nes medicine - nhs education for scotland · 604 trainees . £33m . south east . 54 programmes ....

Quality Education for a Healthier Scotland

NES Medicine : Looking back & Looking Forward

Stewart Irvine Medical Director NES

4th National Scottish Medical Education Conference


Outline

NHS Education for Scotland

Single System Working

Training Management

Quality

Professional Development

Strategic Planning



Medicine

Dentistry

Nursing & Midwifery

Allied Health Professions

Pharmacy

Psychology

Healthcare Science

Optometry

Source : NES – Fast Facts http://www.nes.scot.nhs.uk/media/2550555/FastFacts2014.pdf

http://www.nes.scot.nhs.uk/media/2550555/FastFacts2014.pdf


NHS Scotland Workforce

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

Female

Male

Headcount - Source : ISD Scotland http://www.isdscotland.org

http://www.isdscotland.org/Health-Topics/Workforce


NHS Scotland Medical Workforce

Consultant 22%

Staff and associate specialist

grades 7% Other trained

grades 2%

Undergraduates 20%

Doctors in training

25%

GPR 2%

GP 18%

GP Salaried 3%

GP Retainee 1%

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

http://www.isdscotland.org/


Education and training matters…..

Properly planned and carefully conducted medical education is the essential foundation of a comprehensive health service.

Goodenough, 1944

Training is patient safety for the next 30 years. Temple, 2010

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

GMC, GMP, 2013


NES Strategic Framework : 2014 - 2019

•Vision

•Mission

•Values

•Ways of Working

•Principles

•Themes


Outline



Training Management

Quality


Strategic Planning


East 39 Programmes 604 Trainees £33m

South East 54 Programmes 1402 Trainees £79m

North 44 Programmes 870 Trainees £45m

West 84 Programmes 2890 Trainees £160m

NES Medicine : Overview

Approx 4,600 Undergraduates, 5,700 postgraduate trainees, 1033 LEP x Specialty Environments


Aspiring to Excellence and Efficiency


Workstreams …


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

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

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


NES Medicine : Overview


Outline



Training Management

Quality


Strategic Planning


Recruitment 2013


Applications to Medical + Dental School

0 2 4 6 8 10 12 14 16

K Northern Ireland

F Eastern

L Scotland

J Wales

G Greater London

C North West

A North East

All

B Yorks & The Humber

E West Midlands

I South West

D East Midlands

H South East

Source : UCAS – applications to medicine + dentistry http://www.ucas.com/data-analysis/data-resources

http://www.ucas.com/data-analysis/data-resources


Origins of Medical Undergraduates

0%10%20%30%40%50%60%70%80%90%

100%

England Scotland Wales NI

School

RoWEUNIWalesScotlandEngland

Source : UCAS – applications to medicine + dentistry http://www.ucas.com/data-analysis/data-resources

http://www.ucas.com/data-analysis/data-resources


First choice location for Specialty Training

First Choice ST Location by Country of Birth

0%

20%

40%

60%

80%

100%

Scotland RUK Overseas

Country of Birth

Outside UKOther UKScotland

Source : SMCCS


Trainee Destinations at CCT

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ES NS SES WS All

Training Region

Unknown

Scotland

Rest of UK

Overseas


Strategy for Attracting and Retaining Trainees (StART)

Post Group Establishment Vacancies Filled Unfilled Fill Rate

Foundation 1608 804 804 0 100%

Core 588 289 288 1 99.6%

Run Through 1792 411 372 39 90.5%

HST 1741 345 236 109 68.4%

LAT 139 70 69 50.0%

Total 5729 1988 1770 218 89.0%

Recruitment 2013

3.8%


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 g. Trainers – make me want to train in Scotland


Issues Considered when Choosing Deaneries (CT2 Trainees)

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

Previous familiarity with geographic area

Proximity to home/friends

Reputation of the Deanery

Your long term specialisation plans

City living

Outdoor recreational

Recommendations (family)

Recommendations (lecturers)

Recommendations (other trainees)

Recommendations (others)

Reputation of Foundation schools

Rural living 1

2

3

4

5


Gaps in Programmes

OOP Maternity CCT Unfilled Other 0

5

10

15

20

25

30

35


GMC : Revalidation


Revalidation : SOAR


Revalidation

UK Scotland

# % # %

Defer 6,746 16.62% 371 11.71%

Revalidate 33,829 83.35% 2,797 88.26%

Non-engagement 12 0.03% 1 0.03%

Total 40,587 100.00% 3,169 100.00%


Outline



Training Management

Quality


Strategic Planning


Sources of Evidence for Quality Management

Surveys - GMC

Surveys - NES

Outcomes - ARCP

Outcomes Exams

Visits – GMC & NES

Deanery Reports

College Reports

TPD Reports

LEP/DME Reports

Regulator Reports


GMC : National Training Survey


GMC NTS 2013 : Overall Satisfaction


GMC NTS 2013 : Educational Supervision

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 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

NHS West Midlands Workforce Deanery Yorkshire and the Humber Postgraduate Deanery

North Western Deanery Northern Deanery


GMC NTS 2013 : Patient Safety Concerns


GMC : Review of Quality Assurance and Standards


Quality

Educational Governance Supporting research in medical education – SMERC Supporting undergraduate medical education – Medical ACT


Outline



Training Management

Quality


Strategic Planning



Recognition of trainers Supporting staff, associate specialists and specialty doctors Forensic medical examiners Approved medical practitioners Professionalism and Excellence in Medicine - Leadership training LAMP Launchpad for leadership Scottish Senior Clinical Leadership Fellows Remote and Rural Healthcare – RRHEAL and SSRHW Quality Improvement / Patient Safety / Clinical Skills / Human factors


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 contributes to the teaching, training or supervision of students or trainee doctors.


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 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 f.guiding personal and professional development g.continuing professional development as an educator.

http://www.gmc-uk.org/Trainee_Doctor.pdf_39274940.pdf

http://www.gmc-uk.org/Trainee_Doctor.pdf_39274940.pdf

http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asp

http://www.medicaleducators.org/index.cfm/linkservid/C575BBE4-F39B-4267-31A42C8B64F0D3DE/showMeta/0/

http://www.medicaleducators.org/index.cfm/linkservid/C575BBE4-F39B-4267-31A42C8B64F0D3DE/showMeta/0/


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. 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. 8. Demonstrate an appropriate level of teaching competence. Scottish arrangements for Meeting these criteria The Scottish Trainer Framework


Outline



Training Management

Quality


Strategic Planning


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 offers an approach

which will ensure doctors are trained to the highest standards and prepared to meet changing patient needs.

• 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.


Undergraduate Foundation Broad Specialty Credentialled

Shape of training : Proposed Structure


Shape of Training : Next Steps

To establish a 4 Nation Co-ordination Group to provide oversight, co-ordination and direction to post-Greenaway implementation activities. 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 Ministers on progress, and on issues requiring Ministerial approval.


Health Education England


Outline



Training Management

Quality


Strategic Planning

nes medicine - nhs education for scotland · 604 trainees . £33m . south east . 54 programmes ....

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