Transcript Slide 1

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Future Challenges and Direction
Dr Vicky Osgood Director of Education and Standards
Thank you
The Future
Wessex Deanery
The Future
The future is here; it is just not
evenly distributed
William Gibson
Wessex Deanery
The Future
The future is not the Isle of Wight awaiting our arrival. It is
more like the Great Western Railway, something that we
have to imagine, design and build. If we do not build it
other people will.
Sir Muir Gray director, National Knowledge Service and
chief knowledge officer to the NHS
Developing Areas
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Patient safety
Academia
Clinical Leadership/Engagement
Professionalism
Role of Doctor
Public Health
Health Inequalities
Primary Care
Move of care into community
Curriculum
 Curriculution
Evolving the curriculum to meet patient and
service need as well as the changes in the
science of medicine.
 Impact of genetics
"It is much more important to know what kind of
patient has a disease than to know what kind of
disease a patient has.“
(Caleb H. Parry-1755-1822)
Wessex Deanery
Why does the GMC exist?
 ‘… to protect, promote and maintain the health
and safety of the public.’ (Medical Act 1983)
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Our purpose is to protect, promote and
maintain the health and safety of the public
by ensuring proper standards in the practice
of medicine.
We are the regulator of doctors rather than a
professional body for doctors.
The Role of the 21st Century Regulator
Medical
School
Set standards and
outcomes and
inspect medical
schools
Foundation
programme
GP/
Specialist
Ongoing
practice
Approve entry to the
register, foundation
programme curricula
and the educational
environment
Approve specialist
curricula,
programmes and
posts and require
assurance about the
quality of the
educational
environment
Require on-going
assurance of
competence and
fitness to practise,
and support for
doctors from their
responsible officer
A model for Quality Improvement
PG Deaneries/LETBs
& Medical Schools
& Medical Schools
Royal
Colleges/Faculties
Medical Schools
(Specialty/GP
Council only)
QIF – four elements
Enhanced
monitoring
Approval Against Standards
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Approve
Approve
Approve
Approve
medical schools
programmes
curricula and assessment blueprints
and recognise trainers
Standards now
 Too many ‘domains’
 Tomorrow’s Doctors and The Trainee Doctor too focused on
process and not sufficiently on what we want to see
 Don’t support our regional approach to inspection
 Insufficient recognition of quality improvement
 Need to determine what success looks like – but not ‘tick
box’
 Need to have regard to multi professional and other
regulatory systems
 Can’t ignore the wider healthcare environment (Francis
Inquiry)
A new framework of standards
 An overarching statement that patient safety and equality are
fundamental
 Standards grouped under four quality themes:
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Learning environment and culture
Educational governance
Supporting learners and trainers
Developing and delivering curricula and assessment
 Standards are a broad and enduring description of the level
of quality to be met
 Requirements set out what must be demonstrated to meet
the standards; some may apply to a specific level of training
 Exploratory questions indicate areas we want to investigate
to determine if a standard is being met, and may change
over time based on evidence collected
A new framework of standards: next steps
 June and July 2014: Engaged with stakeholder
groups, including eight workshops across the UK
 Autumn 2014: Revised draft and prepared for
consultation which opens 28th January 2015
 Following consultation, and after making any
changes, we would aim for implementation in 2016
First visit to implement these is the South West
Standards
Requirements
Requirements
Requirements
Theme 3 Supporting Learners and Trainers
Requirements
Introduction
The Shape of Training Review considered potential reforms
to the structure of postgraduate medical education and
training to ensure we continue to train effective doctors
who are fit to practice in the UK, provide high quality and
safe care and meet the needs of patients and the service
now and in the future.
 The Review focused on ensuring doctors are able to meet the
changing needs of patients, society and health services.
 It looked at the transitions from medical school into Foundation and
on into specialty training and continuing professional development
(CPD).
 Chaired by Professor David Greenaway, VC Nottingham University.
Themes of the Review
 Theme 1 – Workforce needs: Specialists or
generalists
 Theme 2 – Breadth and scope of training
 Theme 3 – Training and service needs
 Theme 4 – Patients needs
 Theme 5 – Flexibility of training
 + UG to PG transition
 + Clinical academic interface
Final Report published
Securing the future of excellent patient care: Final Report of the
independent Shape of Training review led by Professor David
Greenaway was published on 29 October 2013.
 The final report offers an approach which will ensure doctors are
trained to the highest standards and prepared to meet changing
patient needs.
 It offers an approach which will be fit for purpose for many years to
come and a framework for delivering change and for doing so with
minimum disruption to service.
Shape of Training model
What now?
Members of the sponsorship board have met since report
6 workshops run last year
Broad based themes to CST
Interaction with Employers
Blurring the primary-secondary care interface
SAS doctors
Academic Pathway
Credentialing
Departments of Health have now produced policy
submissions to ministers
Part of HEE Mandate
HEE, NES, Welsh government setting up Shape of Training
development groups
Don’t forget
2. More ways of involving patients in education and training
3. Medical students need to know what to expect
6. Generic capabilities framework
7. All doctors to progress at own pace within timeframe
8. Longer placements to encourage apprenticeship
9. Training should be done in places that provide high
quality training and supervision.
Broad based framework
Transferable competencies
Generic Capabilities
Three levels:
Professional
Clinical
Cultural and systems awareness
Under each level there would be sub-levels and themes –
some examples on next three slides
Professional
Personal behaviour:
Act with integrity
Communication, teamwork and shared
decision making:
Handover and continuity of care
Quality improvement:
Learning lessons from success and failure
Leadership:
Co-ordinating a multi-disciplinary team
Clinical
Patients:
- Procedural: Consent
- Care: End of life
Underlying causes:
Recognising and knowing what to do when
patients present with possible underlying
causes and co-morbidities – e.g. mental health
Therapeutics and prescribing:
Safe prescribing
Cultural and systems awareness
GMC requirements:
Good Medical Practice
The structure of the NHS and the
independent sector, and the communities
they serve:
Understands the demography and diversity of
the local population e.g. local patterns of
morbidity.
Research and data:
Have an understanding of and participate in
research relevant to specialty
Developing Areas
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Patient safety
Academia
Clinical Leadership/Engagement
Professionalism
Role of Doctor
Public Health
Health Inequalities
Primary Care
Move of care into community
The Future
Those who cannot remember the past are
condemned to repeat it.
George Santayana 1863-1952
Thank you