Welsh Clinical Leadership Training Fellowships · As a Rheumatologist working in Sheffield, UK,...

Welsh ClinicalLeadership TrainingFellowships (WCLT)

Project outlines 2017/18

Welsh ClinicalLeadership TrainingFellowships

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2 | Wales Deanery Welsh Clinical Leadership Training Fellowships (WCLT)

The Wales Deanery is offering an exciting opportunity for up to 8 trainees toundertake a Clinical Leadership Training Fellowship in Wales, working closelywith Medical Directors, or equivalent. These Fellowships are designed to develophigh quality clinical leaders for the future NHS. Graduates from the Welsh ClinicalLeadership Training (WCLT) scheme will be ideally placed to build and leaddevelopments and improvements in the delivery of health care.

The Scheme will provide training and experience in clinicalleadership and management and will equip trainees withthe range of knowledge and skills they require to competeas medical and dental leaders in the modern NHS.Additionally, there will be a structured educationalprogramme provided by Academi Wales.

The 8 posts will represent a cohort of ‘WCLTF’ who willbe able to preference leadership projects from a selectionof proposals submitted by a variety of Health CareOrganisations including Local Health Boards and theWelsh Government. Following discussions with theWCLTF Director successful applicants will be offered anappropriate project. Fellows will also be able to continueclinical duties up to a maximum of 20% of their time. Priorto applying for the Fellowship, applicants are required toobtain the support of their Programme Director in writing.

Applicants for the WCLT Fellowship programme shouldbe medical or dental trainees considering involvement inclinical leadership and health service management as apart of their role on completion of training. Trainees whohave completed foundation training and are currentlyundertaking core or higher training, and are able to takeone year Out Of Programme, are encouraged to apply.Candidates wishing to train flexibly are welcomed andshould indicate this on their application.

Informal enquiries may be addressed to ProfessorPeter Donnelly ([email protected]) orMrs Diane Harris ([email protected]).

Details of the application process, person specificationand further information can be found atwww.walesdeanery.org (follow the links toWelsh Clinical Leadership Training Fellowship).

Interview Date:18 January 2017

Application period:9 November 2016 – 1 December 2016

Please note: Further projects may be availablefollowing the submission of your application.We intend to update this Project Outline Documentweek commencing 14 November, to house up to30 projects in total. The Wales Deanery will beflexible with the specified project options chosen byapplicants to the Welsh Clinical Leadership TrainingFellowship Programme, at the application stage.

Welsh Clinical LeadershipTraining Fellowships (WCLT)



Project title page

1. Improving People Leadership within the Medical Workforce 4-5

2. Predicting the risk of harm on arrival to hospital 6-7

3. Welsh Paediatric Simulation 8-9

4. A Regional Collaboration for Health (ARCH) – A World Class Health& Wellbeing Economy for the South West Wales Region 10-11

5. Controlling the Confusion (part three): creating andsustaining composite teams in health care 12-13

6. Improving Diabetic Foot Care 14-15

7. SPEED and DEEDS – Supporting Patient Engagement in the EmergencyDepartment and Developing Engagement of Emergency Department Staff 16-17

8. Transforming Patient Flow and Improving Patient Safety throughICT-enabled Healthcare 18-19

9. Improve the physical health of community mental health team patients 20-21

10. Realising a Prudent Hospital 22-23

11. Streamlining home therapies for CKD patients requiringdialysis – a model of supported self-care 24-25

12. The design, delivery and management of a unique model incorporatinga combined vascular access and Out Patient Parenteral AntimicrobialTherapy (OPAT) service across ABMU Health Board 26-27

13. Developing a strategy to Reduce Avoidable Mortality in BCUHB 28-29

14. Developing an Engagement Programme & Strategy for Junior Medical Staff 30-31

15. Obstetric Cymru 32-33

16. In Hospital Mortality – understanding our results and putting things right 34-35

17. Improving sepsis care across the Cardiff and Vale UHB 36-37

18. OBS Cymru (Obstetric Bleeding Strategy for Wales) 38-39

19. Developing integrated working within the Cardiff SW clusterwith a focus on establishing a social prescribing model 40-41

20. Developing a transition pathway for young people with complexneeds to adult services 42-43

21. Clinical leadership within Medical Education: Developing a multi-disciplinary,integrated clinical skills and simulation model within Cardiff And Vale UHB 44-45

22. Impact of access issues on the potential for avoidable harm 46

23. Delivering equity and excellence in NHS specialised care within Walesthrough a patient centred, fair and consistent approach to commissioning 47-48

24. Developing a cancer care model pathway which will enhance the deliveryof follow-up services to our patients and influence future service planning 49-50

25. Safer Pregnancy: Working towards reducing stillbirth rates in Wales 51

26. Reducing Harm and Variation in Clinical Services 54

27. Developing a Clinical Strategy in Hywel Dda 56

28. Re-thinking the Interface between Primary and Secondary care. (IIPS) 58

Contents


Project Title 1: Improving People Leadership within the MedicalWorkforce

Medical Director: Dr Paul Buss

Organisation: Aneurin Bevan University Health Board

Project Summary:This is a unique opportunity to undertake the Welsh Clinical Leadership and Improvement Fellowship schemewithin Aneurin Bevan Continuous Improvement (ABCi) team. This team is an improvement team embedded withinAneurin Bevan University Health Board, focussed on supporting Improvement, Innovation and developingLeadership.

ABCi has a strong reputation in delivering courses and building capability. Leading People is a course thatsupports the development of skills in Human Factors to improve staff engagement, performance and patientsafety. Increasing such skills within the Medical workforce is paramount.

The Fellow would develop and lead a project that would involve:

1. Developing a plan for engaging with the medical workforce at all levels

2. Considering whether a bespoke course is required for this group

3. Designing taster sessions to increase engagement

4. Evaluating the experience of medical staff joining the programme using mixed methodologies

5. Writing up and presenting findings on the impact of the project in order to disseminate learning in thisinnovative area.

You would be provided with support and additional coaching from the ABCi team, along with input from theMedical Director, enabling you to contribute considerably to the work undertaken. Furthermore, you will developconsiderable skills in Leadership and engagement.

In addition to the above project the fellow will have the opportunity to take part in, and support the delivery ofother programmes, integrated fully within the ABCi team for the year of your fellowship.

Immediate supervisors:

Benna Waites, Consultant Clinical Psychologist, Joint Head of Psychology Counselling and Arts Therapies,ABCi Associate

Dr John Boulton, Executive Director of ABCi

For more information on the project please contact:

Benna Waites: [email protected] Boulton: [email protected]

continued overleaf


Improving People Leadership within the Medical Workforce continued

Biographies:

Medical Director:

Dr Paul Buss, a consultant Paediatrician since 1993, is based at the Royal Gwent Hospital and has been involved inclinical management roles since 2003 – undertaking an MSc in healthcare management at HSMC Birmingham. Hisprevious role was Assistant Medical Director of Quality and Professional Standards for Aneurin Bevan Health Board.

Previous roles include Deputy Medical Director of Gwent Healthcare Trust in a combined role as Medical Director ofPowys Local Health Board from 2008-09. He has recently taken the lead role in developing a DNACPR policy (Do NotAttempt Cardiopulmonary Resuscitation) for NHS Wales. He is currently also Co-Chair for the review of orphan andultra-orphan medicines in Wales. Other activities included - Chair of the All Wales Medicines Strategy Group (2005-06developing an All Wales Policy - on the usage of medicines, Co payment policy, and also Chairing a Task and Finishgroup on the non surgical cosmetic procedures in Wales. He has a main interest in the alignment of policy withevidence based, financially sound, clinical decision making and the need to increase senior clinical involvement indecisions relating to NHS efficiency.

Clinical Supervisor:

John Boulton is currently Director of Continuous Improvement at Aneurin Bevan University Health Board (ABUHB) inWales. As a Rheumatologist working in Sheffield, UK, John became interested in quality improvement methodologies.After becoming an active member of Sheffield Teaching Hospital’s improvement team he went onto lead the outpatientimprovement program. His work within Rheumatology was shortlisted for a national award, and included improvedscheduling of biological therapies, delivery of biologics within community settings, and improving patient experiencewithin outpatient clinics.

In 2012 John was awarded a Quality Improvement fellowship at the Institute for Healthcare Improvement in the USA,sponsored by the Health Foundation. This enabled him to develop a deep understanding of Improvement science,focussing on measurement for improvement and the principles and techniques needed to improve patient flow withinhospitals. In addition, he spent time developing a patient experience tool for use within chronic disease settings.

Prior to joining ABUHB he worked in the State of Qatar as Clinical Lead for Quality Improvement at Hamad MedicalCorporation. He led the corporate flow strategy resulting in the development of a flow collaborative in order to buildorganisational capability and ultimately produced marked improvements. In addition, he supported IHI’s patient safetycollaborative which resulted in sustainable reductions in patient harm.


Project Title 2: Predicting the risk of harm on arrival to hospitalMedical Director: Dr Paul Buss


Project Summary:Healthcare associated harm is now viewed as avoidable. However, many of the tools and techniques to identifythose at risk are not administered immediately on admission, and may be delayed for various reasons, resulting inhealthcare organisations being reactive in attempting to mitigate risk.

Increasingly there is evidence to suggest that such harms are associated with organisational factors in addition tothe patient factors. Delays, for example, in addition to high hospital occupancy, are strongly associated with harmand increased mortality.

This project seeks to develop a predictive model to identify patients at risk of harm as they are admitted into thehospital. Alongside this an improvement project will be developed in order to support the reduction in risk forthose patients identified.

The project will be led by the leadership fellow, closely supervised by a mathematician and the Exec director ofABCi. The fellow will:

� Analyse data to assess the correlation between harm and hospital factors such as occupancy,ED waiting, mode of arrival, etc

� Analyse data to assess the correlation between harm and patient factors

� Develop a prediction model to identify patients most at risk of harm

� Validate the model

� Test the model in practise

The fellow will also be required to:

� Work closely with colleagues to effectively analyse data and construct the model

� Use effective communication skills to demonstrate the effectiveness of the model

� Build an improvement programme to support the implementation of the tool

� Analyse data for improvement

� Present and potentially publish their work

In addition to the above project the fellow will have the opportunity to take part in, and support the delivery ofother programmes, integrated fully within the ABCi team for the year of your fellowship. Furthermore, you willdevelop considerable skills in Leadership and engagement.


Benna Waites, Consultant Clinical Psychologist, Joint Head of Psychology Counselling and Arts Therapies,ABCi Associate

Dr John Boulton, Executive Director of ABCi


Benna Waites: [email protected] Boulton: [email protected]

continued overleaf


Predicting the risk of harm on arrival to hospital continued

Biographies:

Medical Director:




John Boulton is currently Director of Continuous Improvement at Aneurin Bevan University Health Board (ABUHB) inWales. As a Rheumatologist working in Sheffield, UK, John became interested in quality improvement methodologies.After becoming an active member of Sheffield Teaching Hospital’s improvement team he went onto lead the outpatientimprovement program. His work within Rheumatology was shortlisted for a national award, and included improvedscheduling of biological therapies, delivery of biologics within community settings, and improving patient experiencewithin outpatient clinics.

In 2012 John was awarded a Quality Improvement fellowship at the Institute for Healthcare Improvement in the USA,sponsored by the Health Foundation. This enabled him to develop a deep understanding of Improvement science,focussing on measurement for improvement and the principles and techniques needed to improve patient flow withinhospitals. In addition, he spent time developing a patient experience tool for use within chronic disease settings.

Prior to joining ABUHB he worked in the State of Qatar as Clinical Lead for Quality Improvement at Hamad MedicalCorporation. He led the corporate flow strategy resulting in the development of a flow collaborative in order to buildorganisational capability and ultimately produced marked improvements. In addition, he supported IHI’s patient safetycollaborative which resulted in sustainable reductions in patient harm.


Project Title 3: Welsh Paediatric SimulationMedical Director: Dr Paul Buss


Project Summary:This is a unique opportunity to undertake the Welsh Clinical Leadership Training Fellowship scheme within AneurinBevan.

The School of Paediatrics is committed to ensuring that Wales offers a high quality, curriculum driven, sustainabletraining programme with the aim of producing paediatricians of the highest calibre who will deliver the bestpossible care for children and their families.

Simulation is an integral part of this training and as such this post will make a significant contribution to improvingPaediatric Training in Wales and through this patient safety and quality of care.

ABUHB will facilitate a strategic link between the post holder and ABCi (Aneurin Bevan Continuous Improvement)which will offer opportunities to observe and contribute to improvement and innovation within the organisation.

The appointed Fellow would develop and lead a project that would involve:

1. All Wales Simulation Training Programme

a. To co-ordinate the various training days that are currently run both centrally and in a number of thehealth boards to a more coherent programme.

b. To develop additional training days and courses as identified by the needs assessment that would havebeen completed prior to this post commencing. You would work closely with a very motivated group ofPaediatric consultants and trainees in the Welsh Paediatric Simulation Group (WPSG)

c. To liaise with other specialties and professional groups in Wales who are actively involved simulation inWales to encourage multi-disciplinary courses.

d. To help organise a separate Paediatric Simulation stream at future Welsh Simulation Symposiums.

e. To help the WPSG raise its profile:

i. Health Board Management as well as Deanery

ii. Social Media – Twitter, website, WhatsApp, blog etc

iii. Media involvement (We would arrange media training for them)

2. In-situ Simulation

To embed in-situ simulation training across all the Health Boards in Wales. There are consultant and nurserepresentatives within each of the Health Boards who are part of the WPSG who already run various in-situsimulations with varying success. The aim would not be to try to make them all the same as the needs arevery different across sites but to share good practice and work on a bank of shared resources.

Part of this would be to work on a data sharing forum to share:

a. simulations, preferably with comments and review section

b. “lessons/sims of the week”

3. Quantify the impact of simulation

To work on a project to try to quantify the impact of simulation (both the in-situ as well as the courses)in order to measure what value this adds to patient safety and quality of training.

continued overleaf


Welsh Paediatric Simulation continued


Dr Yvette Cloete: [email protected] Rachel Bebb: [email protected]


Dr Yvette Cloete: [email protected]

Biographies:

Medical Director:




Dr Yvette Cloete is a Consultant Paediatrician at Royal Gwent Hospital, Newport. Yvette is currently the JointSimulation Lead for the School of Paediatrics with Dr Rachel Bebb.

Yvette’s roles include:

� Local Faculty Lead (Trainee and Trainer Support) ABUHB

� Paediatric Training Programme Director (TPD) ST4-8, Wales Deanery

� Joint Quality Assurance Lead for Paediatrics, Wales Deanery

� Wales Regional General Paediatric Training Advisor, RCPCH

Dr Rachel Bebb is a Consultant Paediatrician with interest in Paediatric Emergency Medicine, Royal GwentHospital, Newport.

Her role in education include:

� Educational Supervisor

� Honorary Clinical Tutor for Cardiff University

� Tutor, both bedside and tutorial based, BLS training

� Undergraduate OSCE examiner

� Specialty Tutor for Paediatric


Project Title 4: A Regional Collaboration for Health (ARCH) –A World Class Health & Wellbeing Economyfor the South West Wales Region

Medical Director: Professor Hamish Laing and Dr Philip Kloer

Organisation: Abertawe Bro Morgannwg University Health Board& Hywel Dda University Health Board

Project Summary:ARCH is a unique collaboration between Abertawe Bro Morgannwg University (ABMU) Health Board, Hywel DdaUniversity (HDU) Health Board and Swansea University, which brings health and science working together toimprove the health, wealth and wellbeing of the people of South West Wales.

ARCH aims to modernise our healthcare system allowing us to better meet the needs of our current populationwho now live in a very different world. At the heart of our work are the aims of Prudent Healthcare, to ensurehealthcare fits the needs and circumstances of people and actively avoids wasteful care.

ARCH has developed a Portfolio Delivery Plan for the next 10 -15 years, agreed with Welsh Government. Itdescribes the critical path of project delivery in terms of tranches / Phases with the first phase starting in April2017 and lasting three years.

The ARCH Portfolio is underpinned by research excellence in Swansea University and will develop and translateleading healthcare innovation to the benefit of the population.

The WCLT Fellow will work with ABMU and HDU Health Boards on placement, specifically working on one or twoof the following key service transformation ARCH projects that will be progressing in the first phase of the Portfolio:

� Implementing the Regional Pathology Project (including development of genomics in SW Wales)

� Stand Alone Elective Orthopaedic Unit.

� Redesigning Admission process within Singleton Hospital.

� Implementing the Non-Surgical Cancer Strategy for South West Wales.

� Implementing Health & Wellbeing Villages (Primary Care Services) in 3 Communities across South West Wales.

The Fellow will have the opportunity to attend and observe senior management / decision making forums withinthe University, including Schools of Medicine and Human & Health Science Senior Management Boards, SwanseaUniversity Senior Management Board and Council.

Also ARCH will offer the WCLT Fellow a personal development plan for the 12 month period working withinspirational and visionary clinical leaders.


Professor Hamish Laing, Executive Medical Director and Honorary Professor, Swansea University,

ABMU Health Board


Professor Hamish Laing

Tel: 01639 683307Email: [email protected]

continued overleaf


A Regional Collaboration for Health (ARCH) – A World Class Health & Wellbeing Economy for the South West Wales Region continued

Biographies:

Medical Director and Clinical Supervisor:

Hamish Laing has been Executive Medical Director for Abertawe Bro Morgannwg University (ABMU) Health Boardsince April 2014 having been Director of Clinical Strategy since 2012. He holds the inter-collegiate FRCS in PlasticSurgery, FRCS (Plast) and in 2012 was awarded the Masters Diploma in Organisational Leadership with Distinctionby the Oxford University.

As a founder member of the Faculty for Healthcare Improvement in Wales Hamish believes passionately that saferand better care for patients can also be cheaper for the NHS.


Project Title 5: Controlling the Confusion (part three): creating andsustaining composite teams in health care

Medical Director: Professor Hamish Laing

Organisation: Abertawe Bro Morgannwg University Health Board

Project Summary:Abertawe Bro Morgannwg University (ABMU) Health Board is committed to delivering effective and efficienthealthcare in which patients and service users feel cared for, safe and confident.

Our responsibilities extend to primary, secondary and tertiary services and a range of community based services,including mental health and learning disabilities. We have excellent links with Swansea University through teachingand developing new, innovative ways of working, particularly with the Medical School.

Specifically, making a measurable positive impact in mental health and on frail older people is a component ofdelivering our 6 strategic aims, one of which being ‘excellent patient outcomes and experience’.

The Mental Health Service for Older Adults in Bridgend based at the Princess of Wales Hospital (POWH) offers asingle point of access to mental health services and advice. The service model includes:

� Care Home Inreach Team, which is composed of medical staff, social worker and occupational therapy as wellas the more traditional multidisciplinary team.

� POWH shared care ward where RGN and RMN qualified nursing staff working together within a defined areaalongside members of the inreach team, general medical and psychiatric medical staff.

This model has demonstrated a sustained reduction in unscheduled mental health admissions from care homesettings, coupled with containment of Continuing Health Care (CHC) spend.

The WCLT Fellow will research and evaluate these two closely related existing teams working with the Clinical Leadto tease out the elements that are both innovative and valuable plus where improvements can be made. The aimis to in directly influence service change in mental health, working with clinical colleagues across the Health Board.

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will include theopportunity to work with inspirational and visionary clinical leaders; submit articles for publications andconferences; knowledge of service planning and change; understand how the NHS works from the lens of theclinician, a senior manager and the Welsh Government.


Dr Robert Colgate,Consultant Psychiatrist and Clinical Teacher, Princess of Wales Hospital


Dr Robert ColgateTel: 01656 752752 / 2252Email: [email protected]

continued overleaf


Controlling the Confusion (part three): creating and sustaining composite teams in health care continued

Biographies:

Medical Director:


As a founder member of the Faculty for Healthcare Improvement in Wales Hamish believes passionately that safer andbetter care for patients can also be cheaper for the NHS.


Robert Colgate is a Consultant Old Age Psychiatrist for the Bridgend area. He has a passion for developing othersand has a strong track record in medical education. Publications include the local mental health service for older adultsmodel in Advances in Psychiatric Treatment (Colgate and Jones 2007 and Colgate et al 2012) establishing a firmfoundation for this project.

Robert completed the Academi Wales Medical Leadership Programme in 2015 with distinction as part of the thirdWales cohort and is classed as an enthusiastic professional.


Project Title 6: Improving Diabetic Foot CareMedical Director: Professor Hamish Laing


Project Summary:ABMU Health Board is committed to delivering effective and efficient healthcare in which patients and serviceusers feel cared for, safe and confident. Our values of ‘Caring For Each Other’, ‘Working Together’ and ‘AlwaysImproving’ are at the heart of all of our interactions with patients, the public, and with each other and to ensurethat patient outcomes and experience improves as a result.

Our responsibilities extend to primary, secondary and tertiary services together with a range of community basedservices. We operate four acute hospital sites one of these being Morriston Hospital with 750 beds. We haveexcellent links with Swansea University through teaching and developing new, innovative ways of working,particularly with the Medical School.

Diabetes is a priority improvement area for the Health Board’s Long Term Conditions Commissioning Board.Working in tandem with commissioning is the improvement programme focusing on the care of patients withdiabetic foot disease from home, through to primary care, to prompt review when required in secondary care andappropriate and safe discharge home.

The WCLT Fellow will participate in:

� Our Commissioning Team work on redesigning diabetes services for the population served by ABMU,incorporating also public health.

The Fellow will be involved in a Programme Budget Marginal Analysis project, working closely withSwansea University, Diabetes Research Unit Cymru, clinical and patient representatives.

� Improving the foot care service for people with diabetes at Morriston Hospital with support from the clinicalteam, reducing amputation rates and improving the patients’ experience.

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will include theopportunity to work alongside the multidisciplinary diabetic foot clinic team directly impacting on patientoutcomes; experience how commissioning in a healthcare setting works; work with inspirational and visionaryclinical leaders; understand how the NHS works from the lens of the clinician, a senior manager and the WelshGovernment.


Miss Claire Topliss, Consultant in Trauma and Orthopaedics, Morriston Hospital, ABMU Health Board


Claire ToplissTel: 01792 703460Email: [email protected]

continued overleaf


Improving Diabetic Foot Care continued

Biographies:

Medical Director:

Hamish Laing has been Executive Medical Director for Abertawe Bro Morgannwg University (ABMU) Health Boardsince April 2014 having been Director of Clinical Strategy since 2012. He holds the inter-collegiate FRCS in PlasticSurgery, FRCS (Plast) and in 2012 was awarded the Masters Diploma in Organisational Leadership with Distinction bythe Oxford University. Hamish remains the clinical lead for the Sarcoma Service in South Wales.


Clinical Supervisor

Claire Topliss is a Consultant Trauma & Orthopaedic Surgeon with a specialty interest in foot and ankle trauma.The specialty provides an emergency and elective service to the population of Swansea, areas of Neath Port Talbotand specialist services to the population of Mid and West Wales. Claire’s drive for safer and better care for patients isseen in the establishment of a multidisciplinary joint foot clinic to enable patients to undergo medical and diabeticreviews at the same time as their foot problems are addressed.

Claire has successfully undertaken the Academi Wales Medical Leadership Programme this year and is the HealthBoard’s clinical lead driving diabetic foot care forward.


Project Title 7: SPEED and DEEDS – Supporting Patient Engagementin the Emergency Department and DevelopingEngagement of Emergency Department Staff



Project Summary:Abertawe Bro Morgannwg University (ABMU) Health Board is committed to delivering effective and efficienthealthcare in which patients and service users feel cared for, safe and confident. Our values of ‘Caring For EachOther’, ‘Working Together’ and ‘Always Improving’ are at the heart of all of our interactions with patients,the public, and with each other and to ensure that patient outcomes and experience improves as a result.

Our purpose is to improve the health of our population, reduce health inequalities and deliver effective and efficienthealthcare.


Throughout industry and more recently in healthcare, better employee engagement has been shown to correlatewith better quality, enhanced resilience, decreased burnout, improved recruitment and retention, increasedbottom-up innovation and improved customer/patient experience.

The WCLT Fellow will work on a one year employee engagement programme within the Emergency Department(ED) at Morriston Hospital as part of the newly formed Emergency Care and Hospital Operations Service Group(ECHO).

The overarching aim of the project is to develop our engagement strategy for staff and to translate that intomeasurable benefits for both staff and patients, increasing the exchange of ideas and ownership of the futuredirection of the ED. A key objective is the development of a patient forum for the ED/ECHO service group.

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will include theopportunity to work with inspirational and visionary ED clinical leaders ; knowledge on the subject of staffengagement; submit articles for publications and conferences; understand how the NHS works from the lens ofthe clinician, a senior manager and the Welsh Government.


Dr Andy MacNab, Consultant in Emergency Medicine and Associate Unit Medical Director (Emergency Care andHospital Operations), Morriston Hospital


Dr Andy MacNabTel: 01792 703418 / 3415Email: [email protected]

continued overleaf


SPEED and DEEDS – Supporting Patient Engagement in the Emergency Department and Developing Engagement of EmergencyDepartment Staff continued

Biographies:

Medical Director:

Hamish Laing has been Executive Medical Director for Abertawe Bro Morgannwg University (ABMU) Health Boardsince April 2014 having been Director of Clinical Strategy since 2012. He holds the inter-collegiate FRCS in PlasticSurgery, FRCS (Plast) and in 2012 was awarded the Masters Diploma in Organisational Leadership with Distinction bythe Oxford University.


Clinical Supervisor

Andy MacNab is one of ABMU’s newly appointed Associate Unit Medical Directors (Emergency Care and HospitalOperations) and a Consultant in Emergency Medicine, Morriston Hospital. Andy has a specific interest in paediatricemergency medicine and is a devoted educator. He believes passionately about safer and better care for patientsand improving the patient flow at the front end is part of a whole system approach to improve quality.

Andy has undertaken the Academi Wales Medical Leadership Programme, passed the UWTSD PGC in ClinicalLeadership with distinction, and is a member of the Heath Foundation’s Q Initiative founding cohort.


Project Title 8: Transforming Patient Flow and Improving PatientSafety through ICT-enabled Healthcare



Project Summary:ABMU Health Board assesses the health needs and subsequently commissions, plans, and delivers care for aresident population of approximately 500,000 people. Through its 15,760 staff the Health Board’s responsibilitiesextend to primary, secondary and tertiary services together with a range of community based services.

ABMU has ensured enabling information and technology is a vital strategic component in delivering its aim toimprove the health of the community and deliver effective and efficient healthcare.

A key area is optimising inpatient flow to improve the safety and quality of care and ensure better patientoutcomes by reducing the harm, waste and clinical variation inherent in current paper based systems whichsupport ward and hospital clinical processes. This is the ABMU Patient Flow IT Programme.

The Programme encompasses a range of projects using integrated systems to redesign clinical areas which willprovide intuitive, easy to use electronic tools for front line staff to support the efficient and effective flow ofpatients.

The WCLT Fellow will participate in four specific streams of the Patient Flow Programme work and be encouragedto develop one specific workstream over the 12 month period. The workstreams are as follows:

1) Roll out of Electronic Patient Flow Management System (EPFM) – for the co-ordination, communicationand workflow of the inpatient journey.

2) Developing a Vital Signs Observations Electronic Workflow – using wirelessly enabled medical devicesthat will integrate with the EPFM.

3) Implementing a Digital Patient Record. The Welsh Clinical Portal – providing clinicians in Wales withaccess to key patient information across all settings.

4) Implementing Electronic Prescribing and Medicines Administration

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will includeexperience working with the National Informatics Programme and other Health Boards; knowledge and workingwith the ABMU Digital Strategy; work with inspirational and visionary clinical leaders; understand how the NHSworks from the lens of the clinician, a senior manager and the Welsh Government.


Prof Hamish Laing,Executive Medical Director and Chief Information OfficerTel: 01639 683307 Email: [email protected]


Matthew JohnAssistant Director of InformaticsTel: 01639 683645Email: [email protected]

continued overleaf


Transforming Patient Flow and Improving Patient Safety through ICT-enabled Healthcare continued

Biographies:


Hamish Laing has been Executive Medical Director for Abertawe Bro Morgannwg University (ABMU) Health Boardsince April 2014 having been Director of Clinical Strategy since 2012. He holds the inter-collegiate FRCS in PlasticSurgery, FRCS (Plast) and in 2012 was awarded the Masters Diploma in Organisational Leadership with Distinctionby the Oxford University. Hamish remains the clinical lead for the Sarcoma Service in South Wales.



Project Title 9: Improve the physical health of community mentalhealth team patients


Organisation: Abertawe Bro Morgannwg University Health Board (ABMU)

Project Summary:Abertawe Bro Morgannwg University (ABMU) Health Board is committed to delivering effective and efficienthealthcare in which patients and service users feel cared for, safe and confident. Our values of ‘Caring For EachOther’, ‘Working Together’ and ‘Always Improving’ are at the heart of all of our interactions with patients, thepublic, and with each other and to ensure that patient outcomes and experience improves as a result.

Our purpose is to improve the health of our 500,000 population, reduce health inequalities and deliver effectiveand efficient healthcare.

Our responsibilities extend to primary, secondary and tertiary services and a range of community based services,including mental health and learning disabilities. We have excellent links with Swansea University through teachingand developing new, innovative ways of working, particularly with the Medical School.

We recognise an area of unnecessary inequality is people with mental health problems having poorer physicalhealth than the general population. Several studies have demonstrated that people with psychiatric illness are athigher risk of premature mortality and preventable physical morbidity. People with severe mental illness dying onaverage 15-20 years earlier than the general population.

In Swansea, the Ty Einon Community Mental Health Team have a ‘Physical Health Clinic’ where all patientsprescribed psychotropic medication are offered an annual review for a physical check-up.

The WCLT Fellow will work with the Ty Einon Community Mental Health Team in their clinic. The Fellow will leadthe improvement project that establishes a system to deliver feedback and guidance on intervention to improvepatients’ physical health.

The Fellow will also have opportunity to work with Dr Clementine Maddock on improving care for patients with adual diagnosis of mental health and substance misuse; and contribute to investigating suicide and untowardincidents within ABMU. The role will involve close liaison with GPs.

ABMU offers the WCLT Fellow applicant a personal development plan over the 12 month period.


Dr Clementine Maddock, Consultant Psychiatrist and Clinical Lead, Swansea Adult Mental Health Services,Ty Einon


Dr Clementine MaddockTel: 01792 545780Email: [email protected]

continued overleaf


Improve the physical health of community mental health team patients continued

Biographies:

Medical Director:

Hamish Laing has been Executive Medical Director for Abertawe Bro Morgannwg University (ABMU) Health Boardsince April 2014 having been Director of Clinical Strategy since 2012. He holds the inter-collegiate FRCS in PlasticSurgery, FRCS (Plast) and in 2012 was awarded the Masters Diploma in Organisational Leadership with Distinction bythe Oxford University. Hamish remains the clinical lead for the Sarcoma Service in South Wales.



Clementine Maddock is a Consultant Psychiatrist based at Ty Einon, Swansea. Ty Einon is a centre supported bymultidisciplinary teams for adults with conditions such as Schizophrenia, Bipolar Disorder and Depression. Clementinealso holds a Graduate Diploma in Law and in 2013 she was the winner of the Swansea University School of Law Prizefor the Highest Marks in GDL and the Bar Council Law Reform Essay Prize for the best GDL entry.

Dr Maddock has pan Health Board responsibly working with the Serious Incident Team investigating suicide anduntoward incidents within ABMU.


Project Title 10: Realising a Prudent HospitalMedical Director: Professor Hamish Laing

Organisation: Abertawe Bro Morgannwg University Health Board – Neath Port TalbotDelivery Unit

Project Summary:Prudent healthcare has put NHS Wales at the front of a growing international effort to get greater value fromhealthcare systems for patients. The principles of Prudent Healthcare are the golden thread through whichAbertawe Bro Morgannwg University (ABMU) Health Board aims to work.

Our purpose is to improve the health of our 500,000 population, reduce health inequalities and deliver effectiveand efficient healthcare.

Our responsibilities extend to primary, secondary and tertiary services together with a range of community basedservices. We operate four acute hospital sites one of these being Neath Port Talbot Hospital with 270 beds. Wehave excellent links with Swansea University through teaching and developing new, innovative ways of working,particularly with the Medical School.

Neath Port Talbot Hospital’s (NPTH) vision is for the public and staff to feel prudent healthcare in action -supporting health and wellbeing, providing care when required that fits the needs and circumstances of theperson and actually avoids ineffective or duplicative care that is not to the patients’ benefit or fair. This is ourPrudent Hospital Improvement Programme.

The WCLT Fellow will participate in the NPTH programme and be encouraged to develop one or more of thefollowing workstreams:

� Commission a rapid diagnosis hub for cancer linking primary and secondary care to only do what is needed,in the right place and in a timely way.

� Change the model of outpatients to more coproduction and evidence based practice.

� Implement a discharge to assess methodology working with other public sector services to maximise patientsafety and flow through the hospital.

ABMU offers the Fellow a personal development plan over the 12 month period, which will include experience ofworking alongside multi professional teams, patients and the public; understanding how commissioning in ahealthcare setting works; work with inspirational and visionary clinical leaders; knowledge of how the NHS worksfrom the lens of the clinician, a senior manager and the Welsh Government.

The Fellow will also have an opportunity to work with the Bevan Commission.


Dr Martin Bevan,Medical Director, Neath Port Talbot Service Delivery Unit, ABMU Health Board


Dr Martin BevanTel: (01639) 862594Email: [email protected]

continued overleaf


Realising a Prudent Hospital continued

Biographies:

Medical Director:




Martin Bevan is one our ABMU Health Board’s new Unit Medical Directors, concentrating on Neath Port TalbotHospital with pan Health Board responsibilities. Martin is a Rheumatologist and was lead clinician in ABMU beforetaking up the MD role. He is experienced in the diagnosis and management of inflammatory arthritis, connective tissuedisease, vasculitis, crystal arthritis, soft tissue rheumatism and fibromyalgia.


Project Title 11: Streamlining home therapies for CKD patientsrequiring dialysis – a model of supported self-care



Project Summary:Abertawe Bro Morgannwg University (ABMU) Health Board is committed to delivering effective and efficienthealthcare in which patients and service users feel cared for, safe and confident.

Our purpose is to improve the health of our population, reduce health inequalities and deliver effective and efficienthealthcare. The principles of Prudent Healthcare are the golden thread through which we aim to work.

In keeping with the philosophy of Once for Wales and Prudent, the South West Wales (SWW) RegionalNephrology based at Morriston Hospital has established an innovative new approach to dialysis services byexpanding home based dialysis therapies through its nocturnal dialysis programme, which serves as an exemplarfor potential adoption nationally.

The WCLT Fellow will participate in the following 4 workstreams already ongoing with the SWW home nocturnaldialysis programme, which are:

� Developing an innovative digital / educational platform to deliver healthy literacy.

� Demonstrating the impact of improved healthy literacy.

� Empowering patients to embrace and sustain supportive self-care for better dialysis.

� Enabling flexibility – removing the barriers for better dialysis and a quality of life.

Incorporated in this work is the opportunity to lead initiatives to understand our patient needs, meet theirexpectations and alleviate anxiety about adopting healthcare technologies within their own environment.The fellow will participate in the activities of the national Quality and Patient Safety Subcommittee of the WelshRenal Clinical Network (WRCN) together with the Clinical Lead and other professionals within this dynamic,forward thinking team.

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will includeexperience of working alongside multi professional teams, patients and charities; presentations nationally andsubmitting articles for publications and conferences; understand how the NHS works from the lens of the clinician,a senior manager and the Welsh Government. The Fellow will also have an opportunity to work with the BevanCommission as part on its Innovator programme.


Ashraf Mikhail, Consultant Nephrologist and Clinical Director Nephrology, Morriston Hospital


Ashraf [email protected]

and/or

Christopher Brown, Consultant Renal Pharmacist, Lead Pharmacist for [email protected]

continued overleaf


Streamlining home therapies for CKD patients requiring dialysis – a model of supported self-care continued

Biographies:

Medical Director:




Ashraf Mikhail is a Consultant Nephrologist and Clinical Lead for Regional Nephrology Services (South West Wales).Under his leadership and with his multidisciplinary colleagues the renal unit based at Morriston Hospital has becomethe first in Wales to train chronic kidney disease patients to receive vital dialysis treatment while they sleep.

The Nocturnal dialysis programme, established in 2011, has blossomed into the largest nocturnal programme in theUK, training over 40 patients to go home and dialyse themselves overnight. These patients have all reported a vastimprovement in their own health and a huge reduction in the amount of medications that they have to take. All this hasenabled them to have a much better quality of life, having the energy to enjoy many more activities.


Project Title 12: The design, delivery and management of a uniquemodel incorporating a combined vascular accessand Out Patient Parenteral Antimicrobial Therapy(OPAT) service across ABMU Health Board



Project Summary:Abertawe Bro Morgannwg University (ABMU) Health Board purpose is to improve the health of our population,reduce health inequalities and deliver effective and efficient healthcare.


Prudent healthcare has put NHS Wales at the front of a growing international effort to get greater value fromhealthcare systems for patients. The principles of Prudent Healthcare is the golden thread through which theVascular Access and OPAT service based at Morriston Hospital works - safely and effectively managing patientswith infections as outpatients ensuring that their treatment is optimised, appropriately delivered and supervisedand that risks are minimised.

The WCLT Fellow will be working in a unique service model that is clinically led with vascular access and OPATservices combined. With support from the Clinical Director the Fellow will be involved in and/or lead:

� Cementing the existing team into the day-to-day practice at Morriston Hospital while working with the 3 otheracute hospitals to create and establish parallel vascular access and OPAT services.

� Work closely with community and ambulatory care teams to deliver high quality care in the community.

� Develop pathways and guidelines to support the delivery of high quality care and the collection of data toinform change and planning.

ABMU offers the WCLT Fellow a personal development plan over the 12 month period, which will includeopportunities to work alongside multidisciplinary primary and secondary teams; experience working withmicrobiology and pharmacy to strategically move the service forward; work with inspirational and visionary clinicalleaders; submit articles for publications and conferences; understand how the NHS works from the lens of theclinician, a senior manager and the Welsh Government.


Dr Paul Temblett, Clinical Lead Vascular Access and OPAT Service, Morriston Hospital


Dr Paul TemblettTel: 01792 703470Email: [email protected]

continued overleaf


The design, delivery and management of a unique model incorporating a combined vascular access and Out Patient ParenteralAntimicrobial Therapy (OPAT) service across ABMU Health Board continued

Biographies:

Medical Director:




Paul Temblett is a Consultant Intensivist working at the Ed Major Critical Care Unit Morriston Hospital and isthe Clinical Director for Critical Care. Paul has a specific interest in respiratory medicine and critical care followup/outcomes.

Paul’s broad back ground in respiratory, general and intensive care medicine has provided the basis for continuedwork and progress in delivering safe, effective, prudent and high quality patient care. Since 2011 he has been involvedin developing the unique vascular access and OPAT service at Morriston Hospital. This is an exciting and highlyrewarding piece of work that crosses many boundaries and continues to deliver high quality care.


Project Title 13: Developing a strategy to Reduce Avoidable Mortalityin BCUHB

Medical Director: Dr Evan Moore

Organisation: Betsi Cadwaldr University Health Board BCUHB

Project Summary:Committed to improving the services offered, a key metric for BCU, is mortality. While death for many is inevitable,with the successful implementation of best treatments and systems of clinical care, some deaths may be avoidable.

Mortality reduction naturally a core element of the BCUHB Quality Improvement Strategy, this has already beenelaborated to identify a number of key themes

� Optimisation of our measurement of quality outcomes including mortality

� Targeting diagnostic codes from the ‘Top 10’ associated with death where RAMI greater than 100 (average)taking this as indicative of a reasonable “opportunity for improvement”.

� Effective application of 1000 Lives Goals, in particular, RRAILS, VTE and Infection Prevention and Control

� And fostering the development of organisational capability in leadership and quality improvement.

Given the breath of challenge, there is much a Fellow might do to help. Here there are many opportunities forexperiential learning. The Fellowship proposed is working with Medical Director for Quality & Transformation isto move that strategy from a corporate to an operational level, which for lean organisations such as Unipart,is termed “Policy Deployment”.

An exciting opportunity for a Fellow to not alone develop personally, this has the potential to make a real impacton patient care. Through this Fellowship the expectation is to develop and see approved and applied thatelaborated strategy, and in addition to lead on the development of specific themes. This will depend on theFellows individual preferences and learning needs, but in particular He / She will be expected to support theMedical Director for Quality & Transformation in further developing BCUHB as a premium site where trainees willbe keen to come to learn Quality Improvement.


Dr Brian Tehan,Medical Director for Quality & Transformation


Dr Brian TehanEmail: [email protected]

continued overleaf


Developing a strategy to Reduce Avoidable Mortality in BCUHB continued

Biographies:

Medical Director:

Dr Moore, recently assuming this post, was previously Medical Director and Consultant Anaesthetist at Wiral NHS Trust.

He has an interest in Medical Leadership in particular medical staff productivity and sustainable consultant working.He is most proud of work he has done previously to reduce hospital mortality, unplanned admissions and readmissionsto hospital and in-patient length of stay.


Dr Brian Tehan

The Medical Director for Quality & Transformation, he took up post in September 2015, having previously workedas Assistant Medical Director for Glan Clwyd Hospital. A background in change management, he has extensiveexperience in clinical leadership in addition to further leadership roles in the Safer Patients, and Safer Patients NetworkInitiatives. Building on this, he has completed a GenerationQ Fellowship, gaining a Masters in leadership (QualityImprovement) from the prestigious Ashridge Business School. A current Health Foundation Fellow, he has recentlybeen successful in joining the Health Foundation "Q" Network. Current responsibilities include mortality reduction,the review of deaths, and leadership development.


Project Title 14: Developing an Engagement Programme& Strategy for Junior Medical Staff

Medical Director: Dr Evan Moore

Organisation: Betsi Cadwaldr University Health Board BCUHB

Project Summary:Staff engagement is important. Through the work of Prof. Michael West positive engagement with medical staff –in terms of quality and sense of belonging to an organisation – has been linked to good clinical and financialoutcomes. Moreover from analysis of CQC assessments in England this has been linked with good leadership andoutstanding status. On the other hand negative engagement is associated with increased workplace stress andabsenteeism.

An audit recently conducted across Wales using the Medical Engagement Scale, has raised concern as its shownhigh levels of disengagement among medical staff.

BCUHB In response to this has developed an over-arching medical engagement strategy. Seeking to recruit aMedical Leadership Fellow BCUHB, the intention is for He / She to play a key role in leading the development anddelivery of that strategy as it relates to junior medical staff.

The engagement of medical staff a broad subject, the key outcomes expected include

� Development of a system of best engagement with Junior and Non-Consultant Medical Staff

� Allied to this to develop, test and apply with the Office of the Medical Directors team a communications strategy

� Consistent with the RCP Future Hospitals project to develop and deliver a job description for a senior resident

BCU has an evolving program of developing clinical leaders and a great deal to offer to Welsh Clinical LeadershipFellows. Joining the Office of the Medical Director as a member of that team, the successful fellow will have manyopportunities to be part of improving services and there will be ample opportunities to work alongside Seniormembers of that team, and thereby gain an understanding of Leadership, approaches to change andimprovement methodologies.


Professor Michael Rees & Dr Brian Tehan,Medical Director for Quality & Transformation


Professor Michael ReesEmail: [email protected]

continued overleaf


Developing an Engagement Programme & Strategy for Junior Medical Staff continued

Biographies:

Medical Director:

Dr Evan Moore, Executive Medical Director

Dr Moore, recently assuming this post, was previously Medical Director and Consultant Anaesthetist at Wiral NHS Trust.

He has an interest in Medical Leadership in particular medical staff productivity and sustainable consultant working. Heis most proud of work he has done previously to reduce hospital mortality, unplanned admissions and readmissions tohospital and in-patient length of stay.


Professor Michael Rees

Professor M R Rees has extensive experience in developing academic posts via the Walport process in England andvia the WCAT pathway in Wales and was the initial lead for clinical academic training in Wales. He is also the lead inBCUHB for workforce engagement and professionalism. He has organised several academic training conferences forjunior staff and led on the introduction of post graduate training for the European Society of Cardiac Radiology and anumber of leadership and training initiatives with the BMA. He is currently the national lead for the Bevan LeadershipFellow programme.

Dr Brian Tehan

The Medical Director for Quality & Transformation, he took up post in September 2015, having previously workedas Assistant Medical Director for Glan Clwyd Hospital. A background in change management, he has extensiveexperience in clinical leadership in addition to further leadership roles in the Safer Patients, and Safer Patients NetworkInitiatives. Building on this, he has completed a GenerationQ Fellowship, gaining a Masters in leadership (QualityImprovement) from the prestigious Ashridge Business School. A current Health Foundation Fellow, he has recentlybeen successful in joining the Health Foundation "Q" Network. Current responsibilities include mortality reduction,the review of deaths, and leadership development.


Project Title 15: Obstetric CymruMedical Director: Dr Hoskins

Organisation: Betsi Cadwaladr University Health Board

Project Summary:The purpose of OBS Cymru is to introduce early PPH management and ROTEM guided blood-products useacross all Consultant led maternity units in Wales. The initiative is funded by the Welsh Assembly Government.The applicant will need to have an interest in the field of obstetrics or obstetric anaesthesia and be willing to leadchange within a multidisciplinary environment.

The project aim is to reduce blood usage in the management of PPH and improve maternal outcomes byreducing the rate of massive haemorrhage, ICU admissions and emergency hysterectomy rates. This would bethrough the introduction of point of care testing of coagulation (ROTEM®) and focusing on a more prescriptiveand early care pathway in the management of PPH.

The Fellow will have a number of project goals:

� Develop robust data collection

� Coordinate an All Wales PPH protocol and incorporate a tailored package of changes into PPH managementinto each hospital, including education and support of local champions

� Liaison with ROTEM, procurement, IT and maternity services to enable integration of ROTEM

General project requirements will be to provide Clinical Leadership for implementation of the project plan, toproject manage the work stream, monitor timescales and undertake continual program evaluation. In addition theFellow will provide reporting documents for the Technology Funding, Welsh Assembly Government and WelshMaternity Network.

This is an extremely exciting opportunity to apply current evidence and improve care for obstetric patientsthroughout Wales. The Fellow will have considerable opportunity to disseminate the results of the project throughpeer review journals and academic meetings (the academic background to the project is available on request).

BCU has an evolving program of developing clinical leaders and a great deal to offer to Welsh Clinical LeadershipFellows. The successful fellow will have many opportunities to be part of improving services as we develop newways of delivering care in conjunction with our colleagues in the community. There will be opportunities to workalongside senior in-house leaders as well as external management consultants to gain an understanding ofimprovement methodologies.

For more information on the project please contact: [email protected]

continued overleaf


Obstetric Cymru continued

Biographies:

Medical Director:

Dr Emma Hosking, Hospital Medical Director and Consultant Anaesthetist.

Dr Hosking has extensive experience in leadership, project management roles and quality improvement programs.She has been a departmental clinical director and the clinical lead for the multi-million pound refurbishment of theoriginal Glan Clwyd Hospital building. She is an experienced appraiser, coach and has pioneered values-basedrecruitment in BCU. Dr Hosking has a post graduate certificate in professional practice (clinical leadership). She isdetermined to raise the profile of clinical leadership in BCU and can offer access to a wide range of transformationalleaders and a choice of improvement projects ranging from redesign of clinical pathways to redesign of clinical buildings.


Immediate Supervisors:

Ingrid Volikas, Consultant Obstetric Anaesthetist.

Appointed consultant in 2002 in St Helier Hospital, Surrey and relocated to North Wales in 2010. Lead ObstetricAnaesthetist in both hospitals. First author in publications investigating Remifentanil PCA for labour. MOET instructorand management experience in the development of new services and project design for Glan Clwyd Hospital.Currently involved in the development of the new regional neonatal unit.

James Dougherty, Consultant Obstetric Anaesthetist.

Appointed in 2008, James has been an educational supervisor for 6 years and is now college tutor.He is also clinical lead for a project developing a Day of Surgery Arrival Unit.

For more information on the project please contact: [email protected]


Project Title 16: In Hospital Mortality – understanding our results andputting things right

Medical Director: Graham Shortland

Organisation: Cardiff and Vale University Local Health Board

Project Summary:Cardiff and Vale is actively engaged in specialty specific and general hospital mortality work-stream reviews,to help us improve our outcomes for patients.

These include the National Emergency Laparotomy Database, Fractured Neck of Femur outcomes as well asgeneral mortality outcomes.

This innovative project is designed to look at 3 features of Hospital Mortality

� Local Critical Care Mortality at UHW using the ICNARC database

� Cardiff and Vale Mortality analysing Hospital wide mortality indices

� All Wales Hospital Mortality Variation

The Critical Care Directorate in Cardiff and Vale University Health Board is committed to the use of Intensive CareNational Audit and Research Centre (ICNARC) data as a tool for quality assurance. ICNARC helps critical carepatients and units by providing information and feedback about the quality of care to those working in critical careenvironments. CAVUHB uses ICNARC mortality data in critical care an iterative process, forming the basis forquality improvement and service improvement.

The clinical leadership fellow will formulate and lead a strategic response to the outlier ICNARC statusincorporating a number of key areas. The ultimate aim is to improve patient outcomes and lead to a real andappreciable effect for a vulnerable patient cohort.

Initially the fellow will summarise the internal data available now and the current actions taken to date.Secondly the fellow will develop local action plans to improve our results, using quality improvement methodology.We would expect the fellow to formulate plans with principles founded in prudent healthcare. Thirdly the fellowwill then link results from critical care to wider overall hospital mortality and develop an All Wales programme.

Overall Cardiff and Vale Hospital mortality review will analyse with the Information department Cardiff Hospitaloutcomes and develop triggers for condition specific and specialty specific reviews.


Dr Gareth Scholey – Clinical Director Critical [email protected]

Dr Tony Turley – Assistant Medical Director Patient Safety and Clinical [email protected]

For more information on the project please contact: the above

continued overleaf


In Hospital Mortality – understanding our results and putting things right continued

Biographies:

Medical Director:

Dr Graham Shortland BM, DCH, FRCPCH, Executive Medical Director and Consultant Paediatrician.

As Medical Director, Dr Shortland has extensive experience in leadership roles and quality improvement programmes.

� Associate Medical Director Patient Safety and Clinical Governance, UHW, Cardiff, April 2007 to 2009.

� Assistant Medical Director, Innovation and Improvement, Cardiff and Vale UHB December 2009 to May 2010.

� Senior Clinical Lead, Cardiff and Vale, for the Safer Patients Initiative (phase two), and the All-Wales 1000 LivesCampaign.

� Executive Medical Director Cardiff and Vale UHB (C&V UHB) June 2010 to date.

Under his leadership and personal involvement Cardiff and Vale has each year increased the number of Welsh ClinicalLeadership Fellows. He is committed to ensuring successful programmes and outstanding leadership experience forthose choosing Cardiff and Vale to do their programme


Dr G Scholey, Consultant Intensivist and Clinical Director at University Hospital of Wales and has been responsible fordeveloping the recent changes of the Critical Care Service at Cardiff, most recently the outreach programme and therecent development of the Post Anaesthetic Care Unit – which incorporated a WCLF.

Dr Tony Turley, Consultant Anaesthetist and Intensivist, will provide support and coaching. He has major experience inQuality Improvement and is the current UHW Assistant Medical Director for Patient Safety and Clinical Effectiveness aswell as the Clinical Director of Perioperative Care. He has supported and trained Welsh Clinical leadership Fellow postsfrom their inception.


Project Title 17: Improving sepsis care across the Cardiff andVale UHB

Medical Director: Dr Graham Shortland

Organisation: Cardiff and Vale University Health Board

Project Summary:Sepsis is responsible for over 44,000 deaths per year across the UK, of which over 2100 are in Wales. TheNCEPOD report “Just Say Sepsis” has identified that many of these deaths could be prevented by timelyrecognition and appropriate treatment of sepsis. Across Wales, through the RRAILS programme, mortality fromsepsis has fallen, but still lags behind what is seen in the best centres in the world. Cardiff and Vale UHB’sambition is to match this via a multi-streamed approach, from Primary Care and the Ambulance Service, throughthe Emergency Department right up to Critical Care. Cardiff and Vale UHB acknowledged the need to improvesepsis care by appointing a Sepsis Lead Consultant and a Sepsis Lead Nurse. Subsequently a UHB-wide SepsisGroup has been established to drive improvements in sepsis care, building on work already done locally, nationallyand internationally. The post-holder will be expected to be a key player in developing and implementing strategiesto improve sepsis care and may also have the opportunity to work with groups within Cardiff University in sepsisresearch. The post-holder would also be expected to participate in the RRAILS project, run by the 1000 Lives +(part of Public Health Wales). This post represents an exciting opportunity to be involved in delivering majorimprovements in sepsis care, helping the UHB to become a Centre of Excellence for sepsis.

continued overleaf


Improving sepsis care across the Cardiff and Vale UHB continued

Biographies:

Medical Director:

Dr Graham Shortland BM, DCH, FRCPCH, Executive Medical Director and Consultant Paediatrician.






Under his leadership and personal involvement Cardiff and Vale has each year increased the number of Welsh ClinicalLeadership Fellows. He is committed to ensuring successful programmes and outstanding leadership experience forthose choosing Cardiff and Vale to do their programme.


Dr Paul Morgan, Consultant Intensivist and Sepsis Lead

Dr Paul Morgan is a graduate of the 1985 class of the (then) University of Wales College of Medicine, Cardiff. Training inAnaesthetics and Intensive Care Medicine, he was appointed as a Consultant in 1996, initially in both fields, but since2004 he has been a whole-time Consultant Intensivist, based mainly at the University Hospital of Wales but with dutiesalso at University Hospital, Llandough. He has been a member of Council of the Welsh Intensive Care Society since2009, serving as Secretary for a year from 2011-12 and then as Chair from 2012-15. Sepsis has always been a majorpart of his working life and he was involved in the local launch of the Surviving Sepsis Campaign. Since 2012 he hasbeen working with the UK Sepsis Trust to promote sepsis awareness and education amongst the public and healthprofessionals alike. He has been a key player in the UHB’s events for World Sepsis Day and has also attended sepsisevents at both Westminster and the Senedd. In September 2015 he was formally appointed as Sepsis Lead for theCardiff and Vale UHB, working to improve sepsis care across the organisation by working with and across the ClinicalBoards to examine care processes and to improve sepsis care delivery.


Project Title 18: OBS Cymru (Obstetric Bleeding Strategy for Wales)Medical Director: Dr Graham Shortland

Organisation: Cardiff & Vale University Health Board

Project Summary:The purpose of OBS Cymru is to improve PPH management in all delivery settings in Wales. The initiative issupported by the Welsh Government, 1000 Lives and the Maternity Network. The applicant will need to have aninterest in the obstetrics or obstetric anaesthesia and be willing to lead change within a multidisciplinaryenvironment.

The project aim is to reduce blood usage in the management of PPH and improve maternal outcomes byreducing the rate of massive haemorrhage, ICU admissions and hysterectomy rates. This is throughmultidisciplinary quality improvement including introduction of point of care testing of coagulation (ROTEM®) andfocusing on a more prescriptive and early care pathway.

The Fellow will have a number of project goals, including:

� Integrating an All Wales PPH protocol into all maternity areas,

� Collating, analysing and disseminating quality improvement data (including outcome, process and balancingmeasures) across sites to facilitate change,

� Developing a cost effectiveness analysis for the technological aspect of the project.

General project requirements will be:

� To provide Clinical Leadership for implementation of the project plan,

� To project manage the work stream, monitor timescales and undertake continual program evaluation.

This is an extremely exciting opportunity to apply current evidence and improve care for obstetric patientsthroughout Wales. The Fellow will have considerable opportunity to disseminate the results of the project throughpeer review journals and academic meetings (the academic background to the project is available on request).

Cardiff and Vale University Health Board has an evolving program of developing clinical leaders and a great dealto offer to Welsh Clinical Leadership Fellows. The successful fellow will have many opportunities to be part ofimproving services, not only in the UHB but on a national scale.


Dr Rachel Collis and Dr Sarah Bell, Consultant Obstetric Anaesthetists.


Dr Sarah BellEmail: [email protected]

continued overleaf


OBS Cymru (Obstetric Bleeding Strategy for Wales) continued

Biographies:

Dr Rachel Collis

As lead in obstetric anaesthesia in The University Hospital of Wales for many years, Dr Collis has led a number of verysuccessful change management programmes which have arisen through a long standing interest in clinical riskmanagement. This has included the introduction of MEOWS charts, PPH protocols and a maternity specific sepsispathway. A number of changes have developed from case review and audit into major research projects, culminating inan Innovation and Technology grant being awarded to this project. Dr Collis was awarded a Master’s degree withdistinction in Health Care Risk Management in 2014.

Dr Sarah Bell

Dr Bell is project manager for OBS Cymru with Dr Collis. She has a longstanding interest in PPH research and hascompleted the Leading Improvement in Patient Safety course.

Dr Graham Shortland, Executive Medical Director and Consultant Paediatrician

As Medical Director, Dr Shortland has extensive experience in leadership roles and quality improvement programmes.Under his leadership and personal involvement Cardiff and Vale has each year increased the number of Welsh ClinicalLeadership Fellows. He is committed to ensuring successful programmes and outstanding leadership experience forthose choosing Cardiff and Vale to do their programme.

Dr Anthony Turley Clinical Director Perioperative Care and Assistant Medical Director Patient Safety andClinical effectiveness.

Dr Turley has initiated a series of highly successful WCLF posts to completion in his clinical areas and will provide anyfurther advice or support to help deliver the project.

Professor Peter Collins, Consultant Haemotologist in Thrombosis and Haemostasis and Professor atCardiff University.

Professor Collins will provide academic leadership in the project. He has published extensively on haemostatic supportof acquired bleeding disorders and has been the academic lead on developing the point of care testing algorithm forthe treatment of post-partum haemorrhage.


Project Title 19: Developing integrated working within the CardiffSW cluster with a focus on establishing a socialprescribing model



Project Summary:GP clusters were established in Wales in 2014 with the aim of improving health within the local population. CardiffSW Cluster consists of 11 GP practices that have developed close links with community groups within the thirdsector, public health, allied health professionals (community pharmacists, cluster pharmacists, physiotherapists,dieticians), intermediate care and secondary care. The basis for development of the cluster is the integratedworking among all partner organisations, with a view to improve health outcomes through the promotion ofhealth and well-being. A wide range of projects is in progress based on the Cluster Action Plan.

Social prescribing is in development in two cluster practices, where well-being coordinators assess patients andsignpost to local resources to help with problems such as mental health and well-being, weight management,smoking cessation, alcohol and substance misuse, debt advice and other social problems. There is evidence forthe role of social prescribing in improving health outcomes using both physical indicators and measures ofpsychological and social wellbeing.

The goals of the Leadership Fellow will support the development of these initiatives with a focus on establishing amodel of social prescribing across the cluster. This will involve:

� Researching models of social prescribing in other areas of the country such as The PembrokeshireCompassionate Communities Programme and The Bromley By Bow Centre in Tower Hamlets, London.

� Develop links with local community groups and develop a system for referral, working with the cluster ITconsultant to facilitate transfer of information and allow rapid access to local services

� Collaborate with Public Health to promote local initiatives to improve health outcomes and analyse data at acluster and practice level.

� Engage with patient and community groups and support the empowerment of the population in coproductionin addressing their health needs


Dr Karen Pardy


Dr Karen PardyEmail: [email protected]

continued overleaf


Developing integrated working within the Cardiff SW cluster with a focus on establishing a social prescribing model continued

Biographies:

Medical Director:

Dr Graham Shortland BM, DCH,FRCPCH, Executive Medical Director and Consultant Paediatrician.








Dr Karen Pardy MBBCh, MRCPCH, MRCGP, Community Director, Cardiff SW Cluster

Dr Karen Pardy is a graduate of the University of Wales College of Medicine, Cardiff (1997), and completed her GPtraining in 2004. She has been a GP Partner at Lansdowne Surgery in Cardiff since 2006. She became CommunityDirector for Cardiff SW Cluster in 2013 and is also Community Director for Child Health, working as part of the ChildHealth and Primary Care Interface Group. She has experience in quality improvement projects both at the Clusterlevel and at the Health Board level and is committed to promoting leadership within the Primary Care setting.


Project Title 20: Developing a transition pathway for young peoplewith complex needs to adult services



Project Summary:The proposed project addresses the transition requirements of a defined group of children and youngpeople (CYP) with complex health needs, for whom no comparable adult service exists.

The process of transition is an important part of the care of people with long term conditions in line with thestrategy and vision of CAV UHB‘s Shaping Our Future Wellbeing 2015-2025. The timely publication of NICEguideline [CG43] “Transition from children’s to adults’ services for young people using health or social careservices” in February 2016 The work proposed also falls under the remit of the 2015 WG document Togetherfor Health: A Neurological Conditions Delivery Plan.

The fellow will research and formulate:

1. The best model of medical care to fit the needs and goals of the young people and their families

2. The associated clinical governance mechanisms with reference to NICE CG43

3. The resource implications of implementation of such a pathway and the risks involved with maintainingthe status quo

4. The potential to achieve integration of the model of medical care into a multiagency pathway to includeeducation and social care

The fellow will develop a multidisciplinary project management group to include the project supervisors plusrepresentatives from adult medicine, paediatric and adult specialist nursing and general practice and will becomean honorary member of the Acute and Community Child Health Directorate Management Teams

The fellow will acquire the generic problem and management skills to any other issues they meet in their futurecareer. Recognition of their work could lead to participations in related UK projects. Three examples:

1. Multiagency working including Welsh Government

2. Work with Deanery and RCPCH (or RCP) on curriculum development and teaching of this important aspect ofclinical work.

3. Development of a SPIN (special interest) in Complex Care & Transition


Dr Frances Gibbon, consultant paediatric neurologistDr Catherine Norton, consultant community paediatrician


Dr Frances Gibbon

continued overleaf


Developing a transition pathway for young people with complex needs to adult services continued

Biographies:

Dr Frances Gibbon BMedSci, MB ChB FRCPCH

Dr Gibbon was appointed as Consultant Paediatric Neurologist in Cardiff in 1997 having trained in Manchester andCardiff. She has a longstanding interest in the health of teenagers having joined Professor Phil Smith, consultant adultneurologist, in the establishment of a teenage epilepsy clinic in 1996; this was the second such clinic in the UK. She isthe clinical lead for paediatric neurology at the Children’s Hospital for Wales and has many years of experience of thechallenges faced by young people with neurodisability in both acute and community care settings. She has been theeducational supervisor for previous Grid Trainees in paediatric neurology. She currently sits on the executive council ofthe British Paediatric Neurology Association as professional support officer.

Dr Gibbon led the CAV UHB team working with WHSSC to establish the recently funded South Wales PaediatricNeurorehabilitation service and she is the WHSSC Gatekeeper for paediatric neurology and neurosurgery. She hasrecently joined the WG joint Stroke and Neurological Conditions Implementation Group (NCIG) and was previously amember of the Neurology, Neurodisability and Neurosurgery standards groups for the WG Children and Young PersonsSpecialist Services (CYPSS) project.

Dr Catherine Norton MB BCh BSc MSc MRCPCH DCH

Dr Norton has 12 years experience as a Consultant Paediatrician initially encompassing Community, Acute andneonatal care but now specialising in Community child health, notably Complex disability and Autism

She works as part of a multidisciplinary team in Cardiff and enjoys collaborating across teams and services, leading asCo-Innovator of the C & V Complex needs strategy promoting enhanced joint working across professionals with theintention of reducing barriers to seamless care for CYP with complex health care needs

She has extensive management and partnership working experience including leading as Clinical Director of theCombined Child health service in Cardiff and Vale supporting Acute, community and specialist services between2010-13.

Dr Norton is also the National Chairperson of the Neurodevelopmental workstream for Together for Children and youngpeople (T4CYP National strategy and delivery of improved services to CYP with Autism , Learning Disability and ADHD)Coordinating a National Multiagency group with representation from all 7 Health boards in Wales, tasked withdeveloping and delivering a national pathway for Neurodevelopmental assessments and interventions for young peopleacross Wales.

Medical Director:









Dr Frances Gibbon


Project Title 21: Clinical leadership within Medical Education:Developing a multi-disciplinary, integrated clinicalskills and simulation model within Cardiff AndVale UHB



Project Summary:

Developing a multi-disciplinary, integrated clinical skills and simulation model within Cardiff and Vale UHB.

The Cardiff and Vale University Health Board (CVUHB) is committed to introducing a quality assured, curriculumdriven simulation-based training available to all levels of health care professionals. To this end we are looking for aClinical Leadership Fellow who would welcome the opportunity to lead a team of medical educators inimplementing this training within the Health Board. The Fellow will steer the development of an integratedsimulation and clinical skills model, embedding the learning from critical incidents into improved clinical practice,resulting in improved patient safety and quality of care. This post is suited to those candidate who have specificinterest in leadership and medical education and aspire to take up a lead educator role in the future. He or she willbe closely supervised and be given specific roles and objectives to achieve within the overall plan.

This Fellowship is a one-year programme designed to providing the successful candidate with the opportunity to|:

� Have a central role in establishing this multi-disciplinary, integrated clinical skills and simulation model withinthe department of medical education and at clinical board level.

� Lead on project delivery, including implementation, monitoring and reporting.

� Develop generic clinical leadership skills that can be transferred to all aspects of future professional life.

� Complete the CVUHB Senior Clinical Leadership Programme.

� Shadow senior executives in clinical leadership and management positions with CVUHB

� Attend Academic Wales Medical Leadership Programme.

� Obtain accreditation with the Academy of Medical Educators.

� To pursue clinical commitments up to a maximum of 20% of their working timetable in an area of theirown interest.

continued overleaf


Clinical leadership within Medical Education: Developing a multi-disciplinary, integrated clinical skills and simulation model withinCardiff And Vale UHB continued

Biographies:

Medical Director:





Senior Clinical Lead, Cardiff and Vale, for the Safer Patients Initiative (phase two), and the All-Wales 1000 LivesCampaign.


Under his leadership and personal involvement Cardiff and Vale has each year increased the number of Welsh ClinicalLeadership Fellows. He is committed to ensuring successful programmes and outstanding leadership experience forthose choosing Cardiff and Vale to do their programme.”


Dr John Dunne MB, BCH, BAO, DRCOG, MRCGP, FFARCSI, FRCAnaes, FICM(hon) is a Consultant CardiothoracicAnaesthetist, Clinical Skills/Simulation Lead and Foundation Programme Director within Cardiff and Vale UniversityHealth Board. He is an instructor in ATLS, ALS and a previous APLS instructor for many years. In addition he hasinstructed on the IMPACT and TREATS courses and as Clinical Skills/Simulation Lead within the Health Boardcontinues to be heavily involved in delivering clinical and simulation skills to all levels of health care professionals.

Under his leadership, the department of Medical Education has successfully developed a Clinical Skills & SimulationProgramme, offering a wide range of clinical skills. He is committed to promoting communication and collaborationwithin the health board in consolidating the already sterling work performed by his colleagues in delivering these skills.He is committed, enthusiastic and communicates well with sledgehammer charm in completing any task.


Project Title 22: Impact of access issues on the potential foravoidable harm

Medical Director: To be determined by the host body of the clinical leadership fellowor through the CMO

Organisation: Healthcare Inspectorate Wales

Project Summary:Health Boards in Wales make constant judgements on how to prioritise the use of scarce resources in order tomeet the needs of patients. Waiting time statistics provide a measure how these judgements impact on thetimeliness of care, but are a crude way of measuring the relative impact of such waits on the outcomes andexperiences of patients with different types of needs. Similarly, the rural nature of Wales means choices may bemade between accessing adequate local services versus referral to specialist, more distant, centres.

Healthcare Inspectorate Wales uses intelligence to assess risk and to help it decide what to inspect and where toinspect. Historically this information has been based on a range of sources including data, concerns, complaintsand incidents. Although this approach can proved effective at identifying where difficulties have arisen with careprovided, it is less effective at identifying where patients are potentially at risk because of their inability to accesscare in a timely way. A recent example of this is the concerns raised by the Royal College of Surgeons regardingpatients dying whilst on the waiting list for cardiac surgery.

The aims of this project are to get beneath crude waiting times targets and consider how information can be broughttogether from relevant sources to help identify where difficulties accessing services are most likely to be impactingon patient outcomes. This will be of interest to healthcare providers and also to Healthcare Inspectorate Wales.

The project should

� Deliver a framework and mechanism for benchmarking based on patient outcomes and other key indicatorswhich has support from relevant experts

� Establish an assurance mechanism incorporating Board level monitoring and peer review, and including anappropriate level of inspection which may address issues relating to NHS commissioning, planning and/ordelivery in the chosen area

� To draw on national and international best practice to assist healthcare providers in overcoming the challengesin minimising adverse patient outcomes in the chosen area


Ruth Studley / Alison Kedwardhttp://hiw.org.uk/about/whowe/team/?lang=en


Kate ChamberlainTel: 0300 063 8379

Biographies:

Medical Director:

To be determined as stated above


Alison Kedwardhttp://hiw.org.uk/about/whowe/team/?lang=en


Project Title 23: Delivering equity and excellence in NHS specialisedcare within Wales through a patient centred, fairand consistent approach to commissioning

Medical Director: Dr Sian lewis

Organisation: Welsh Health Specialised Services Committee

Project Summary:This is a unique opportunity to work in an all Wales high profile organization which reports to the CEOs of all 7Health Boards. In addition because the organization commissions 76 specialised and highly specialized servicewe are able to offer a range of project opportunities tailored to the interest of the successful applicant.

The key objective of the project is to work in one specialty area to develop and agree the quality indicators againstwhich the service will be measured. It is this quality evidence on which will determine whether that service willcontinue to be commissioned from any particular provider. This will involve a detailed understanding the serviceand the most meaningful performance indicators. It will then involve negotiation with clinical staff and managerswith the provider organisations as to the reporting systems and identifying areas for quality improvement.

The successful applicant will be directly supervised by Dr Sian Lewis Acting Medical Director who hasconsiderable experience in medical education and a track record of delivering a successful clinical leadershipproject previously.

The general project requirements are as follows:

1. To work with the team to develop a Project Initiation Document

Defining the background to the project (ie the problem it’s trying to solve) and its scope

� Defining the benefits and timescales

� Identifying and managing risk

� Identifying roles and responsibilities

� Developing a project plan

2. To provide clinical leadership for implementation of the project plan and chair project group meetings inassociation with the WHSSC team working on the project.

3. To jointly project manage the work-stream, monitoring timescales and mitigating as necessary

4. To undertake programme evaluation based quality improvement NHS quality improvement methodology.

Separate to this the successful applicant will attend executive level meetings related to commissioning anddevelop business case writing skills.


Dr Sian Lewis (Medical Director) and Dr Pushpinder Mangat (Deputy Medical Director) will provide a separatementoring role.


Dr Sian LewisEmail: [email protected]

continued overleaf


Delivering equity and excellence in NHS specialised care within Wales through a patient centred, fair and consistent approach tocommissioning continued

Biographies:


Dr Sian Lewis is Deputy Medical Director of Welsh Health Specialised Services and also works as a part timeconsultant haematologist in Hywel Dda University Health Board. Previously she held medical management roles withinHywel Dda and a number of roles within the Wales Postgraduate Deanery. She has led on a number of major changemanagement initiatives including remodelling A&E services within a district general hospital and establishing the firstpostgraduate medical education quality systems in Wales. She is a member of the GMC Quality Scrutiny Group andholds an MBA and a Postgraduate Certificate in Medical Education.

Mentor:

This role will be provided by Dr Pushpinder Mangat (Deputy Medical Director WHSSC and ABM UHB).


Project Title 24: Developing a cancer care model pathway which willenhance the delivery of follow-up services to ourpatients and influence future service planning

Medical Director: Professor Peter Barrett-Lee

Organisation: Velindre NHS Trust

Project Summary:Velindre NHS Trust has identified a need to develop a cancer care model pathway which will enhance the deliveryof follow-up services for our patients and influence future service planning.

With an increasing incidence of many cancers and improvements in their diagnosis and treatment, there areincreasing numbers of cancer survivors. Currently around 2 million people in the UK are living with or beyondcancer.1 These individuals require support in areas such as detecting recurrent cancer, control of symptomsrelating to the cancer or its treatment, and practical, emotional and financial support. The Welsh Government’sstrategy document recognises the increasing need for ongoing support for people following a diagnosis of cancer:

‘Follow up care for people with cancer after treatment must be based on evidence and the individual person’sneeds. New multi-disciplinary models of follow up need to be evaluated and developed both to support thepatient in recovering as fully as possible and to enable the early detection of recurrence.’2

The Velindre Cancer Centre’s strategy recognises the need to develop ‘follow up pathways’ for tumour sitesincluding the roles of medical and non medical staff. The strategy also recognises the importance of and supportsthe development of clinical leadership.3

With tightening and restricted resources, both human and financial, it is important to ensure that we are usingavailable resources in a way that is patient-focussed, evidence based and reduces waste, harm and variation.The project is timely as the Trust makes plans for site development and cancer services across SE Wales.This project will influence the future service model.

The one-year programme will focus on working with Site Specific Teams to identify one or more potential areasfor risk-stratified follow up and review the evidence for follow up in the identified area(s). Work will involve obtainingthe views of stakeholders with regard to the potential acceptability of, and barriers to, redesigning follow up.The Fellow will design an ideal follow up schedule and to work with clinical and non-clinical staff towardsimplementation.

The Fellow will be part of the Trust service improvement team and will have the opportunity to set up and chairregular meetings of a project board and to report on progress.

continued overleaf

1 Macmillan. (2015). www.macmillan.org.uk (accessed January 2015).

2 Welsh Government. (2012). Together for Health – Cancer Delivery Plan

3 Velindre NHS Trust. (2012). Delivering Quality, Care and Excellence. Service, Workforce and Financial Framework 2011/12 – 2015/16.


Delivering equity and excellence in NHS specialised care within Wales through a patient centred, fair and consistent approach tocommissioning continued


The project will be supported by a Clinical Manager and General Manager

The Educational Supervisor / Clinical Manager

Dr Louise Hanna is the Local Faculty Lead and Chair of the Medical Education Board. Dr Hanna had a key role in thegynaecological cancer follow up redesign project

Director of Cancer Services

Mrs Andrea Hague is the Director of Cancer Services. Mrs Hague is experienced in management within the NHS andCancer Centre and has a leadership role on many service development and improvement projects.


Dr Louise HannaEmail: [email protected]

Mrs Andrea HagueTel: 029 2061 5888Email: [email protected]

Biographies:

Medical Director:

Professor Peter Jeffery Barrett-Lee MBBS BSc MD (Lond) FRCR FRCP (Edin) FRCP (Lond)

I have the lead role for breast cancer academic clinical research at Velindre NHS Trust and at the Institute of Cancerand Genetics, Cardiff University. The Velindre Cancer Centre provides specialist cancer services to 1.5 million peopleliving in South East Wales. One of the 10 largest cancer centres in the UK, activity has increased significantly over theyears. We now see over 5,000 new cancer referrals and around 50,000 outpatient appointments each year. TheCancer Division employs over 650 staff and has a budget of around £49 million.

In my own practice based at the Cancer Centre breast cancer recruitment figures have exceeded the targets set by theWales Cancer Trials Network (WCTN) [Target: 10% of new patients entered; achieved & exceeded consistently since2004]. On a national level I was lead breast oncologist for the SE Wales Network, and am currently Vice-Chair (2007)of the breast cancer NSAG which advises WAG and a member of its guidelines group. I am also a member of the UKNCRI Breast Group (elected 2004), recently helping develop & present national guidelines for the monitoring &management of cardiac effects from the use of adjuvant trastuzumab (Herceptin) therapy. In 2009 I was elected Chairof the UK Breast Cancer Intergroup charged by the NCRI with developing the next generation of clinical trials in theUK. I am member & Secretary of the British Breast Group, a national multidisciplinary society running scientificmeetings twice annually & whose membership includes many of the scientific & clinical leaders in the field. In 2006 mybreast cancer team at Velindre received a runners-up award in the “Hospital Doctor Awards” for the best UK oncologyteam of the year.

I became Medical Director of Velindre NHS Trust in February 2010, and therefore have responsibilities for both ourDivisions - Velindre Cancer Centre and The Welsh Blood Service including being the Responsible Officer. Revalidationplans are well underway, and there has been positive engagement from all clinicians I am please to say. I have beenmarried for 30 years to Lynne who is a published Novelist, and have three grown up children - Luke (Culinary artsgraduate and Chef), Joe (4th Year Medical Student), and Georgie (Psychology Student). In my spare time I playfootball, go mountain biking, walking and continue to try to surf in the Gower.


Project Title 25: Safer Pregnancy: Working towards reducingstillbirth rates in Wales

Medical Director: Dr Quentin Sandifer, Executive Director of Public Health Services/MedicalDirector, Public Health Wales

Organisation: 1000 Lives improvement Service, Public Health Wales

Project Summary:Reducing stillbirth rates in Wales is a key priority for Welsh Government. In February 2013, the Health and SocialCare Committee (HSCC) of the National Assembly for Wales held a one day inquiry into stillbirth rates in Wales.This resulted in the publication of nine recommendations (NAW 2013) that would contribute to reducing thestillbirth rates in Wales. This inquiry remains open and organisations are called upon regularly to provide updatesto the HSCC on the progress made against the recommendations.

The National Stillbirth Working Group (NSWG) established in Wales in 2012 and was initially led by the 1000 LivesTransforming Maternity Services Mini-Collaborative. This group ceased to exist from November 2013 and theCollaborative came to an end in March 2014.

This group has been re-established by the Maternity Network Wales. Since January 2015, this group has beenchaired by the Chief Nursing Officer for Wales, Professor Jean White. The group is made up of representativesfrom all seven Health Boards, PHW, WG, Perinatal Pathology and the All Wales Perinatal Survey at CardiffUniversity. Membership is multi-disciplinary and includes Obstetricians, Midwives, Pathologists and Academics.

The NSWG have committed to reducing stillbirth rates year on year. In 2017, it is anticipated (although notconfirmed) that Welsh Government will set a specific target for stillbirth reduction within a given time period.

This broad programme is currently addressing the following work-streams:

� Improve the management of reduced fetal movements

� Improve detection and management of small for gestational age babies

� Improve the detection and management of gestational diabetes

� Increase the learning from post mortem examinations

� Learn from the perinatal review process, both nationally and locally.

� Improve the information given to women, their families and the wider public

� Increase and contribute to the knowledge base surrounding stillbirth

� Improve and standardise bereavement care in Wales

continued overleaf


Safer Pregnancy: Working towards reducing stillbirth rates in Wales continued

The fellow will:

Work with the Maternity Network Wales specifically focussed on the work of the National StillbirthWorking Group. This will include:

1) Contributing to and continually revising the on-going operational plan for the various work-streamscontributing to the stillbirth reduction aim in Wales, using PDSA cycles.

2) To jointly project manage the work streams, monitoring timescales and mitigating as necessary

3) Provide clinical leadership for the following work streams:

� Improve the management of reduced fetal movements

� Improve detection of small for gestational age babies

� Improve the detection and management of women who with gestational diabetes

� Standardised post stillbirth care pathway, which would include investigations, bereavement care andcommunication with the woman and her family

4) Work in partnership with colleagues leading the other work streams, contributing to their interventions andutilising the opportunity to learn from the wider team.

5) Regularly visit and meet front-line clinical teams across Wales ensuring that interventions are being deliveredwithin Health Boards and assisting and supporting teams where difficulties may be encountered

6) Provide reporting documents as necessary for the NSWG, the Maternity Network Steering Group, the HSCCand Welsh Government.

7) To undertake evaluation of interventions supported by Quality Improvement methodology

8) Regularly reflect on their Leadership development, actively seeking feedback from colleagues in the MaternityNetwork

9) Acknowledge the challenges in leading national improvement work and be prepared for resistance to change

10) Embrace the opportunity to develop excellent communication and negotiation skills necessary for situationswhere conflict may arise.


The Clinical Lead, Dr Claire Francis will take on the role of educational supervisor and line manager for the post.Claire Roche, Maternity Network Manager will take on the role of Deputy Supervisor in the absence of Dr Francis.Whilst the Supervisor will line manage the fellow, the fellow will be afforded the opportunity to work in anenvironment of empowerment and respect, having the freedom to lead key pieces of work but with support,coaching and mentoring from the Clinical Lead and Network manager.


Claire RocheTel: 07815 006859

continued overleaf


Safer Pregnancy: Working towards reducing stillbirth rates in Wales continued

Biographies:

Medical Director:

Dr Quentin Sandifer is the Executive Director of Public Health Services and Medical Director / Responsible Office atPublic Health Wales. His responsibilities include screening, microbiology services, health protection and emergencyplanning. He is also the organisation’s Caldicott Guardian.

Dr Sandifer joined Public Health Wales in October 2012 from NHS Camden and the London Borough of Camdenwhere he was Executive Director of Public Health (joint) for 3 years. Before that he spent 5 years working in strategichealth authorities in England including serving as a regional lead for screening and emergency planning and prior tothat he was an Executive Director of Public Health in a health authority in Wales. Before entering public health practicein the early 1990s Dr Sandifer worked as a family doctor both in the United Kingdom and in Canada.


Dr Claire Francis is a Consultant Obstetrician at The University Hospital of Wales, Cardiff and Vale University HealthBoard and Honorary Lecturer at Cardiff University Medical School.

She trained in Obstetrics and Gynaecology across South Wales with extended experience in Fetal Medicine. Afterqualifying in 2005 Claire initially worked as a Locum Consultant at Glangwili General Hospital, Carmarthen but since2006 has worked at the University Hospital of Wales specialising purely in Obstetrics.

Claire is responsible for providing care to high risk patients, including antenatal care to women with complex medicalproblems, particularly cardiac disease. She also runs a multiple pregnancy clinic.

Claire was involved in the Wales Maternity Services Review in 2012, being a member of the Quality and SafetySubgroup. Since 2013 she has also been a case report assessor for MBRRACE-UK


Project Title 26: Reducing Harm and Variation in Clinical ServicesMedical Director: Philip Kloer

Organisation: Hywel Dda University Health Board

Project Summary:Ensuring that services are safe and of high quality is a clear driver for Hywel Dda University Health Board.Supported by the Medical Director the Clinical Fellow will lead a process to

� develop a systematic process for identifying harm and unwarranted variability across the Health system inHywel Dda

� develop robust methods of extracting, collecting and collating evidence relating to harm

� Use the information from case note reviews, clinical audit and condition specific mortality data to improvelearning and identify harm and variation

� develop a method of presenting and communicating evidence of harm and variability to staff in a way thatdrives action and engages teams or individuals to take action

� more generally develop a strategy to engage clinicians and managers in reducing harm and variability, movingto a culture which encourages clinical ownership of the information and responsibility for seeking tosystematically and measurably reduce harm and variability

There will be opportunities to attend and present the programme at executive meetings and various committeeswithin the Health Board including Quality and Safety, Business Planning and Performance, as well attending avariety of ad hoc meetings as determined by the Clinical Fellow’s development needs.

Experience of chairmanship of committees will be provided through the project group.

The Clinical Fellow will have opportunities to address many areas of the clinical leadership competenciesdescribed in the NHS Leadership Framework (2011) including

� Setting direction

� Creating the vision

� Delivering the Strategy

� Improving Services

� Working with Others

Key leadership learning points will be;

� Communication and clinical engagement

� Project management techniques

� Developing solutions to complex problems

� Embedding solutions in a whole system

� Developing networks

� Working with teams

� Data analysis


Dr Philip Kloer, Medical Director & Director of Clinical Strategy


Karen PreeceTel: 07815 006859Email: [email protected]

continued overleaf


Reducing Harm and Variation in Clinical Services continued

Biographies:

Dr Phil Kloer – Medical Director and Director of Clinical Strategy

Dr Kloer is a Consultant Respiratory Physician who has trained in Wales, Southampton and New Zealand. He waspreviously Director of Clinical Strategy and then Interim Director of Primary Care, Community, and Mental HealthServices at Hywel Dda University Health Board before taking on his current role as Medical Director and Director ofClinical Strategy. He previously chaired the National Rapid Response to Acute Illness (RRAILS) Steering Group, whichwas responsible for driving the implementations of NEWS into every acute hospital in Wales and the development of anapp that has been downloaded in over 25 countries. He has also chaired the Measurement and Information workstream of the National Unscheduled Care Board. He is passionate about driving improvements in the public experienceand outcomes of health services.

Dr Kloer will be the clinical supervisor for the post.

Karen Preece – Assistant Director in the Medical Directorate

Karen has over 20 years experience in the NHS including 6 years at Board and Director level. She has a strongbackground in commissioning, planning and delivery and significant experience of leading major change andperformance improvement aimed at delivering high quality patient care, both within and across organisations.

Karen will also be a key support for the Clinical Fellow.


Project Title 27: Developing a Clinical Strategy in Hywel DdaMedical Director: Dr Philip Kloer

Organisation: Hywel Dda University Health Board

Project Summary:This is a fantastic opportunity to join a new clinical leadership team in Hywel Dda University Health Board at atime when it is reviewing and renewing its clinical strategy. The Health Board is determined that its strategy will beclinically led and this post will have a key role in its development. The strategy will determine how health servicesare provided for 400,000 people across a large geographical area in beautiful Mid and West Wales. The HealthBoard has 4 main hospitals, over 50 GP surgeries, Mental Health & LD services and Community services. Thepost holder will have the opportunity to focus on a specific service strategy area depending on their area ofexpertise, or take a broader view on the overarching strategy for the organisation. The successful candidate willbe able to learn from experienced clinical leaders and health planners and contribute to the debate and thinking.They can also learn about planning in Healthcare and other considerations for the Board such resource utilisation.

The Clinical Fellow will be mentored by the Medical Director and supported by a senior manager with extensiveexperience in service change and improvement and these will provide an excellent learning opportunity.

The Clinical Fellow will have opportunities to address many areas of the clinical leadership competenciesdescribed in the NHS Leadership Framework (2011) including

� Setting direction

� Creating the vision

� Delivering the Strategy

� Improving Services

� Working with Others

They will present their work at Health Board/ Committee. They will also have the opportunity to get involved inthe innovative ARCH project – a joint venture with Hywel Dda University Health Board, Abertawe Bro MorgannwgUniversity Health Board and Swansea University

Supported by the Medical Director they will have the opportunity to attend a variety of meetings as determinedby their development needs.

continued overleaf


Developing a Clinical Strategy in Hywel Dda continued

Biographies:

Dr Phil Kloer – Medical Director and Director of Clinical Strategy

Dr Kloer is a Consultant Respiratory Physician who has trained in Wales, Southampton and New Zealand. He waspreviously Director of Clinical Strategy and then Interim Director of Primary Care, Community, and Mental HealthServices at Hywel Dda University Health Board before taking on his current role as Medical Director and Director ofClinical Strategy. He previously chaired the National Rapid Response to Acute Illness (RRAILS) Steering Group, whichwas responsible for driving the implementations of NEWS into every acute hospital in Wales and the development ofan app that has been downloaded in over 25 countries. He has also chaired the Measurement and Information workstream of the National Unscheduled Care Board. He is passionate about driving improvements in the public experienceand outcomes of health services.

Dr Kloer will be the clinical supervisor for the post.

Karen Preece – Assistant Director in the Medical Directorate

Karen has over 20 years experience in the NHS including 6 years at Board and Director level. She has a strongbackground in commissioning, planning and delivery and significant experience of leading major change andperformance improvement aimed at delivering high quality patient care, both within and across organisations.

Karen will also be a key support for the Clinical Fellow.


Project Title 28: Re-thinking the Interface between Primary andSecondary care. (IIPS)

Medical Director: Mr Kamal Asaad

Organisation: Cwm Taf UHB

Project Summary:The interface between Primary and Secondary Care is of paramount importance to patient care. This project isabout identifying the current problems with the interface, the impact of improvements and how they can beimplemented.

There are three main parts to the project:

1. Undertake a systematic review of referral systems and processes. This part of the project would commencein ENT and Cardiology. However, we would look to identify a third area within the organisation to ensure thescoping is representative of a number of key areas. This review would have a particular emphasis on thepatient journey across the interface.

2. Develop a means of identifying patients according to their category of need within specialities so that referralsand patient information across the interface are immediate and accurate.

3. Whilst Technology can support the referral process all change is based on changing behaviour. CTUHB hasrestructured to support a more behavioural change approach to challenge and alter practice across theprimary and secondary care interface. Having support from Executive Board all the way through to the WelshClinical Leadership Training Fellow (WCLTF) will aid the final implementation of the behaviour changerequirements identified for improving patient care.

Whilst this project may seem large the beauty is that CTUHB is structurally aligned to support it and we havesigned up support from both primary and secondary care as evidenced in the WCLTF’s supervisors.


Mr Kamal Asaad Medical Director Cwm Taf University Health Board.

Dr Stuart Hackwell General Practitioner and Locality Clinical Director for Merthyr Tydfil

Mr Vijay Singh Consultant ENT Surgeon and Clinical Director for Head and Neck Services


Mr Kamal AsaadEmail: [email protected]

Dr S HackwellEmail: [email protected]

continued overleaf


Re-thinking the Interface between Primary and Secondary care. (IIPS) continued

Biographies:

Medical Director:

Mr Kamal Asaad

Kamal qualified in Cairo in 1978 and came to the United Kingdom in 1984. He has been in Wales since 1995, initiallybeing the senior registrar at UHW from 1995-1997.

Kamal was appointed as a Consultant Obstetrician Gynaecologist at North Glamorgan NHS Trust in October 1997.In 2002 he was also appointed as Trust Postgraduate Organiser and still undertakes this role. He then became ClinicalDirector of Women & Children’s Services at North Glamorgan from 2004-2008.

In April 2008 Kamal was appointed as Divisional Director of the Integrated Services Division and the PostgraduateOrganiser at Cwm Taf NHS Trust. In September 2010 he was appointed as Medical Director for Cwm Taf HealthBoard.

Kamal is an Examiner with Cardiff University and with Royal College of Gynaecology for membership examinations.He has a major interest in education & training and staff development. He also has a major interest in RiskManagement and Clinical Governance.


Dr Stuart Hackwell

Stuart has been a GP in Morlais Medical Practice in Merthyr Tydfil since 2008. With a patient population of 17000 it isone of the 3 largest Practices in Cwm Taf and serves one of the most deprived areas of the South Wales Valleys.

He was appointed Locality Clinical Director for Merthyr Tydfil in September 2015 at Cwm Taf University Health Boardand is passionate about how General Practice can innovate and transform to meet the challenges of the next 20 years.He works closely with the Merthyr Tydfil GP Cluster in developing new models of care including the use of SocialServices Duty Officers to see patients with social needs directly in Primary Care. He is one of the joint clinical leadswith cardiology in the establishment of a community cardiology clinic and has also been involved with the new modelfor early cancer diagnosis in Cwm Taf.

If you wish to know more about theWelsh Clinical Leadership Training Fellows (WCLT)please contact the Deputy Postgraduate Dean,Professor Peter Donnelly: [email protected]

Wales Deanery | November 2016


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