One hundred per cent of senior health service managers would be willing to consider changing their own working hour arrangements, for example, an extended day, weekend working or extended week, according to a HMI survey.
One hundred per cent of senior health service managers would be willing to consider changing their own working hour arrangements, for example, an extended day, weekend working or extended week, according to a HMI survey.
The survey revealed that 58 per cent of senior health managers believe that significant changes and savings can be made as a result of the Croke Park Agreement.25 per cent do not accept that the Agreement will result in significant changes or savings, while 17 per cent are not sure.
There was a divergence of views on the opportunities which it was felt are now available in the area of reconfiguring the design and delivery of health services. While a minority feel there are no opportunities, the majority view is that it will provide an opportunity to implement greater efficiencies. In this survey, as in previous ones, there is a demand for streamlining and properly integrating management structures and devolving decision making to local levels. There is also concern that opportunities could be limited as the reconfiguration is being driven from corporate level, resulting in confusion and uncertainty on the ground as to the way forward, especially in the wake of the departure from the service of a number of senior managers.
It is felt that clear objectives and open communication are required and that each manager should have a specific job description
It is felt that clear objectives and open communication are required and that each manager should have a specific job descriptionThere is support for the use of ICT and business process re-engineering to drive these savings and efficiencies and the removal of artificial boundaries which affect patient care. One respondent urged that lead hospitals should be determined with smaller hospitals and former primary care areas reporting into these hospitals, “which will lead to economies of scale and a more integrated service.”
When queried as to the role of the manager in implementing change within the health system, the majority view is that this is crucial, but at present is being restricted because of lack of clarity on the direction of the health service. It is felt that clear objectives and open communication are required and that each manager should have a specific job description.
Fifty per cent of respondents believe that they have the necessary supports/skills to implement the required changes in their area, almost one third believe that they do not have these necessary support/ skills and 17 per cent say they don’t know.
Asked if the Croke Park Agreement had been useful in their organisation in implementing change, over 40 per cent said “not yet,” about one third agreed it had, 17 per cent said it had not, while eight per cent said they did not know.
There is strong support for lead-in training periods or re-training for those who would be redeployed or relocated
Realistic changes to services, leadership and job satisfaction are the approaches which would encourage most people to redeploy or relocate, while 67 per cent say managers should get a say in the staff they get under redeployment. There is strong support for lead-in training periods or re-training for those who would be redeployed or relocated. There is also concern that redeployment/relocation could result in competence gaps, initial decreased efficiency in services due to lost learning and could be stressful for the individuals concerned.
It is felt that the recent exit packages have been rushed in and have left the service with major gaps in staffing, particularly in the absence of redeployment. There is also concern that has resulted in loss of organisational knowledge, uncertainty among staff, increased stress due to expanding roles and that the role of managers in delegating, empowering and motivating staff will be critical. Nearly 60 per cent would welcome an increased level of responsibility.
There is very wide support for the development of risk, safety and quality measures and for the involvement of senior management in this. Greater education for all staff, regular risk assessments and decision making closer to the point of service delivery are all urged.
