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Medical Council Statement of Strategy 2014-2018

Protection of the public is at the core of the Medical Council’s role. As Council President, I am delighted to present our strategy, which aims to enhance patient safety in Ireland over the next five years. This is only the second formal statement of strategy by the Medical Council. The first one, produced in 2010, served the Council, the public, patients and the medical profession well, underpinning the implementation of the Medical Practitioners Act. This five-year strategy aims to build on the achievements of the first strategy, guided by a new vision, mission and values to reflect the Council’s role in the current times. This simple and straightforward document maps out the six key priorities for the next five years and sets down the vision, the mission and the values that will underpin the Council’s work.

Professor Freddie Wood

President

Objective 1

Develop an effective & efficient register that is responsive to the needs of the public and medical profession

Objective 2

Create a supportive learning environment to enable good professional practice

Objective 3

Maintain confidence by developing a proportionate and targeted approach to regulatory activities

Objective 4

Develop a sustainable & high performing organisation

Objective 5

Build an organisational culture that supports leadership & learning

Objective 6

Enhance patient safety through research & greater engagement

More Information

Strategic Objective One: Develop an effective & efficient register that is responsive to the needs of the public and medical profession

We will ensure that all doctors on the register are safe to practise through an increasingly integrated approach to their initial and continued registration.

  • We aim to achieve this goal by:
    1. Ensuring safe pathways onto and within the register
      • Establish an on-going programme to review registration rules and procedures, and revise as necessary. Ensure registration procedures support appropriately qualified and trained doctors to attain registration.
      • Implement programmes which better enable safe and appropriate access to practice for doctors entering the register and moving within its divisions, including engagement with employers on matters such as induction and orientation.
      • Communicate with those who recruit and employ doctors to promote better understanding of the purpose of the register, its distinct divisions and assessment criteria for entry to practice.
    2. Pursuing operational excellence in registration processes
      • Finalise and operate a framework of continuous improvement to ensure registration processes are of the highest possible standard.
      • Establish internal and external quality assurance arrangements to improve the quality of our registration processes.
    3. Ensuring registration processes respond to legislative change
      • Respond quickly to national legislation changes that impact on registration processes.
      • Ensure timely response to legislation amendments at European level which impact on registration processes, including amendments to EU Directive 2005/36/EC.
    4. Ensuring that continuing registration reflects continuing fitness to practise
      • Oversee compliance with conditions attached to doctors’ registration, including health related conditions, through governance and monitoring arrangements.
      • Ensure doctors confirm continuing fitness to practise at retention of registration, including their maintenance of professional competence.
  • What are the intended outcomes?
    • Registration processes, including pre-registration examinations, which allow appropriately qualified doctors straightforward access to the practice of medicine in Ireland.
    • Recruiter and employer arrangements for entry to practice aligned with registration processes for safe and appropriate access to practice.
    • Our registration services are considered efficient and effective.
    • Legislation is implemented as soon as it is enacted.
    • An effective framework is in place for the retention and remediation of doctors, and the monitoring of doctors who have conditions imposed which restrict their practice
  • How we will measure effectiveness
    • External accreditation of the registration processes achieved by 2015.
    • Increase in the use of the Supervised Division by the HSE.
    • Measures developed to evaluate the effectiveness / quality of our registration processes, including turnaround time.
    • Rule changes in response to new legislation implemented within an appropriate timeframe.
    • Monitor outcomes of annual retention process.
    • Monitor outcomes of cases referred for performance assessment.
Strategic Objective Two: Create a supportive learning environment to enable good professional practice.

We will deliver measureable improvements in the quality of education, training and lifelong learning for doctors.

  • We aim to achieve this goal by:
    1. Defining and communicating what it means to be a good doctor

        • Publish guidance on good professional practice for doctors, which is in turn shared with the public, and support the development of good professional practice through access to high-quality undergraduate education, postgraduate training and lifelong learning.
        • Ensure learning outcomes are defined at each stage of professional development which reflect our framework of competencies applicable to all doctors; namely the Eight Domains of Good Professional Practice.
        • Drive consistency in student fitness to proceed by producing guidance for medical schools and monitoring implementation.
    2. Shaping high quality learning environments for doctors
      • Continue our programme of accreditation, building on our role at undergraduate level, while developing our newer role in postgraduate training. This will be grounded in an evidence based and targeted approach, including collating and responding to research on trainee views.
      • Continuous review of our accreditation standards incorporating international best practice to ensure our accreditation activity is of the highest standard and meets the changing needs of the medical profession.
      • Complement our education standards through publication of thematic guidelines to drive improvements in key aspects of the clinical learning environment.
    3. Enhancing lifelong learning and specialisation opportunities for doctors
      • Review professional competence system and implement recommendations for enhancement. This will include professional competence requirements to ensure a focus from doctors on review, including peer review, data and outcomes.
      • Evaluate the way medical specialties are recognised and make any necessary improvements based on this evaluation.
    4. Fostering good health among doctors
      • Publish guidance on health in practice, which is promoted through our role in education, training and lifelong learning. This will highlight the need for learning and training institutions to support student and trainee wellbeing.
      • Review our health procedures to ensure they facilitate an appropriate response for doctors with health concerns. Establish formal arrangements to allow us to work more closely with partner organisations.
      • Provide support to individual doctors through the Council’s Health Committee to assist them to pursue good practice.
  • What are the intended outcomes?
    • The medical profession and the public have clear direction on what it means to be a good doctor.
    • The quality of the system of medical education, training and lifelong learning is enhanced through accreditation, thematic reviews, and guidelines.
    • Our expectations of clinical sites as learning environments are articulated, communicated and applied.
    • A more targeted and effective approach to our system of maintenance of professional competence.
    • Guidance on health for good practice and better support for individual doctors where this is required.
  • How we will measure effectiveness
    • Revised and updated guidelines on good professional practice for doctors.
    • Regular reviews of doctors’ knowledge and attitudes to our guidance on good professional practice.
    • External validation of Medical Council standards and processes for accreditation in medical education.
    • A review of our current professional competence systems.
    • Regular monitoring of doctors’ experience of professional competence systems.
    • Monitoring of outcomes of Medical Council health procedures.
Strategic Objective Three: Maintain the confidence of the public and profession in the Council’s processes by developing a proportionate and targeted approach to regulatory activities.

We will oversee a more effective and appropriate approach to resolution of complaints by working with external partners, implementing reforms and learning from experience.

  • We aim to achieve this goal by:
    1. Influencing enhanced procedures to progress complaints throughout the health system 
      • Develop a framework with employers in the private, public and voluntary health sector to ensure that complaints are addressed properly and at the appropriate level in the system.
      • Work with complainants and patient advocacy groups/ representatives to ensure clarity on the system for resolution of complaints, including when complaints should be dealt with by the regulator.
      • Manage the Council’s complaints and inquiry process in a fair and cost-effective manner.
      • Work with the Department of Health, other relevant government departments and international regulatory networks to ensure legislation at national and EU level supports effective and appropriate resolution of complaints.
      • Make targeted and appropriate use of procedures to assess and remediate doctors’ performance in response to concerns.
    2. Safeguarding the integrity of the register 
      • Implement reforms in complaints management processes that improve patient protection and reflect good practice: This will include Preliminary Proceedings Committee procedures, Fitness to Practise inquiry procedures and guidance on indicative sanctions.
      • Ensure that complaints are progressed quickly and efficiently, within published timeframes.
      • Improve appropriate transparency in our complaints handling processes by ensuring consistency in the release of documentation.
    3. Learning from experience 
      • Ensure themes and issues emerging from the Council’s complaints and inquiry processes are captured, analysed and inform the development of guidance on good professional practice for doctors.
      • Work with partner organisations, including, employers, policy makers, other regulators and international partners, to share learning arising from fitness to practise procedures.
  • What are the intended outcomes?
    • Complaints relating to a doctor’s fitness to practise are addressed by the regulator, where appropriate.
    • More transparent complaints and inquiry procedures.
    • Efficient systems resulting in a cost-effective handling of complaints.
    • Guidance to the profession reflects trends and addresses issues emerging from complaints and inquiry processes.
  • How we will measure effectiveness
    • Framework for complaints managed and developed.
    • Trend analysis of the origin of complaints.
    • Systems in place to measure the efficient handling of complaints, including the timeframes to progress complaints.
    • External assessment of complaints and fitness to practise procedures.
    • Number of reports developed by the Medical Council arising from themes & issues emerging from the complaints and inquiry process.
Strategic Objective Four: Enhance patient safety through insightful research and greater engagement.

Patient safety is enhanced through the generation of better research evidence, the provision of information and effective communication with patients, doctors and partner organisations.

  • We aim to achieve this goal by:
    1. Conducting research to inform our work
      • Develop our research capacity, both in-house and through collaboration with partners.
      • Establish a programme of research, aligned to our overall corporate strategy, and gather information to better understand how good professional practice is developed and maintained.
      • Use and share the evidence base about good professional practice to drive improvements in patient safety and quality of care through our own work and through work with partner organisations.
    2. Shaping and responding to emerging legislation and policy
      • Continue our ongoing relationship with relevant government departments to contribute to the development and implementation of legislation and policy.
      • Work with international partners, particularly those involved in medical regulation, to contribute to and respond to policy changes at European level.
      • Share data and research with partner organisations to inform policy developments.
    3. Building and strengthening strategic relationships
      • Establish and implement formal agreements with relevant partners to share information and other resources.
      • Develop and implement plans to communicate and work collaboratively with partner organisations on matters related to the Council’s role.
    4. Effective communication
      • Develop an improved and open approach to communication with the public through the implementation of targeted communications plans.
      • Develop communication, interaction and engagement opportunities with doctors through targeted communications plans.
      • Increase use of online channels of communication to reach the public and the profession.
      • Greater interpersonal engagement through organisation of and participation at forums, conferences and events.
  • What are the intended outcomes?
    • The views of patients and doctors play a greater role in informing the Council’s decision-making.
    • An improved evidence base to inform strategic decisions.
    • The public, doctors and partner organisations will have access to better information.
    • A more integrated approach to medical regulation across the Irish health sector is achieved through more effective relationships with partner organisations.
  • How we will measure effectiveness
    • Collection and analysis of data on the use of online channels of communication.
    • Improvements in public confidence in the Medical Council.
    • Improvements in doctors’ confidence in Medical Council procedures.
    • Tracking the level of engagement with partner organisations.
    • Number of research and policy reports issued. 
Strategic Objective Five: Build an organisational culture that supports leadership and learning.

Council members and staff are supported as part of a learning organisation, focused on effective regulation.

  • We intend to achieve this goal by:
    1. Implementing good-practice governance and human resources
      • Ensure our learning and development strategy equips and supports Council members to carry out their role effectively within a sound governance framework.
      • Ensure our learning and development strategy equips employees with the skills required to deliver on the strategic objectives of the organisation.
      • Develop and regularly review the learning and development strategies to monitor their effectiveness and return on investment.
    2. Balancing capacity and capability
      • Review the organisational structure to ensure that it supports the delivery of the strategy.
      • Conduct a skills audit to identify the skills needed to support our strategy. Develop and / or acquire those skills.
    3. Aligning culture and strategy
      • Roll out a leadership development programme to maximise leadership capability across the organisation.
      • Integrate strategic objectives into all aspects of the organisation, particularly the performance management development system (PMDS) and the governance evaluation of Council.
      • Devise initiatives to engage with and involve staff in order to develop a vibrant and cohesive workplace culture.
    4. Effective internal communication
      • Further develop our consultative approach to communication across the organisation.
      • Ensure Council has the information required to monitor and oversee the implementation of the strategy effectively and on a regular basis.
      • Ensure staff members have the information, including clarity on Council decisions, required to meet business and strategic objectives effectively.
  • What are the intended outcomes?
    • A commitment to continuous learning and improvement by Council and staff.
    • Motivated and engaged staff.
    • A culture of high performance within the organisation.
    • Organisational structure designed to best support the successful delivery of the strategy.
    • Timely, well informed and transparent decisions made by Council.
    • Effective systems in place to share knowledge and information across the organisation.
  • How we will measure effectiveness

    Employee measures:

    • Structured feedback from employees.
    • Absentee rates and retention rates.
    • Measuring achievement through effective use of the PMDS system.
    • Employee engagement survey.
    • Implement a skills audit of employees.
    • Develop a workforce plan to recruit personnel with the necessary qualifications or outsource necessary expertise to address skills gaps.

    Council measures:

    • Annual Council Governance Evaluation.
    • Mid-term Council Governance Review. Record Council member participation at meetings, committee and training activities.
Strategic Objective Six: Develop a sustainable and high performing organisation.

We will ensure the effective alignment of resources, people and culture to produce reliable, sustainable business results.

  • We aim to achieve this goal by:
    1. Delivering value for money
      • Implement best-practice procurement procedures, as outlined in the National Public Procurement Policy Framework.
      • Implement a programme of strategic procurement that drives maximum efficiency and effectiveness within the procurement function.
      • Engage in public sector aggregation and shared service initiatives.
    2. Developing and maintaining a sustainable business model
      • Develop and deliver a medium-term financial strategy to ensure the organisation’s core objectives are met within the prevailing economic environment.
      • Examine ways to diversify revenue streams.
      • Reduce operational costs by methods such as outsourcing and using shared services.
    3. Focusing on organisational capability, with an emphasis on business process improvement
      • Implement a business process improvement framework. Attain external accreditation of Medical Council processes, commencing with our registration processes.
      • Develop a corporate data strategy and develop systems, including IT systems, to capture and analyse high-quality data that can inform our work.
      • Ensure that all the organisation’s systems and processes are focused on the needs of those who use our services.
      • Develop a quality assurance framework that allows us to better monitor and understand our business delivery, risk and compliance.
  • What are the intended outcomes?
    • Operational cost reduction through, for example, greater use of information systems and collaborative working with partner organisations.
    • High-performance, proactive contract management.
    • Diversified revenue streams.
    • Clear understanding about our longer-term financial needs and higher levels of transparency, accountability and demonstration of value for money.
    • Understanding of the concept of business process improvement established across the organisation to facilitate communication, training, and implementation of business process improvement initiatives.
    • Council processes attain external accreditation starting with the registration process.
    • Service user experience is enhanced by systematically collecting service related data.
    • Confidence that our business systems and processes are fit for purpose and are complied with.
  • How we will measure effectivness
    • Agreed percentage of diversification of revenue targets achieved.
    • Achieve breakeven by 2015.
    • Generate revenue surplus by 2017.
    • Percentage reduction in key contract spends agreed under the Corporate Procurement Strategy.
    • Reporting of operational and system improvements.
    • Annual assessment of public satisfaction with Medical Council processes.
    • Data on quality processes to form the basis for business process improvement initiatives.
Strategy Wheel

Strategy Wheel

Strategic Roadmap

Strategy Roadmap