Roles of the DSCT team
members
Review of documents available
Who is this new kid on the block?
Reason for the DSCT existence:
“ To ensure equitable access to appropriate
and improved quality of care for mothers,
newborn babies and children. Responsible for
clinical governance and skills development. “
Primary role and focus of the
DSCT specialist
“The primary role of the District Clinical
Specialist is supportive supervision and
clinical governance and not the direct
delivery of clinical services.”
“The specific focus of the DSCT is
maternal and child health.”
DSCT’ s in South Africa : Ministerial Task Team Report 2012
Clinical governance:
 To provide the means of developing the organisational
capability to deliver sustainable, accountable, patient focused,
quality assured healthcare.
 '... a framework through which organisations are
accountable for continually improving the quality of their
services and safeguarding high standards of care by
creating an environment in which excellence in clinical
care will flourish.' (Donaldson and Gray, 1998).
 It's about everything we do to improve the quality of care that
people received from us', '...It's everyone business
Authority of the DSCT:
“ The
authority of persons occupying
DSCT posts will arise partially from the
posts themselves , but more so from
their individual credibility based on their
knowledge and experience.”
DSCT’ s in South Africa : Ministerial Task Team Report 2012
Management style
 Old – functional management with beaurocratic
structures
 New – Matrix management
“In matrix management, leaders suddenly find themselves
having to master the challenges of managing crossdivisional teams over whom they have little formal
authority.”
“.organizational management in which people with similar
skills are pooled for work assignments.”
Matrix management
Advert for DSCTposts –
1. Knowledge
 Own clinical discipline, legislation , regulations
and policy
 QA , programme planning, implementation and
evaluation
 Information management
 HR and financial management
2. Skills:
 Leadership
 Communication
 Problem solving
 Computer literacy
and the following attributes - self confidence
objective, ethical and empathetic
3. Key performance areas
(KPAs)of DCST:
 Deliver quality health care for mothers, new born and
children at district level
 Promote equitable access to the appropriate levels of
care
 Up to 10% of time in clinical care and 10% in research –
to maintain competency. (80% in district)
 Support service delivery a/c discipline at district facilities
 Promote clinical effectiveness at facilities – outreach,
protocols etc
KPAs continued:
 Logistics: work with DMT to establish and maintain
systems, surveillance, health information,
communication, referral guidelines. Ensure appropriate
infrastructure and resources
 Monitoring and evaluation: Critical event analysis,
morbidity and mortality meetings/audits
 Reporting effectively : to DSCT, community, NGOs, to
management structures.
JOB DESCRIPTION SPECIALIST DYADS
Ministerial Task Team Report: 2011
Regional hospital
(1.2m population)
OBGYN- Paediatrician
Facility based
District hospital
Family physicians
Facility based
MOU
PHC
CHC
Provincial specialist
OBGYN/Midwife
Paediatrician/Paediatric nurse
Anaesthetist
Family Physician/PHC Nurse
PHC outreach
teams
Primary focus
Families at home
Secondary focus
Medical and nurse specialists
Presentation to National Health Council 8/2011 on DSCT roles
Doctor job description:
Nurse job description:
 General –
 General
 Promote equitable access
and appropriate care
 Promote the provision of
appropriate primary
prevention, promotive and
curative health care services
 Assist with strategic &
operational planning
 Co-ordinate, monitor ,
support discipline related
services
 Maintain competency in the
discipline
 Assist with strategic &
operational planning
 Clinical leadership & support
in the functional areas of
expertise
Medical and nurse specialists
Doctor job description:
Nurse job description:
 Facility support -
 Facility support -
- Clinical focus - packages,
outreach & participation
- Clinical focus - packages,
outreach & participation
- Policies & protocols
 Organisational support –
 Organisational support
- Infrastructure , equipment &
resources
- Infrastructure , equipment &
resources
- Staff development, support
- Staff development, support
- Unit systems & management
Medical and nurse specialists
Doctor job description:
Nurse job description:
 Systems and logical support
 Systems and logical support
- Information, referral and
surveillance
- Information, referral and
surveillance
 M&E
 M& E
- Quality improvement
programmes and reporting
systems
- Quality improvement
programmes and reporting
systems
- Mortality audits
- Appropriate mortality audits
Group activity:
 What is the role of the DCST in the district - go beyond
objectives and to state practical priority functions
 How is the role of the DCST different from other
stakeholders on the district management team eg the
district managers, MCH and PHC programme managers,
operations managers, coordinators and information
officers?
 How do you give the DSCT posts authority?
 How have you managed these roles thus far? What
factors have helped hindered this?
Do we know who we are?
Accepted
Making a difference
together