Essay on "Healthcare Like Many Countries"

Essay 9 pages (2763 words) Sources: 10 Style: Harvard

[EXCERPT] . . . .

According to a published report on the policies that govern performance reviews,

"The Level 2 process involves the VMO completing a Level 1 performance review form and forwarding it to the nominated person in accordance with the process set out above. The public organization must then nominate at least two reviewers to undertake the Level 2 review. They should include the supervisor/manager of the VMO (usually the relevant Head of Department or Divisional Director unless that position is held by the VMO being reviewed) and, as appropriate, the relevant hospital Director of Medical Services, Divisional Director, or a medical administrator. A VMO who has objections to the reviewers who have been appointed may put a request to the relevant Chief Executive that the persons appointed as reviewers be changed ("Visiting Medical Officer (VMO) Performance Review Arrangements")."

Both the performance reviews and the rules that govern reappointed are essential to having some control of the VMOs who are selected for various positions and the ability of VMOs to maintain their positions. It is crucial that patients receive a high quality of care in any facility that they are visiting. The purpose of the overall healthcare reform is to guarantee that the healthcare is not only available to the population but that the healthcare is also efficient and beneficial to the patients.

Change management will also be an essential component in dealing with these challenges. For instance, within the public hospital setting, it may be difficult for some of the current employees who have only operated under the old system, to understand the different requirements of the new system.

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It may also be difficult for them to accept doctors who are independent contractors, particularly if they have only worked with hired doctors in the past. Therefore management must be aware of the various adjustments that must be made in order to make hospital staff, nurses and conventional doctors feel more comfortable with the process. Management must ensure that all members of the medical community governed by the district are on the same page so that the delivery of care will be consistent regardless of the facility where the care is given.

Resource implications

At the current time there have already been some concerns as it relates to the amount of resources available within the district. Some aspects of the reappointment process may require additional resources associated with handling the process of selecting VMOs. There must be a concerted effort to make certain that the available resources are used properly and used in a manner that guarantees the maximum efficiency.

Additional financial backing may be needed to properly train staff and nurses concerning providing consistent care. Small workshops or meting should assist with ensuring that all the medical professionals understand the need for VMOs and the purpose that they serve at the facility. Failure to do so may create tension between VMOs and those that assist them if the issue of consistency is not addressed in a formal way. Resources must be allocated as it pertains to this issue.

Performance reviews are also essential to the success of VMO pressence at the district's facilities. The cost associate with the review will not be enormous because the forms are available on the internet and they can be printed as needed which reduces waste. However, personnel will be needed to ensure that all of the requirements of the review are met, this is particularly true for the level 2 evaluations which are more complex. As such funds need to be allocated to pay for any extra expenses associated with personnel needed to complete the reviews.

Possible management strategies

Management must be prepared to handle the recruitment, selection and finalization processes that will be an aspect of the Quinquennium. This means that staff must have the proper competencies such as organizational skills and interviewing skills. That is the staff selected to handle the reappointment process must have the ability to keep all the information concerning the VMOs organized properly according to their specialties. In addition any staff that is responsible for interviewing and selecting VMO's must have the ability to ask the proper questions to ensure that the most competent doctors are selected.

Capital funds-funds reserved for the purchasing of capital or fixed assets-must be carefully managed. Failure to do so can be extremely problematic for the facilities within the district. Management must take survey of its entire inventory to determine what type of equipment will need to be purchased in the near future. Additionally the district needs to determine if land needs to be purchased so that new facilities can be built. Capital funds are limited and as such they must be managed in a way that ensures that the maximum benefit is realized.

Having the proper operating funds are also essential to healthcare reform and the form of outsourcing discussed in this report. Operating funds are utilized to pay for operating expenses such as payroll, employee benefits and pensions. Operating funds are essential for the daily operations of any healthcare facility. As such the district must stay abreast of the operating expenses of each of its facilities and properly manage these funds so that the facilities can remain open.

During this time the lines of communication must remain open and staff has to understand what is required of them. In addition supervisors and managers must ensure that they effectively communicate with staff and that any concerns are addressed in a professional and timely manner. Failure to do so may result in the selection of doctors who are not competent and as such the mission and goals of healthcare reform in the country might go unfulfilled.

Conclusion

The purpose of this internal report was to provide an analysis and overview of the Visiting Medical Officer (VMO) Quinquennium (reappointment) Process. The research indicates that the process is a type of outsourcing in which VMOs act as independent contractors in providing care at public hospitals. This process is design to find and recruit the most qualified specialists in a myriad of different field to provide care to the growing patient population. The VMOs are required to undergo a level 1 performace evaluation each year. In addition those who are appointed to serve three years or more are expected to undergo a level 2 evaluation which is much more complex. The research indicates that management must properly handle capital funds and operating funds if the process is to be successful. The ultimate aim of the reappointment of VMO's is to provide the public with the healthcare that it deserves at a rate consistent with the growth of the aging population. This type of outsourcing is one of the ways in which this goal will be accomplished.

Works cited

Background National Health Reform. viewed 31 July 2011,

http://www.health.nsw.gov.au/initiatives/healthreform/background.asp

Le, Q, McManamey, R 2005, 'The Discourse of Outsourcing: Some Implications for Health Services and Education,' viewed 16 July 2011, .

National Health Reform. viewed 31 July 2011 http://www.health.nsw.gov.au/resources/initiatives/healthreform/pdf/discussion_paper.pdf

Position classification descriptions. viewed 31 July 2011 http://www.health.nsw.gov.au/aon/position_classification.asp

Primary Healthcare Reform in Australia. viewed 31 July 2011 http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nphc-draftreportsupp-toc/$FILE/NPHC-supp.pdf

Quinquennium-extension to 2009 and new Quinquennium to 2014

Visiting Medical Officers. viewed 31 July 2011 http://www.health.nsw.gov.au/countrycareers/doctors/visiting_medical_officers.asp

"Visiting Medical Officer (VMO) Performance Review Arrangements." viewed 31 July 2011 http://www.health.nsw.gov.au/policies/pd/2011/pdf/PD2011_010.pdf

Visiting Medical Officer (VMO) Model Service Contracts. viewed 31 July 2011 http://www.health.nsw.gov.au/policies/pd/2009/PD2009_052.html

Visiting Practitioners Appointment . viewed 31 July 2011

http://www.health.nsw.gov.au/policies/pd/2005/PD2005_496.html READ MORE

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Quoted Instructions for "Healthcare Like Many Countries" Assignment:

“

MANAGING OUT: THE PUBLIC SECTOR IN THE COMMUNITY

Process Analysis ***** (2500 words)

An***** a process of *****˜managing out***** that has been implemented or changed in the Australian public health care sector. The analysis should be presented in the formats of an internal report. (REFER UNDER FOR PROCESS CHOSEN FOR ANALYSIS)

The analysis should cover the following points:

1. The context, including any relevant (but very brief) historical background leading up to the process being implemented.

2. Process outline, including a brief description of what was actually implemented in terms of managing out with various parties.

3. The challenges and complexity for management, including but not limited to potential risks or problems and why there might be local variations in service delivery in what is supposed to be a coherent and consistent system.

4. Resource implications, including financial, associated with addressing the challenges.

5. Possible management strategies.

Notes for Assistance

ï‚§ Include in the report a definition of *****˜managing out*****.

ï‚§ Internal report needs to have the scope to cover all five points above. (The 5 points could also be used as headings- demonstrating the requirements).

ï‚§ Need to demonstrate an ability to cover the appropriate style, content and analysis.

ï‚§ When management strategies are developed they need to take into account the availability of such resources as:

ïƒ¼ï€ key staff with appropriate competencies

ïƒ¼ï€ operating funds

ïƒ¼ï€ capital funds

ïƒ¼ï€ capital equipment

ïƒ¼ï€ office space and fittings

ïƒ¼ï€ telecommunications

ïƒ¼ï€ other related agency needs

ïƒ¼ï€ appropriate policies

ïƒ¼ï€ standard operating procedures.

The existence and extent of these elements determine whether management has properly designed, sequenced and resourced the strategy.

ï‚§ The overall aim is to relate contextual understanding of trends in Australian public policy to a particular process of managing out and enable analysis of concrete problems entailed in managing out and to explore potential solutions.

ï‚§ Need to demonstrate clear understanding of the relationship between the managing out process and some of the main themes, concepts, problems and resources

ï‚§ Need to demonstrate ability to apply theoretical and contextual understanding to a concrete example.

ï‚§ Choose a process of managing out that gives scope to raise the issues. It is not the subject of the process that is important ***** it is analysing and managing the issues associated with the process.

ï‚§ Avoid lengthy descriptions of the process.

Comments

Has the public health sector (agency) *****˜outsourced***** a function previously managed in-house?

The *****˜outsourcing***** might have been to the private sector, the *****˜not for profit sector***** or even to another tier of government.

The assessment task is to identify, within the public health sector, the people and or the records of the outsourcing process.

The selected example then needs to be described, (who did what to whom, when and why and with what results) and an*****d, using the 5 points (described above).

THE PROCESS CHOSEN ***** to form the basis of the internal report

A background paper was previously prepared concerning this topic, yet it doesn*****t an***** a process of *****˜managing out***** ***** see background.doc

Prior to implementation of the National Health Reform (see 7 below) New South Wales (NSW) comprised 8 Area Health Services, including Northern Sydney Central Coast Health ***** in 2009 this Area Health Service undertook an Area-wide VMO Quinquennium Process (see 1 and 2) to reappoint VMOs to Hospitals within the Area. The process involves a required Committee *****Medical and Dental Appointments Advisory Committee (see 5). VMOs may be considered *****˜contractors*****, in that they are not employees of the organization.

As a result of the National Health Reform Agreement ***** the former Northern Sydney central Coast Health has been *****˜split***** into:

- Northern Sydney Local Health District

- Central Coast Local Health District

With each District now being governed by a Board ***** the Northern Sydney LHD Board has asked for a background paper on the VMO Reappointment process.

Write an Internal Report to the Northern Sydney Local Health District Board (see 10 and 6 below) concerning the Visiting Medical Officer (VMO) Quinquennium (reappointment) Process (to an***** the process used and provide lessons learnt).

To support this task in the former Northern Sydney Central Coast health a centralised unit was formed ***** the Senior Medical Staff Unit. ***** (see attach 1). The process undertaken was compliant with the NSW Health Policy (see 1 and 2 below and attach 2 and 3). From a governance perspective, at the time ***** accountabilities were:

- Director Medical Workforce (reports to) Director Workforce (reports to) Chief Executive (reports to) Director-General.

- Under the new National Health Reform Agreement the *****˜future***** of the Senior Medical Staff Unit is still in question ***** staff will have to be split to support the 2 Local Health Districts (no further resources are available). The Unit is currently based within the footprint of the Northern Sydney LHD though.

The process resulted in the appointment of 700 Visiting Medical Officers (Hi Nel, Using the former organisaton configuration (NSCCAHS approx 15,163 headcount) VMO*****'s make up approx 5.3% of the workforce (Headcount, 700 in quinquinnium ***** email from Director Workforce Informatics, 20 July 2011 to Nel Buttenshaw

1. Visiting Medical Officer (VMO) Model Service Contracts - http://www.health.nsw.gov.au/policies/pd/2009/PD2009_052.html

2. Visiting Practitioners Appointment

http://www.health.nsw.gov.au/policies/pd/2005/PD2005_496.html

3. Application for Appointment Senior Medical and Dental Practitioners

http://www.nscchealth.nsw.gov.au/employment/documents/seniormedicalpractitione-applicationforemployment.pdf

4. Annual Report ***** NSW Health 2009/10 (pg 293 for Northern Sydney Central Coast Health)

http://www.health.nsw.gov.au/pubs/2010/pdf/annualreport10.pdf

5. Corporate Governance & Accountability Compendium for NSW Health (pg 93 ***** medical & dental appointments advisory committee)

http://www.health.nsw.gov.au/resources/policies/manuals/corp_gov_compendium_pdf.asp

6. Local Health Boards Announcement ***** Minister*****s Media Release

http://www.health.nsw.gov.au/news/2011/20110701_00.html

7. Background ***** National Health Reform

http://www.health.nsw.gov.au/initiatives/healthreform/background.asp

8. Visiting practitioners and staff specialists delineation of clinical privileges policy for implementation

http://www.health.nsw.gov.au/policies/pd/2005/pdf/PD2005_497.pdf

9. Visiting Medical Officers*****' Fee-for-Service Agreement

http://www.health.nsw.gov.au/policies/PD/2005/PD2005_434.html

10. Northern Sydney Local Health District

http://www.health.nsw.gov.au/services/lhd/ns/index.asp#

*****

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