Download pptx - Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital “Modern Matron” Rachel Adam Physiotherapist

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital

“Modern Matron”

Rachel AdamPhysiotherapist


Clinical Service Lead – Orthopaedics

• Hampshire Hospitals Foundation Trust– Across 3 sites

• 3 Fracture clinics • 3 Trauma wards• 2 Pre assessment clinics • 2 Elective wards• Staff– 164 Nursing / 64 medical / 56 admin


How did the opportunity arise?

• Previous experience:–MSK outpatient lead for HHFT– Leading multi professional teams

• Hungry for new challenges and seeking greater responsibility



• Actively seeking new opportunities• Open to stepping outside the known • AHP highlighting opportunities where AHP can deliver

what is required• Convince others to take a risk to provide a personal

opportunity– Highlight qualities and skills AHP’s offer


Qualities and Skills • Training / academic entry

– Problem solving / goal setting– Organisation complex information– Theories and frame work – Autonomous – Decision makers – Communication skill – Influence and have confidence in different unknown situation – Credibility with others

• Career structure– Exposed to variety of role, leaders and experiences to learn and develop – Lateral thinking

• Fresh eyes / not historic thinkers


Challenges faced………… personal and professional

• Painful learning curve – Challenged my personal resilience – How a ward runs and how performance is evaluated – Nursing practice and language – My role

• Volume of work Urgent and High Importance• Eyes wide open

– Level of responsibility, challenge and accountability within the main frame – Myself and nursing team– Challenged my beliefs of the practices of other professional groups

• Delivering safe and quality care, preventing harm to patients and staff– Ensuring patients receive safe, high quality care with dignity and respect– Safe Staffing: 24 /7 with significant staffing vacancy – Communicating and influencing a work force on shift

• Forgiving myself for not being a nurse


Thoughts on the future• The right person with the skills to deliver what is expected of the role

– Look past perceived professional boundaries

• Need to make seek and create opportunities to demonstrate what we have to offer as credible senior leaders within the NHS– AHP’s need to rise to the challenge– Accept responsibility outside of professional boundaries and usual

practice – Opportunities within a structured leadership pathway


Pulling it all together,

• Meeting challenges– Ward level leadership– Observation of inefficiency in ward processes – Observed professional accountability mismatch at ward level

• Gap in leadership pathway opportunities

An existing AHP lead taking responsibility for the elective orthopaedic ward……combined role trial.


An AHP in a combined clinical and ward management role

Laura WinesPhysiotherapist


The Role

• Clinical Specialist Physiotherapist working on trauma, elective and day surgery wards

• Responsible for a team of physiotherapists and a 7 day physiotherapy service

• Managing a 16 bed elective orthopaedic ward including staff management and day to day operation management

• Working with the Orthopaedic Unit nurse lead to develop services provided by the whole Orthopaedic Unit



• Elective ward charge nurse retired• Clinical services lead for orthopaedics opened up job

opportunity to all AHPs as well as nurses• Actively seeking new opportunities


Qualities and Skills • Rotational physiotherapist, observe different leadership styles, different

ways of operating a ward• More opportunities as an AHP to move from band 5 to band 7, gaining

management skills and experience as a leader• Clinical reasoning/evidence based practice/problem solvers – embedded

from undergraduate level and used every day• 5 years in orthopaedics at RHCH – aware of the challenges and the potential

of the ward. Objective for the new ward lead was to integrate nursing and therapy.

• Elective Orthopaedics – rehabilitation integral to patient flow • Natural progression – wanting to gain more responsibility and seek new

challenges and still remain in the service which I had already invested in


Challenges Professional•New role – no set precedent. Working out daily, weekly, monthly activities and balancing clinical physiotherapy duties with ward management•Increasing awareness of my dual role, uniform challenges•Exposure to the divisional operations taking place outside of the ward, no previous experience had provided a basic understanding – steep learning curve•Understanding the 24/7 ward activity•Ward staff VS staff on ward – non-professional ward activity and accountability for care and quality and facing inequality between professional groups in particular access to professional development•Trying to bridge the gap between nursing and AHPs through stereotypes, historical processes, using my combined leadership role


Challenges

Personal•Being under two management structures•Being patient – no immediate change•Feeling like a small fish in a big pond all over again•Humbling experience – having to reflect back on who I was prior to the new exposure and help others to see/learn through my experiences


Putting into practice•Ward management recruitment - where possible, to consider applicants regardless of their professional degree but for the knowledge, skills and qualities they have gained during their experiences•Managers of AHPs to support progression into ward management posts/speciality specific leadership opportunities•Integration of AHPs and nurses on the ward-To ensure accountability for care and quality which is non-professional specific-To support each other to allow equality for non-clinical responsibilities-To therefore create a dynamic workforce which can deliver the needs of the patient at the time of need-May require combined leadership where there is potential for resistance


AHPs interested in ward management

• Feeling truly part of the NHS, being at the centre of activity and involved at every level, increased job satisfaction

• Understand the way the NHS works not just the ward or the department you work in

• Potential for your work/ideas to spread to other wards and then to other Trusts, high impact


From OT to Sister


The Skills of an AHP

• Problem Solving• Empowerment

• Working Autonomously• Team Work• Rehabilitation

• Discharge Planning


The Challenges

• Knowledge of a ward

• Perceptions of others

• Managing nursing staff not therapists


Advice

• Preparation

• Learn the ropes

• Support network

• Keep the patient at the centre
