West of Scotland Regional Trainers Day 2013
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Transcript West of Scotland Regional Trainers Day 2013
West of Scotland
Regional Trainers Day 2013
“Just when we
thought we had a
handle on it….!”
Looking ahead!
“To improve is to change; to be
perfect is to change often.”
Winston Churchill
“Any change, even a change for
the better, is always
accompanied by drawbacks
and discomfort.”
Arnold Bennett
Changes within NES
John McKay
Assistant Director for Quality Improvement and
Performance Management
David Cunningham
Assistant Director for Continuous Professional
Development
NES Vision Project
Professional Development
Training Management
Business Support
Quality
Multi-Professional leadership and external
engagement
Throughout Scotland all Deaneries should
be doing the same things the same way.
2014 Single Scottish Deanery
5 Regional offices
Glasgow
Edinburgh
Dundee
Aberdeen
Inverness
Scottish Wide ES and Training
Practice Accreditation and reaccreditation standards and
process
National Strategy for CPD
“NES should be the first port of
call for all Doctors in Scotland
meeting CPD needs”
2CQ Reconfiguration
Recruitment
Stage 2 Cut off score increasing
2012 6%
2013 11%
2014 14%
Candidates Demonstrated Round 1
2012 74%
2013 84%
StART Alliance:
Scotland’s Strategy for Attracting and Retaining
Trainees
After round 2 - still 25 vacancies in Scotland
Scotland: Home of Medical Excellence
NES + stakeholder groups
Improve recruitment and retention in specialty
training
Revamped advertising, use of social medial
Newly commissioned work on what ‘attracts’
trainees
Trainee Ambassadors: Word of mouth is strongest
influence
Recruitment
Alternative Foundation Competency
Certification more robust
ALS certification before
commencing in training
NES will become Tier 2 Visa
sponsor for whole programme from
February 2014
RCGP
E-portfolio!
Curriculum update Oct 13:
Prescribing Safety –
Based on GMC commissioned survey
More focus on knowledge of therapeutics and
demonstration of skills for safe/appropriate
prescribing and medication reviews
Improved skills in management of polypharmacy
Mental Health –
Co-morbidity of physical conditions in metal health
Assessment and safety planning for suicidal
patients
Promote hope and demonstrate compassion
Exam Changes:
AKT
Wide selection of
questions
Every AKT drug
calculations
Free text to replace
choosing from lists
Content shaped
towards prescribing
safety
CSA
At least 2 cases with
major prescribing
component
New tests of
prescribing behaviour
Child actors cases
from Nov 13
may include paediatric
prescribing
Handwritten scripts
WPBA: COT/CBD/SEA/Audit/Learning Log
Future Assessment Changes
GMC mandated there should not be assessment for
assessments sake
All assessments should have meaningful formative
feedback
DOPS to be replaced by Integrated Clinical Skills
August 2014
Structured Learning Event (SLE) format in
development for August 2015
Will allow wider use of material for assessment
e.g prescribing, SEA/audit discussions in addition
to existing WPBA
Focused CBD pilot due for reporting
How to pass the CSA?
A year of Reports!
Francis Report
Report into failing standards of care
in Mid Staffordshire
290 recommendations
20 refer directly to medical
education
Impact of Medical Education:
GMC set standards for educational
environments/approved practice settings
Prioritisation of Patient Safety within Quality Assurance
Training Visits
Routine quality visits to training environments
Trainees actively encouraged to provide feedback on
standards of patient safety and quality of care (GMC
survey and trainee post assessment questionnaires)
More information sharing between service providers and
Deaneries
Any visit identifying patient safety concerns to be shared
with PCOs
Clinical Leadership Training for all trainees (LaMP)
GMC Recognition and Trainer Approval:
Traditionally in place for GP
Trainers
From 2013-14 will be extended
to cover secondary care
named ES/CS’s and
undergraduate teachers
Based on standards already
set out in ‘The Trainee Doctor’
and ‘Tomorrow's Doctors’
Academy of Medical Educators:
7 Framework areas used to set standards –
Ensure safe and effective patient care through
training
Establish and maintain and environment for
learning
Teaching and facilitating learning
Enhancing learning through assessment
Supporting and monitoring educational progress
Guiding personal and professional development
Continuing professional development as an
educator
Adapted for GP by RCGP
New Self Submission Documentation for ES
and Training Practice approval/re-approval
Scotland wide document
Referenced to standards set in RCGP version of
AoME Framework areas
More detailed document for each ES
Approval for individual ES’s and the Practice as an
educational environment
Re-focusing of questions and visits to meet set
standards
GP Training in West of Scotland is already well
placed to comply will all requirements
Shape of Training Report
Why change?
Needs of patients are changing fast
Increasing multiple-morbidity
Super-specialisation can be a
hindrance in some instances to
good patient care
Consensus opinion:
More generalists able to work across specialties
Better preparation for working in multi-professional
teams
Greater career flexibility
Training needs to be tailored to meet changing
patient need
Training should be based on what kind of doctors
are needed
More doctors capable of providing general care
across a range of different settings
Doctors will progress to credentialing in specialist
areas (including GP).
More opportunities for doctors to change roles
Local workforce and patient need should drive
opportunity
Full registration should move to the point of
Graduation with measures in place to demonstrate
Graduates are fit for purpose
So what may it look like?
Two year Foundation Programme to remain initially
Doctors will enter ‘themed’ broad based specialty
training e.g. ‘Community’ might include GP,
Psychiatry, Paediatrics, COTE
Will last between 4 and 6 years
Transferable competencies between specialties
Exit point will be a CST (Certificate of Specialty
Training)
Further career enhancement via ‘credentialing’
Delivery Board to be established
All Doctors to develop generic
skills in:
Patient safety
Communication with patients and
colleagues
Teamwork, Management and
Leadership
Evaluation and application of
research
19 Recommendations:
8. Appropriate organisations, including employers
must introduce longer placements for doctors in
training to work in teams and with supervisors
including putting in place apprenticeship based
arrangements.
9. Training should be limited to places that provide
high quality training and supervision, and that are
approved and quality assured by the GMC.
So where does this leave EGPT?
Educational case for UK 4 year GP
Training widely accepted
RCGP still pressurising for 2 years in GP
Cost neutrality imposed
Re-focusing of some existing posts
towards ‘community’ slant
On a very positive note:
May CSA 3rd best pass rate in UK for 1st attempt
takers
2013 GMC Survey West of Scotland Deanery rated
3rd top of 20 UK Deaneries for overall satisfaction
for GP Training
1st among large Deaneries in UK