LTFT and SuppoRTT: The Basics Event... · 2019. 6. 13. · 15% in HEE NW Rise by 37.9% since 2012...
Transcript of LTFT and SuppoRTT: The Basics Event... · 2019. 6. 13. · 15% in HEE NW Rise by 37.9% since 2012...
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LTFT and SuppoRTT: The BasicsDr Shirley Remington, Deputy Dean for Learner Support
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Housekeeping and aims of day
• Seminars
• 1:1 support
• Fire alarms
• Phones
• Privacy
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• Background
• Recent changes to application
process
• New application process
• FAQS
LTFT – The Basics
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Facts and figures 2018 - 5959 less than full time trainees
15% in HEE NW
Rise by 37.9% since 2012
1.5% of foundation doctors
Most common in paediatrics 20% least common in surgery 4%
15% of female trainees 2% of male trainees
Most common in age 30-39 group
71% are for childcare
Introduced in 1969
900 trainees in HEE NW
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LTFTT – Types Eligibility
• Type 1: carer or health including disability
• Type 2: develop special skills/interest
• Approval process unchanged
Funding types
• Jobs share
• reduced hours post
• supernumerary
Minimum 50% ( GMC 2011)
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LTFTT – Types
• New gold guide ( another expected 2020)
• NHS employer guidance-flexible training champions
• GMC statement in 2017 re additional work
• Flexible working law change 2014
• New contract effects
• Return to work support
• Emergency Medicine initiative April 2017 and renewed 2018
• Improving junior doctors lives
• Updated local policy
• Local locum guidance
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New Opportunities
• TIS
• Local Flexible Training Champions
• New contract
• GMC statement 2017
• EM pilot and extension
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Process and Tips
• Eligibility - done once
• Start early.
• Build links with local flexible training lead – specialty and Trust
• Notice to return to fulltime.
• If returning after break ensure Trust are aware
• Use SuppoRTT Opportunities
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Key challenges – LTFT Trainee
• Fitting in
• Personal expectations
• Conflicts in WLB
• Finance
• Rigidity- negotiation skills
• Return to work programmes
• ARCPs
• NTS survey 2018 high
percentage say colleagues
unsupportive
• Isolation
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Common Questions - Answers
• Study leave pro-rata with sessional commitment
• Annual leave pro-rata
• On call pro rata (may do more to max total
working week 40hrs)
• Post approval-only needed if training slots
exceeded
• RHFT work 50-80% time
• Supernumerary up to 60%~(80 in last year
training)
• Slot share 60%
• GMC rule- minimum 50% time
• Responsibilities training programme as full time
• Arcps /revalidation as fulltime
• Locums
• Paid employment
• Bank holidays
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How much notice to start?
3 months.
Why do I need to do a new form every time I rotate?
So your school, LEO and team aware/pay.
How do I go full-time again?
3 – 6 months notice, complete and submit a form, and let your
school know.
Out of hours and daytime percentage is different – which
counts towards CCT?
Where do I get information?
www.nwpgmd.nhs.uk/content/less-full-time-training
FAQs
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SuppoRTT
• All schools have policy
• Everyone not working for 3+months
will follow process
• Lots of available support
• Leads in Trusts and schools to
embed process (temporary funding to
start in next few months)
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What actually happens
• Share with school potential dates of absence and if possible return date.
• Discuss what potential return will look like and plan with either ES or TPD
record on form the plan
• Start planning for return – planned events that can be useful while off, KIT days,
School and HEE offers ( don’t ignore emails)
• Keep in touch with school/trust and prior to starting back meet ES to plan what
return will actually look like
• Confirm date of return
• Firm up plans
• Contact Trust and school return champions
• Meet ES and plan against educational needs including any left from prior to break.
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Transition back to practice
• Induction – even if worked in place before - preferably tailored – things change -
policies equipment
• Update elapsed mandatory training
• Regular meeting with ES to confirm progress starting with one prior to start date
• Extra support if needed and increased supervision initially
• Meet ES at planned point post return and agree full resumption of
responsibilities
• First ARCP – if long return does CCT need extending – panel decision
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Key concerns of all returners
• Confidence- self and support
mechanisms
• Being watched and assessed
• Trainers attitudes
• Ability
• Fatigue
• Managing on call / shifts
• Managing home life
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Support available
Mentoring and coaching
KIT activities – generic specific
Personalised return plans and Human factors and simulation days- school and more general
E learning for health package on returning and LTFT
Educational support and funding for education while off when supporting return
Pastoral support including LEO
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Support for trainers and trainees - LTFT
• eLearning for Health - http://portal.e-lfh.org.uk/Component/Details/473676
• HEE NW LTFT
• HEE NW locum guidance
• NHS employers flexible training leads guidance
• Gold Guide
• Academy of Royal Colleges return to practice
• NHS Careers Website
• BMA document 2014
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Overall Satisfaction
75.
76.5
78.
79.5
81.
82.5
84.
85.5
2012 2013 2014 2015 2016 2017 2018
FT LTFT
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Contact
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Thanks and Questions
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The Lead Employer Model – Supporting
Trainees Following Time Out of Training
www.sharedservices.sthk.nhs.uk
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Time out of training
• Long term sickness cases (+28 days)
• OOP
• Maternity leave (up to 52 weeks + AL)
• SuppoRTT schemes implemented by each
specialty school
www.sharedservices.sthk.nhs.uk
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Who does what? – Employment Services
www.sharedservices.sthk.nhs.uk
• Pre-employment checks
• Issue contracts
• Process maternity / paternity / adoption / shared parental leave
• Process excess mileage / removal of expenses
• Process work schedule changes
• Answer generic employment-based queries
Contact: [email protected]
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Who does what? – HR Case
Management
www.sharedservices.sthk.nhs.uk
• Provide HR advice and support
• Process occupational health referrals
• Provide guidance about key HR policies including attendance
management, conduct, grievance
• Manage long term sickness cases in line with Trust policy
• Link in with HEE regarding the on-going management and support of
trainees
Contact: [email protected]
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Long term sickness
www.sharedservices.sthk.nhs.uk
• The majority of the work the LE does with regards to returning to
training is with trainees who have been off work due to long term
sickness (+28 days)
• ‘Training Clock’ – The difference between returning to work and
returning to training.
• Referrals to Health, Work and Wellbeing
• Working with trainees to implement any restrictions / adjustments
recommended by HWWB clinicians
• Support the trainee in undertaking fewer / restricted duties / working
at a slower pace etc.
• Anything longer than 12 weeks – contractual change
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Supportive measures
www.sharedservices.sthk.nhs.uk
• Phased return to work
• Amended hours e.g. varied start / finish times
• Induction / period of shadowing
• LTFT
• Adjustments to duties e.g. no on calls / OOH / night work
• Buddy / mentor scheme within the department / host organisation
• Access to Work input
• Reasonable adjustments – the balance.
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Health concerns & The Equality Act
www.sharedservices.sthk.nhs.uk
• Definition of a disability:
• S6(1) Equality Act 2010 – a person has a disability if they have a
physical or mental impairment and the impairment has a substantial
and long term adverse effect on their ability to carry out normal day to
day activities
• EqA Schedule 1 – the effect of an impairment is long term if it has
lasted for at least 12 months, it is likely to last for at least 12 months
• Recurrent conditions
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Reasonable adjustments – in line with
the Equality Act
www.sharedservices.sthk.nhs.uk
• Purpose of a reasonable adjustment is to avoid or eliminate a
disadvantage to a disabled person
• What is reasonable will depend on the employer and the
circumstances
• The onus is on the employer to investigate and suggest adjustments
(with advice from HWWB)
• Medical advice can assist
• Access to Work input
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Maternity / Adoption and Parental Leave
www.sharedservices.sthk.nhs.uk
• KIT days – Taken during SMP period
• Supported Return to Training days – Taken during AL
• Max. 10 days over the maternity leave period
• Accrued annual leave (calculations)
• Risk assessments – every trimester during pregnancy + upon return
• Support and guidance re breastfeeding
• HWWB support if needed
• Management information – picking up on trainees who resume work
in line with rotation days
• Avoidance of immediate return to duties with less supervision
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Out of Programme
• Differentiation between different categories of OOP
• Gold Guide with regards to OOPC
• HWWB input for OOP cases – Declaration + support if needed
• Avoidance of immediate return to duties with less supervision
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Any questions
www.sharedservices.sthk.nhs.uk
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TOP TIPS FOR RETURNERS
Dr Jenny Barber
ST6 in Obstetrics and Gynaecology
NORTH WEST KIT EVENT
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Expectation! Reality!
Top Tips for Returners
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Just like riding
a bike?
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Anxious
Guilty
Under-confident
Lonely
Looking forward to more mental
stimulation
Adult company
Personal fulfilment / sense of self
Tired
Technical skills
Organisational demands
Decision-making
Better doctor?
Prioritisation
Time management
Team awareness
Empathy
Overwhelmed
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Family support
Nursery times
Sleepless nights
Nursery lurgy!
Exams
OOH / On-calls
Specialty demands /
expectations
Portfolio
It's not the same for everyone!
Partner's job
CV
Nursery lurgy!
Commute
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Some Practical Tips
• Sort out childcare (including a Plan B!)
• Think about LTFT
• Make contact with work early to plan your return -
Educational supervisor or College Tutor
• KIT days
• Book some annual leave
• Plan meals
• Be open and honest
• Speak to other trainees
• Accept (organised!) chaos
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It will be ok
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But what if it's not?
• Educational supervisor
• College Tutor
• TPD
• Other trainees
• SuppoRTT programme
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And Finally...
Don't make any rash decisions!
Be kind to yourself!