Journal of Medicines Optimisation - Mar 2022

Journal of Medicines Optimisation • Volume 8 • Issue 1 • March 2022 54 enthusiasm and progress made so far. I have established a rapport with these individuals and naturally find myself coaching them using the GROW 12 model, redefining the goal of the task, listening to them, delegating roles such as embedding the formulary as part of the EMIS prescribing tool and advising them when required, empowering them to offer ideas to improve the current process and agreeing action plans and schedules during individual appraisals. Due to underlying health conditions, the third individual is currently off sick. The fourth individual has avoided any direct conversations about the task, appears to be rather occupied and dismissive and has made no progress whilst seems to be focusing on ‘other’ priorities. The attitude indicates ‘Unconscious Incompetence’ and demonstrates Low Skill/Low Will behaviour suggesting need for further guidance and support. I intend on rearranging an individual appraisal session to address the issues and provide feedback .12 I need to ensure that I am descriptive, but not judgemental, focus on the performance rather than the individual and be clear and specific and ensure the meeting is focused on achieving a solution. The SBIR 12 model would be used to guide me through the process. SBIR will give me the opportunity to set the scene and discuss the lack of progress observed on this task. I will prepare a list of emails and proposed meetings as evidence to demonstrate my willingness to offer support and where the individual has chosen to ignore. I will describe how the dismissive behaviour is impacting on team morale and will aim to achieve a desired resolution after listening and understanding the individual’s reasons. During this process I need to ensure that I extract myself from the situation, compose my emotions as well as appear empathetic and understanding. Six months into the project, the position for a new dietitian is currently being advertised, to support with the process. The Audit has been completed at 6 practices, where 280 patients have been assessed and reviewed against the guidance, resulting in 192 interventions and an approximate Annual Cost Saving on ONS Prescribing of £155,000. This does not account for hidden cost savings associated with an improvement in the quality of nutritional care to patients. Application of the CLIP® skills that I have acquired throughout this course and simultaneously leading on this project has been an extraordinary learning experience. It has instilled confidence in me to communicate effectively with different personalities and deal with difficult situations and has provided me with the opportunity to identify and reflect on areas where I need to improve Declaration of interests The author has no interest to declare. References 1. Elia M, (on behalf of the Malnutrition Action Group of BAPEN and the NIHR Biomedical Research Centre (Nutrition) Southampton). The cost of malnutrition in England and the potential cost savings from nutritional interventions (full report): BAPEN; 2015. 2. Heppolette W, Executive Lead – Strategy & System Development, GMHSC Partnership GMHSC Partnership Annual Report and Accounts 2017-18 3. Joint Strategic Needs Assessment Annual Report 2018 4. Advisory Committee on Borderline Substances (ACBS) (2019) Available from: http://www.drugtariff.nhsbsa.nhs.uk/#/00710361- DA/DA00710354/PartXVBorderlineSubstances 5. Business Intelligence Portal: Accessed May 2021 http://www.bigmcsu.salford.nhs.uk/sites/mm/Pages/Home.aspx . Restricted access. 6. Forrest, C., Wilkie, L. (2009) London Procurement Programme Clinical Oral Nutritional Support Project Report 2009. London Procurement Programme. Can be accessed online via https://docplayer.net/5105343-London-procurement- programme-clinical-oral-nutrition-support-project.html 7. Department of Health. The NHS Quality Innovation Productivity and Prevention Challenge: an Introduction for Clinicians. 2010. 8. NHS England (2014) Five Year Forward View http://www.england.nhs.uk/ourwork/futurenhs/ 9. Francis, R. Report of the Mid Staffordshire NHS Foundation Trust Public HMSO Inquiry Crown copyright, 2013. 10. NHS England. Guidance for NHS Commissioners on Equality and Health Inequalities legal duties https://www.england.nhs.uk/ourowrk/gov/equality- hub/legal-duties/ 11. NHS England (2015) Guidance to Commissioning Excellent Nutrition and Hydration 2015-18 https://www.england.nhs.uk/wp-content/uploads/2015/10/nut- hyd-guid.pdf 12. CLINICAL LEADERSHIP IN PHARMACY (CLIP®) PROGRAMME RESOURCE MANUAL: Second edition May 2021 13. National Institute for Clinical Excellence (NICE). Nutrition Support In Adults QS24, 2012. http://www.nice.org.uk/qs24/chapter/Quality-statement-1- Screening-for-the-risk-ofmalnutrition