Yorkshire and the Humber Postgraduate Deanery

School of Public Health Annual Conference

Times are a-changin

David Wilkinson MD FRCS

Postgraduate Dean

Consultant Vascular Surgeon

Come gather 'round peopleWherever you roamAnd admit that the watersAround you have grown

What are we trying to achieve?

• Security of supply• Right number of right people with right skills at

right time in right place

• Responsive to needs of patients, public and service

• Excellence in education and training

• Transparency of funding and value for public money

GMC

• Extensive statutory powers (S34 Medical Act 1983)

• Agree independence of Deans from LETB• Visiting educational team available• Plans to approve trainers - consultation• Change “shape” of training• Set generic outcomes - consultation• Clarify CPD• Employer liaison advisors• Vital QA oversight of Deanery QM role

HEE

• Accountable to SoS via DH• Will ensure compliance with education

outcomes framework– No other country, high level relationships OK but poor

indicators for 2012 / 2013

• Allocation of education and training funding• NHSCB and PHE input to strategic operating

framework (& social care next year)• Authorise LETBs and hold them to account• There will / should be tension between HEE

and GMC

LETB

• What the service will look like, workforce needs

• Multi professional

• Throw the net wide– employers, Medical Schools and HEIs,

local authorities, primary care

• QM role??

Yorkshire and the Humber Local Education and Training

Board

• YHLETB was established as a formal sub-committee of the NHS North of England SHA Board at its January 2012 meeting

Provider representatives

• Sir Andrew Cash, Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust

• Dr Peter Belfield, Medical Director, Leeds Teaching Hospitals NHS Trust • Mr Patrick Crowley, Chief Executive, York Hospitals NHS Foundation trust• Mr Chris Butler, Chief Executive, Leeds and York Partnership NHS Foundation Trust• Ms Christine Boswell, Chief Executive, Rotherham, Doncaster and South Humber

Mental Health Foundation Trust• Mr Phillip Marshall, Director of HR, Harrogate and District NHS Foundation Trust• Mr Bryan Millar, Chief Executive, Bradford Teaching Hospitals NHS Trust • Mr Phil Morley, Chief Executive, Hull and East Yorkshire Hospitals NHS Trust• Ms Juliet Greenwood, Chief Nurse, The Rotherham NHS Foundation Trust• Dr Steve Ball, GP Representative (South Yorkshire)• Dr David Brown, GP Representative (West Yorkshire) • Dr Mike Holmes, GP Representative (North and East Yorkshire and Northern

Lincolnshire)

HEI representatives

• Professor David Cottrell, Dean of Medicine, University of Leeds

• Professor Tony Kendrick, Dean, Hull York Medical School

• Professor Rhiannon Billingsley, Pro Vice Chancellor, Faculty of Health and Wellbeing, Sheffield Hallam University

• Ms Shirley Congdon, Pro Vice Chancellor Learning and Teaching, Dean of School of Health Studies, University of Bradford

Non executive director representative

• Mrs Kathryn Riddle, Chair, NHS North of England Cluster SHA

Local government representative

• Mr Steve Walmsley, Deputy Chief Executive, Local Government Yorkshire and the Humber

SHA Workforce and Education

• Mr Jonathan Brown, Strategic Workforce Planning Manager

• Mr Mike Curtis, Deputy Director of Finance

• Ms Joanna Valentine, Acting Associate Director Leadership and Organisational Development

• Mrs Sharon Oliver, Associate Director, Education Commissioning & Workforce Development

• Dr Mark Purvis, Director of Postgraduate General Practice Medical Education

• Mr Adam Wardle, Workforce Programme Director

• Mr David Wilkinson, Postgraduate Dean

Deanery

• Have to move posts• Respond directly to regulator• Protect the money• PGD is at core of LETB• Multi professional Deanery

• Not difficult, mindset, skilled set of staff, commissioning, workforce planning and development

• Multi professional Schools• ▼back office, simulation, innovation, learn from and

about each other

Apart from LETB

Deanery Functions• The Postgraduate Dean’s office• Education provision• Programme management

– Recruitment– Revalidation and doctors in difficulty– Academic Training– Less than full time training– Inter Deanery transfers– Programme Support

• Quality management, data and workforce• Finance

Reorganisation

• Speak to staff• Principles• Formal consultation• Proposal• Faculty and Staff meeting• Senior team• Team meetings• Go live!

Themes

• Quality management

• Patient safety; Serious Incidents, revalidation

• Clinical Skills investment and strategy

• Workforce planning

Revalidation

• RO role

• Pilot - Assessment Paperwork

• Serious Untoward Incidents

• Conduct / Probity

• Absence – central reporting mechanism

LARGE SMALLMEDIUM PSYCH

Serious Incident reports Sept 2010 – Feb 2012

Main events

• Obstetric

• Drug errors

• Delayed diagnosis

• Deteriorating patient

• Wrong site surgery

Main locations

• General wards

• Labour ward

• Emergency Department

• Theatres

Importance for trainee ?

Personal reaction

• Learning - all• Remediation – some• External referral - few

• Large investment across a number of specialties

• Practice on simulator first

• Curriculum development?

• Local delivery to reduce costs

• Quality training

• Patient safety

Simulation and Clinical Skills

Simulation – next steps

• Postgraduate School strategies

• Commissioning model development

• Faculty training• Faculty time

Workforce Planning - Drivers

• DH / JWG

• Workforce predictions - CfWI

• Colleges

• Local workforce data

• Employers

• Planning

Workforce planning

How many trainees do we need ?

• Lack of data on proportion of service vs training

• ‘Bulge’ of CCT production; will outputs exceed opportunities ?

• promote GP capacity• promote GP choice• assist less popular • encourage alt workforce• review distribution•

Impact

• Service

• Training quality

• Cost

• Patient safety

Reduction / Expansion

• ST1/CT1 level

• GP

• Core Surgery

• Foundation

• Anaesthetics / ICM

• Medical and surgical specialties

• Leadership & management

Clinical Leadership Opportunities

• Piloted in 2010/11

• Developed in 2011/12

• National drive to improve clinical leadership

• 12 month out of programme experience

• Match-funding

• Plan to continue

Thank you

Questions?