2. Aim:
Study of a completed project.
Learning Styles
Experimental Conceptual
Modeller
(Trial and Error) (Theory) (Copy)
High Risk Moderate Risk Low Risk
Preferred Path:
Modeller Conceptual Experimental
3. 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
5. NHS Rotherham
Sir Gerry thinks doctors need closer managing
www.news.bbc.co.uk/1/hi/health/6234919.stm
6. 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.
7. 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.
8. Tasks
Duration in
Activity Description Dependency
weeks
A Improve communication between the hierarchy. --- 2
B Maximum utilisation of consultant schedule. A 2
C Consultants see more patients. B 1
D Maximum utilisation of Surgeon schedule. C 2
E Surgeons perform more surgeries. D 1
F Replacing general anaesthesia with local anaesthesia. --- 4
G Space allocation for Splitting up O/T into 2 divisions. A 2
H Approval from Ministry of Health. G 2
I Approval from Infection control department. H 2
J Fund allocation from NHS Trust for the division. I 4
K Planning and Execution of Operation theatre division. G 1
L Surgery staff schedule for simultaneous operations. K 1
M Staff feedback system to improve patient services. A 1
Monthly schedule system regarding meetings between
management and floor staff to resolve issues and improve
N efficiency. A 1
9. Spare Time
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
10. Gantt Chart
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Week
Activity
A
B
C
D
E
F
G
H
I
J
K
L
M
N
11. Risk Assessment
High Low
Risk
Managed Reducing
High Carefully waiting list
HI/LR
Importanc
e of
project to
organizati
on Reject Routine
Low
12. Cost Benefit Analysis (CBA)
Balances between costs involved and benefits offered.
Positive if benefits higher than costs and vice versa.
Boardman A E (2004)
NHS benefits are higher than costs as survival is challenged
with no other option remaining rather than invest in efforts
towards reducing waiting lists.
Beta Probability.
(a = 12 weeks/Earliest, b = 15 weeks/Latest, c = 26
weeks/Actual).
Expected weeks = 16 weeks.
13. Group Development
Forming: Norming:
Uncertainty about group Members Closed relations formed.
more assertive.
Structure emerges.
Output low.
Self conscious.
Performing:
Storming:
Fully operational.
Solidarity.
Members more assertive.
Aggressive/personal attack.
Adjourning:
Leadership change.
Membership turnover.
Over.
Consultant has utilized group development
tools to extract work from NHS staff & mgmt.
14. Group Think
Concerns. Diagnosis.
• Over confidence in terms of • Calculated risks with pros
uncalculated risks. and cons.
• Ethics are compromised in • Ethical concerns are
decision making. addressed and taken into
• Self Censorship or reserve consideration.
rights to discuss different • Leader encourages criticism,
aspects and directions. 2 groups with optimistic
• Majority rules with no space critical analysis.
for objections. • Devil’s advocate and
• Negative and closed vision adjudicator process.
about competitors • Broad minded study about
competitors activities,
Source: e.g..SWOT analysis.
http://www.cedu.niu.edu/~fulmer/groupthink.htm
15. Individuals at work
Time
Innovation
NHS
Chief
Executive
Patient services
NHS floor
Admin staff
Skills
Technical HRD
16. Leadership
Manager is a
Good Employee
( GE ).
Consultant is a
Great Solution
Provider ( GSP ).
Leader is a Great
Actor ( GA) .
Source: www.NHSLeadershipQualities.nhs.uk
17. Culture
Role 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.
18. Conclusion:
• 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).
19. •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.
