Canberra Health Service Medical Imaging Restructure Update · Medical Imaging at Canberra Health Services has undergone a great deal of change in recent times. In particular, the

Canberra Health Service

Medical Imaging Restructure Update Dear Member, Attached is correspondence the HSU has received from Canberra Health Service regarding the proposed restructure of Medical Imaging (also see previous Newsletter 509 from 29 July). Member feedback requested The HSU industrial team is now reviewing the documents received. We are seeking urgent feedback, views and comments from our members. Please review the attached documentation and provide comment and feedback by Thursday 19 September. You can submit it by email to [email protected] with subject line CHS Medical Imaging. Not a member of the HSU? Now is time to join and have your say! You can join online at www.hsu.asn.au/join or call 1300 HSU NSW and join over the phone. A union’s effectiveness and negotiation power depends upon the strength and density of its membership base. Join your work colleagues today by becoming a member of the Health Services Union and help us continue to protect and improve your working life. In unity,

Gerard Hayes Secretary, HSU NSW/ACT/QLD

Newsletter: 671/2018 Date: 16 September 2019

Distribution: All members CHS Contact: Your HSU Organiser

https://www.hsu.asn.au/wp-content/uploads/2019/07/19509-Canberra-Health-Service-Proposed-Restructure-Medical-Imaging.pdf

mailto:[email protected]

http://www.hsu.asn.au/join

PO Box 11 WODEN ACT 2606 | Phone: 132 281 | Website: www.health.act.gov.au

Dear Medical Imaging Staff Medical Imaging Restructure

I wrote to you on 26 July 2019 proposing a restructure of Medical Imaging at Canberra Health Services and commencing consultation about this. I am writing now to advise you of the outcome of the consultation and the organisation of Medical Imaging that has now been decided. Following a series of meetings with staff and union representatives, your feedback was collated and evaluated. A wide range of feedback was received, and I would like to thank all staff who participated in this process. Your input was thoughtful, constructive and comprehensive, and provided many important points which have been considered in discussion with Charles Ngu, Clinical Director of Medical Imaging. A document summarising the consultation process, points raised and management responses is attached. Based on this input, a final proposal was put forward to Bernadette McDonald, Chief Executive Officer, and was agreed by her. A copy of the final agreed medical imaging organisational chart is also attached. The following is an outline of the proposed changes relative to the historical structure:

• The Executive-level Director of Medical Imaging position will not continue.

• A new position, Director of Business Operations Medical Imaging, will be established, reporting to the Clinical Director. The position will be dual-classified as Medical Imaging professional level 6 and Senior Officer Grade A.

• The Chief Radiographer position will remain unchanged but will report to the Clinical Director.

• A new position, Assistant Director of Nursing (ADON) Registered Nurse 4.1 will be

established. This position will report to the Clinical Director, with professional line support provided by the Director of Nursing in the Office of Nursing and Midwifery and Patient Support Services. The position will also provide professional line support to other senior nurses in the Medical Services Group.

• The Medical Imaging Clinical Nurse Coordinator (CNC) position will remain at the

Registered Nurse 3.1 level. The position description for this role will be revised in discussion with the incumbent, in the context of the introduction of the ADON.

• A new Senior Officer Grade C position will be created to ensure Quality and Safety is

managed as a priority throughout the department. This position will report to the Director of Business Operations.

• The Administrative Services Officer Level 5 Office Manager will be reclassified to a

Senior Officer Grade C to provide senior administrative support to the department as the Operations Manager, Medical Imaging and report to the Director of Business Operations.

http://www.health.act.gov.au/


PO Box 11 WODEN ACT 2606 | Phone: 132 281 | Website: www.health.act.gov.au

• A new Administrative Services Officer Level 4 Personal Assistant position will be created to provide administrative support to the Clinical Director.

What are the benefits? The new structure has been developed to provide strong clinical and corporate governance, strong leadership across all health professionals, with well-supported and managed administrative functions. Next steps? The new positions will be advertised and recruited in the usual manner, in keeping with Canberra Health Services policy and the Public Sector Management Act. If you have any questions regarding this letter, please contact Dr Olivia Jakobs, A/g Business Manager, Medical Services Group by telephone 5142 0009 or by email [email protected]. I would again like to thank all staff in Medical Imaging and the union representatives who participated in the consultation process. I have found it to be a very valuable experience, reflective of our recently established organisational values of Reliable, Progressive, Respectful and Kind. I am confident that this process and the outcome has put Medical Imaging in an excellent position to move into the next phase of development of the service as we work to meet the challenges that lie ahead. Yours sincerely

11/09/2019 Dr Paul Dugdale Executive Director Medical Services Canberra Health Services





Clinical DirectorSSPEC

Personal Assistant

ASO4

Director Business OperationsMI6 - SOGA

Chief Radiographer

HP6

Radiologist 20 Staff Members

Operations Manager

SOGC

Quality and Safety OfficerSOGC

Administration Manager

ASO6

1 x ASO5

3 x ASO4

13 x ASO3

4 x ASO2

Medical Imaging ADONRN4.1

CT/Angio ManagerHP5

MRI ManagerHP5

Ultrasound Manager

HP5

Nuclear Medicine/PET Manager

HP5

Team LeaderHP4 x 2

Clinical TutorHP4

Director of Training

2 x 0.5 FTE

1 x HP4

1 x HP4

10 x HP4

2 x HP4

2 x HP3

6 x HP2

21 x HP3

24 x HP2

Clinical Nurse Educator

RN2

12 x RN2

31 x RN1

14 x Registrars

Medical Imaging Organisational Chart

11/09/2019

Angio CNCRN3.1

Contracts/

Resource Officer ASO5

Medical Imaging CNC

RN3.1

Director of Nuclear Medicine/PET

SSPEC

1

Medical Services Group

Executive Director of Medical Services, ext. 42009

© Australian Capital Territory, Canberra | health.act.gov.au | Enquiries: 132281

Medical Imaging Proposed Restructure

Response to Consultation Contents

Executive Summary ................................................................................................................................ 2

Timeline summary of consultation ......................................................................................................... 3

Points raised by staff and management response ................................................................................. 5

Implementation .................................................................................................................................... 15

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Executive Summary

Medical Imaging at Canberra Health Services has undergone a great deal of change in recent times. In particular, the CHS restructure in early 2019 resulted in the establishment of a Clinical Director of Medical Imaging, a medical specialist position responsible for the overall management of the department. In order to achieve a robust, well-rounded leadership model with clear lines of responsibility at the management level under the Clinical Director, a new management structure for Medical Imaging with clear roles and responsibilities that support the expanding service was developed in discussions between the Executive Director of Medical Services (EDMS), the Clinical Director of Medical Imaging and the Chief Executive Officer.

The proposed new structure was put forward to staff and unions and a process of consultation was embarked upon in commencing late July and closing in mid-August 2019. The following report documents the consultation process, including the timelines, activities undertaken, feedback received, issues raised and corresponding management responses. A variety of issues was identified through this process, including two significant matters raised that resulted in changes to the proposal.

The first of these concerned the introduction of a new role, the Director of Business Operations. In the original proposal this role was classified as a Health Professional level 6. Concern was raised by staff that classifying the role as such may limit the potential pool of candidates. Concern was also raised that the duty statement required a clinical workload and appeared to preclude anyone who is not a radiographer. It was suggested that classification at Senior Officer Grade A might draw a wider selection of applicants, or that possibly the role should be dual-classified. This feedback was considered along with advice from People and Culture. As a result, it was determined that the role could be dual classified as a Medical Imaging level 6 (MI6, which is the appropriate equivalent of the Health Professional level 6 in the new Enterprise Agreement) and a Senior Officer Grade A. The clinical workload requirement was removed from the MI6 duty statement and replaced with the duty to maintain professional registration.

The second matter was the management structure of the nursing stream. The original proposal was to increase an existing RN 3.1 nurse manager to an RN 3.2 position to better reflect the responsibilities and demands of role. Concern was raised that a more senior manager such as an Assistant Director of Nursing was needed in the department. The perceived need for a more senior nursing manager related to both operational and professional requirements of Medical Imaging nursing staff and the department. This feedback was considered along with advice from the Executive Director of Nursing and Midwifery and Patient Support Services. As a result, it was determined that an ADON (RN 4.1) would be introduced into the structure, and the existing RN 3.1 positions would be retained. The position description of the RN 3.1

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(non-angiography) will be reviewed with the incumbent to ensure it is appropriate, with the introduction of the ADON.

A range of other feedback was received through the consultation process, which together with the recommended response is documented in this report. Some of the feedback received was out of scope of this consultation, which is focused on the management structure of the Medical Imaging department. This feedback was noted and will be considered by the new Medical Imaging management team after the implementation of the new structure, as part of future budgeting and process improvement activities.

Further detail about implementation of the new structure is contained this report under the Implementation heading.

Timeline summary of consultation

Consultation undertaken

Date Activity

24 July 2019 Meetings to introduce initial proposal and the consultation process held at 12.15pm (approximately 30 attendees) and 1pm (approximately 18 attendees) in the Medical Imaging Conference Room, Canberra Hospital. Facilitated by Paul Dugdale, Executive Director of Medical Services. All Medical Imaging staff invited.

26 July 2019 Letter of further detail with attachment showing proposed new structure and formal invitation to consult sent to all Medical Imaging staff and relevant unions.

29 July 2019 Copy of present structure organisational chart sent to all Medical Imaging staff at request of some staff.

31 July 2019 Consultation meeting at 2pm in the Medical Imaging Conference Room, Canberra Hospital with Medical Imaging Staff (approximately 30 attendees).

5 August 2019 Consultation meeting at 1pm in the Medical Registrar teaching room, Canberra Hospital facilitated by Paul Dugdale with approximately 15 radiologists and radiology registrars.

6 August 2019 Consultation meeting at 2.30pm in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with approximately ten Medical Imaging administrative staff.

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6 August 2019 Consultation meeting at 3.15pm in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with six Medical Imaging nurses.

6 August 2019 4pm in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with three radiographers, sonographers and nuclear medicine scientists.

7 August 2019, Consultation meeting at 8.45am in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with approximately ten Medical Imaging nurses.

7 August 2019 Consultation meeting at 9.30am in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with approximately ten Medical Imaging staff and three union representatives.

8 August 2019 Consultation meeting at 2.30pm in the Medical Imaging Conference Room, Canberra Hospital facilitated by Paul Dugdale with approximately eleven Radiographers, sonographers and nuclear medicine scientists and one union representative.

Total staff attendance at consultation sessions*

Some individuals attended more than once

153 attendances

Feedback received outside of consultation meetings

Date Item

29 July 2019 Two emails received from staff

2 August 2019 One email received from staff

7 August 2019 Two emails received from staff

12 August 2019 Eight emails received from staff

12 August 2019 Letter received via email from ANMF

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Points raised and management response

Issue

Classification and role of the Director of Business Operations

Points raised:

• The original proposal distributed for consultation showed this role classified as a Health Professional level 6.

• Concern was raised by staff that classifying the role as a Health Professional may limit the potential pool of candidates.

• Concern was also raised that the duty statement appears to require the role to have a clinical workload, and appears to preclude anyone who is not a radiographer.

• It was suggested that classification at the SOG A level might draw a wider selection of applicants, or that possibly the role should be dual classified.

• It was also suggested that the role needs to be elevated in the structure.

• Clarification was sought on how the Director of Business Operations role supports the Clinical Director in terms of administrative workload.

• Clarification was also sought on the function of the positions that roll up to the Director of Business Operations.

Management response:

• The feedback is noted and has been considered.

• Based the feedback, the role will be dual-classified and advertised as available at the Medical Imaging 6 and Senior Officer Grade A levels. The position descriptions for both classifications in this role are at Attachment A and Attachment B.

• The position descriptions and organisational chart have been reviewed to ensure that the operational and administrative relationship between this role and the Clinical Director is clear.

• The organisational chart was reviewed and minor changes made to clarify the functional relationships.

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Issue

Clinical Director role and responsibility

Points raised:

• Concern was raised that a CD with a dual clinical-administrative role will have limited capacity to be effective in both roles due to the demands of both roles.

• While noting strong support for the present CD, the demands of both the clinical and administrative aspects of the combined role are significant.

• Concern was also raised that while there is strong support for the present CD, the department has not fared well under the leadership of a radiologist in the past.


• The feedback is noted.

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Issue

Nursing management structure

Points raised:

• Concern was raised that a more senior manager such as an ADON is needed in the department due to reasons outlined in the feedback.

• The perceived need for a more senior nursing manager related to both operational and professional requirements of Medical Imaging nursing staff and the department.

• Concern was also raised about the potential for any staff to be made excess as a result of this restructure.



• The previous proposal to elevate the nurse manager (non-angiography suite) position from RN 3.1 to RN 3.2 has been revised as follows.

o The existing two RN 3.1 nurse manager positions will be retained. An RN 4.1 Assistant Director of Nursing (ADON) will be introduced. This is a new position (position description at Attachment C).

o The position description of the RN 3.1 nurse manager (non-angiography suite) will be reviewed in discussion with the incumbent and changes made recognising the introduction of the ADON. It is envisaged that the RN 3.1 will take on an enhanced support function on the floor.

• Nursing staff have a dotted line of professional supervision and support from the Director of Nursing in the Office of the Executive Director of Nursing, Midwifery and Patient Support Services (not depicted in the organisational charts which have been used during this consultation because the focus of the present process is the management structure of Medical Imaging).

• No nursing staff are being made excess as a result of this process.

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Issue

Administrative staffing matters

Points raised:

• Clarification was sought about the role and responsibility of some of the new positions which have been proposed, how these relate to the higher management positions, and how the workload will be redistributed from the present structure.

• Concern was also raised about the potential for any staff to be made excess as a result of this process.



• The position descriptions and organisational chart have been reviewed and slight changes made to ensure that the role and responsibility of these positions is clear.

• The ASO 5 Office Manager position will be abolished, while two new administration SOG C positions will be established. Management affirms it will proceed with this. If an ASO 5 officer becomes excess as a result of this, every effort will be made to place them elsewhere in CHS and the provisions in the Enterprise Agreement and Public Service Management Act will be applied.

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Issue

Health Professional staffing matters

Points raised:

• Questions were raised about the capacity for Health Professionals in senior management roles (the Chief Radiographer and potentially the Director of Business Operations) to take on a clinical workload while also working as a senior manager.

• It was also suggested that HP5 modality managers need supernumerary time for management tasks in order to fully support senior management.

• The importance of specific correct nomenclature in relation to the health professions in Medical Imaging on structural diagrams, duty statements and other documents was noted.

• Questions and concerns were also raised about a variety of matters that are outside of the present consultation, which is focused on the management structure of the Medical Imaging department.



• The position description of the Chief Radiographer will be revised with the incumbent to check that it is appropriate.

• The position description of the Director of Business Operations has been revised to ensure that it is appropriate.

• The remaining feedback is noted and will be considered by the new Medical Imaging team after the implementation of this restructure, as part of future budgeting and process improvement activities.

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Issue

Medical Staffing matters

Points raised:

• A question was asked about the role of the Quality and Safety Officer.

• Questions were also raised about matters that are outside of the present consultation, which is focused on the management structure of the Medical Imaging department.


• The role of the Quality and Safety Officer was explained during consultation meetings with staff.


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Issue

Angiography Suite and other nursing matters

Points raised:

• Input was provided about the level, role and responsibility of the Angiography Suite CNC relative to the nursing unit manager.

• Input was also provided about nursing students, Clinical Educator resources, assignment on nursing rosters and nurse overtime.



• The Angiography will report to the newly created ADON 4.1 position.


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Issue

Nuclear Medicine matters

Points raised:

• The Director of Nuclear Medicine/PET (a position created several years ago) was missing from the organisational chart.

• Other input was provided about matters that are outside of the present consultation, which is focused on the management structure of the Medical Imaging department.


• The Director of Nuclear Medicine/PET has been added to the organisational chart.


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Issue

Other comments about the structure or organisational chart

Points raised:

• Concern was raised that the structure appears to be top heavy (large manager layer). • Some staff commented that the organisational chart does not clearly depict the intention of the

restructure as it has been explained in consultation meetings. • It was raised that the seniority of the Director of Business Operations is understated and needs to

be more clearly delineated from the Chief Radiographer. • The full nursing structure was not pictured. Breast Imaging was missing. • The depiction of two HP4 team leaders is misleading because they are not 2 FTE and the HP4

managers in each modality are different in reality but appear equal on the organisational chart.



• The structure is not top-heavy when considering the ratio of managers to staff. This restructure and consultation were specifically focused on the management level, and any sense that the management structure being proposed was out of proportion was conveyed unintentionally.

• The organisational chart has been reviewed and slight changes made to ensure that it appropriately depicts the structure being proposed and implemented.

• A chart of all services offered by MI will be developed by the MI management team, although the chart will not show all specific staff members in those services.

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Issue

The implementation process

Points raised:

• Concern was raised about the potential for any staff to be made excess as a result of this process. • Questions were also raised about the process of recruitment for any positions that are created or

become vacant as a result of this process. • Questions were asked about how the success or other outcome of the restructure will be

monitored and evaluated. • Concern was raised that the full picture of information was not made available at the outset of the

consultation period.


• There is no intention to reduce the size of the medical imaging workforce. If any officer becomes excess as a result of this process, every effort will be made to place them elsewhere in CHS and the provisions in the Enterprise Agreement and Public Service Management Act will be applied.

• All positions that are created or made vacant as a result of this process will be advertised and recruited in the usual manner in keeping with CHS and ACT Government policy.

• The success of the structure will be monitored by the Medical Imaging management team and the Executive Director of Medical Services. All staff are welcome to provide input and comment via the management and executive offices.

• In good faith, further information about management’s thinking in relation to the proposal was put forward during the consultation process.

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Implementation

Upon endorsement and approval of the CEO, the EDMS will write to staff and unions to advise them of the outcome of the consultation process. After that, new positions will be advertised and recruited to in the usual manner in keeping with CHS and ACT Government policy. The new positions to be advertised and recruited are the:

• Director of Business Operations • Assistant Director of Nursing (ADON) • Senior Officer Grade C Operations Manager • Senior Officer Grade C Quality and Safety Officer • Administrative Services Officer level 4 Personal Assistant to the Clinical Director

Concurrent with the recruitment process, the position description of the RN 3.1 nurse manager (non-angiography suite) will be reviewed in discussion with the incumbent and changes made recognising the introduction of the ADON. The EDMS and Clinical Director will work with the Medical Services Group Finance Account manager to ensure that the Medical Imaging budget matches the revised staffing establishment. These actions align with and will form part of the broader workforce strategy in Medical Imaging, which is being developed by the Director of Workforce Planning, People and Culture. All out of scope feedback gathered as part of this consultation process will be handed over to the the new management team in Medical Imaging to engage with once fully recruited.

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Action Officer Details

Name:

Paul Dugdale

Phone:

5124 2009

Position:

Executive Director of Medical Services

Division:


Branch:

NA

Documents

Canberra Health Service Medical Imaging Restructure Update · Medical Imaging at Canberra Health Services has undergone a great deal of change in recent times. In particular, the