Category: Uncategorised

Have you ever seen a model ship in a bottle? How do they do that? It obviously doesn’t fit through the bottleneck. So, how do they get it in there?

Like most things, creating the ship in a bottle requires the right knowledge, skills and attitude. First of all, you need the knowledge of the process and how to pull it off. Second, you must acquire a set of skills ranging from designing the model through to having a very steady hand and using tools in confined spaces. Success also depends on having the right attitude, including a great patience and perseverance for when you slip unexpectedly or get stuck in the wrong place.

What’s that got to do with resident doctors?

In a recent interview, Philip Banfield, the BMA’s chair of council, discussed the “mess” of the current UK training system which “bears no relationship to the workforce needs.” He illustrated this with the example of training in anaesthetics. Last year there were several thousand applicants for just a few hundred training posts at a time when the UK has a shortfall of around 1,900 qualified anaesthetists.

Data published by the NHS, illustrate that competition rates for doctors seeking to secure a training post are increasing at an alarming rate:

• There was an average of 4.7 applications for each available post
• For Emergency Medicine (ACCS) CT1/ST1 the competition ratio was 7.6
• For CT1 Core Psychiatry Training it was 9.5
• Clinical Radiology ST1, 11.9
• Ophthalmology ST1 had 14.4 applicants per post
• Public Health Medicine ST1, 17.5
• Neurosurgery ST1 was 19.7
• And what about competition for Cardiothoracic surgery ST1? There were over 45 applicants for each available post.

Now consider these figures in conjunction with the well documented shortage of qualified consultant grade doctors, with the direct impact this is having on waiting lists and locum costs. It’s very clear there’s a restrictive bottleneck in the training and workforce planning system.

Any job selection process is effectively a competition. Unfortunately, the data can make the process of applying for and securing a training post seem more like a lottery.

So, how do you give yourself the best chance of winning?

Well, to win a lottery, you need to buy a ticket. The more tickets you buy the better chance you have of winning. That logic may well be one of the factors that is impacting the data. It would appear that numerous doctors making multiple applications is inflating the competition rates for some programmes. That may well be true, but the bottleneck still exists.

So, how can you give yourself the best chance of squeezing through the bottleneck and onto the training programme of your choice?

Let’s go back to getting the ship in the bottle.

You give you best chance by focusing on acquiring the right knowledge, skills and attitude.

Yes, you need acquire the appropriate base level medical knowledge, but bear in mind that it’s highly likely that every other applicant will have that too. So you need a bit more. You need to have knowledge of the system. For example, what are the scoring criteria for being shortlisting candidates for the training programme you are interested in? We provide links to reliable sources of information in our various blog posts and free information.

Once you know what’s required, then you can set about gaining the appropriate skills and experience. Again, this is more than direct medical or surgical skills. Dependent on the programme you are applying for, you are likely to improve your chances through evidence of participation in audit, contributions to publications and for training and experience in teaching. When it comes to the interview stations, you may well need to excel in a patient communication scenario or delivering a presentation.

Next, let’s think about attitude.

You will improve your chances if you are proactive and do the right things for the right reasons. Don’t wait to be asked if you want to participate in an audit or in developing a poster or research paper. Make enquiries in your current post about how you can contribute. Don’t just take courses to get points to tick a box. Take useful courses that will genuinely support your development. And don’t wait to take courses at the last minute. Take your Teach the Teacher, leadership or communication skills course sooner rather than later. That way, you have the opportunity to put what you learn into action and gain genuine experience. You will then be well placed to share those experiences, to demonstrate you knowledge and abilities when it comes to the interview stages.

If you’re involved in supporting resident doctors who are aspiring to securing a training post, then you will do well to encourage them in this direction.

And if you are one of those resident doctors, what steps are you taking to give yourself the best chance of squeezing through the training bottleneck?

Stephen McGuire – Managing Director

By Professor Dr Jacqueline Baxter. Professor of Public sector leadership and management.

Jacqueline Baxter is professor of Public Leadership and Management at The Open University UK and a longstanding member of Oxford Medical’s Faculty of Tutors. Her research interests lie in the areas of leadership emergence, leadership strategy and identity, plus online teaching and learning. You can find her on LinkedIn at: https://www.linkedin.com/in/professor-jacqueline-baxter-53206a12/

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Remote meetings are, in my experience, often poorly chaired, lack structure and value and take up employees valuable time. Since the pandemic, meetings often run back-to-back, meaning people arrive in them unprepared and still thinking about the last meeting. In addition, meetings have increased as the time it takes to get from one to another has now been eradicated, along with the thinking and down time this used to provide.  A good question to begin with is why are we having this meeting and what do we hope we are going to achieve ? Not all meetings are necessary. Some meetings can be avoided by other means of discussion – Padlets that illustrate others’ thoughts in a productive way, online polls etc.

But if you do have to have a meeting, just like any other type of remote interaction, remote meetings take thought and preparation. Some of the ways that you can make your meetings better are outlined below:

Setting a clear agenda and stating why this meeting is necessary

People often do the former and forget the latter! Have you made it clear why people should be attending your meeting? I have often been in meetings where I have felt completely redundant. Either because the topic was out of my scope of interest, or because no one actually asked my opinion throughout the whole 2 hours! Or stated why it might be relevant.

A clearly defined agenda is fundamental to the success of remote meetings. Chairs should communicate the purpose, goals, and structure of the meeting in advance, ensuring participants understand their roles and what is expected of them (Mroz et al., 2018). Providing a detailed agenda enables attendees to prepare effectively and fosters a sense of accountability. Define who is accountable for what, preferably before the meeting. Which brings us to …

Getting people psychologically into the room!

Yes they are there, their cameras are on and their faces are on screen, but are they there? Compacted schedules due to increased online meetings are common now, across the public services. Leaders report back-to-back meetings from 8 am until 6pm, leaving precious little time for anything else. If you are dealing with back-to-back meetings, chances are that you will still be thinking about the last one, when you come into this one…

How can you, as chair, set a question before the meeting, that gets people into the room? Or create a short mindfulness exercise to give people the space to reflect on the subject of their current meeting.

Establishing your ground rules

Setting clear ground rules regarding punctuality, muting microphones, and minimizing multitasking can help maintain focus. Research by Rogelberg et al. (2006) highlights the importance of meeting norms in enhancing group cohesion and productivity. For example, if you want to see people interacting ask for cameras on when they are a) either asked a question or b) respond to a question. Using the chat box can be handy if you want to get a response from everyone, but take care, you need to outline that this is what chat is for. If you are using breakouts for a meeting, make sure everyone is familiar with what happens when you put people into a group – if they are not, they may suspect a tech malfunction and leave!

Utilising tech effectively

Leveraging appropriate tools and platforms is critical for remote meetings. The chair should ensure that the chosen technology supports the meeting’s objectives, whether it involves video conferencing, shared documents, or interactive polls. According to Dennis et al. (2008), the alignment of meeting tools with the task at hand improves efficiency and participant satisfaction. Polls, quizzes and other apps can enhance collaboration (Baxter, 2024) and encourage quieter members of the group to voice opinions in a safe space. Which leads us to…

Encouraging inclusivity and participation

Remote meetings can amplify the challenges of unequal participation; for example, introverts can ‘disappear’ in larger meetings. Chairs can actively encourage all attendees to contribute by directing questions to quieter participants and acknowledging their input. They can also use names (much easier in the remote environment), enhancing psychological buy in (Cutler et al., 2021). This approach aligns with the findings of Pentland (2012), who demonstrated that inclusive communication patterns lead to more effective collaboration.

Preparing people in advance helps with engagement. If they haven’t had time to read the papers, give them time in the break and don’t be afraid to juggle the agenda items accordingly. Remember the meeting needs to be worth your time and others, so do what you have to make it so !

Managing time effectively

I become really worried if I don’t know when my breaks will be in a meeting. I also become tired, frustrated and start looking through my emails if the chair doesn’t outline when the break/s will be.

Time management is particularly crucial in remote settings where attention spans can wane. There is plenty of evidence that indicates that attention spans in remote environments are short. Allocating time for each agenda item, monitoring adherence to the schedule, and ensuring discussions remain focused are all parts of a remote chair’s job. Paying attention to people who have switched off cameras or are clearly scrolling the internet, is also part of the mix. Of course you can’t force people to engage, but you can create an environment where it becomes more likely that they will.

Effective time management not only increases productivity but also respects participants’ time constraints (Leach et al., 2009). Plentiful comfort breaks that are outlined from the start, can help with individuals’ management of meetings and colour their expectations and experiences. If a meeting looks likely to go on outside the given time, ensure that you alert people to this at the earliest opportunity, ideally at least 15 mins before the originally scheduled end point. This helps you reach agreement on whether to either extend the meeting, or carry points forward to another time. There is little worse than people ‘dropping off’ a call, leaving you sitting alone in the room…

Monitoring engagement online

Non-verbal cues are harder to read in remote meetings, making it essential for chairs to monitor engagement through active questioning and periodic check-ins. Research by Allen et al. (2015) suggests that maintaining engagement requires a combination of verbal interaction and visual aids, such as slides or screen-sharing. However, bear in mind that slides take up screen space – if people are joining by phone or tablet this will limit interaction. Polls do a good job of monitoring interactions, by providing a visual representation of people’s thoughts. The humble chat box can also be used for this, although you should make clear what you want the chat box to be used for at the beginning of the meeting. I have been in meetings where individuals were criticising the chair, in the chat box!

Providing summaries and action items

As with any meeting, the chair should conclude the meeting with a summary of key points and clearly defined action items. This practice ensures accountability and aligns with the recommendations of Cutler et al, (2021), who emphasise the role of follow-ups in sustaining meeting effectiveness.

Fostering a positive atmosphere

Finally, a positive and supportive tone set by the chair can influence the overall meeting atmosphere. Encouragement, humour, and expressions of gratitude contribute to a collaborative and motivated group dynamic (Fredrickson, 2001).

Conclusion

The chair’s role in remote meetings extends beyond mere facilitation; it involves creating an environment that fosters collaboration, inclusivity, and productivity. By setting clear agendas, utilising technology effectively, and ensuring participation, chairs can add significant value to remote meetings, benefiting both the attendees and the organisation as a whole.

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References

Cutler, R., Hosseinkashi, Y., Pool, J., Filipi, S., Aichner, R., Tu, Y., & Gehrke, J. (2021). Meeting effectiveness and inclusiveness in remote collaboration. Proceedings of the ACM on Human-Computer Interaction, 5(CSCW1), 1-29. \

Dennis, A. R., Fuller, R. M., & Valacich, J. S. (2008). Media, tasks, and communication processes: A theory of media synchronicity. MIS Quarterly, 32(3), 575-600.

Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218.

Leach, D. J., Rogelberg, S. G., Warr, P. B., & Burnfield, J. L. (2009). Perceived meeting effectiveness: The role of design characteristics. Journal of Business and Psychology, 24(1), 65-76.

Mroz, J. E., Allen, J. A., Verhoeven, D. C., & Shuffler, M. L. (2018). Do we really need another meeting? The science of workplace meetings. Current Directions in Psychological Science, 27(6), 484-491.

Pentland, A. (2012). The new science of building great teams. Harvard Business Review, 90(4), 60-70.

Season’s greetings from all at Oxford Medical Training!

Over the festive period, you can make purchases, book spaces on courses and access your online courses via our website as normal. If you need to contact us for any reason, here is a list of our office hours over the 2 week holiday period, (all times GMT):

• Monday, 23rd December, 08:30-17:00
• Tuesday, 24th December, Christmas Eve, 08:30-15:30
• Wednesday, 25th December, Christmas Day, CLOSED
• Thursday, 26th December, Boxing Day, CLOSED
• Friday, 27th December, CLOSED
• Saturday, 28th December, CLOSED
• Sunday, 29th December, CLOSED
• Monday, 30th December, 08:30-17:00
• Tuesday, 31st December, Hogmanay, 08:30-15:30
• Wednesday, 1st January, New Year’s Day, CLOSED
• Thursday, 2nd January, 08:30-17:00
• Friday, 3rd January, 08:30-17:00
• Saturday, 4th January, 08:30-12:00

You can book courses, purchase materials, and access your online courses through our website as normal during this time.

If you contact us by email ([email protected]), then we will receive your message and respond when we return.

Should you have any urgent queries before that time, then please call 0131 526 3700 and leave a message. We operate a monitored out-of-hours answerphone service and will respond as appropriate.

Our Frequently Asked Questions page provides answers to the majority of queries we receive and may quickly provide you with the information you need.

Have a peaceful and happy festive period and we look forward to a fantastic 2025.

In this short video, Ella, who is a member of our Resident Doctor Panel, shares how she has been preparing to apply for a post on a higher training programme.

The course which Ella refers to in her video is our Teach the Teacher Course for Doctors.

Our Resident Doctor Panel is a small group of doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more about the Oxford Medical Resident Doctor Panel.

This page has been updated following a check on the CST portfolio guidance on 31st October.

Completing your application for a training post can be a challenging task. You want to ensure that you stand out from the crowd by presenting the full breadth and depth of the experience that you’ve gained to date. At the simplest level, this means scoring as many points as possible on the self-assessment for IMT, or highest grade on your when your are uploading your index page for CST. However, it’s essential that you are honest when claiming your points and follow the guidance correctly.

Which course and what score or indicator?

Every year, large numbers of doctors contact us on this topic. Many are confused about points and indicators they can claim for the various “Teach the Teacher” course formats that we offer. The criteria tyically changes from one year to the next, and this year is no exception. Some doctors, understandably, become quite anxious about making the right choice.

We can assure you that all of our courses are CPD accredited and are accepted as evidence of training for thousands of doctors every year. It’s important to be aware that there are different scoring criteria in play for surgical and medical training programmes. This year, the scoring or recognition criteria has changed significantly once more. For 2024/25 selection processes, updated information for IMT and ACCS was shared well in advance. However, detail of the completely revised CST recruitment process was publicised very late on 27th September – and a check on their webpage on 31st October reveals that there has been a further change.

If you’ve already taken a course, then you will want to ensure you claim the correct number of points or choose the correct indicator. Alternatively, if you are still considering which course to take, then you want to ensure your make the best choice.

Here’s a table to summarise the latest publicised scoring for the most popular Medical Teaching Course options, as of 27th September.

Oxford Medical Course	CPD points	IMT/ ACCS Application Points	CST index page indicator
Teach the Teacher Course for Doctors (2 days, tutor led in Virtual Classroom or In-Person)	12	1	D
Teach the Teacher Online Course	3	0	D

For clarity, the following sections outline the differences between IMT/ACCS and CST programmes to help you with this matter.

2024/25 IMT and ACCS Recruitment – Application Scoring – Training in Teaching

The self-assessment scoring for these programmes is quite different this year than for previous years. A document called “Changes to the application scoring matrix from 2025…” was posted on the Physician Higher Specialty Training Recruitment Document Library December 2023. Here is a copy of the summary table in the “Training in Teaching” section of this document and on current IMT Recruitment Application scoring webpages.

For IMT/ ACCS: Option	Score available	Notes
I have a higher qualification in teaching e.g. PG Cert or PG Diploma.	3	This could be full time over one academic year or part-time over multiple years.
I have had training in teaching methods which is below the level of a PG Cert or PG Diploma	1	This should be additional to any training received as part of your primary medical qualification. Training should be delivered with a duration of at least six hours (i.e. a one-day course) of synchronous (live) teaching time.
I have had no training in teaching methods.	0

The “Summary of changes” table at the start of this document includes the following paragraph:

“The guidance on the one-point option has been amended to specify that the training must have included a minimum of six hours (one day) of synchronously delivered teaching; (i.e. being taught live by a teacher) “

For IMT or ACCS applications at CT1 level, you score 1 point for our tutor-led 2-day Teach the Teacher Course for Doctors , whether you take the course in our Virtual Classroom, or in-person. Both formats fulfil the criteria of “synchronously delivered teaching” and being “taught by a live teacher”.

Our instant-access Teach the Teacher Online Course is designed for you to work through alone and at your own pace. It does not involve a live tutor, and therefore cannot be used this year for IMT or ACCS self-assessment scoring.

These changes also apply to 25 physician higher specialities at ST3/ST4 level.

2024/25 CST index page indicator – Teaching Experience

This year, the new process only went live on the information website on 27th September 2024 and information on Teaching Experience has changed since then. So, here’s a summary of the latest information as it appears on the 2024/25 Core Surgical Training Portfolio Guidance for Candidates webpage for NHS England, Scotland and Wales at time of writing our blog-post.

The updated guidance page includes the following paragraphs:

Candidates will no longer be asked to complete self-assessment on Oriel.

Instead, candidates invited to interview will be requested to upload an index page with the appropriate indicators for each domain.

Candidates will assign a letter from A to E to each domain showing which category of evidence they think their evidence sits in (A being the top, E being the bottom).

The portfolio has moved to this structure as the category acts as a guide for the assessor and is not the final score allocated – this is determined during the interview.

https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/surgery/core-surgery/core-surgical-training-self-assessment-scoring-guidance-for-candidates

Although the scoring for “Training Qualifications” is described as having been removed from this process, a Teach the Teacher Course is still relevant for CST recruitment withing the Teaching Experience section..

Here’s a screenshot from the “Commitment to specialty (all surgical specialties)” indicator guidance section near the bottom of the NHS webpage.

Expanding the “Training experience” tab describes the indicator to select when uploading your index page. It includes the following information as the last two entries on the table.

For CST: Teaching Experience Options	Indicator	Notes
I have undertaken some educational activity focused on learning to teach	D	This would include any form of educational event focused on learning the skills of teaching – such as a training the trainers course online or otherwise
I have not provided teaching	E

Information under the Evidence required” tab states:

“A certificate for the educational event focused on learning how to teach”

So, the certificate which you receive for completing any of our Teach the Teacher courses means you can select indicator D on the scale of A-E. Your final grade for Teaching Experience will be determined by your assessor during interview. So, being able to confidently explain what you learned from your course will be essential for your success.

For CST programme applications, you can select indicator D for any of our Teach the Teacher courses, including, 2-day tutor-led Teach the Teacher Course for Doctors, whether that is taken in our Virtual Classroom or In-person, our Extended Teach the Teacher Course, or our Teach the Teacher Online Course where you gain access to materials which you work through on your own or at your own pace.

Please note: The bottom of the “2024/5 Core Surgical Training Portfolio Guidance for Candidates” webpage states “Page last reviewed: 27th September 2024; Next review due 27th August 2025.”

Other things to consider

Completing the application is only the first hurdle in achieving your training post. If you are successful in getting through to interview then you have the challenge of presenting yourself at your best during the intensive interview process. So, you need to gain as much experience in numerous areas between now and then. You will need to demonstrate your patient communication, team communication and leadership skills. Taking courses in these subjects will give you fresh input and help you to clarify your thinking. And it’s always worth considering a dedicated interview preparation course to help you pull everything together.

We’ve got more advice on our CST & IMT Interview Free Advice webpage.

All the best with your application and continue to develop your abilities to maximise your potential.

Stephen McGuire – Managing Director

On 18th October 2024, Oxford Medical became part of the Reducate EdTech Group.

Reducate was founded with one common goal: that the world is a better place with skilled professionals. We share the same vision. Reducate has positioned itself as a frontrunner in the European EdTech market, offering a diverse range of brands and solutions across multiple sectors. By joining the EdTech Group, we have the opportunity to enhance our services, for example by leveraging advanced technology and in-house studios. This ensures that we will be able to continue providing the highest quality professional skills CPD courses for doctors in the market. Read more about Reducate on their corporate website.

Words used to describe doctors and the NHS have come into sharp focus recently. At long last, the powers that be have agreed to replace the misleading title “junior doctor” with resident”. One step forward. Simultaneously, the new UK Government are coming under fire for persistently describing the NHS as being “broken”. They have referred to some aspects of the service as being a “shame on the nation.” They have said that cancer diagnosis is “more likely to be a death sentence for NHS patients than those in other countries.” When healthcare leaders, media commentators and political opponents have challenged this language, the Government have doubled down and refused to apologise.

Words matter

As children, the adults around us may have told us that, “Sticks and stones will break your bones but names can never hurt you.” However, how many of us actually believe that? Words matter. They can have a major impact on the way we think, feel and act.

“Don’t think about a big red balloon that’s ready to burst!”

During our patient communication skills courses, we regularly introduce phrases like this, then pause for a moment as a springboard for discussion. No pictorial images of the big red balloon are required. Words are powerful in changing what we are paying attention to.

All too often, negative language will encourage a negative response. As a result, participants struggle to effectively interact, pushing each other in opposing directions. If we believe that we are participating in something that is broken, that we are somehow involved in bringing shame, then some of us may become antagonistic. Many are likely to become despondent, demoralised and detached. We’ve discussed before in our blog-posts that we risk the self-fulfilling prophecy of doctors who expect burnout to be part of their lives, rather than developing true resilience.

Our previous experience also shapes what we understand. In the past, there were common tales of patient interactions with major misunderstandings of doctor’s titles: “I insist on seeing the Senior House Officer and not just some Consultant….” “Junior doctor” was always an inappropriate, misleading title, and healthcare systems in other countries already use “resident” instead. But how many UK patients will think the resident actually lives in the hospital? It may well take a bit of explanation and some time to embed the change.

Moving forward

Change can be hard. It’s often easy in the early stages but difficult to sustain. It took many people and organisations a long time to move on from using Senior House Officer. In fact, some never moved on at all, and you may still hear that term hanging around. Change is a topic which is common to a lot of our courses. It’s relevant for teamwork, leadership, management, mentoring, teaching and patient communication.

If we want to get past the negativity, and to get helpful new language embedded, then we have to be part of the solution, rather than part of the problem. Everyone has a part to play. So, what can we do as individuals?

It has to start with our own communication and our belief in the impact of our own words. We have to find ways to reframe what we are saying to help both ourselves and others focus on the right things. We need to find the equivalent of moving on from, “Don’t think about a big red balloon that’s ready to burst” to, “Think about sitting beside calm water on a sunny day.” It helps if we can set ourselves reminders, to maintain awareness, and catch ourselves when we drop into the old outdated or unhelpful language.

If we lead by example, then it’s easier to support and challenge other members of our team – those who look up to us, our peers and our own leaders. This may require learning effective methods and developing abilities of providing constructive feedback and critique.

Change won’t happen by itself. What steps are you taking that will make a difference?

Stephen McGuire – Managing Director

Each year, we expect the seasons to follow a very familiar pattern. However, the career progression calendar for doctors is always far more predictable than the weather. In early August, a new cohort arrives fresh from medical school. At the same time, those in their Foundation Years progress to their new level and their latest rotations. As they do so, plans for next year come into focus.

For many, this includes wanting to secure a place on a training programmes such as IMT, ACCS or CST. Though the exact dates for application windows opening and deadlines may not always be known as far in advance as we’d like, they’re still more predictable than the weather!

We can tell from the volume of doctors who are already taking our Teach the Teacher Courses that competition is higher than ever. Everyone want to secure those points for Training Experience on their self-assessment application. But successfully securing your ideal training post will need more than simply ticking that box on the form.

To help, we’ve created a dedicated webpage which provides you with an overview of the recruitment process. We include explanations of the self-assessment and interview stages. In addition, we also include essential advice on how to best prepare yourself for success.

Please note: offers have now ended

We’re delighted to be celebrating Oxford Medical’s 20th anniversary this weekend!

We were established on 10th August 2004, and now provide professional skills training to thousands of doctors each year, both in the UK and across the globe.

To mark the occasion, we’ve got some short-term special offers for you, meaning you can make big savings as you give your professional skills a major boost.

Offers go live on Friday 9th August and end 23:59 BST on Sunday 11th August 2024. Make sure you don’t miss out!

Develop your abilities – Maximise your potential.

*Sale prices cannot be combined with any other offer or coupon code.

We’re delighted to announce that Oxford Medical have been awarded the Customer Service Excellence hallmark from the UK Government Cabinet Office.

You may, or may not, be familiar with Customer Service Excellence Standard accreditation. When it first came to our attention, we were initially attracted by the authenticity and credibility provided by genuine independent assessment. Then, on further investigation, we realised that the framework and assessment process could also provide us with a structured approach to consider our ways of working. Taking an honest look at ourselves, combined with input from our assessor has acted as a catalyst for new ideas, informing our strategy and actions for improvement. So, it’s more than just a badge.

Audit process

We chose an approach that was pretty much in line with the classic clinical audit cycle which can be applied to any quality improvement initiative.

• The first step for audit is to identify a recognisable standard. Rather than just floating along in your own bubble, you need to seek out a relevant standard or framework. A standard can take many forms. It could, for example, be a recommendation from NICE, guidance from a Royal College or a goal defined within your own organisation. In our case, we used the set of 57 defined elements which constitute the Customer Service Excellence Standard.
• The next step is to measure your performance by collecting relevant “evidence”. Measurements can be figures – it’s often easier when they are – but there may be other valid forms of evidence. It could a policy document, the record of a specific event, patient feedback or description of common team behaviour. In short, it can be anything that helps you to accurately describe the current reality.
• After this comes analysis of the evidence in comparison to the standard. Are you meeting, exceeding or falling short of the standard? Why? And what are the implications?
• Once you’ve answered those questions, it’s time to initiate change.

It’s tempting to stop there. But the difference between a process and a cycle is that the latter is ongoing. So, once you’ve initiated change, you need to make sure it’s embedded and actually making things better. Taking steps to improve one thing can often have unexpected impacts. There can be surprising knock on benefits, which are always good to recognise. However, “improvement” in one place can easily create a new problem elsewhere. So, it often makes sense to pay attention to a suite of standards, monitoring performance in a variety of ways, capitalising on benefits and addressing new shortfalls.

Independent, external assessment

Even when we follow good audit practices, human nature, familiarity or even lack of awareness of possibilities can mean we often have blind spots to what is really going on around us. This is where external assessment can have a major impact. Being open to the scrutiny of a suitably experienced independent auditor and listening to their feedback can be very revealing. Care Quality Commission inspections, appraisal and ARCP meetings all fall into this category.

There’s no doubt that the auditor’s attitude can have a major impact. In a ideal world, they should provide supportive, constructive critique, rather than taking the “Gotcha!” approach. But the attitude of the team is another factor in determining if there are true benefits from an external assessment. Being overly defensive, or resistant to either hearing facts or comparison to others are major obstacles to accepting reality – an essential step in achieving improvement.

Thankfully, working with Assessment Services was a very positive experience. By engaging with our assessor and listening carefully to his observations, we’ve identified a number of initiatives for making progress. In addition, we’ve also heightened our awareness of our abilities and the things we do well. This is a vital part of any audit process, as the solutions to our challenges often lie within our strengths.

So, now we have to get on with putting our ideas into action, pay attention to the results and make sure we get ourselves ready for another successful assessment process next year.

Stephen McGuire – Managing Director