[PDF] - Welcome Professor Stewart Irvine Director of Medicine Director of PDF Document

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06/04/2014 1

Scotland Deanery Launch Day

Welcome

Professor Stewart Irvine Director of Medicine

Quality Education for a Healthier Scotland

Director of Medicine NHS Education for Scotland Vision…..

Quality Education for a Healthier Scotland

The medical directorate leads the advancement of postgraduate medical education in Scotland for the benefit of trainers, trainees and ultimately the patients who receive their care….

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06/04/2014 2 Education and training matters….. Properly planned and carefully conducted medical education is the essential foundation of a comprehensive health service comprehensive health service.

Goodenough, 1944

Training is patient safety for the next 30 years.

Temple, 2010

Quality Education for a Healthier Scotland

You should be prepared to contribute to teaching and training doctors and students.

GMC, GMP, 2013

NHS Scotland Medical Workforce

GP GP Salaried 2% Consultant 22% GP Retainee 1% GP 18% Staff and associate specialist grades 7% GPR 2% Other trained grades 2% Quality Education for a Healthier Scotland Undergraduates 20% Doctors in training 26%

2012 Head count, Source : ISD : http://www.isdscotland.org/

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06/04/2014 3 Complexity …

4,600 medical

undergraduates

5,700 postgraduate trainees
1033 LEP x specialty

training environments

221 training programmes
£325m budget
Multiple stakeholders

Quality Education for a Healthier Scotland

Cross-directorate

responsibilities

Quality Education for a Healthier Scotland

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06/04/2014 4 Aspiring to Excellence and Efficiency

Quality Education for a Healthier Scotland

Workstreams …

Specialty Training Boards Regional Offices Executive Team Training Management Quality Professional Development

Quality Education for a Healthier Scotland

Strategic Planning & Directorate Support

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06/04/2014 5 Workstreams

Workstream + Accountable Leads Sub‐Workstreams Training Management Bill Reid, Philip Cachia, Moya Kelly Anne Dickson Programme Management Recruitment Systems Administration Trainee Management Trainee Support Trainee Support Quality Alastair McLellan, Ronald McVicar Duncan Pollock Quality Management Quality Improvement Medical ACT PFPI Research Professional Development Gillian Needham, Anthea Lints Adrian Dalby Pre and Post CCT Training Faculty Development Continuous Professional Development Career Support Deanery Development Di t t O ti l S t Quality Education for a Healthier Scotland Strategic Planning + Directorate Support Rowan Parks, David Bruce Duncan Pollock Directorate Operational Support Facilities Management Finance People Strategy and Planning Local – Directorate / Corporate / Regional National – Scottish / UK

Aims of the Day…

To formally launch the Scotland Deanery.
To hand over the leadership of the Vision

i l t ti t th W k t implementation to the Workstreams.

To allow the Directorate staff a chance to meet

colleagues and to learn more about the work done in the directorate and Deanery.

To familiarise staff with the workstream lead teams and

th k t ti iti

Quality Education for a Healthier Scotland

the workstream activities.

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06/04/2014 6 Implementation …

Quality Education for a Healthier Scotland

Programme

10.00am Registration & Coffee 10.30am Welcome Professor Stewart Irvine 10.45am Write a strapline / slogan for the Groups Scotland Deanery 11.30am Keynote address Mr Malcolm Wright 12.00pm Future plan Professor Stewart Irvine 12.30pm Lunch 1.15pm Market Street – 5 things you didn’t know All 1.45pm Workstream Workshops Workstream Lead Teams 3.00pm Plenary with Q&A Professor Rowan Parks

Quality Education for a Healthier Scotland

y 3.30pm Coffee 3.45pm Closing Remarks Professor Stewart Irvine 4.00pm Close

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06/04/2014 7

Scotland Deanery Launch Day

Future Plans

Professor Stewart Irvine Director of Medicine

Quality Education for a Healthier Scotland

Director of Medicine NHS Education for Scotland Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

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06/04/2014 8 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

UK Shape of Training Review

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

ffers

an approach which will ensure doctors are trained to the highest standards and prepared to meet changing patient needs. It ff h hi h ill b fit f

Quality Education for a Healthier Scotland

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.

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06/04/2014 9 Shape : Key Messages

Patients and the public need more doctors who are capable of providing

general care in broad specialties across a range of different settings. This is being driven by a growing number of people with multiple co- morbidities, an ageing population, health inequalities and increasing morbidities, an ageing population, health inequalities and increasing patient expectations.

We will continue to need doctors who are trained in more specialised

areas to meet local patient and workforce needs.

Postgraduate training needs to adapt to prepare medical graduates to

deliver safe and effective general care in broad specialties.

Medicine has to be a sustainable career with opportunities for doctors to

change roles and specialties throughout their careers

Quality Education for a Healthier Scotland

change roles and specialties throughout their careers.

Local workforce and patient needs should drive opportunities to train

in new specialties or to credential in specific areas.

Shape : Key Messages

Doctors in academic training pathways need a training structure that

is flexible enough to allow them to move in and out of clinical training while meeting the competencies and standards of that training. F ll i t ti h ld t th i t f d ti f di l

Full registration should move to the point of graduation from medical

school, provided there are measures in place to demonstrate graduates are fit to practise at the end of medical school. Patients’ interests must be considered first and foremost as part of this change.

Implementation of the recommendations must be carefully planned
n a UK-wide basis and phased in. This transition period will allow the

stability of the overall system to be maintained while reforms are being made.

Quality Education for a Healthier Scotland

A UK-wide Delivery Group should be formed immediately to oversee the

implementation of the recommendations.

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06/04/2014 10

Undergraduate Foundation Broad Specialty Credentialled

Shape of training : Proposed Structure

Quality Education for a Healthier Scotland

Shape of Training : Next Steps

To establish a 4 Nation Co-ordination Group to provide oversight, co-

rdination and direction to post-Greenaway implementation activities.

Remit and Accountability Remit and Accountability

provide policy oversight, co-ordination and direction for implementation

activities arising from the Shape of Training report

commission specific activities, and individual workstreams where required,

that will inform and contribute to implementation of the Shape of Training recommendations, and to receive progress reports and recommendations from commissioned activities

report to respective Ministers on progress, and on issues requiring

Quality Education for a Healthier Scotland

Ministerial approval.

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06/04/2014 11 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

GMC : Recognition and Approval of Trainers Recognition vs Approval

Quality Education for a Healthier Scotland

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06/04/2014 12 Recognition of Trainers : Scope

The roles covered The arrangements relate to:

a. named educational supervisors in postgraduate training
b. named clinical supervisors in postgraduate training
c. lead coordinators of undergraduate training at each local education

provider

d. doctors responsible for overseeing students’ educational progress for

each medical school. Recognition will not be necessary for other doctors whose practice

Quality Education for a Healthier Scotland

Recognition will not be necessary for other doctors whose practice contributes to the teaching, training or supervision of students or trainee

doctors. But recognition will be available to trainers not currently in the four

specific roles.

Recognition of Trainers : Standards

GMC will use the existing standards for postgraduate training set out in The Trainee Doctor and for undergraduate education in Tomorrow’s Doctors. GMC will use the seven areas originally set out by the Academy of Medical GMC will use the seven areas originally set out by the Academy of Medical Educators to provide a structure:

a. ensuring safe and effective patient care through training
b. establishing and maintaining an environment for learning
c. teaching and facilitating learning
d. enhancing learning through assessment

e supporting and monitoring educational progress

Quality Education for a Healthier Scotland

e. supporting and monitoring educational progress

f. guiding personal and professional development

g. continuing professional development as an educator.

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06/04/2014 13 Recognition of Trainers : Responsibility / Milestones

Local education providers such as hospitals and general practices will

use the seven areas to show how they identify, train and appraise trainers in each of the four categories above.

Education
rganisers

(EOs) ie postgraduate deans and medical

Education
rganisers

(EOs), ie postgraduate deans and medical schools, will then use that information to show us what local arrangements are in place to meet our standards.

a. Submit a timeline for implementation for trainer recognition - by 31 December 2012. b. Confirm that criteria and systems are in place and ready for data entry – by 31 July 2013. c. Confirm that full information has been entered for all trainers in the four roles in

Quality Education for a Healthier Scotland

c. Confirm that full information has been entered for all trainers in the four roles in light of the EO criteria and that the trainers have all been categorised as provisionally or fully recognised – by 31 July 2014. d. Confirm that all trainers in the four roles, or entering any of the four roles, are fully recognised ie have met the EO criteria, without use of interim concessions – by 31 July 2016.

Recognition of Trainers : Scotland

Criteria for Trainer Recognition :

1. Comply with all legal, ethical and professional obligations including completion of mandatory training requirements. 2. Comply with all aspects of GMC’s Good Medical Practice. 2. Comply with all aspects of GMC s Good Medical Practice. 3. Be currently practising within their field. For undergraduate trainers this may include academic practice or health professionals in disciplines other than medicine. 4. Have appropriate time allocated for their role. 5. Demonstrate awareness of their role and how that role fits with other educational and clinical roles. 6. Know how to get support if needed and know about the relevant EOs’ quality management procedures. 7. Demonstrate awareness of the curriculum and level of students/trainees.

Quality Education for a Healthier Scotland

8. Demonstrate an appropriate level of teaching competence.

Scottish arrangements for Meeting these criteria The Scottish Trainer Framework

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06/04/2014 14 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

GMC : Review of Quality Assurance and Standards

Quality Education for a Healthier Scotland

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06/04/2014 15 GMC : Review of Quality Assurance

1. Approval against standards: Consistency and divergence in the GMC’s

quality framework

2. The case for approving the educational environment
3. Reporting the outcomes of quality assurance activities
4. Quality measures: measuring systems and measuring outcomes
5. The QIF
6. The use of evidence to support decisions on quality
7. The purpose and nature of ‘visits’
8. Responding to concerns

Quality Education for a Healthier Scotland

8. Responding to concerns
9. The role of the medical Royal Colleges

10.Legislative reform

GMC QA Review : Standards for Local Education Providers

1. Management of education and training: board level engagement or

equivalent

2. Safe supervision

3 Team working

3. Team working
4. Educational infrastructure
5. Time for trainers to train
6. Time for trainees (support for learning and reflection)
7. Individual review meetings
8. Selection, Appointment and Review of Trainers
9. Local mechanisms for learning through audit including Significant Event

Audit and quality improvement projects

Quality Education for a Healthier Scotland

Audit and quality improvement projects 10.Educational governance including audit and trainee feedback on their training experience 11.Supporting learners in difficulty

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06/04/2014 16 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

GMC : National Training Survey

Quality Education for a Healthier Scotland

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06/04/2014 17 GMC NTS 2013 : Overall Satisfaction

Northern Ireland Medical & Dental Training Agency Wales Deanery South West Peninsula Deanery NHS Education for Scotland (South-East Region) Northern Deanery NHS West Midlands Workforce Deanery Wessex Deanery Defence Postgraduate Medical Deanery London Deanery North Western Deanery Mersey Deanery NHS Education for Scotland (East Region) NHS Education for Scotland (North Region) Severn Deanery NHS Education for Scotland (West Region) Northern Ireland Medical & Dental Training Agency Quality Education for a Healthier Scotland

77 78 79 80 81 82 83

Kent, Surrey and Sussex Deanery East Midlands Healthcare Workforce Deanery East of England Multi-Professional Deanery Oxford Deanery Yorkshire and the Humber Postgraduate Deanery

GMC NTS 2013 : Educational Supervision

Mersey Deanery NHS West Midlands Workforce Deanery Yorkshire and the Humber Postgraduate Deanery North Western Deanery Northern Deanery NHS Education for Scotland (West Region) NHS Education for Scotland (South-East Region) South West Peninsula Deanery East of England Multi-Professional Deanery East Midlands Healthcare Workforce Deanery Wales Deanery Northern Ireland Medical & Dental Training Agency Kent, Surrey and Sussex Deanery Wessex Deanery NHS Education for Scotland (North Region) Mersey Deanery Quality Education for a Healthier Scotland

83 84 85 86 87 88 89 90 91 92

London Deanery Defence Postgraduate Medical Deanery Oxford Deanery NHS Education for Scotland (East Region) Severn Deanery

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06/04/2014 18 GMC NTS 2013 : Patient Safety Concerns

Quality Education for a Healthier Scotland

GMC NTS 2013 : Patient safety concerns (% respondents)

NHS Education for Scotland (South East Region) NHS Education for Scotland (North Region) Northern Deanery Defence Postgraduate Medical Deanery Overall South West Peninsula Deanery East of England Multi-Professional Deanery Wessex Deanery NHS West Midlands Workforce Deanery Yorkshire and the Humber Postgraduate Deanery NHS Education for Scotland (West Region) Northern Ireland Medical & Dental Training Agency Mersey Deanery North Western Deanery East Midlands Healthcare Workforce Deanery London Deanery NHS Education for Scotland (South-East Region) Quality Education for a Healthier Scotland 1 2 3 4 5 6 7 8 9 10 Severn Deanery Wales Deanery NHS Education for Scotland (East Region) Kent, Surrey and Sussex Deanery Oxford Deanery South West Peninsula Deanery

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06/04/2014 19 GMC NTS 2013 : Bullying and Harassment

Quality Education for a Healthier Scotland

GMC NTS 2013 : Bullying and Harassment

Quality Education for a Healthier Scotland

Source

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06/04/2014 20 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

Strategy for Attracting and Retaining Trainees (StART)

Post Group Establishment Vacancies Filled Unfilled Fill Rate Recruitment 2013 Post Group Establishment Vacancies Filled Unfilled Fill Rate Foundation 1608 804 804 100% Core 588 289 288 1 99.6% Run Through 1792 411 372 39 90.5% HST 1741 345 236 109 68.4%

Quality Education for a Healthier Scotland

LAT 139 70 69 50.0% Total 5729 1988 1770 218 89.0%

3.8%

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06/04/2014 21 Strategy for Attracting and Retaining Trainees (StART)

Key Elements of StART :

Informing
Connecting
a. Research and Market Research
b. StART and ScotMT Website Redesign
c. Careers Fairs
d. Trainees – the T in StART – Trainee Ambassadors
e. Keeping in Touch

f. StART & Social Media

Quality Education for a Healthier Scotland

g. Trainers – make me want to train in Scotland

Issues Considered when Choosing Deaneries

(CT2 Trainees)

Recommendations (family) Recommendations (lecturers) Recommendations (other trainees) Recommendations (others) Reputation of Foundation schools Rural living

1 2 3 4 5

(CT2 Trainees)

Job opport nities/no of acancies Previous familiarity with geographic area Proximity to home/friends Reputation of the Deanery Your long term specialisation plans City living Outdoor recreational Recommendations (family)

Quality Education for a Healthier Scotland

0% 20% 40% 60% 80% 100%

Cost of living in that area Ease of entry Good social life/night life Job opportunities/no of vacancies

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06/04/2014 22 StART : Key Findings of Commissioned Research

The greatest influence on medical students’ decision making is lifestyle,

including location – with proximity to friends and family, and familiarity with the local and work environments impacting mostly on decision making.

Career decision making among doctors in training is more complex, but
verall the greatest influencers are cited to be work-related factors,

specifically good working conditions, desirable location, good reputation for quality training and availability of linked training positions (linked with their partners’ appointment).

While some factors that have been identified are personal and are not

amenable to intervention – improving the quality of the working and training experience may increase the attractiveness of posts and locations.

Quality Education for a Healthier Scotland

g p y p

Early positive experiences are very important to careers decision making.
Overseas doctors are more tolerant of less desirable options including poorer

working conditions and departments with lesser reputation.

Quality Education for a Healthier Scotland

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06/04/2014 23 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

UK Selection and Recruitment

GP Recruitment – NRO Foundation Recruitment – UKFPO f Impact of UK recruitment Application numbers 127,000 (2007) > 19,000 (2011) 2012 SRDB Policy and Pilot Evaluation 80% of recruitment teams wished to continue with UK recruitment >75% of involved consultants wished to continue with UK recruitment

Quality Education for a Healthier Scotland

UK MDRS – Medical and Dental Selection and Recruitment Single IT System – ORIEL February 2014 pilot roll out

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06/04/2014 24 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

Health Education England

Quality Education for a Healthier Scotland

45,000 Trainees, £5bn budget

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06/04/2014 25 Health Education England

providing national leadership on planning and developing the healthcare

and public workforce

authorising and supporting the development of Local Education and

Training Boards (LETBs) Training Boards (LETBs)

promoting high quality education and training, including responsibility for

medical trainee recruitment

allocating and accounting for NHS education and training resources and

the outcomes achieved

ensuring the security of supply of the professionally qualified workforce
supporting the development of the healthcare workforce across a multi-

professional and UK-wide context

Quality Education for a Healthier Scotland

supporting innovation across the NHS in order to improve the quality of

care

delivering against the Education Outcomes Framework to ensure the

allocation of education and training resources is linked to quantifiable improvements

Health Education England

Quality Education for a Healthier Scotland

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06/04/2014 26 Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

Key challenges

1. UK Shape of Training Review
2. GMC Recognition and Approval of Trainers
3. GMC Review of Quality Assurance
4. GMC National Training Survey
5. Strategy for Attracting and Retaining Trainees (StART)
6. UK Selection and Recruitment
7. Health Education England

Quality Education for a Healthier Scotland

8. Health and Social Care Integration
9. The Economy

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06/04/2014 27 Illustrative Outlook for Scottish DEL Expenditure

Quality Education for a Healthier Scotland Source : Report on the Future Delivery of Public Services by the Commission chaired by Dr Campbell Christie. Published on 29 June 2011.

NES Budget

Medical Dental ED Psych HCS Other NMAHP Pharmacy

Quality Education for a Healthier Scotland

Finance & Corporate

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06/04/2014 28 NES Budget

Traing Grade Salaries Medical ACT Dental ED Psych HCS Ed Gov Other Support S/L NMAHP Pharmacy QM

Quality Education for a Healthier Scotland

Other Finance & Apraisal Corporate CPD

Scotland Deanery Launch Day Closing Remarks

Professor Stewart Irvine Director of Medicine

Quality Education for a Healthier Scotland