Clinical and Medical Directors Subcommittee
Update 16 April 2007
Chairman: Dr David Scott (Medical Director)
Deputy Chairman: Mr Peter Hirsch (Clinical Director)
Dear Colleague
Spring Update 2007
This is the second update from the BMA’s Clinical and Medical Directors Subcommittee, your representatives at the BMA. Usually, these updates will be sent to medical directors who, I hope, pass them on to their medical management colleagues. However, the annual conference mailing has given me an opportunity to write to you all.
As mentioned in my previous update, a key current piece of work is liaising with the NHS Institute on its enhancing engagement in medical leadership project. At the meeting of the subcommittee last month, the Chair of the project steering group, Dr Pat Hamilton (President of the Royal College of Paediatrics and Child Health), gave members an outline of the project’s work thus far and the role of the Academy’s steering group, and invited further participation in their work. There was a useful and frank exchange of views on the issues arising from this project, particularly on the current and future role of BAMM and its Fit to Lead programme and the level of direct involvement in the project from practising medical managers. Dr Hamilton agreed to include representatives from the subcommittee on the steering group and the three reference groups dealing with the undergraduate, postgraduate and post-CCT curricula. If you have ideas or concerns that you would like to feed into this project do let me know via the e-mail address above.
We had a detailed discussion about the support that the BMA can offer medical managers, particularly from its regional services network. The members of the subcommittee agreed that the lack of clarity regarding what the BMA had to offer medical managers discouraged many from making use of the Association’s services. A draft paper on the support regional services could provide medical managers was discussed. Whilst it was clear that support could and, indeed, was provided to medical managers with regard to their personal contracts, it was less clear whether the BMA could advise us in the conduct of our jobs as medical managers. I will be working with the BMA industrial relations officer responsible for medical managers and others in regional services to spell out the services the BMA has to offer. Meanwhile, if you have any concerns about your contract as a medical manager or any other issues regarding your terms and conditions of service, do contact askBMA in the first instance on 0870 60 60 828 or via the BMA website. It was also agreed that the subcommittee itself needed to provide more guidance both for members and for BMA staff to enable them to assist members more effectively. To that end the subcommittee agreed the final draft of revised guidance on the role of medical directors and resolved to produce detailed guidance on medical director contracts and on job plans for both clinical and medical directors.
The subcommittee then received an enlightening presentation from one of its members, Ron Hopkins, on the CATS schemes in the North West, particularly that in Greater Manchester. As you may be aware, the BMA has been campaigning for much greater openness in the contracting arrangements for these national schemes and it seems to be having some success. However, as Ron pointed out, these schemes may not be confined to the North West and the impact they could have on the number of patients making use of traditional NHS secondary care services and on the financial viability of those services was very significant. As you work towards the 18 week target, you may wish to keep an eye on any proposals of this nature emanating from your PCT. You may also find it helpful to check the Department of Health web page on 18 weeks to see what colleagues have already achieved in attempting to meet this target http://www.18weeks.nhs.uk/public/default.aspx. By meeting it, you may be able to persuade your PCT and GPs that CATS schemes would not be necessary.
A regular part of the agenda of the Subcommittee is discussion of the implementation of the consultant contracts, not just locally in England but also in the other nations of the UK. Across the UK there seem to be efforts to reduce consultant PAs generally and supporting professional activities in particular. It was noted that in a number of trusts job planning was still not properly in place and that this, in turn, undermined the case for the full allocation of 2.5 SPAs. The subcommittee also noted that PAs over ten were good value for trusts compared to employing a new consultant to undertake the work and that over-aggressive job planning could discourage flexibility on the part of consultants. Nonetheless, I believe that the subcommittee should do more to support medical managers in the job planning process and will discuss with colleagues in the BMA how to take this forward. Your thoughts on what support you think you need would be helpful.
As mentioned in my previous update, the BMA’s Health Policy and Economic Research Unit has been working on an NHS finance survey drawing on the knowledge of medical directors in primary and secondary care. The report based on the responses of secondary care medical directors was signed off at the meeting last month and, subject to some fine-tuning should be published shortly. I hope to be able to send copies to all medical directors. We would still like more responses from medical directors in primary care to improve the quality of the data. If you have received the survey and not yet sent it back, please do so. The recent report on the appraisal of medical managers is also due to be published shortly and will be available via the BMA web site and at the medical managers conference on 15 May.
Finally, I hope that you will respond positively to the conference mailing with this letter and that I will see many of you at the conference in May.
David Scott
Chairman, Clinical and Medical Directors Subcommittee
NB: For more information on CATS please go to the BMA's CATS campaign page.