JOB DESCRIPTIONCARDIFF AND VALE UNIVERSITY HEALTH BOARD

JOB DETAILS

Job Title: Medical Director

Pay Band: As determined by the UHB Remuneration and Terms of Service Committee within the Policy Framework set by the Welsh Government

Base: Health Board Headquarters

ORGANISATIONAL ARRANGEMENTSAccountable to: UHB Chief Executive and Board for all strategic, professional

and regulatory issues for doctors and dentists (hereafter Doctors).

Reports to: Medical Director, NHS Wales, Welsh Assembly Government for professional advice and information)

Key Relationships:

UHB BoardSenior clinicians and clinicians across all sectors directors and management team Unified Public Health ServiceOther NHS organisationsLocal AuthoritiesLocal and national voluntary organisationsMembers of the Stakeholder Reference groupStaff representatives and trade unionsProfessional bodies and associations Patients / service users and their relatives/carers The publicCHCsLocal partnershipsIndependent ContractorsProfessional and regulatory bodiesEducational institutions (higher and further) Postgraduate DeanAdvisory CommitteesAMs. MPs, Ministers and WAG OfficialsMembers of the National Advisory Board and National Delivery Group

Our Values: ‘CARING FOR PEOPLE; KEEPING PEOPLE WELL’

Cardiff and Vale University Health Board has an important job to do. What we do matters because it’s our job to care for people and keep them well. Our values guide the way we work and the way we behave with others. Post holders will be expected at all times to behave in accordance with our values demonstrating commitment to the delivery of high quality services to patients.

JOB PURPOSE

The Medical Director will be responsible for medical leadership, building, motivating and developing a team of clinicians, to drive forward service transformation across the Cardiff and Vale UHB healthcare community. As an Executive member of the Board, the Director will hold corporate responsibility jointly with other Board members for the strategic direction, corporate policy making and development and delivery of UHB objectives. The Medical Director will provide strategic medical advice to the Board.

Particular key responsibilities will be to:

Ensure that the UHB makes a significant contribution to health improvement and the reduction of health inequalities.

Act as the principal source of medical advice to the Board and act as a professional lead for all doctors and clinical networks within the healthcare community employed by the UHB.

The Medical Director will be the nominated Responsible Officer for all doctors within the UHB as required by the General Medical Council.

Jointly lead on the clinical governance agenda, in conjunction with the Nurse Director and Director of Therapies and Health Science, for the overall discharge of clinical governance in the UHB.

Undertake the role of Caldicott Guardian, ensuring that systems and processes for safeguarding the quality of clinical care are in place and working effectively.

Provide leadership on the medical implications of service reconfiguration, clinical performance and conduct, medical education, research and development, senior doctor appraisal and validation across the health community.

Take national responsibility for certain aspects of health strategy and policy through an Honorary Associate Medical Director, NHS Wales appointment.

Create an environment in which excellence, research and development, public protection and patient safety can flourish to meet the challenges of the 21st Century.

Work collaboratively with Welsh Medical Directors and CMO on the development of pan‐Wales approaches to service quality and development.

KEY ACCOUNTABILITIES

Improving Population Health and Patient Services

Work collaboratively with the Executive Director of Public Health to ensure the Unified Public Health Service (UPHS) and other agencies support the Board in leading programmes to improve population health as well as the public health agenda.

Championing the change in emphasis from in‐hospital care to effective prevention, early intervention and long‐term community based support.

Drive the redesign and modernisation agenda across the healthcare community.

Lead and foster effective clinical leadership so that the UHB provides safe, high quality, acceptable care for patients / service users in accordance with NHS standards for services in Wales, within the resources available.

Initiate and facilitate effective partnerships and alliances between the UHB and other agencies, so as to influence the agendas of these bodies and to draw on their experiences and perspectives in creating local NHS and community strategies, policies and actions, to deliver long‐term health improvements.

Delivery of an integrated healthcare system across primary, secondary and community sectors by working with the Director of Primary and Community Care and Mental Health Services and the Director of Public Health; providing leadership and management of the integration of the various components of the UHB, to develop a unified organisation which delivers a service that:

o delivers improved population health and wellbeing;o 1000 Lives Campaigno reduces inequalities; ando improves patient safety.

Motivate all clinical staff to benchmark services continuously against best practice evidence, research and audit, to ensure high quality standards of patient care.

Foster a culture which embraces and recognises the opportunities for the utilisation of new clinical and service technologies.

Performance Ensure effective clinical and managerial structures are in place to achieve the

financial and corporate objectives set for the UHB, ensuring the effective, efficient and economical use of resources in achieving planned activity and delivery of all required performance targets.

Take strategic responsibility for service and policy development, particularly relating to national or regional initiatives and directives from the National Institute of Clinical Excellence (NICE), Health Inspectorate Wales, the Annual Operating Framework and the Local Delivery Plan.

Ensure the development of clinical information strategies, to assess health needs and to support evidence based decision making.

Responsibility for effective local systems, which will enable individual doctors and clinical professionals to discharge their professional obligation to report clinical colleagues if there is cause for concern, or reason to believe that their conduct, performance or health might present a threat to patients / service users as outlined in 'Duties of a Doctor' and to raise these concerns in confidence.

Responsibility for ensuring that effective clinical audit processes are in place.

Strategic Development and Partnership Working

Engage with and promote co‐operation and collaboration with other organisations, to develop strategic partnerships and alliances to improve the health of local communities and ensure effective partnership working.

Actively support the development of effective strategic links between health service planning and delivery and the public health function.

Support the development of a culture of public involvement that is open and transparent, ensuring that users, carers and the general public’s views are effectively represented and appropriately incorporated into decision making across the UHB.

Develop effective relationships with the CHC’s, Professional Fora and Stakeholder Reference Groups, to ensure strategic plans are developed with full cognisance of their views.

Governance

Develop effective organisational arrangements and capacity that enables the UHB to meet its strategic aims within a framework of strong, effective governance. This should be consistent with the standards of good governance set for the NHS in Wales, which are based on the Assembly Government’s Citizen Centred Governance Principles.

Responsibility and accountability for all medical clinical governance issues and shared responsibility with the Nurse Director and Director of Therapies and Health Science for the overall discharge of clinical governance in the UHB.

Ensure a robust and clearly understood approach is taken to clinical governance, including Clinical Risk for the UHB.

Establish clear lines of accountability and ensure that all relevant clinical staff are managed, supervised and trained appropriately with regard to clinical services, managing through a strong governance framework and in accordance with the regulatory requirements

Improving whole system clinical governance to ensure that effective clinical governance is in place across the whole patient journey, including the interface between primary and secondary care.

Monitor the quality of patient care against national and local indicators. Establish appropriate working relationships with relevant local representative organisations.

Improving the quality of prescribing by giving expert medical support to the Prescribing Advisory Team and others as required.

Co‐ordinate inspections by external bodies including the Royal Colleges, the Deanery and response to National Confidential Enquiries. The Medical Director will advise the Trust Board of the outcome and implications of external inspections and will ensure that recommended actions are implemented.

Ensure a proactive approach to risk management, including the systematic, identification, assessment and management of risk.

Contribute to the development and continued operation of a framework of strong, effective governance, consistent with NHS values in terms of safety, openness, probity, and accountability.

Leadership of the Medical Profession

Establish and head up a strong team which will provide clinical leadership.

Develop processes, which ensure the optimisation of clinical leadership, full engagement and commitment of all clinicians, to deliver improvements to patient accessibility and clinical outcomes.

Develop an organisational culture that supports clinical engagement in decision making and a drive for continuous service change and improvement to deliver high quality, safe services in the new environment.

Facilitate the development of an organisation, which encourages personal development and learning; encourages and supports innovation; team building and creative partnerships and a commitment to patient safety.

Improving the quality and scope of health outcomes achieved by primary care, by means of ensuring that the benefits of the new General Medical Services contract are realised. This includes the process of verifying the Quality Outcome Framework, or any successor contract.

Advise the Board on the impact of legislation, and national policy on the UHB’s

ability to deliver services e.g. European Working Time Directive, Modernising Medical Careers, the implementation of the amended Consultant Contract, SAS Contract, GP Contract and the introduction of reduced working hours.

Provide advice on medical staffing issues, having regard to statutory requirements and national and local policy and guidance. This includes the implementation of national policy, directives and the use of clinical indicators, to ensure safe and appropriate standards in medical practice.

Take a lead role in the resolution of any employment matters for the UHB medical staff, working closely with the Director of Workforce and Organisational Development. This relates to conduct, capability, competence or performance and to manage the exclusion and disciplinary procedure for medical and dental staff, on behalf of the UHB, ensuring that there are appropriate processes in place to embrace all medical and dental staff across the UHB area

Ensure that job planning and appraisal for senior doctors is conducted to a high standard.

Ensure that appraisal and job planning for senior doctors and dentists occurs and is carried out to a high standard with clear objectives being given, which meet the

needs of the doctor/dentist, the UHB and cognisant of validation requirements, liaising with the GP appraisal coordinators as and where appropriate.

Ensure effective medical workforce planning in order to provide the appropriate level and mix of skilled to address the health needs of the UHB, both now and in the future

Act as a communication channel between the UHB and the Welsh Government, the office of the Chief Medical Officer for Wales, the General Medical Council, and National Clinical Assessment Service.

Manage regulatory and performance issues within all medical staff groups.

Education, Research and Development

Ensure that standards of postgraduate medical education and training meet national requirements and contribute to the successful recruitment and retention of doctors in training, across all areas of healthcare.

Maintain and develop links with Higher Education Institutions, ensuring robust communication takes place with the Postgraduate Dean and Royal College Advisors on postgraduate training issues and the Medical School. Ensure that all recommendations from external visits have an action plan and that these are implemented.

Oversee processes for the delivery of undergraduate education In conjunction with Undergraduate Organisers

Ensure that appropriate medical education is in place for doctors in training and for all career grade doctors within the UHB.

Lead the UHB’s research and development agenda to ensure that outcomes of relevant research are assessed within the UHB. This will include fostering an evidence based culture by working with clinical colleagues to ensure appropriate use of research evidence in order to improve practise and service delivery.

Work with Universities and Postgraduate Dean to facilitate teaching and training and to ensure collaboration on strategy and delivery in R&D.

Take a key role in the Research and Development strategy, either directly or, by working closely with the R&D Director

Ambassador for the UHB

To contribute to NHS Wales strategy development and delivery and to actively engage in work at a national level.

As one of the cadre of senior leaders within Wales, to contribute to the wider health and organisational agenda of NHS Wales and Welsh Government.

The Medical Director will act as an ambassador of the UHB and NHS Wales.

OTHER RESPONSIBILITIES

The post holder may be required to undertake other relevant duties, including the operational lead for specific services and localities, as required by the Chief Executive.

PERFORMANCE APPRAISAL

Performance will be appraised and objectives agreed on an annual basis with the UHB Chief Executive and the Chief Medical Officer, Welsh Government.

MEDICAL DIRECTOR PERSON SPECIFICATIONCARDIFF AND VALE UNIVERSITY HEALTH BOARD

Qualifications

Qualified Medical professional. Unblemished registration with GMC. Evidence of continued professional development. Post graduate medical qualifications. Further evidence of management training and a commitment to ongoing

professional development.

Experience and Knowledge

Must be or have been a practising GP or worked at Medical Consultant level. Clinical Governance. Medical Management Significant organisational change experience / managing difficult and complex

change. A track record of achievement in:

o Effective performance management;o Introducing robust systems and processes; ando Facilitation of groups.

Undertaking sensitive negotiations. Successful initiation and facilitation of strategic partnership working and alliances. A good understanding of the health and social care management environment in

Wales and of roles and responsibilities within it. A good understanding of national targets. A good understanding of performance management methodology. Developing an organisational culture that promotes clinical engagement in

decision making and leading continuous change and improvement in services, encouraging the use of new clinical and service technologies.

The Safety and standards agenda. An understanding of the principles of Public Health Medicine that are relevant to,

and underpin the work of the UHB.

Abilities and Personal Qualities

Innovative, with strong service focused approach, exceptional communication, interpersonal, negotiating and influencing skills.

Ability to think and act strategically and to articulate a clear sense of direction and vision to a wide audience.

Ability to build effective relationships with a range of internal and external stakeholders.

Demonstrable leadership and ambassadorial skills with an ability to demonstrate a flexible leadership style.

Commitment and passion for citizen focused service with the ability to embed such an ethos at all levels of the organisation.

High level of;o Negotiating skills;o Interpersonal skills; ando Communication skills.

Ability to contribute to policy development. Decisive leader, capable and committed to translating policy and analysis into

practical actions. Strong prioritisation skills with the ability to manage competing demands. High degree of analytic skills. High degree of report writing skills. Team player with experience of managing teams. Ability to deal with the media.

NHS Wales Medical Director – Behavioural Competence StructureDrawn from NHS Wales Leadership Qualities Framework, NHS Wales Executives Behavioural Competency Structure and other strategic documents.

Setting DirectionSeizing the futureThinks and acts for the future.

Acts now to articulate, shape and implement a compelling, shared vision that takes current service developments into a coherent future strategy.

Acts quickly and decisively in a crisis and builds new programmes and capabilities rapidly.

Introduces flexible, innovative approaches to achieve service improvements and promotes organisational ability to cope with change and shape the future.

Leads continuous service improvement, encouraging the use of new clinical & service technologies

Intellectual flexibilityHandles information and clarifies complexity.

Synthesizes, reframes and prioritises complex demands, consequences and critical points from a mass of disparate and conflicting data

Demonstrates ability to move between significant detail on the ground and the strategic big picture, modifying plans and actions to take account of new/diverse views, information and standpoints.

Interprets complex medical workforce strategic agenda into action on the ground.

Broad scanningGathers information from a wide range of sources.

Checks what is happening on the ground, asking patients / service users, their carers and staff about their experience of services and is visible and accessible at all levels – “walking the talk”.

Actively seeks out diverse viewpoints, promoting inclusivity. Purposely uses wider networks to keep up with developments in

medicine, health, social care, housing, and education, building relationships with partners, clinical and academic colleagues.

Political AstutenessUnderstands the politics / power bases.

Builds consensus alliances through purposeful engagement with key networks of interest groups and influencers to shape and deliver change.

Demonstrates understanding of complex stakeholder networks and ensures actions take account of political sensitivities in building agreements.

Balances political, professional, technical, financial and cultural considerations to achieve change.

Drive for resultsSustains a focus on improving performance to meet challenging goals.

Focuses and clarifies objectives and boundaries and is goal focused, resisting any pressure to be deflected from achieving quantifiable service improvements.

Takes calculated risks within integrated governance, to achieve longer‐term service improvements creating enduring benefits of improved healthcare for patients / service users and carers.

Wants to make a real difference to people’s health and well‐being by delivering a high quality service and by developing improvements to service.

Uses a range of strategies to shift the organisational emphasis from in‐hospital care to effective prevention, early intervention & long term community based care

Ensures high standards of medical care, using audit and clinical information strategies to demonstrate quality outcomes for patients and their carers.

Financial LeadershipEnsures sustainable financial viability and most effective use of resources to achieve strategic aims.

Contributes to the management of financial flows in the UHB to deliver short & long term objectives.

Focuses use of resources on achieving the future vision of the organisation, advising on the impact of diverting resources from current programmes to invest in development and change.

Demonstrates financial literacy/quantitative problem‐solving skills. Contributes to the delivery of agreed recovery plan and contributes to

resolving deficits Ensures a high standard of financial management and control, with

financial systems / procedures promoting the efficient and economical conduct of business, safeguarding financial proprietary, governance and regularity throughout within the organisation.

Delivering the ServiceLeading change through peopleMakes change inclusive mobilising people’s energy and commitment

Engages others as partners in developing a shared vision within the organisation and across the local health and social care and academic community to achieve buy‐in and commitment.

Aligns efforts and shares leadership and power to achieve integrated service improvements, winning and retaining the respect of other clinicians.

Builds organisational frameworks for continuously improving quality and safeguarding high standards of care supporting others who lead implementation.

Builds effective clinical leaders and teams, removing obstacles to effective working. Holds team members to account through stretching performance and rewards systems.

Holding to accountPromotes a high performance culture.

Accepts personal responsibility for the medical workforce, holding others directly accountable for delivering what has been agreed, both within and outside of the organisation

Intervenes swiftly and consistently to address poor performance or inappropriate behaviour where this is impacting on patient safety and effective service delivery. Challenges and confronts conflict affecting service standards or safety, brokering agreement.

Embeds the duty of providing high quality patient / service user care throughout the organisation, ensuring that the Board receives reports on quality and safety and that appropriate action is taken.

Provides high quality advice to the Board on all matters relating to medicine.

Ensures statutory and regulatory aspects of medicine are delivered, including validation requirements for all doctors.

Empowering othersFosters independence.

Delegates effectively, securing resources as required and providing space for others to be creative.

Takes risks with others, coaching their development using failure as an opportunity to learn.

Explains clearly and concisely the reasons for plans and actions to affected people, stakeholders and partners and listens and acts on responses.

Leads the investment in talent management, ensuring that appropriate development processes are in place for the medical workforce (including succession management). Coaches and mentors others to help them maximise their contribution.

Nurtures doctor’s ability to lead and encourages the development of clinical leaders

Effective and strategic influencingUses range of influencing strategies.

Uses a range of effective influencing strategies that will bring about desired outcomes and long term change in health services, building and using extended networks of influence.

Gains commitment and credibility from the local community through responsive involvement of local people, staff and other agencies in shaping local health priorities and strategy.

Champions the organisation in external forums e.g. local authorities, Government bodies and national organisations and represents both the organisation and the medical profession at local, national and international level.

Collaborative workingEngages constructively with internal and external stakeholders.

Creates the conditions to promote sustainable partnerships and works closely with health, social care and academic partners on all important investment decisions to ensure joined up action which creates enduring benefits for stakeholders.

Leads the shared duty to engage the public and other bodies in planning and monitoring services and is informed on the current and changing priorities of partners, modifying own plans in order to seek “win‐win” outcomes.

Demonstrates effective management of relationship with Chief Executive, Chair and Board members, jointly creating cohesive strategies for delivering world class health care.

Personal QualitiesSelf beliefInner confidence to succeed.

Takes on stretching challenges that some peers may back away from. Constructively challenges others, regardless of position or status. Willing to take tough decisions and is openly optimistic about

achievement of goals. Stand up for what they believe in, speaking up and have a can do sense

of confidence. Makes the care of people first concern, treating them as individuals

respecting their dignity.Self‐awareness Understands the nature and cause of own emotional reactions to

particular situations and takes account of the likely implications and impact of own behaviour.

Understands own emotions, strengths and limitations.

Role models effective behaviours and shows understanding of own strengths and limitations in providing leadership that makes a difference to patients / service users, carers and staff.

Self‐managementManages own emotions and demonstrates resilience.

Manages responses and reactions consistently when under pressure remaining calm in a crisis and without transferring unnecessary stress on others.

Takes conscious steps to manage own emotions and absorbs and deals constructively with criticism and performance feedback.

Models a healthy approach to work / life balance, having a range of interests outside of work.

Personal integrityCommitment to openness, honesty, inclusiveness and high standards.

Stands up for that which is consistent with stated NHS values and delivers on own commitments even when this is difficult and there may be personal cost.

Acts as a consistent role model for engaging staff, patients / service users and other stakeholders at all times, taking a fair and inclusive approach to decision making within a framework of integrated NHS governance.

Open, and honest, acts with integrity and uphold the reputation of the medical profession. Requires and expects others to be open and honest in their communication.

Works with others to protect and promote the health and wellbeing of patients / service users, their families and carers, and the wider community.

Provides a high standard of practice and care at all times, respecting people’s confidentiality.

Professional IntegrityCommitment to the medical profession and to standards of conduct and ethics

Models a professional approach to medicine and maintains practical competency and credibility.

Accountable for actions and omissions in personal clinical practice and is always able to justify own decisions.

Always acts lawfully, whether those laws relate to own professional practice or personal life.

Maintains clear professional boundaries with those in their care or anyone close to them.

References: NHS Wales ‐ Leadership Qualities Framework (“LQF”) ; NHS Wales Chief Executive Development Center ‐

Competence Framework Welsh Assembly Government ‐ Accountable Officer Memorandum for Chief Executives of NHS Trusts Welsh Assembly Government ‐ Accountability, Performance and Development Handbook for NHS Wales

Chief Executives Welsh Assembly Government – “One Wales” Welsh Assembly Government – Consultation Document on Reorganisation LHB NHS Institute for Innovation and Improvement – Leadership Indicators NHS England ‐ Competence and Experience Framework for Chief Executives NHS Wales & IHM ‐ Leadership Framework; Audit Commission Report ‐ Financial Failures in NHS Trusts, Department of Health UK ‐ Kennedy Bristol Inquiry Report on Care of Children; Leadership Roles in Meeting the Challenge of Change ‐ University of Leeds Review Of Leadership Theory And Competence Frameworks ‐ Exeter University Centre for Leadership

Studies Seven Leadership Leverage Points ‐ Institute for Healthcare Improvement (MDcomp framework v2 0309