Training Today - nes.scot.nhs.uk · Training Today West of Scotland Region efficiency savings....

The Medical Directorate of NES, incorporating the 4 Deaneries and Specialty Training Boards (STBs), is currently undergoing major reorganisation; a process termed the ‘Medical Vision’. The key benefits of the Medical Directorate ‘Vision’ are:

1. to create standardised approaches to delivering all key activities throughout NES – and to eliminate the current variance that exists among all 4 Deaneries, whereby there are at least 4 different ways of effecting core activities,

2. to establish clear lines of accountability and responsibility for effecting core activities,

3. where possible, to rationalise the resources and manpower that are required to effect key activities.

NES is under considerable financial pressure through obligation to deliver

Please send ideas for development within the region to [email protected]

Training TodayWest of Scotland Region

efficiency savings. However, demands upon NES from our regulator the GMC are increasing – the most recent example being the introduction of revalidation of trainees. Only through freeing up resources within NES will we be able to resource the next wave of demands that are placed upon us.

The process has been led by ‘5C’, an external management consultancy group. The first step was to redefine, in considerable detail, all of the activities that NES is currently engaged in. This led to characterisation of 4

NES Vision: a clearer view Contents June 2013

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main ‘work streams’ under which all NES activities can be grouped: these work streams are ‘Quality’, ‘Training Management’, ‘Professional Development’, ‘Strategic Planning & Directorate Support’. As an illustration, within the ‘Quality’ work stream, there are 5 sub-work streams (‘Quality Management’, ‘Quality Improvement’, ‘Medical Act’, ‘PFPI’ and ‘Research’). Under these headings there are 36 ‘groups of activities’ and 335 different activities. Work stream leads have been appointed from the 4 Postgraduate Deans and from the 4 GP Directors in NES and these leadership roles will be assumed in August 2013. The Dean is jointly leading on the Quality work stream with Dr Ronald MacVicar (the GP Director in North Deanery).

The next stage is to map out how Deaneries actually conduct their key activities, e.g. within the ‘Quality’ work stream the first 2 processes to be mapped are ‘managing programme visits’ and ‘providing

and overseeing lay representatives’, but this is just the beginning of an exercise that will ultimately include mapping of all Deanery activities and linking all NES staff with these activities.

Central to ‘Vision’ is a commitment by the NES Medical Directorate to continue to support 4 regional Deaneries. STBs also have a key advisory role (to the Medical Directorate Executive Team (MDET)) in delivery of specialty training: their roles and function are unlikely to change substantially through implementation of Vision.

The next few months will see a marked acceleration of implementation with more engagement of Deanery staff. As we go forward, for sure there will be challenges and uncertainty but failure is not an option. Pursuit of single ways of conducting our core NES activities wherever trainees are located in Scotland is a goal worth achieving.

NES Vision: a clearer view

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Ed was appointed as Consultant Geriatrician at Gartnavel General Hospital, Glasgow, in 1999 and was Lead Consultant from 2009-2012. He completed an MSc in Clinical Leadership at Glasgow University Business School in 2010. After holding the post of Postgraduate Tutor, he was appointed Deputy Director of Medical Education for NHS Greater Glasgow & Clyde in 2010. Having had a role within the deanery since 2011, he has now taken over the role of Associate Postgraduate Dean for Doctors in Difficulty.

Recently Ed has been leading with colleagues on the development of the NES health and wellbeing strategy for doctors in training, which includes the production of an online video educational resource click here for more information. A key personal objective for him is to develop the concept of doctors in difficulty and to bring it under a broader umbrella offering professional support to all doctors in training.

Thank you! 98.5% (that is 2502) West of Scotland Deanery trainees completed this year’s GMC NTS.

That response rate placed us 7th in the league table of 20 UK Deaneries, and highest among the four Scottish Deaneries. We are grateful to our trainees who participated, to the trainers and hospital teams who promoted trainee participation, especially to Diane MacKay and her team and also to Angela Gregg who effected our strategy to maximise returns.

The response significantly enhances the value of this year’s dataset. Well done to all concerned – the challenge will be to maintain that success in future years!

Training in how to use the new GMC reporting tool is planned for those who are interested – click here for more information.

GMC National Trainee Survey 2013: West of Scotland Deanery - Best Response Rate in Scotland!

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New Associate APGD Dr Ed Spilg


Training In Focus

FoundationSince 2005, the two year Foundation Programme in the UK has formed a vital bridge between Undergraduate medical studies and a working career in UK clinical practice. It is administered nationally through the UK Foundation Programme Office and regulated by the GMC and is organised into Foundation Schools with their own management structure. The Scottish Foundation School encompasses all Foundation posts in the country and, under the direction of Dr Kim Walker, is managed through the four Scottish PG Deaneries.

In the West of Scotland we supervise approximately 50% of Scotland’s Foundation trainees with 390 F1 and 390 F2 doctors across the region. Utilising 17 hospitals in 5 Health Board areas is challenging but we have developed 24 balanced two year programmes with a split between rural (district) hospital and central teaching hospital placements for each trainee. We are also proud of our Academic Foundation programme

which is popular across the UK and provides a firm basis for trainees keen to embark on an academic / research based career.

The introduction this year of the ARCP process for all Foundation trainees has produced an interesting challenge and the administration across our 24 programmes has been expertly organised by Audrey McPetrie and the admin team. The Foundation programme curriculum was substantially changed in August 2012 along with the assessment methodology which has meant a complete review/change to the Foundation E-portfolio and this has also meant a new learning experience for all of us (trainees and trainers). Assessments have become much more formative and we are trying to move away from required numbers of different assessments. This will make the ARCP process interesting as we assess the progress of each trainee!

Foundation training in the UK remains very popular internationally. The applications for August 2013 were oversubscribed by 295 this year. In

February 2013 (with about 2 weeks notice) we had the pleasant problem of being asked to create 24 new F1 posts in the West of Scotland (as part of 45 across Scotland) to accommodate the increased output of UK medical schools this year. This gave us the opportunity to meet some of the requirements of the recent Collins review “Foundation for excellence” recommending the incorporation of increased management of long-term conditions and psychiatry, as well as acute care into our programmes. Thanks to everyone who worked and continues to work on this project!

The Deanery is very grateful to the support of the admin team at 2CQ, the centre and consortium administrators across West Central Scotland, our 24 Foundation programme directors and 3 Consortium Leads, and numerous Educational and clinical supervisors, who have been instrumental in ensuring the success of the West of Scotland Foundation Training.

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Trainers and the GMC

The formal ‘recognition of trainers’ process, required by the GMC, will come into force in July 2014. This will apply to training roles in both undergraduate and postgraduate medical training. The postgraduate roles to be recognised include ‘educational supervisor’ and ‘clinical supervisor’. This recognition involves meeting 7 areas of standards regarding selection, training and practice and appraisal against these.

In summer 2014, the Deanery, in partnership with Directors of Medical Education, requires to provide the GMC with a list of recognized trainers. Before then, the Deanery will be collating information about those known to be holding educational supervisor roles and liaising with Directors of Medical Education in respect of those regarded as being clinical supervisors. A new web-based interface to the Scottish Training Database (Pinnacle) is being

designed to facilitate this. Discussion is also being held regarding the development of a new section in the appraisal system ‘SOAR’, to support educator appraisal.

However, collating such lists may not be as simple as it might appear. The terms are simple enough, but our use of them for particular posts to date has not always been consistent across specialties nor equated to those expected by the GMC. For example, the remit generally regarded by the GMC as held by a ‘clinical’ supervisor is held, for the Scottish Foundation School, by Foundation ‘educational’ supervisors. For some training posts both remits are held by the same person. The most striking difference of terminology under the new recognition process, is that while most secondary care clinicians would be regarded as supervising clinicians for trainees, only a few in each unit would be regarded as formal ‘clinical supervisors’ for trainee posts.

Training Together Across The Region: Revalidation and Recognition


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Training Together Across The Region: Revalidation and Recognition

Such supervisors are to be selected, designated and trained individuals, for each placement that is part of a rotation within an overall post (e.g. gastroenterology within medicine) and would oversee the completion of reports and promote the following at placement (unit) level: appropriate training and teaching; trainees functioning within expected level of competence; clinical supervision being readily available and appropriate to level of competence; trainee involvement in audit and risk management; access to educational opportunities suitable to fulfil a particular trainee’s requirements; access to assessment completion; appropriate unit induction and identification of poorly performing trainees. There is a working

expectation that there will be a job-plan equivalence of about 0.25 PA per week for such clinical supervisors.

Training to support attainment of the 7 GMC areas is currently available nationally and locally through SCOTS and STAR courses and also through a range of other courses, e.g. College and University courses. An additional STAR module specifically for the clinical supervisor, using the revised definition, will be made available in the summer of 2013. In addition, a national framework document is being prepared, outlining the 7 areas and how they apply to trainers at different stages in their career, in terms of competencies and suggested training.

Trainers and the GMC

Doctors in training face specific pressures related to their professional stage and development, including coping with the demands of each new clinical placement, furthering their medical careers and maintaining social and personal networks. They may not always prioritise their own health care and may at times be unwilling to admit illness or accept that they are not coping with the demands of their career. This may lead to a failure to recognise, acknowledge and act on the early warning signs of illness.

The early stages of a medical career are demanding and the health and wellbeing of doctors in training must be a priority, not only for the

individual doctor, but for the medical profession as a whole, to ensure a healthy medical workforce for the future.

As part of its response to these concerns, the NES Medical Directorate commissioned, via the West of Scotland Deanery, the production of a video educational resource for doctors in training on the theme of health & wellbeing. The Health & Wellbeing for Doctors in Training video will sit on the Knowledge Network on-line platform as a “stand alone” educational resource and will be accessible to all NES doctors in training from August 2013. The ongoing development of this project links it in to the broader theme of Professional Support which NES offers to all doctors in training.

Supporting Effective Stress Handling


Training Success to Share:

As Radiology TPD, Alasdair McCafferty became aware that our new intake of trainees for 2012 were mostly very young and not long out of University. Furthermore, many of them were moving to Glasgow to take up post, having no good knowledge of the area. Some even had little knowledge of Scotland. An informal peer-support system seemed the best way of making these trainees feel welcome, not just to the training scheme, but to the West of Scotland also.

He asked for volunteers from our more senior radiology trainees and then passed their email addresses on to the new trainees, a couple of months before their fresh start in August. Sometimes it can be the smaller details that cause unnecessary anxiety when moving to a new post in a new area and the new trainees therefore had a contact they could use to ask questions, such as – where is the best place to live, what will I need on my first day and so on.

Feedback from the trainees has been very positive. Not all trainees felt the need to contact their ‘buddy’ but those


that did found the access to local knowledge useful and reassuring. The new trainees will still have access to their ‘buddy’ after starting, but the early contact will hopefully make them feel welcome in the training scheme and importantly more at home in the West of Scotland. After all this is where we want them to stay once trained. The Deanery is very enthusiastic about this example of practical support, which has also been noted by the GMC as an area of good practice. Other specialty leads, thinking of extending the idea to their programme, may wish to contact Alasdair for more details.

[email protected]

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Peer-support success in radiology

Performance Support Unit

Doctors can find themselves in a variety of difficulties at different stages in their lives and careers. The Deanery is here to positively support all doctors in training; the current emphasis of support targeting ‘doctors in difficulty’ is rather unhelpful, even the term is somewhat pejorative. The appointment of Dr Ed Spilg, as APGD affords the opportunity to review how we configure the support that we offer our trainees, and how we can change our emphasis towards presenting a positive public face that proactively seeks engagement with trainees to optimise outcomes and realise potential.

A major new focus of professional support will be a strategy promoting health & wellbeing beginning with an excellent video resource - click here for more information. There will be more integration of teams in Foundation, GP and Hospital training, who engage with those trainees

struggling to achieve their training goals. In addition, better alignment of support mechanisms, improvement in lines of communication and greater links with APGDs who provide careers advice (Dr Liz Murphy) and who can advise on LTFT training (Dr Andrea Caldwell) will enhance our holistic approach.

At the hub of Deanery Professional Support will be, we hope, a shared database to allow longitudinal follow-up and tracking of outcomes. This will provide greater insight into success factors that determine better outcomes from the interventions that are provided. The aim is to implement Professional Support by late summer / early autumn 2013.


Training Updates From Our Sections

The Quality CycleQuality Management within the West of Scotland Deanery is a cyclical process and works on a principle of triangulation and verification of information. Survey findings are not taken in isolation; rather results are reviewed against previous sets to identify trends and issues.

There are two main survey points in the year, the GMC National Training Survey (Spring) and the NES Post Assessment Questionnaire (Autumn/Winter) and the information gathered from these is used to inform the QM activities of the year. The focal point for the cycle is the Specialty Panel Review process held in autumn which offers the opportunity to look at all of the QM data held on file and allows the QM Team to decide on actions for the coming year. The 2013 Speciality Panel Reviews will be held in September/October. It has been suggested that the information discussed in the panels would be useful to programme directors and the QM team is looking to offer attendance to as many programme directors as possible. Dates will be circulated over June.




Training Updates From Our Sections

Deanery Visits

Visits undertaken as part of the 2012-13 cycle Visits to follow as part of the 2012-13 cycleGlasgow Royal Infirmary & Southern General HospitalO+G (FY/,GPST)

Southern General Hospital Medicine and Surgery (FY,GPST)

Glasgow Royal InfirmaryMedicine and Surgery (FY) *

Royal Alexandra HospitalMedicine (FY)

Inverclyde Royal Hospital Medicine and Surgery (all grades)

Forth Valley Royal Hospital Surgery (all grades)

Royal Hospital for Sick Chil-drenPaediatric Cardiology (all grades)

Southern General HospitalObstetrics and Gynaecology (FY, GPST) *

The Beatson Unit, Gartnavel Hospital Medicine (CMT,FY,GPST)

Forth Valley Royal HospitalEmergency Medicine (FY,GPST)

The Beatson Unit, Gartnavel HospitalMedicine (CMT,FY,GPST) *

Southern General HospitalNeurosurgery (ST) *

Ayr Hospital Surgery (FY,ST)

Victoria InfirmaryMedicine and Surgery (FY) *

Deanery Visits(re-visits indicated by *)

Data & the Deanery:

A half-day training session designed to equip Programme Directors and other Educational leads with information about how the Deanery gathers and uses data and how to find their way around the new GMC NTS Reporting Tool will be offered on a pilot basis on 30th August 2013.

A further event is planned for postgraduate administrators and specialty team leaders on 5th September - click here for more information. Further events may be offered if feedback suggests they are helpful.

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TPD CPDFriday 30th August 2013 & Friday 29th November 2013 - to be held at: 2 CQ, 14:00 - 17:00.

SCOTS Courses (incl Doctors in Difficulty Course)information can be found at www.portal.scot.nhs.uk

Ed Sup & Clinical Sup Courses (locally run)email [email protected] for more information.

‘Data and the Deanery’how the Deanery gathers and uses data and how to find their way around the new GMC NTS Reporting Tool. Read the related article by clicking here.

Day one: for TPDS and other educational leads, Friday 30th August 09:15 – 13:00 in the Clyde Room.

Day two: for Postgraduate administrators and specialty team leaders Thursday 5th September, 13.30 – 17.00 in the Clyde Room

Please note the training is restricted to 14 places and they will be allocated on a first come, first served basis. Please contact Angela Gregg to book email: [email protected]

Training Times For Your Diary

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Dr Derek Gillen, Consultant Gastroenterologist at Gartnavel General Hospital / Western Infirmary in Glasgow and our West of Scotland Associate Postgraduate Dean (APGD) for Core Medical Training (CMT) died suddenly on 5th May. Derek had previously been Training Programme Director (TPD) for the West Consortium of CMTs prior to becoming APGD. As APGD, Derek brought patience, enthusiasm and great commitment to his role and gained a reputation locally and nationally for striving to raise training standards among CMTs.

A Much Valued Colleague

Dr Derek Gillen (1967 - 2013)Derek led the Scottish CMT TPDs and represented Scotland on the CMT SAC. He was a strong advocate for ‘Learning to Make a Difference’, a CMT SAC project, that sought to facilitate roll out of learning of Quality Improvement (QI) methodologies and engagement in QI project work; Derek recognised the benefits to future quality of patient care that could be realised by empowering CMTs through provision of training in QI. Derek will be greatly missed by Deanery colleagues and is survived by his wife and his five children.


The recent, successful, 3rd NES National Education Conference featured the launch of START, our Strategy to Attract (to Scotland) and Retain (within Scotland) Trainees. This work now begins! Knowledge gaps will be addressed in qualitative and quantitative research to be undertaken through University of Aberdeen, in association with SMERC. The START core group, together with Bright Signals, an external marketing agency, has been working on strategic goals, headline messages, how we might work with trainees to promote the strengths of our training, how we might work through social media and how we might maximise our impact through participation in careers fairs. START aims to maximise fill rates in all programmes throughout Scotland and as the West of Scotland Deanery has the largest number of gaps in our training programmes we have most to gain from START.

So what can trainees, trainers and the Deanery in the West of Scotland do NOW for START?

1. We need to develop headline messages conveying the strengths of all of our WoS training programmes – in particular aspects that convey uniqueness, excellence or successful outcomes (exam success, prize winners, and NTS outcomes).

2. We would like to invite trainees from as many programmes as possible who are keen and willing to work with us, as enthusiastic advocates of our training programmes (for podcasts, scheduled Twitter hours, and to attend careers fairs) and to volunteer to work with us as part of the WoS team.

3. We need TPDs to update their programme descriptors and to consider how these can be presented as attractively and

as informatively as possible for a new online web resource to support recruitment.

4. Consultants who act as Educational & Clinical Supervisors are well placed to promote training opportunities in WoS to trainees – and we would like to encourage awareness that emphasising the positive messages (rather than dwelling on the negatives) could reap benefits in terms of recruitment to their LEP and to their specialty programmes.

5. We need trainers to contribute to the planning of a careers fair to be hosted in WoS.

START needs your involvement. If you can help progress any of these themes, or have good ideas that will contribute to the success of START please contact me at: [email protected]

© NHS Education for Scotland 2013. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES.

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