Case Studies

NHS Medical Workforce Planning

Jane Riley of JAD Associates, in collaboration with a Turnaround Finance Associate responded to a request from an NHS Strategic Health Authority client for a focused piece of work to deliver a three to five year medical workforce plan for the Region. Medical (doctors and dentists) workforce planning has historically been patchy or non-existent at a Local level across the UK, as most such planning has usually been carried out at National level with little Regional input. This project was therefore commissioned as a first step in seeking to significantly improve medical workforce planning for this particular Strategic Health Authority.

The initial approach was to write a business case for conducting the project whereby the local health authority Workforce Leads were consulted and a facilitation approach was endorsed. There was generally a high level of enthusiasm for the project as needed doing. As the final conclusion of the Business Case was that the project could potentially become quite large, a modular approach was recommended and JAD Associates was subsequently engaged onto Module One of the project, the Mechanical Projection.

The Mechanical Projection was a forecast of what might happen in the absence of any actions designed to alter the outcome. It included:

gathering data on the current workforce profile;

initial validation and checking;

applying a consistent format to support subsequent modelling;

deriving the ratios, assumptions and medical workforce drivers;

building a model using financial modelling techniques;

producing a initial projection of where requirements were heading; and

workshops to validate the projection with the Workforce Leads

The key outcome at the end of this module would be a baseline snapshot of what the Region had now in terms of medical workforce and what the requirement would be in the absence of any policy initiatives. This snapshot would be without opinion.

One of the primary outputs from this Module was the learning that was achieved, particularly with respect to the modeling approach, communication processes and data sources, and the Strategic Health Authority was keen to capture this experience to inform and build on in subsequent Medical Workforce planning exercises. The Client commented: The brief changed along the way as data was collected and analysed, raising different questions. The JAD Team was flexible and responsive to those changes.

Key conclusions of the Mechanical Projection indicated:

The drivers behind growth in the medical workforce extended beyond those used in the modeling exercise, productivity, changing technology and work practices or changes in work patterns (such as restrictions imposed under the European Working Time directive for example);

There appeared to be no link between demand (i.e. the needs in relation to workforce growth in terms of numbers or balance between specialties) and supply coming through the training system. The supply systems therefore appeared to work independently of any future projection of demand;

There appeared to be no consistent understanding or Region-wide approach to other factors affecting workforce planning such as the impact on demand of leavers / joiners to the system through retirement, natural wastage, turnover etc. Information gathering throughout the execution of the project was a complex, inconsistent exercise

At the outset of the project it was agreed that Medical workforce planning is acknowledged to be difficult because there are many stakeholders and partners and communication or interaction between them is considered insufficient. During the execution of Module One JAD Associates certainly encountered all these problems and more. Nevertheless, significant progress was made in producing a baseline snapshot of the Regions Medical Workforce which could now be built on and expanded. The client commented that the project represented value for money and It took us on the first step on the way to solving our problem which is what we requested. We would be very happy to use JAD Associates again and recommend to others.

Management of Change in a Fabrication and Manufacturing Business

Jane Riley of JAD Associates was asked by the Managing Director of a fabrication and manufacturing business to advise on steps to be taken in restructuring the factory in order to maximise efficiencies in light of changing customer demand.

As a first step Jane reviewed all the personnel files and catalogued the history and processes in place. In conjunction with the client Jane then developed a bespoke redundancy programme for the business, starting with a voluntary programme, aimed at easing the immediate financial burden on the Company and paving the way to a restructuring of job roles and processes to take place in line with new product lines being developed. As Jane provided step by step guidelines, the Client was then able to manage this process with minimal telephone consultation with JAD Associates subsequently.

The Client commented: 'Jane's attention to detail, knowledge of her subject and her reliability ensured a very effective solution for our business. I would thoroughly recommend using JAD Associates to others.'

ISO 17025:2005 Certification for a Specialist Calibration Laboratory

As a result of changes in management personnel,David Riley of JAD Associates was requested to review the position of the certified management system used in a Specialist Calibration Laboratory. The key brief was to ensure that the laboratory would continue to maintain its UCAS accreditation, produce a gap analysis and, where deficiencies were found, manage the corrective and preventative actions necessary.

Short comings were identified in the systems used for internal auditing, the management of feedback and non conforming work, and how management reviews were carried out.

Under David's guidance, a comprehensive, yet operationally focussed internal audit programme and findings reporting system was initiated and carried out prior to a surveillance visit by UKAS.

A focussed Management Review was also suggested to the laboratory with short and concentrated monthly meetings that were no more than an hour long and which are designed to look at the ongoing and operational issues. An annual Management Review was also scheduled to review the overall trends and strategic needs of the Laboratory.

The changes to the laboratory management system were easily accepted by all levels of staff and were fully compliant with the ISO17025:2005 standard. They were no longer perceived as 'getting in the way', and have improved the laboratory processes significantly.

The auditor from UKAS commented that it was plain to see that 'the laboratory had gone through a step change improvement'.

Health, Safety and Environmental Management Systems in a Food Supply Chain Company

David Riley of JAD Associates was contracted to review the health and safety arrangements of a growing Food Supply company in Lincolnshire.

A full and detailed compliance audit was carried out and documented to identify all applicable regulations and Safety risks for the organisation. With a clear understanding of the needs and direction of the business, a detailed suite of policies and procedures were subsequently put in place.

In order that staff would appreciate the common sense approach of the procedure requirements a basic training programme was developed for all current staff and all new recruits to the organisation. This programme involved Manual Handling issues as they affect the company, Workplace Transport issues, Office Ergonomics and Work related travel.

JAD Associates now carry out retained Heath and Safety responsibilities for the company that include the analysis of accidents and near hit accidents, the update of legislation and annual audits.

Failure Investigation and Analysis of Hydraulic Pump Bearings

David Riley of JAD Associates was asked to inspect, investigate, analyse and report on a number of bearing failures that had occurred in a critical application used to supply hydraulic oil to lubrication and control systems in a primary pumping system.

David was asked to witness a set of stripped parts, participate in two further strip downs on site and to report on further components supplied by the customer.

The findings of the investigation led to issues with the viscosity of the pumped medium, the compatibility of the greases used within the pump bearings and also the fitting arrangement of a number of the bearings.

On completion of the bearing investigation the Engineering Project Manager for the maintenance company involved stated that JAD Associates had been able to take the investigation down avenues that they would not have considered and that these avenues proved subsequently to reveal facts that would prevent future problems and failures