Transcript ACCEA - AAGBI
Clinical Excellence Awards
September 2009
Clinical Excellence Awards (CEA Awards)
• The purpose of this presentation is to inform and encourage all Consultant Anaesthetists to consider applying for a CEA award
Locally
or
Nationally
this year • In 2009 the number of applications from Anaesthetists increased yet again • And more Anaesthetists got National awards than ever before - 38 Bronzes (26 – 2008) • - well done, keep it up
2010 National Clinical Excellence Awards Round - essential reading
2010 National Clinical Excellence Awards Round
• Closing date will be
Friday 11 th December 2008
.
• All fully completed applications, ranked lists from employers, nominating bodies and specialist societies must be received by 5pm on that date.
• Forms and Guide on website in July • On-Line Application System begins in September
Clinical Excellence Awards (CEA)
• Part of a continuum 1-12 Levels • Employer Based Awards (EBA) – Up to 9 points awarded locally by employers – 9 points from employer called local bronze • National awards awarded by ACCEA – Bronze award Level 9 – Silver award Level 10 – Gold award Level 11 – Platinum Level 12
Clinical Excellence Awards
• Slow process - may take 15+ yrs to Bronze • Consultants in post for 1 year on 1 st in the award year may apply April • Included in NHS Pension scheme • Employer based awards cannot be removed (at present) • ACCEA reviewed every 5 years
Age 35 41 42 52 47 - 50 55 – 58 60 – 65 CEA Awards Comments Level 1 More consultants are getting their first point within 2 years of appointment Level 4
OR
Average rate of 1 point every 2 years Considered for a national Level 9 Enters the national / regional lists and starts what is usually a 3 year process of progression Considered for employer-based Level 9 Recognition of outstanding contribution to the Trust, possibly from a management perspective Again on the maximum rate of 1 point every two years Considered for a Level 10 Fewer awards maintain the extreme competitive nature of the process – again takes 2 / 3 years Level 11 As above Level 12 One a year!
What’s an Award worth, approximately
•
Employer Based or National
–
Employer Based Award
• Level 1-6 (£3k each) - only Employer Based • Level 7-9 (£6k each) • Level 9 can Employer Based or National –
National Award - approximately
• Bronze • Silver • Gold • Platinum = = = = Level 9 Level 10 Level 11 Level 12 £35k £46k £58k £76k
And all are in the NHS pension scheme
Employer Based CEA Committees
• 10 – 15 members • 50% Consultants (Medical Director = manager) • Chaired by CE or non-exec Director • Up to 3 managers • 1 or 2 lay representatives • 1 university representative if appropriate • All to have diversity training
ACCEA Regional sub-committees
• Up to 24 members • 6 lay members (including Chairman) • 12 medical members (including medical Vice Chair) • 6 employers (CEOs) • Regional Chairman is responsible for good practice in regions Trust CEA committees and can attend them
CEA application forms
•
The Form is the KEY to the whole process
• What achievements you claim on the Form is the information that is considered • In big Trusts and Nationally that is all the committees know about you • Read all ACCEA info and get colleagues help • Start early and invest some time in doing the best form you can
Points worth remembering (i)
• A ward for excellence not working hard • National awards are for national activity but not at expense of local work • Need Chief Exec/Trust support • The form is all the ACCEA will see • Each domain is scored separately so put something in each • Make it understandable (avoid acronyms) • Strictly follow ACCEA guidance on website
Points worth remembering (ii)
• Be factual - don’t exaggerate or be overly modest • Risks GMC referral for lack of probity • Give quantified information, quoting dates, activity data, audits, appropriate benchmarks • Specify achievements since last award date • New line for each entry, bullets help clarity • All specialties compete
Points worth remembering (iii)
• • •
Clinical activity rarely counts
– Even if onerous – If you are paid to do it – it doesn’t count either
Word document
– It can be cut and paste – Check the ‘word count’ frequently – Write everything – then prioritize – No acronyms / abbreviations – Spell check it
Use the scoring scheme for advice
Routine data entry
• Take care to complete each box • Be clear about employment • On line Form goes from ACCEA to your Chief Exec so wrong employer won’t help!
• Be up to date with your employer-based award level
Personal Statement
• Sets the scene • Is not scored, but… • Follow instructions - surprising how many
doctors cannot count to 4!
• Pick out most significant achievements • Only since last award • Successful applicants Personal Statements all now published on website - read for ideas
Job plan section
• • See Format sample in ACCEA 2010 Guide • Summarise job plan with PAs and other activities relevant to NHS • Say which work is paid or unpaid • Describe working week for each post held, consultant anaesthetist, clinical director, senior lecturer, college tutor, specialist society officer etc.
5 Domains – 1. Delivering a service – 2. Developing a service – 3. Managing a service – 4. Research – 5. Teaching –
These are summative
Changes to evidence required for the 5 Domains
•
Read CEA advice from National Quality Board and National Leadership Council
David Nicholson’s letter of 19 June (on website) • Need to specify your individual contribution • Evidence of achievements in quality and clinical leadership cf “
High Quality Care for All”
• In 2010 guide there are examples of edited extracts from actual applications
National Quality Board Advice
19/6/2009 • Focus on the 3 dimension of quality (safety, effectiveness, and patient experience) • Use
Indicators for Quality Improvement
when providing evidence • All applicants should be fully participating in relevant National Clinical Audits • Contribution to research and evidence/evaluative base for quality
National Quality Board Advice
19/6/2009 • Consultants who make exceptional contributions to – patient safety – achieving excellent clinical outcomes – improving the patient experience • Applicants should provide evidence demonstrating their performance across all 3 dimensions recognising that their exceptional contribution may focus on just one
National Leadership Council Advice
19/6/2009 • Developing the potential in others • Leading change for benefit of patients staff and public • Leadership Development Activities and how this has improved quality of care • Removing barriers in the workplace • Participation in innovation and productivity • Suggestions to strengthen the CEA
1. Delivering a service
• •
0
Not eligible – For a number of reasons ranging from doing the minimum required or questionable conduct as a clinician or a colleague just doing the job
2
Fulfils contract competently – Performs competently in his/her job. There are no questionable issues regarding conduct as a clinician, colleague, researcher or teacher. Slightly more than the job with safety and quality assurance (e.g. operative mortality and /or morbidity documented)
• •
1. Delivering a service
6
Definitely over and above – Exemplary standards in dealing with contractual requirements, patients, relatives and all grades of medical and other staff, ideally include reference to validated patient or carer survey or feedback on the service (external or peer review reports). Demonstrated usage of evidence-based practice. Excellence in leadership of the team, for example in the work of Chairman of a Division / Head of Department. Voluntarily contributes to recognised quality assurance schemes.
10
Outstanding – Innovative contribution to clinical governance and/or service delivery of proven worth (audited or published). Leadership role in relation to clinical governance.
2. Developing a service
• •
0
Not eligible – For a number of reasons ranging from doing the minimum required or questionable conduct as a clinician or a colleague to no local input
2
Fulfils contract competently – Contribution to local audit cycles and completing them with actions. Enhancement of quality and safety. Analysis of risk and managing it
2. Developing a service
• •
6
Definitely over and above – Use of multi-professional approaches contractual requirements to service delivery, improvement in service / patient-centred delivery. National appointments to Societies, for example NSF, HIMP, Colleges, developing innovation in service delivery with evidence of improved outcomes (clinical governance). Reduced risks, enhanced patient safety
10
Outstanding – Achievements as a national leader / international profile / chairing national committees, for example NICE / Government Advisor / other. Demonstrable change in evidence-based practice.
3. Managing a service
• •
0
Not eligible – Does not contribute to service management or involvement is contrary to clinical guidelines and / or trust policies. Just attending meetings
2
Fulfils contract competently – Change management aimed at improving the effectiveness or efficiency of service, which an individual has led.
3. Managing a service
• •
6
Definitely over and above – Leadership, Chairing Trust / University committee contractual requirements e.g. Clinical Director. Conducting appraisal for peers / non-consultant career grade doctors. Major reviews, enquiries or investigations, for example Medical Director. Actively contributes to College / Speciality Advisory Committee (SAC member)
10
Outstanding – Professional practice for example leading / chairing national committee or enquiries. Change champion roles
Expanding (example)
• • Clinical Director (since 2007)
As Clinical Director of anaesthesia since 2007 (now 54 consultants in department) I organise rotas, manage job plans to provide a flexible service and have introduced new systems to staff emergencies reducing patient waits to under 3 hours
4. Research
•
In case of a DGH doctor, involvement in high quality research should attract a higher score than in the case of a university employee where there is a contractual requirement to undertake to be involved in research.
• 0 Not eligible – Does not undertake any research or has no citations in peer reviewed journals.
• 2 Fulfils contract competently – Citations in peer reviewed journals or than ‘case reports’. Office bearer / invited speaker.
more
4. Research
• •
6
Definitely over and above – Citations in significant impact journals or evidence of actually leading research projects not just lending support. Evidence of research grants secured, directing research departments, successful supervision of higher degrees. Multi centre activity, high recruitment levels.
10
Outstanding – Evidence of important research leading to altered national practice, editorial writing or significant editorial function in significant impact journals. Visiting professorships, funding review board membership
5. Teaching and Training
• •
0
Not eligible – Refuses to train and be involved in teaching and training. Just students on ward rounds. Poor attention to trainees.
2
Fulfils contract competently – Above but ‘obliges’ with the odd lecture to undergraduates and / or postgraduates (medical and non-medical).
5. Teaching and Training
• •
6
Definitely over and above – Regular student contact, regular contractual requirements lectures to undergraduate or postgraduate organisations. Peer reviewed and other publications on educational matters. Positive student feedback. A major input: above plus examiner for College, or other health professions. Institutional success in regulatory body and QA audits of teaching.
10
Outstanding – Leadership and innovation in teaching, undergraduate and postgraduate courses organiser and regular contact and lectures plus examining. Postgraduate teaching in other UK centres and abroad (presentations/invitations to lecture nationally and internationally. Office holder at College / Association level, involvement in setting educational trends.
Additional forms - Options
• Teaching, Research, Management?
• Only complete an additional form if there is something significant to include • If in doubt take advice
Scoring
• Each domain is scored • 24 members of committee score • 12 medical members • 6 employer representatives • 6 lay members • Scores are 0, 2, 6, 10
Lay members
• Provide patients’ perspective • Understand excellence • Will not understand many acronyms • Need you to explain why something is important • Show your form to a non medic to check this
2010 round dateline (guide)
• Start early (or continuously) • College Regional process starts June/July – RCA shortlist in by late September • AAGBI parallel process starts September – AAGBI closing date October 16 th 2009 • • Other Specialist Societies dates vary
Form must be finalised to meet Trust date
2010 round dateline
• The Guide to the Scheme (2010 round) is now on website since July 2009 • Results of the (2009) round were published on website in August 2009 • The 2010 round is expected to open by the end of September 2009 • Closing date for receipt of all applications, ranked lists and citations is:
5 pm, Friday 11 th December 2009.
2010 round change for "B" Distinction Award holders
• Previously old "B" Distinction Award holders have had the option of applying for either a Silver or Gold Clinical Excellence Award • • In future starting in the 2010 round, "B" holders will
ONLY
be able to apply for a
SILVER CEA
.
When to apply nationally
• Depends on level – (see next slide) • From 2008 the ACCEA agreed to consider
Anaesthetists from level 3
• For Bronze, most successful applicants have been a consultant 10 years and have at least level 4-5 awards • Normally at least 4 yrs between levels 9-12 • When there is new achievement of excellence
CEA level previously held by new Bronze Award recipients 2007
CEA Reviews
• Come 4 years after a National award • Take these as seriously as the original application • Complete with same care as new form • Only include information since receiving last award • Renewals may be at 5 years or 1 year (inadequate form) or 2 years (e.g. sick)
2010 CEA application Forms
– 2010 Forms and Guide on ACCEA website – Similar to last year, use for RCA / AAGBI process – On-Line Application System begins in September – So complete on 2010 form – Character limitation in boxes – E-versions only – Clear rules – locally and nationally – Competitive – Exclusive –
No form = No award
2009 National Award Round Results
• Successful Consultants told in July 2009 • Available on ACCEA website August 2009 • Payment backdated to April 2009 • Therefore need to fill in 2010 round form if not successful in 2009 round • GOOD LUCK
Anaesthetic specific data
• Anaesthesia is under-represented in CEA awards • ACCEA are aware and want to address it • Under-representation demonstrated e.g.
– Bronze 2004: 0.6% of ‘eligible consultants’ (Ave 1.2% for consultants in all specialities ) – Bronze 2005: 0.7% of ‘eligible consultants’ (Ave 1.2%) – Bronze 2006: 0.7% of ‘eligible consultants’ (Ave 1.3%) – Bronze 2009: 0.8% of ‘eligible consultants’ (Ave 1.3%)
Clinical Excellence Awards May 2007
1-4 CEA 5-8 CEA 9/B 10/11/A 12/A+ Anaesthetists 21.15% 5.35% 4.76% 1.56% 0.19% NB Discretionary Points not included All consultants 21.72% 7.85% 8.13% 3.72% 0.85%
All award holders at June 2007
Level 1
Clinical Excellence Awards Levels 1 -9
Level 2 Level 3 Level 4 Level 5 Level 6 Level 7 Level 8 Level 9 Anaesthesia Average
What can departments do?
• All eligible Consultants should submit a form • Award holders should advise others on understanding form and its completion • All Local Trust Award committees should – Follow ACCEA national guidelines/process – New Employer Based (Local) guide later this year – Have an anaesthetist on them (16% of 10 = 1) – Provide data for equality monitoring over last 10 yrs – If none of these speak to the Trust LNC
Keep records: Concept of Points/years
Numbers in red are the expected points/years if all specialities treated equally
Surg Med Num of Cons
12 15
Expected Points 0.35
1997 Pts Award ed Points Point/ years 1998 Pts Award ed Points Point/ years 1999 Pts Award ed Points Point/ years 2000 Pts Award ed Points Point/ years 2001 Pts Award ed Points Point/ years 4 5 5 6 5 6 6 6 16 18 6 5 33 35 5 6 55 58 5 5 82 ^ 75 v 86 Obs
6
Anaes
21
2 7 4 4 3 3 3 11 3 21 4 35 4 30 v 53 3 9 4 19 3 32 4 105v 47
National 2005 no's
If Anaes quota 16%
45 % of previous level
Actual 2004 Actual Actual Actual Actual Actual 2005 2006 2007 2008 2009 CEA for Anaesthesia 2004-2009 Level 9 Level 10 Level 11 Level 12
322
51 25
49%
29
57%
29
57%
16
31%
26
51%
38
75% 152
24
23%
14
58%
7
29%
9
37%
17
71%
11
46%
12
50% 59
9
10%
3
33%
3
33%
0
0%
1
11%
3
33%
3
33% 34
5
5%
1
20%
1
20%
1
20%
2
40%
0
0%
2
40%
Total Points B1,S2,G3,P4 152
100%
66
43%
56
37%
51
34%
61
40%
57
38%
79
52%
Anaesthesia CEA 2004-09
15 10 5 0 40 35 30 25 20 2004 2005 2006 2007 2008 2009 Bronze Silver Gold Platignum
Anaesthesia CEA 2004-09
Total Points B1,S2,G3,P4
90 80 70 60 50 40 30 20 10 0 2004 2005 2006 2007 2008 2009 Total Points B1,S2,G3,P4
Workshops at AAGBI Annual Congress, 23
rd
– 25
th
September 2009 Liverpool
Advice on applications for Local and National CEA awards to increase your chances of success.
- Examples of completed forms - and improvements. - Advice for anaesthetists on each domain - Consideration of model job plan and the time spent over and above the NHS contract .
- Abundant practical tips. - Opportunities to discuss your own form . • Workshops will be limited to 25 delegates only. Book Early BYOF - Bring your own form, if you want
Best of luck
but don’t forget
Liverpool
23 rd -25 th September 2009