1. An acute trust had serious difficulty managing its employment relationship with a consultant surgeon, mainly relating to allegations regarding his conduct, over a number of years. Relationships had reached the point where communication was almost entirely conducted via respective legal advisers. This resulted in the surgeon submitting an extremely complex series of grievances. These were investigated thoroughly and a report submitted to the Trust Board.
2. An NHS trust had identified a problem with the use of temporary medical staff and in particular the high cost of using agency employees. After consultation with relevant managers the consultant produced a number of options for replacing agency staff with permanent employees and a recruitment strategy for achieving this, with a potential cost saving approaching £1 million in a full year.
3. A Mental Health trust received information via the local counter-fraud service that one of its doctors appeared to be abusing his Section 12 rights to provide a psychiatric opinion to local authorities. The consultant carried out extensive investigations in liaison with local counter-fraud specialists which extended across 3 Social Services areas. The investigation resulted in disciplinary action against the doctor concerned and an arrest warrant being issued on criminal charges.
4. One Arms-length NHS organisation required project management expertise to assist with the introduction of the new national pay modernisation scheme. It soon became clear that the HR provider service (outsourced) could provide no additional resources to assist in the task. The consultant had to create source documents for all staff, secure agreement to these with managers and employees, undertake job assessments and job evaluations for over 150 staff (many of whom were in unique posts) and prepare portfolios of evidence for remote evaluation panels. The project developed to include competency profiling for staff and the development of associated skills appraisals and, latterly, the implementation of Very Senior Managers' Pay. Support is continuing.
5. A voluntary sector organisation had received allegations that the manager of a particular branch office was bullying and harassing members of staff. The client had already suspended the manager to facilitate the investigation. It soon became clear that there was a possibility of a climate of fear and intimidation within that part of the organisation, so it was necessary for potential witnesses to become confident in the impartiality of the consultant and the confidentiality of the investigation. Once this was overcome it was possible to clarify allegations, which were thoroughly investigated using evidence of witnesses. The allegations were put to the manager with the cooperation of his trade union. A final report was presented to the client with findings and a recommendation that there was a disciplinary case to answer.
6. A number of NHS trusts have from time to time required advice on remuneration for Directors. Initially this covered Chief Executives and Executive Directors, but with the introduction of Foundation Trusts has expanded to include Chairman and Non-executive Director Posts. These are normally undertaken using a number of resources including analysis of published survey data, analysis of vacancy advertising and carrying out independent surveys tailored to the client's individual needs.
7. Two large NHS Trusts received allegations of bullying and harassment against senior members of clinical staff. In each case the consultant carried out an extensive investigation. Those investigations culminated in detailed reports followed by presentations to subsequent disciplinary hearings.
8. A large trust had difficulties managing the inter-personal relationships between an Associate Specialist and other medical members of the clinical team. This had resulted in allegations and counter-allegations of bullying and harassment, some involving use of IT. The consultant conducted a thorough investigation and produced a detailed report, which he presented to subsequent disciplinary hearings.
9. A Primary Care Trust in the South of England identified major concerns over a number of issues. These included the capability of the HR Director, the conduct and/or capability of the Director of Nursing and allegations of patient abuse at one community hospital. The consultant worked with Directors of the Trust to identify an action plan for the HR Director. He worked with an independent (external) nurse manager to carry out a widespread investigation into the allegations against the DN and produced a joint report to the Trust Board. He provided intense support, coaching and advice to the newly-appointed Modern Matron to enable her to carry out a detailed investigation into the abuse allegations, which resulted in disciplinary action.