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Implementation Plan – Tier 4 Senior Medical Structure
June 2014
1. Purpose This document aims to provide an overview of the proposed senior medical workforce structure including Senior Medical Officers and Visiting Medical Officers (Tier 4) for Children’s Health Queensland Hospital and Health Service (CHQ HHS) which will be operational when the new Lady Cilento Children’s Hospital (LCCH) opens in late 2014. The Implementation Plan is intended to be used during the consultation with staff and unions to outline the proposed process for recruiting to the new structure.
2. Introduction In preparation for the opening of the LCCH in late 2014, the CHQ HHS Executive Management Team (EMT) has been working to develop an appropriate structure to manage the services that will be provided in the new hospital. The Executive structure (Tier 1) for CHQ HHS was established through an open merit recruitment process in 2012 to create a more streamlined structure at the Executive level. The Tier 2 structure (divisional directors and associated management teams) have been recruited and commenced during early 2014). This was followed by the recruitment of the Tier 3 structure (service directors and associated management teams). With few exceptions, Tier 3 Medical Directors are now identified and have contributed to the determination of the final senior medical workforce (Tier 4) which is the subject of this Implementation Plan. The Tier 4 senior medical workforce is organised under clinical divisions and services, which are considered best suited to the delivery of safe, high quality, team based care to children and young people. The senior medical workforce structure has been developed based on point-in-time endorsed models of care for the LCCH and departmental schedules for LCCH services. The models of care will be used to assist the commissioning process for the new hospital. The transition to LCCH is a complex undertaking and the structure presented reflects currently available data, service modelling and resourcing. Subsequent changes to these assumptions may lead to change in the structure presented in this Plan. Any subsequent changes will be communicated to staff and unions in a timely manner. The development of the senior medical workforce structure has primarily been based on actual historical medical workforce and activity data from the Royal Children’s Hospital and Community Services and the Mater Children’s Hospital. The Executive Director of Medical Services and Divisional and Medical Directors have been supported by their Service Medical Directors in preparing the final senior medical workforce structure and Implementation Plan. CHQ HHS has and will continue to undertake organisational change and reform in accordance with government policy and relevant industrial obligations.
3. Scope of the change
This implementation plan outlines the impacted senior medical positions and proposed senior medical workforce for the LCCH. The positions that are impacted by the Tier 4 medical recruitment will be the current Senior Medical Officers and Visiting Medical Officers within CHQ HHS. The Tier 4 senior medical structure Implementation Plan covers the remaining Senior Medical Officer and Visiting Medical Officer positions in the Divisions of Medicine, Surgery and Perioperative Services, Critical Care, and Community Health. The Child Youth and Mental Health (CYMHS) medical workforce is out of scope for this consultation process as consultation for these positions were included in the CYMHS Tier 5 and below consultation which took place in April 2014.
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The medical workforce below Tier 4 (junior doctors/interns etc) are out of scope of this implementation plan as these are temporary positions and standard recruitment and selection processes will apply.
The existing organisation chart and new organisation charts at the divisional and service level are provided in Attachments A to I. An FTE summary of the current structure (RCH) and the proposed FTE for the LCCH is provided in Attachment J. The proposed roles included in the workforce structures reflect those required to deliver services based on point in time models of care and activity based funding for the LCCH. CHQ HHS has and will continue to consult with staff and unions. Under the Workforce Establishment Strategy, staff will need to submit their application for LCCH positions through a targeted advertising process. Information on the Workforce Establishment Strategy was provided to the LCCH Union Consultative Forum in late 2013 and is available on the CHQ HHS Building our workforce intranet site. The appointment categories for the Tier 4 Senior Medical Recruitment will comprise full and part time - Senior Medical Officers and Visiting Medical Officers. Once recruitment to the Tier 4 senior medical officer structure is finalised, identification of clinical lead/deputy functions will be considered and communicated.
4. Principles The medical workforce structure has been developed according to a number of guiding strategic initiatives, frameworks and principles including:
• Blueprint for better health care in Queensland agenda for change
• Health services focused on patients and people
• Investing, innovating and planning for the future
• CHQ HHS Strategic Plan and associated Strategies
• Consistency with the Framework Contract for the employment of SMOs and VMOs from August 4th 2014
• Modelling of clinical activity across Royal Children’s and Mater Children’s hospitals
• Expected efficiencies gained from combining the services and workforce capabilities of Mater Children’s and Royal Children’s hospitals
• Increased flexibility of rostering
• Changes in models of care and service delivery.
5. Supporting staff through change CHQ HHS values and respects its staff, and the contribution they make in the delivery of health services. Staff who are not successful in the recruitment to the Tier 4 positions and identified as requiring placement, the support offered will include:
• Individual discussion with the affected staff to provide certainty about the impact of the changes as soon as is possible within the process.
• Consultation with staff and relevant unions as to ways to minimise the effects of the change.
• Employee Assistance Program (EAP) including face-to-face counselling and other strategies available through EAP.
• Support of their manager as well as the Human Resources team.
For staff generally the support will include:
• Offering detail about decisions and impacts as soon as possible in the process
• EAP including face-to-face counselling and other strategies available through EAP.
5.1. Employees requiring placement (ERPs) All efforts will be made to find suitable vacant positions for permanent CHQ HHS staff displaced through this process at their substantive level. In the event there are exceptions to this principle, CHQ HHS will consult with the affected staff member.
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Where a substantive staff member is not placed against a role in the new structure or is not able to be placed against a suitable vacant position, the staff member will be declared surplus will be managed in accordance with Public Service Commission (PSC) Directive 6/12 ‘Employees Requiring Placement’ and the relevant process will be followed.
6. Timeline for implementing change Note: the dates provided below assume formal approval of the Workforce Establishment Strategy.
Timing Activity
3/6/2014 to 17/6/2014 Formal consultation period on the proposed medical health workforce structure for Tier 4 positions, including discussions with the LCCH Union Consultative Forum.
3/6/2014 Information on the CHQ HHS ‘Building our workforce’ intranet page made available for staff. Staff are also able to make enquiries through their line manager or by telephoning Human Resources.
18-19/6/2014 Union and staff feedback considered.
20/6/2014 Implementation of new structure commences.
20/6/2014 to 4/7/2014 Advertising of all Tier 4 medical positions.
July 2014 Recruitment process to all positions.
7. Consultation Employee engagement and consultation with relevant unions will occur in a timely manner to ensure employees are kept informed and up to date regarding the organisational structure and advertising and recruitment process. Information will be provided via staff forums, newsletters, intranet site fact sheets, and Q&As and cascade through executives and managers. Staff on extended leave will also be kept informed.
7.1 Providing feedback Stakeholders are invited to provide written feedback in relation to the implementation by close of business Tuesday 17 June 2014. Staff to: [email protected] Unions to: [email protected]
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ATTACHMENT A CHQ HHS Medical Management Organisational Structure (Tier 3)
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ATTACHMENT B
Proposed LCCH Senior Medical Structure – Division of Medicine
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ATTACHMENT C Current RCH Senior Medical Structure – Division of Medicine
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ATTACHMENT D Proposed LCCH Senior Medical Structure – Division of Critical Care
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ATTACHMENT E Current RCH Senior Medical Structure – Division of Critical Care
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ATTACHMENT F
Proposed LCCH Senior Medical Structure – Division of Surgery & Peri-operative Services
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ATTACHMENT G Current RCH Senior Medical Structure – Division of Surgery & Peri-operative Services
Children’s Health Queensland Hospital and Health Service
Current RCH Senior Medical Structure - Division of Surgery & Peri-operative Services
Paediatric
Otolaryngology,
Head and Neck
Surgery
Gastroenterology,
Hepatology and
Liver Transplant
Paediatric Plastic
and Reconstructive
Surgery, Oral
Maxillofacial Surgery
Paediatric
Orthopaedic Surgery
Divisional and
Medical Director
Surgery & Peri-operative
Paediatric
Ophthalmology Trauma
VMO
2.2 FTE
SMO/VMO
3.6 FTE
SMO
1.0
FTE
VMO
1.45
FTE
SMO
4.0
FTE
VMO
Casual
**
VMO
0.87 FTE
Paediatric Neurosurgery
SMO/VMO
5.7 FTE
VMO
0.9 FTE
Paediatric
Surgery &
Urology
Burns
**Note: In relation to casual positions in Gatroenterology, Hepatology and Liver Transplant positions, they are not included in the FTE count but have been included in this organisational chart for completeness.
NOTE: FTE includes the current Director position.
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ATTACHMENT H
Proposed LCCH Senior Medical Structure – Division of Child and Youth Community Health Service
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ATTACHMENT I
Current RCH Senior Medical Structure – Division of Child and Youth Community Health Service
