rŵk healthcare consultancy is a sole trader organisation, registered as RWK Works
Ltd. Services are provided by Richard (Dick) Waite, who up to March 2009 was a senior
manager in the Healthcare Commission. Dick is based in Devon, but also works at national
levels and overseas.
Current and recent contracts include...
Interim Chief Operating Officer for the National Institute for Cardiovascular Outcomes
Research (NICOR) at the Institute of Cardiovascular Science, UCL.
Reviewing clinical audit systems for the Hong Kong Hospital Authority.
Surveying universities and NHS trusts about the inclusion of patients’ experiences
within education and training (part of a King’s Fund/King’s College London project
for the DH Patient and Public Involvement Team and the NHS Institute for Innovation
Evaluating synergies between national audits for stroke and falls (for the Healthcare
Quality Improvement Partnership, HQIP).
Reporting on issues of patient confidentiality and consent in national clinical audit
(for the NHS Information Centre for Health and Social Care).
Tender evaluation for the Health Foundation’s Closing the Gap programme.
Analysing interviews with children and teachers in relation to outdoor learning (the
Exmoor Curriculum) for the University of Plymouth.
Key skills and achievements...
Richard (Dick) Waite is a successful independent consultant and trainer.
Long career at senior managerial level within healthcare and local authority regulation.
Experienced at working with clinical leaders, managers, patients’ representatives
and politicians at national levels, in addition to other regulators and government
Good at translating policy into practice, seeking to understand the strategic vision
of ministers, chairs and board members and then designing and implementing practical
I always start with the questions “how will this affect patients, how will what we
do improve care?” I do not have a clinical background, but by working closely with
many clinicians over the years, and having been both a manager and a patient myself,
I can help bridge the gaps between how patients, clinicians and managers think.
Keen to take on new challenges - eg, I led the development of the new healthcare
associated infection (HCAI) national registration system for the NHS, on behalf of
the Care Quality Commission; I wrote first drafts of the Strategic and Business Plans
for the newly-formed Healthcare Quality Improvement Partnership (HQIP); I joined
the transition team that set up the Healthcare Commission. I helped to establish
the National Institute for Clinical Outcomes Research.
Known for disentangling difficult issues, with a track record of taking on complex
topics, and managing and coordinating teams to produce high quality outputs to tight
timescales (eg, HCAI registration system, value-for money national reports for the
Audit Commission, inspection guides).
Managed a major programme with an annual budget of £5.5 million (the National Clinical
Audit and Patients’ Outcomes Programme), delivering quality outcomes within budget
Experienced in directly managing staff, but also at moulding ‘matrix’ teams that
involve colleagues from other departments and clinicians on placement or secondment.
I am familiar with using appraisal systems to ensure that everyone is clear about
what needs to be achieved. I believe that the teams I lead pull together well and
deliver high quality work to time and cost.
Career before rŵk...
HCAI Registration Project Lead (2008-2009): I led the design and development of
the Care Quality Commission’s new HCAI registration system for the NHS. From a standing
start in June 2008, I quickly identified how the new regulator could meet the requirements
of the new 2008 Health Act, setting out the options and agreeing design plans with
the new regulator’s Chair and Chief Executive and senior DH staff. I drew up the
published guidance for trusts, and secured the necessary commitment of team members
and resources from within the Healthcare Commission and from CQC. To ensure success
I needed to build a team via matrix working across directorates and between different
organisations. Each work stream was in turn led by extremely capable and committed
colleagues. A real ‘can do’ spirit prevailed and delivery of all project phases was
achieved against very challenging timescales. The IT solution went live in January
2009, and all trusts submitted applications by the deadline of 6 February. The register
was published on 3 April 2009. Key responsibilities:
coordinating inputs from many teams within the Healthcare Commission, other stakeholder
organisations and DH
designing an HCAI registration system that fitted the requirements of the legislation
producing key papers, budget, plans
drafting guidance for trusts (published and website)
National Clinical Audit and Patients’ Outcomes Lead (2004-2008): I was appointed
by the Healthcare Commission to manage the national clinical audit programme. Inherited
challenges included a backlog of unresolved contractual issues, delayed starts and
failure to deliver. I devised a recovery plan that produced a governance framework
and business processes designed to provide good value for the public money spent.
The programme kept within its budget each year, growing in size to £5.5m and becoming
better balanced across the different areas of patient care, reflecting consultation
about priorities with the National Clinical Directors (the ‘tsars’) and the Welsh
Assembly Government. The audits – managed via contracts placed with the medical and
nursing royal colleges - became one of the major ways in which the Healthcare Commission
engaged with national clinical organisations and frontline staff. Our quality assurance
processes helped the outputs from the audits become more consistent, with more focus
on achieving tangible improvements for patients. Key responsibilities:
managing small team of staff
quality assuring national audits
procuring audits, including European tendering process
developing guidance for national audit teams
commenting on draft national reports
liaising with stakeholders (eg, NICE, DH, ‘tsars’, Welsh Assembly Government, NPSA
and other regulators, Royal Colleges, patients’ organisations, local clinical audit
staff, Health Foundation)
Transition consultant (2004): In 2004 I was appointed as part of the Transition
Team developing the Healthcare Commission. I led a project to identify clinical peer
review schemes, and consulted on how the findings from such schemes might be used
in the new regulator’s assessments. The skills needed included intelligence gathering,
the ability to engage with and interpret the views of many different stakeholders
at the most senior levels, analyse and present data, and the ability to produce recommendations
to devise a workable solution. Key responsibilities:
identifying the peer review schemes in use and assessing their strengths and weaknesses
engaging clinical leaders and sponsors of the schemes (eg, the royal colleges), leading
to agreements on sharing and partnership with the new regulator
Senior Manager Audit Commission (1994-2004): Managing a small team, we produced
national reports and local audit guides for the inspection of NHS services. Outside
of healthcare, I led a team examining PFI in schools. We put special emphasis on
promoting improvement via the use of plain language in the reports, and providing
different types of presentation for different audiences (clinicians, managers, patients
and the public, trust boards). These studies involved delivering high quality outputs
that received considerable media interest. I am used to presenting results on radio,
national television and large conferences. The studies were conducted in a challenging
environment, requiring fast delivery of high quality research and involving a wide
range of stakeholders including patients and their representatives, MPs, the DH,
and local trust staff of all kinds from the Chief Executive and Board members to
front line clinicians and managers. Most of these studies included the production
of a local audit guide. Our national and local recommendations faced intense scrutiny
from the DH and services – often challenging and initially unpopular, they needed
to be credible and workable from all angles. Team leader, project manager and lead
national report author for these national VFM studies:
PFI in Schools (January 2003)
Dentistry (published September 2002)
Critical Care (October 1999)
Anaesthesia (December 1997)
GP Fundholding (May 1996 and July 1995)
Also produced a national report based on local auditors’ NHS Plan audit findings
(July 2003), and worked jointly with the Commission for Health Improvement (CHI)
on a study of Cancer (December 2001)
Manager, District Audit Service (1991-1993): In 1990 the Audit Commission was given
responsibility for the external audit of health authorities and trusts, and began
recruiting suitable specialists to carry out local value for money (VFM) reviews.
Audits producing reports and action plans presented to clinical heads and chief executives
across the south west included:
children’s services, day surgery, nurse staffing
local government topics included evaluating councils’ use of competitive tendering
Research Fellow/Team Leader (1985-1990): I worked in a self-financing charitable
company, based within the University of Sussex. At the Institute of Manpower Studies
(now the Institute for Employment Studies) I won funding from a range of different
sources, including government departments, research councils, health authorities
and trusts. We also undertook work for some of the ‘blue chip’ private sector companies,
including labour market analyses and employment strategies appropriate in the light
of school leaver projections.
I am computer literate, including use of the main statistical packages (eg, SPSS),
the Windows environment, use of common business software (eg, Word, Excel, PowerPoint).
I have carried out both quantitative and qualitative research (using NVivo for analysis),
taught experimental design and statistics to students and acted as a source of advice
Prince 2 trained.
Educated to PhD level in psychology/behavioural ecology.
Outside of work...
Ever since my academic days I have been involved in natural history and conservation
work. I am a Board member of the Devon Wildlife Trust. I have volunteered at a local
National Trust garden and forestry yard and recently gained a Royal Horticultural
Society certificate. I have been an organic gardener since student days, and grow
nearly all of my family’s fruit and vegetables (and make our own cider...). I chaired
the food production group within my village’s Transition Project.