the British Association for Physicians of Indian Origin (BAPIO) fears the scheme could be used as a mechanism for filling posts left vacant following the April 2006 immigration ruling that led to the exodus of thousands of international graduates.

“The Department of Health should come clean on the service needs that have made such an initiative necessary. BAPIO’s policy has always been to press for proper workforce estimations and allowing the required number of overseas doctors to enter the UK and then giving them the opportunity to make progress by treating them on merit,” he said.

Dr Mehta said employers must ensure that MTI doctors are given proper induction, mentoring and training and the same pay as UK trainees to ensure they are treated fairly.

“Also it is important that it is made clear to these doctors at the outset the details about their prospective jobs and that this training will not lead to further career opportunities in the UK and that their training may be aborted if they do not demonstrate necessary competencies,” he says.

Juniors are voicing similar concerns. Delegates to the BMA’s recent Junior Doctors Conference, who noted that the scheme has striking similarities to the Permit-free Training Visa, passed a motion calling on the government to ensure that training places are genuine and of high quality.

Health minister Ann Keen said the MTI will enable international medical graduates from countries where medical training was not widely available to secure “vital” training and work experience in this country.

BAPIO’s view on the issue

Tags: MTI, Overseas recruitment
Posted in Hospital Dr News | No Comments »

Masters degree in medical leadership launched

By Mike Broad - 4:14 pm

A new masters degree in medical leadership has been launched for aspiring clinical and medical directors, and chief executives.

The degree, run by the Royal College of Physicians, Birkbeck College and the London School of Hygiene and Tropical Medicine, has been designed to specifically meet the needs of medical practitioners.

It aims to give senior doctors an appreciation of organisational management and leadership. The MSc consists of nine modules, which can be completed in two years.

Professor Ian Gilmore, president of the RCP, said: “The responsibility for planning and transforming the delivery of health services for a large organisation is a complex one, and one in which doctors should be fully involved.

“With this in mind we have developed this programme to help prepare the next generation of medical leaders, and encourage doctors from a wide variety of backgrounds to apply.”

Applicants need to enrol by the end of July 2009.

Tags: Leadership, RCP, Training
Posted in Hospital Dr News | No Comments »

Patients don’t want to choose a different hospital

Pulse - 3:55 pm

The government’s flagship initiative for GPs offering patients a choice of hospital is proving irrelevant in many areas of the country.

An investigation by Pulse magazine reveals that only 6.4% of referrals in the past financial year were for patients travelling from outside hospitals’ normal catchment areas, with the proportion of ‘out-of-area’ patients as low as 3.5% at rural hospitals.

The analysis of data from 84 hospital trusts in England shows the number of patients exercising the right to choose their hospital has more than doubled since 2004/5 – but from a low base.

Co-operation better than competition for NHS

Dr Hamish Meldrum, chairman of BMA Council - 27th May 2009 5:18 pm

Since the Thatcher reforms of the late eighties, the NHS in the UK has been following policies of competition and commercialisation in the belief that they will drive quality up and costs down.

While the three Celtic nations have now turned their backs on the market, not just for ideological reasons but because there is little evidence that it was bringing benefits, England has pressed on with a succession of market-based developments - including the private finance initiative, independent sector treatment centres, payment by results, polyclinics and GP-led health centres.

There is little evidence that these policies have been beneficial and much that indicates their detrimental effects. Proponents of the commercialisation agenda argue that the present financial crisis is a reason for pressing on even further with these policies, claiming that we need new incentives to drive quality and efficiency in these difficult times. They fail to realise that what really drives doctors is the knowledge that they are doing the best for their patients and working co-operatively with their colleagues to design and deliver the most beneficial healthcare services.

One hopes that Mid Staffordshire NHS Foundation Trust and Maidstone and Tunbridge Wells NHS Trust - both of which failed patients and were criticised by NHS watchdog the Healthcare Commission - are isolated cases. But there is a danger that, if we continue to put the achievement of financial targets before the delivery of high-quality clinical care, such tragedies will continue to occur.

The BMA’s stance is not some sort of old-fashioned, 70s-style, ideological trade-union battle, raging against the forces of capitalism. It is an evidence-based analysis that argues that the present policies in England are moving the NHS away from its founding principles and, more importantly, not encouraging the collaborative approach we are going to need if we are to preserve and build on these principles through the difficult years ahead.

The NHS belongs to all of us, but we mustn’t just take it for granted; we need to look after it. By working together, we can do more than just preserve it, we can make it better.

A longer version of this article appeared in BMA News on 23 May

Tags: Privatisation
Posted in BMA | No Comments »

How to become a flexible trainee

By Mike Broad - 5:01 pm

Flexible trainees are part-time doctors in training. Flexible training provisions have been in existence in the NHS since 1969. But, impetus to improve access to flexible training only developed in the late 1990s, with new attitudes to work-life balance and introduction of the Part-Time Workers regulations in 2000.

Flexible training is seen as a way to recruit, retain and motivate doctors, who might otherwise quit the NHS because of other commitments. It’s particularly relevant to the medical profession because of the rising proportion of female trainees, who may want to have children, and the high staffing levels required to comply with the Working Time Directive. However, research by PMETB shows that demand for flexible training continues to be largely unmet.

Historical problems with becoming a flexible trainee

Trusts have perceived flexible trainees as expensive to employ. Pre-2005, a part-time doctor (doing out-of-hours work) was paid a full-time basic salary and an additional supplement of 5% or 25%.
Although slot shares increased, many flexible posts were supernumerary, making their employment more expensive still. Extra funding from the Department of Health was made available to help fund flexible training but expired in April 2004. In addition to cost issues, the flexible training scheme was administered differently from deanery to deanery, with inconsistent approaches and attitudes.

Revised arrangements for flexible training

In 2005, revised arrangements were introduced to improve access to flexible training and make the roles more affordable for employers. These arrangements were outlined in two documents Principles underpinning the new arrangements for flexible training and Equitable pay for flexible training. The guiding principles were to retain doctors who are unable to train on a full-time basis; to promote work-life balance for doctors; to ensure training on a time equivalence (pro-rata) basis; and maintain a balance between educational requirements and service delivery in the reduced hours.

Flexible trainees now receive basic pay and a supplement for out-of-hours work. Basic salary is determined by the actual hours worked and the supplement is paid as a proportion of the calculated basic salary. Band FA attracts a 50% supplement, FB attracts 40% and FC attracts 20%. Flexible trainees who do no out-of-hours work do not receive a supplement.

The revised pay system brought hourly rates of pay in line with that of full-time trainees. And an independent appeals mechanism was introduced for cases where an application was rejected. The Department of Health in England agreed an additional £7million in recurrent funding to ensure its success.

Flexible training criteria

Trainees are required to undertake at least 50% of a normal working week. Day time working, on call and out-of-hours duties should be undertaken on a pro rata basis equivalent to full time trainees in the same specialty, provided they can do so. Trainees are normally expected to move between posts within rotations on the same basis as full time trainees but not necessarily at the same time. When full time trainees normally have an out-of-hours commitment, a flexible trainee will only be entitled to train without completing the out-of-hours commitment for a maximum period of six months subject to educational approval.

There are different ways of structuring flexible trainee roles. Slot sharing is where two flexible trainees are employed and paid as individuals (often for 60% or more) and work together. They share one place on a rota but not a contract and may overlap sessions. Job sharing is when two trainees share a full time post salary, work half the hours and receive 50% of the training opportunities. Then there are supernumerary posts that are additional to the normal complement of trainees on a rota. Sometimes trusts use a less than full-time trainee in a full-time role to avoid the additional expense of a supernumerary role. They typically work four rather than five days a week.

More information on flexible training.

Who is eligible to apply for flexible training?

While all doctors are theoretically eligible to apply, deaneries are prioritising two categories; the first, and most prescient, includes doctors in training with a disability or ill health, or responsibility for caring for children or an ill or disabled partner or relative.

The second category includes those doctors in training with unique opportunities for their own personal or professional development, such as representing their country in sport, or a short-term extraordinary responsibility, such as a national committee.

Religious commitments will also be considered and non-medical professional development, such as management or law courses. Other reasons may be considered but it would be dependent on the particular situation and the needs of the specialty.

How does a junior doctor apply to become a flexible trainee?

The trainee should seek advice on eligibility for flexible training in a meeting with the postgraduate deanery representative. If the trainee is not already working within the grade and specialty, appointment through open competition will be necessary. Potential applicants who do not discuss with the associate postgraduate dean their intention to train flexibly in advance of application to a post will find that funding is unlikely to be immediately available.

The trainee will need to agree a training programme with the deanery. Time for protected study and research should be included within a normal working week.

The regional specialty education committee or programme director will approve the training programme on behalf of the postgraduate dean and the appropriate Royal College. This approval should take no longer than six weeks to obtain. Approval will be given initially for one year subject to annual review.

Approval of the deanery and the employing trust will be necessary for funding of the post. As the recurrent funding available is limited, applicants considering flexible training should apply as early as possible and at least three months in advance of anticipated need.

Once all approvals have been obtained, the start date will be confirmed with the trainee, and the NHS trust requested to issue a contract.

More details

Case studies

Low availability of flexible training

The number of flexible trainees remains low. There are approximately 2,100 currently in the NHS, which represents around 6%. In 2005, the revised arrangements were anticipated to enable 20% of junior doctors to train flexibly by 2010. The Chief Medical Officer’s 2007 Annual Report called for more flexible training opportunities, as did the PMETB Survey of Trainees in 2007. It shows that 22% of female trainees would like to train flexibly but are not doing so currently.

Funding for flexible training currently comes partly from the trust where the doctor works and partly from the budget of the postgraduate medical deaneries. However, the proportion the trust pays is significantly higher than under the old arrangements. The BMA claims that many Category 1 doctors – those with a disability or ill health or caring responsibilities – are still being prevented access to flexible training. They continue to campaign on the issue.

More information:

Medical Careers

MMC

Flexible Careers Scheme

Tags: Flexible trainees, MMC, Training
Posted in Guidance | No Comments »

Job planning and appraisal for consultants

By Mike Broad - 26th May 2009 10:31 pm

In 2000, the NHS Plan called for a new career and reward structure for consultants that would raise productivity. It started a process of developing better arrangements for professional development and increased clarity around a senior doctor’s commitments.

After protracted negotiation and revision, the consultant contract was implemented on 31 October 2003. It’s a time-based contract with consultants employed to work a basic 40-hour week, divided into ten programmed activities (PAs). Seven and a half of these PAs should be for direct clinical care and associated administration, with two and half SPAs for career and service development and research.

The contract is designed to pay consultants for all the hours they agree to work and to ensure that there is accountability for the work agreed in the consultant’s job plan. Most consultants are contracted to work more than the basic 40 hours and are now paid for this extra work at the same hourly rate.

Job planning for doctors

Job planning is a systematic activity designed to produce clarity of expectation for consultant and employer about the use of time and resources to meet individual and service objectives. A job plan review must occur at least annually and it culminates in a job plan meeting.

The review considers progress against agreed objectives and the factors affecting it. It is the opportunity to agree changes to duties and responsibilities, a plan for achieving personal objectives, the need for additional programmed activities, the relationship with other paid work, the support needed from the employer and establishment of eligibility for pay progression.

Similar information is required for the doctor’s job plan review and appraisal and the timing and inter-relatedness needs consideration.

Relationship between job planning and appraisal

The job plan is a prospective agreement setting out duties, responsibilities, objectives and supporting resources for the coming year and should cover all aspects of the consultant’s professional practice.

An appraisal seeks to identify personal and professional development needs. Appraisal is based on the GMC’s document Good Medical Practice (General Medical Council, 2001), which describes the principles of good medical practice, and standards of competence, care and conduct expected of doctors in all aspects of their professional work.

The process of job planning for doctors

A job plan should include the consultant’s main duties and responsibilities, the scheduling of commitments, the support needed in fulfilling the job plan, and personal objectives, including any continuing medical education and training, and their relationship with wider service objectives.

A wide range of people may be involved in the job planning process, including the consultant, clinical manager, general manager and chief executive. For clinical academic staff both NHS and university representatives should be present.

Prior to the job plan meeting, the two most important activities are collection of information and reflection. In addition, it is essential that the consultant has undergone their appraisal, resulting in a personal development plan (PDP).

The meeting must be informed by the job plan’s purpose which is to: prioritise work and reduce excessive workload, agree how a consultant can support the wider objectives of the service, agree how the NHS employer can best support a consultant, provide the consultant with evidence for appraisal and revalidation, and agree the appropriate number of programmed activities for the workload.

A partnership approach should be adopted to job planning. The consultant and the clinical manager will probably collect different supporting information and it is good practice to share this prior to the job planning meeting. Consultant information may include the previous year’s job plan, workload, clinical audit and governance issues, wider internal and external commitments, ideas for improving the service and the PDP from the appraisal process.

The clinical manager may bring wider information such as quantity and quality targets for the directorate and performance against them, clinical audit and governance issues, proposed changes to service and changes in skill mix and numbers of staff.

Both the consultant and clinical manager have to be aware of the effects of other initiatives and how the service offered needs to meet the service required. These could include changes in practices and services of other directorates or of other providers, national clinical audit and governance issues, change in requirements of local health community or tertiary referrals, even the requirements of doctors in training or education.

Team approach to job planning

Team job planning takes account of the role of each team member in terms of service delivery and their achievement of team objectives. Team job plans can be powerful tools so long as each individual agrees to participate and that they still retain the right to sign an individual job plan agreement with the employer.

Job planning by team, rather than by individual, should not be viewed as a timesaving solution. If anything, it will take considerably longer and can be structured on a consultant-only or multi-disciplinary basis.

To team job plan the clinical lead needs to understand the demand, capacity and gap. They must determine what direct clinical care activities are required to deliver the full service, ensuring there is a detailed understanding of the consultant role and hours required.

Then individual work programmes need to be developed from the team job plan. Individuals should have personalised schedules based on their average NHS working week and any individual external commitments they may have. The team should agree and sign a ‘statement’ about how they work as a team, defining their shared objectives and detailing how they intend to share the responsibility of the team job plan.

A regular review is required to assess progress against the annualised job plan and to ensure working arrangements agreed remain the most effective and appropriate.

Flexibilities in job planning

Local contractual flexibilities can be introduced for those consultants on the 2003 contract. In work schedules, for example, the hours worked on a day to day basis can be varied. PAs can be worked in half units as well as whole, and the number of PAs per week can vary. A location other than principal place of work may also be agreed.

Pay progression for consultants

A key criteria for consultants to progress on pay is to have participated satisfactorily in the appraisal and job planning process; they must have done their best to work to the agreed job plan. They also need to comply with the provision for offering to perform up to one more additional paid PA per week if they wish to undertake private work.

Objective setting for doctors

Job planning is more than agreeing a timetable. The objectives should set out a mutual understanding of what the consultant should achieve over the period that they cover. An objective is a task, target or development that needs to be achieved. It should reflect the needs of the consultant, organisation and health community, and its resource implications should be known.

A mix of objectives may be agreed. Some will be hard objectives – these refer to something quantifiable that must be achieved, such as meeting waiting targets or gaining accreditation. Some will be soft objectives – these refer to activities that are difficult to quantify. They describe how someone goes about their job, such as patient involvement.

Personal development objectives relate to improving skills or knowledge that improve care. While team objectives might include improving pathways and protocols. Performance standards can also be used to ensure performance doesn’t dip below acceptable standards.

To craft an objective the consultant needs to agree, with their clinical lead, the local priorities to be addressed; they need to define an objective for each priority; detail the actions required to achieve the objective; then agree the measures against which the objective will be reviewed, and how it will be monitored; and, finally, discuss the support required to achieve the objective.

It can by useful to use a framework, such as SMART, when discussing and agreeing objectives. SMART stands for specific, measurable (quantified or descriptive), achievable and agreed, relevant, timed and tracked.

More guidance

See the Department of Health’s Consultant job planning – standards of best practice.

Many hospitals also have guidance, for example: Kingston Hospital, Cambridge University Hospitals, Oxford Radcliffe Hospital.

Tags: appraisal, Consultant contract, Job planning, PAs
Posted in Guidance | No Comments »