Case study 7 - Medacs Healthcare

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Introduction

Medacs Healthcare is a leading provider of recruitment and managed healthcare services to the public and private sectors. Established in 1990, Medacs Healthcare operates a global network including operations in the UK, Europe, Australia, New Zealand, Asia and the Middle East. The organisation is the largest provider of locum doctors to the NHS via the Government-approved framework, and has an active database of 7,500 doctors in the UK. After a competitive tendering process by the Revalidation Support Team, Medacs Healthcare was chosen in June 2011 to run the pilot with locum doctors in England who do not fall within traditional clinical governance systems.

Challenges

As an organisation that has over 1,000 full time locums attached to it, Medacs Healthcare faced a number of significant challenges. Marketing Director, Trevor Lambert, explains:

“It’s our responsibility as the largest locum agency to ensure that our doctors have the best experience of revalidation possible. However, because of the very nature of being a locum agency, we had to overcome some difficulties.”

First, not all of Medacs Healthcare’s doctors are based in the cities where the company has offices; some are in very remote locations, so when Medacs provides assistance with revalidation, it has to be a model that will work over wide areas in both urban and rural settings.

“Medacs also has doctors from many different specialisms, who practise in very different environments, from a hospital to a GP surgery,” Trevor explains, “as a consequence their circumstances can vary dramatically. So, we needed to ensure that we could cater for all types of locums. Also, because our placements can be short, there is an inherent difficulty for doctors wanting to collect evidence or patient and colleague feedback.”

Action

Medacs Healthcare assigned a full-time project manager, Yvonne Greig, who developed a project plan and monitoring system.

They began by recruiting and training 40 appraisers from their database of locum doctors.

“We had a lot of interest in becoming an appraiser,” Yvonne explains. “Doctors felt that it was good for their professional development. We were tasked to appraise 125 doctors from October 2011 until December 2011, this was a challenge in itself. As the timescale was so short, we concentrated our appraisals in the Greater Manchester and Greater London area. Appraiser training days were run in Manchester and London. The training was very detailed and focused on the importance of delivering regular, high quality appraisals.”

A dedicated administrator scheduled meetings between the appraiser and appraisee to ensure the process ran smoothly and effectively. Most appointments were arranged at weekends in Medacs Healthcare offices in London and Manchester, for the convenience of both parties. Medacs Healthcare put a lot of resource into helping the doctors undergoing their appraisals understand what was required from them. “For the locums going through the revalidation pilot, in addition to our normal regular communication, we sent them e-shots that included relevant information and pointers to useful resources, such as the GMC guidance. We found that one-on-one contact where possible was useful too. We called doctors individually to make sure they understood the types of feedback they needed to collect.”

To further allay any concerns the doctors might have about revalidation, Medacs Healthcare established a Revalidation Portal, where doctors can log on and ask questions. At the moment, the portal gets around 12-14 questions a day, but this number is expected to increase when revalidation starts.

Yvonne Greig describes the benefits of the portal: “Because of the varied circumstances of our locums, there will be questions specific to them that may not be covered in more general guidance. The portal is a speedy way for them to get their questions answered. It’s a personalised service.”

In addition to the portal, Medacs is also rolling out training in revalidation to all their placement officers – the staff that communicate with the locums on a regular basis. This way, the locums will be able to ask their regular point of contact any queries about revalidation too.

Getting feedback from the organisations in which locums are placed is extremely important. In order to assist Medacs Healthcare’s doctors, each organisation is sent an assessment form to complete to give feedback on the doctor after every placement. This ensures feedback is given in a timely manner. Whilst locums are encouraged to liaise directly with the relevant parties at the organisation for feedback, Client Officers (staff directly in contact with the organisations in which locums are placed) can also help to chase up feedback on locums, if they run into difficulty. Once feedback is received, it is sent to the doctor for them to store in their portfolios.

Results and benefits

In total, 125 doctors went through the appraisal process as part of the RST pilot. Medacs Healthcare also recruited and trained 40 appraisers.

During the pilot, Medacs Healthcare developed feedback loops in every process to ensure that they could quickly identify and solve any issues as soon as they arose. Yvonne Greig believes that understanding the doctors’ experience of revalidation will be key to ensuring the process runs smoothly.

“The learning from the pilot and the feedback from the doctors have been invaluable,” Yvonne explains. “In addition to the portal, we found that we need to either develop or use a comprehensive online toolkit, which contains all of the documents needed for the appraisal. It will contain the feedback forms for doctors to pass on to their colleagues and patients and they will be able to save feedback on the system too. We’re currently trialling off-the-shelf systems to see if they will suit our needs; if they don’t we will investigate into developing our own.”

In addition, Medacs Healthcare is investigating a number of different channels for delivering messages about revalidation, such as a webinar that will present GMC guidance in an engaging and succinct way.

Yvonne explains “Taking part in the pilot has given us a clear understanding of the challenges involved in developing a revalidation process. We got excellent feedback from all pilot participants who found the process very rewarding and useful preparation for the introduction of revalidation later this year. Medacs Healthcare is currently finalising its revalidation process and we’ve taken on board feedback from pilot participants on how we can support them through revalidation. We’re committed to providing our locums with the best possible experience of the revalidation process.”

Key findings

• Constant feedback loop – Trevor Lambert says: “Throughout the process we were constantly asking those taking part for feedback so we could assess what was working and what wasn’t. It gives us a really clear steer about where to focus our efforts when looking at the processes we will implement on a wider scale. We will always build this feedback loop into all our activity.”
• Addressing doctors’ concerns about revalidation – Yvonne Greig explains: “Some doctors are very prepared, but for some they can become very worried about the process. We found that one-on-one contact and giving the opportunity for doctors to ask questions is important.”
• Clear and consistent communication about revalidation – Medacs Healthcare communicates information about revalidation with their doctors through regular e-shots and by telephone and will have a dedicated revalidation team who will support locum doctors through the process. The Medacs Healthcare Revalidation Portal will be developed over time to provide answers to frequently asked questions and access to useful resources.