Clinical Leaders Programme – Centenary BOA poster prize winner – Rakesh Dhokia

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Mr Rakesh Dhokia - Consultant Orthopaedic Spine Surgeon, Belfast

"I am personally delighted to have won the Centenary BOA poster prize for the Clinical Leadership Programme 2018. I gained entry to the prestigious programme following a competitive interview with the UKSSB, who provided full sponsorship. The programme itself was delivered over 4 sessions throughout the year and each session was structured as 2 days in Newcastle. I also enrolled with the Chartered Management Institute and was awarded a Level 7 Certificate in Strategic Management and Leadership.

The focus of the programme is to develop clinical leadership skills for future Orthopaedic Consultants and develop effective strategies in service transformation. There is a mix of formal training, self-directed learning and mentoring. I found the individual coaching for personal development most valuable. The programme provides direct access to established NHS leaders and strategists within the Department of Health.

My project was based on the issue of significantly long waiting lists for elective spinal surgery in Northern Ireland. This at the time of starting the project was almost 3 years for first Consultant review appointment. The idea for the spine “MegaClinic” was formulated by Mr Niall Eames, Consultant Orthopaedic Spine Surgeon and Clinical Director. The focus of the project was to establish a patient centred approach to tackle the waiting list problem and empower both patients and clinicians in the process. The clinicians consisted of musculoskeletal specialist physiotherapists, GP’s with specialist interests and junior trainees. Co-located clinics commenced with 2 consultants overseeing a team of 16 clinicians treating approximately 150 patients attending a single 4-hour session. Patients were managed in line with agreed pathways and clear protocols. Specifically, patient satisfaction with the process was evaluated with more than 94% of patients reporting the service received was “good” or “excellent” and they felt they were treated with dignity and respect throughout the new process. 6 mega clinics have now run with more than 900 patients reviewed. Previous measures such as waiting list initiatives to the independent sector have been short term. The estimated financial saving of these clinics to date is approximately £40,000. The success of this clinic relies on robust pathways, patient and clinician education and low conversion to surgery. The conversion rate to surgery in our clinic was less than 10%. We predict this model could effectively be reproduced in other specialities.

I would encourage senior trainees, post CCT trainees and new consultants to apply to the programme through the UKKSB. In addition to sponsorship there is opportunity to gain direct mentorship and coaching from senior spinal surgeons within the society, which remains long after the completion of the programme."