Update on Implementation of the recommendations of the UK Shape of - - PowerPoint PPT Presentation

Update on Implementation of the recommendations of the UK Shape

• f Training Steering Group

Professor Ian G Finlay Chair UK Shape of Training Steering Group

Shape of Medical Education and Training Review (SoTR)

www.gmc- uk.org/Shape_of_training_FINAL_Report.pdf_53977887. pdf

Tasked to consider how medical education and training should adapt to meet the changing needs of patients over the next 30 years

What are these changing needs?

Percentage of patients with 2 chronic conditions needing care in the community according to age

Innovation, data and artificial intelligence

• By 2030s it is anticipated that 50% of current

jobs will not be required

• In 2012 the top 10 technology based posts did

not exist in 2004

• Data generated and stored last year equates

to the previous 5000 years

• 25% teaching in first year of science based

degrees obsolete at graduation.

Workforce implications

• Life long learning (governed)
• Career changes
• Current entrants to the workplace have

different values and expectations

• Portfolio careers
• Career breaks
• Potentially work longer

Focus on hospital care

25% in-patient could be treated in the community

Secondary Care Medical Workforce

1000 2000 3000 4000 5000 6000 7000 1 9 9 6 1 9 9 8 2 2 2 2 4 2 6 2 8 2 1 2 1 2 2 1 4 Consultant Doctor In Training 100% 110% 120% 130% 140% 150% 160% 170% 180% 190% 200% 1 9 9 6 1 9 9 8 2 2 2 2 4 2 6 2 8 2 1 2 1 2 2 1 4 Consultant Doctor In Training

Data from : ISD Scotland

Focus on specialist training

Specialist Training General Skills

Future hospital commission report

• “All too often our most vulnerable patients

are failed by a system ill-equipped and seemingly unwilling to meet their needs”

• “ There is increasing evidence of substandard

care provided to many older patients with care poorly coordinated and reports of patients being moved between wards and within wards ‘like parcels’.” (Royal College of Physicians London, 2013)

Current Post-Graduate Medical Training

§ Many attributes but outdated § Organised in “silos” § Medical Royal Colleges and Faculties. § Rigid and inflexible § Time based – no allowance for ability § No capacity to “upskill” the trained workforce in a governed structure.

Shape of Training review was a framework for change

§ Proposed broad concepts, ideas and solutions § Open to interpretation § Did not consider the practical implications of implementation § Ministers convened the UKSTSG

UK Shape of Training Steering Group

• Policy advice for Ministers in relation to

implementation of the recommendations

• 4 Nation consensus
• Minimal service disruption
• Facilitative of National strategic plans

Securing the Future of Excellent Patient Care

October 2013 March 2017

UKSTSG Report and the Ministerial Statement

www.gov.scot/publications/2017/08 /9303/downloads

Principles of Shape of Training

• 1. Medical education and training will first and

foremost take account of patient need (service providers)

• 2. There needs to be an emphasis towards more

Generic skills

• 3. Increased flexibility within and between training

pathways

• 4. Training support the delivery of more care in

community settings

• 5. Credentialing for better governance and

flexibility purposes

Principle 1

Training will first and foremost take account of the needs of patients/service

• Hitherto service providers have not been able to

provide input as to the kind of doctor that they need to deliver an effective and efficient service.

• A mismatch has developed between the needs of the

service and training.

• “General surgery”

Principle 2

Recommendation – to develop a more general emphasis to training What do we mean by a “generalist”?

• To deliver the appropriate acute unselected take in

hospitals

• To provide continuity of care
• To engender the expectation that most doctors in the

future will contribute to the care of unscheduled patients

Principle 3

Curricula and training pathways are inflexible

• Previous learning not easily recognised.
• Little flexibility within and between pathways.
• Concept of the “finished fully trained doctor”

giving way to one of “career long learning”.

• Competency not time based
• Transferable

Principal 5 -Credentials

What are credentials?

• Discrete modules of learning delivered in a

governed and educationally supervised environment.

• Components of current curricula or entirely

new areas of learning.

• Determined by objective service /patient need
• Recognised by GMC/others

Principal 5 -Credentials

What will they achieve?

• Provide the flexibility for doctors to change careers,

develop portfolio careers and to train in new techniques and technologies.

• Provide flexibility for service providers to rapidly

respond to innovation

• Provide governance in areas currently unregulated e.g.

ad hoc Post CCT fellowships/cosmetic surgery.

• Provide a better governance and delivery framework

for specialist and sub sub specialist services.

What is happening now?

• 1. Credentialing Framework
• Developed by GMC.
• Stakeholder consultation.

What is happening now?

• 1. Credentialing Framework
• Developed by GMC.
• Stakeholder consultation.
• 2. Introduction of capability and competency

based training

What is happening now?

• 1. Credentialing Framework
• Developed by GMC.
• Stakeholder consultation.
• 2. Capability rather than time based training
• 3. Curriculum Oversight Group
• GMC.
• Reviewing curricula submissions.
• UKSTSG principles.