Managing Money, Measurement and Marketing in the Allied Health Professions

Robert Jones, Fiona Jenkins

• Publisher: CRC Press
• Year: 2018
• eBook ISBN: 9781315357638
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

High-quality Allied Health delivery through a motivated, committed and expert workforce depends on strong management and leadership. To provide this, Allied Health Profession managers need solid, evidence-based business skills just as much as clinical knowledge and ability. This book focuses on the key management areas of money, measurement and marketing as applied to the Allied Health Professions. Bringing together nationally and internationally acknowledged and recognised experts from around the world, it explains the finances of healthcare, particularly in a cash-strapped environment, information and information management, and the marketing of services - in the broadest sense - based on a robust foundation of business planning and business-case development, project management, service level agreements and specification. Report writing and presentation skills are also covered, along with editors' quality and leadership evaluation framework, the Management Quality Matrix. The information, background and practical techniques covered in this book will make it a thought-provoking and indespensible resource both for managers and leaders of Allied Health Professionals and for those training future managers and leaders.

Chapter 1

The jigsaw of reform: pushing the parameters

Robert Jones and Fiona Jenkins

The jigsaw of reform

The Allied Health Professions (AHPs) are a key piece of the jigsaw of reform resulting from changes in global healthcare funding and provision. The pressure is on all of us to provide higher quality care for less cost. The focus of this chapter is an overview of the issues facing all of us, setting the scene for the detailed discussions which are presented in subsequent chapters related to money, measurement and marketing, to support our roles in successfully dealing with the challenges we are facing as healthcare managers and leaders.

Healthcare is fast moving and changing; the ways in which our services have been organised and managed are being challenged. The National Health Service (NHS), like other global health services, is facing a period of uncertainty – the only certainty being that cost savings are required. The NHS is required to make unprecedented savings. The scale is enormous and the pace that is needed is unprecedented. This is accompanied by the added pressure caused by service user expectations, the global economic downturn and ‘credit crunch’, together with public service pension deficit, demographic shifts and aging populations, developments in technology and innovation, the world wide web and ease of access to information, public services and the green agenda and many others. Organisational change is being driven by Governments worldwide in the quest to make public services efficient, effective and value for money. How will the global ‘credit crunch’ and the resulting enormous public sector borrowing requirement affect services and future funding allocations?

Is funding in your service assured? Do you, like most of the rest of the developed world, have growing requirements and a finite budget? One certainty is that AHP managers must be aware of politics, funding, technological change and the economics of healthcare in order to manage and lead their services effectively. The evidence base is growing and the effectiveness and contribution of AHP interventions is increasingly recognised. Our roles in assessment, diagnosis and management of acute and longer term conditions, as well as our growing scope of practice, places us well to contribute to this challenging agenda. Healthcare leaders and managers are increasingly being made accountable for the clinical, financial, corporate and information governance of the services they provide. Instead of providing care to patients there is a shift to engage patients in modelling the care they receive, putting patients at the centre of what we do, rather than just being the end point.

Providers of care – by whom to whom and where?

Our workforce is also changing, the different age profiles of our workforce have differing priorities and expectations. Whether starting a career, portfolio working, moulding it around family life, or whatever suits staff needs, jobs are less likely to be constant for a whole career. We need to ensure that our services meet the needs of individuals as well as service requirements, always looking ahead. Regulation is an increasingly important piece of the ‘jigsaw of reform’ and one that managers must be aware of in order to ensure compliance to safeguard patients. The ever increasing tendency for litigation requires practice to be of the highest quality supported by registration mechanisms. Careers are changing; they are much more competency based rather than skills and knowledge based, less profession specific with more blurring of old professional boundaries. Healthcare is moving towards a protocolised system to reduce variability and raise standards, this may be beneficial to service users and staff alike, but at the same time beware of the dangers of being over prescriptive. There are a number of workforce questions which will need to be addressed when developing a high quality workforce, for example:

1. Can the organisation afford all the staff needed?
2. Do your staff want to work the hours you need them for?
3. Do you provide a seven day service?
4. How skilled are your support staff?
5. Have you the right mix of grades and skills?

The ‘baby boomer’ generation – those born between 1945 and 1970 – have different aspirations from their parents. They have worked hard, are well informed, have high expectations from healthcare and want to remain fit. They do not want mixed sex wards, to wait for treatment or receive second best. They want the best, and they want it now! Their children have even higher expectations. The care we provide needs to fit our changing population, who they are and where they are, multicultural and acknowledging individual needs.

In the 21st century care is, and will increasingly be, provided in a wide variety of settings: hospital, multiple hospitals working in a network system, clinics, home, residential care, school, high street outlets, supermarkets, railway stations, health maintenance centres, aided living centres, devolved self-care models with clinical support, everywhere! There are many different models of health provision and commissioning, we work in different areas with differing needs. In England, for example, there are five levels of commissioning.

1. National commissioning schemes.
2. Regional group commissioning schemes.
3. Specialist care group commissioning schemes.
4. GP group commissioning schemes.
5. GP individual level choice.

Care purchasers will determine what is required, we must be prepared to diversify and meet the challenges of purchasing and provision.

Technology

Developing technologies are transforming many aspects of healthcare, from advances in imaging techniques, to telemedicine and the electronic patient health record. Information technology with advanced informatics and decision-making to support safer practices all require the use, storage and sharing of data. Rapid changes in technology be they clinical, educational or managerial are in place now and will be the shape of things to come. Technology is changing the way in which service users access care and how they can be supported through the use of multimedia. This is seen through the growing use of electronic appointment booking systems and the exchange of clinical information by electronic transmission between care providers. AHPs and their leaders must embrace this technological age or be left at best playing catch-up or at worst decommissioned.

Changes in organisation

Change in the NHS is a continual cycle, arguably too much change without ‘bedding in’ best practice and the benefits of experience. However, to stand still is not an option for anyone. Changes in healthcare are driven by financial, political, economic and social factors. Consumer changes, with increasing life expectancy, the increase in long term conditions, widespread access to health information and increasing demand for quality, quantity and immediacy of healthcare have required health strategists to re-evaluate the organisation and structure of healthcare services in the developed world. AHP managers have often been required to consider what might be the ‘best’ organisational structure for their services – this remains a recurrent challenge.

The importance of organisational structure cannot be ignored as the structure supports the context for the provision of the most effective clinical service, improved clinical outcomes and sharing of information, improved communication, clinical governance and the management of risk. Management structures should be defined after the functions of a service are determined.

Who is the profession for? Increasingly healthcare is developing workforces and capacity through the use of highly skilled and competent practitioners rather than depending on workforce development based on the traditional profession centred approach. Emphasis is increasingly on the patient’s experience in health and social care with services provided by multi-disciplinary teams in vertical and horizontal integration models, not interrupted by organisational boundaries or professional barriers which might militate against streamlined working. This is likely to increasingly involve alternative patterns of employment in which staff are employed in multidisciplinary networks centred around specific clinical clusters such as cancer networks, children’s services, elderly care services rather than uni-professional structures. However, the process is by no means complete, there is little doubt that the role and power of the profession has evolved in the context of rapidly changing needs.

Successful collaborative working places the patient or service user at the centre. Whilst working towards this objective we need to acknowledge and respect the backgrounds, skill, knowledge and competencies of one another from every professional background whilst at the same time forging new inter and multi-disciplinary structures.

Although we are embarking on a remodelling of organisational structures to support our service provision, there are many positive attributes which flow from our professional backgrounds and we can take forward into the future including: putting the patient first – subordinating self-interest; the pursuit of continual improvement and service re-design; collaborative team working; professional behaviour and a willingness to redraw and breakdown professional boundaries. The most important thing for our patients is the quality, responsiveness and affordability of our care and es...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• List of figures
• List of tables
• List of boxes
• Series foreword
• Foreword
• Preface
• About the editors
• List of contributors
• List of abbreviations
• List of books in this series
• 1 The jigsaw of reform: pushing the parameters
• 2 Money, money, money: fundamentals of finance
• 3 Commissioning for health improvement: policy and practice
• 4 Striking the agreement: business case and service level agreements
• 5 Thriving in the cash strapped organisation
• 6 Information is power: measure it, manage it
• 7 Information management for healthcare professionals, or what has IT ever done for us?
• 8 Allied health records in the electronic age
• 9 Data ‘sanity’: reducing variation
• 10 Outcome measurement in clinical practice
• 11 Benchmarking AHP services
• 12 Management quality and operational excellence
• 13 Management Quality in the AHPs and Evaluation Matrix
• 14 Evaluating clinical performance in healthcare services with data envelopment analysis
• 15 Project management for AHPs with real jobs
• 16 Marketing for AHPs
• 17 Effective report writing
• 18 Demonstrating worth: marketing and impact measurement – self-referral
• 19 Improving access to services: a practical approach to understanding demand and capacity to support service re-design
• Index