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
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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