Peninsula Foundation School Committee Minutes 

Wednesday 1st December 2021 10.00 – 13:00. 

via MS Teams   

1. Apologies TG confirmed apologies received from those listed above. 

2. Agree meeting notes from September 2021 Foundation School Committee Meeting.    

TG confirmed the quality team were going to review the ‘you said, we did posters’ to show the trainees that something productive comes from the quality panels. TG will update with further information at the next meeting.  

SR emphasised that all trusts must inform the foundation school of a trainee’s absence of more than 15 days.   

SM confirmed that it is not possible to bulk extend the access of supervisors to the Curriculum SharePoint site. If any supervisor cannot access the site, they will need to request it for the foundation school to approve or contact SM or NB.  

DB contacted Plymouth Medical School to discuss a regional teaching session on reflective practice. The medical school were not able to provide this so DB has written a piece on reflective practice and developed a PowerPoint to send out to all educational supervisors and other trusts in the region. DB will show this as part of the agenda.  

Summary narrative examples have been discussed nationally. The UKFPO have now published examples, but trainees must be aware that these examples will evolve over time.  

SLE requirements have not reduced, and supervisors should still be advising trainees to complete them. HLO 1 of the new curriculum requires evidence for all 5 capabilities in both Mental Health and Clinical so trainees are likely to see an increased number of SLEs in this area.  

FB to ask Mark Mellor to review the core topics not covered by any teaching to establish if they can be delivered by eLearning. Actioned carried over.  

SR reminded all trusts that they should be encouraging the completion of a PSG in each placement but mandate as a minimum one must be done in the 2nd placement.  

Add ARCP to agenda of FSC in May 2022 to provide discussion on the organisation of ARCP panels to ensure they are Gold Guide compliant and provide consistency for all trainees.  

Human factors courses were well attended, and the feedback received has been very positive.  

SR reiterated that if trusts are struggling to provide supervisors for trainees to contact her and she will liaise with Geoff Smith to provide some assistance if required.  

Academic recruitment has changed to Specialised Foundation Recruitment and Interviews will be held on Wednesday 8th December. Higher calibre of applicants this year. Some national changes might see the Peninsula change how trainees are recruited into these posts. As part of the post expansion, Plymouth are proposing to have academic trainees as well as Torbay, Exeter and Cornwall.   

AC was planning to show a video at the meeting but due to clinical commitments and technical issues this has not been possible. Trainees in Exeter have put together some examples of a summary narrative and the UKFPO have also provided examples.  

DB showed a PowerPoint on narrative. Narratives always have a beginning, middle and an end. Sometimes it is more complex than that and trainees should be aware that it's not just a linear process on narrative. Trainees should learn that narrative changes, and they should also be aware that people use metaphors and figurative language in their in their narrative which have specific meanings behind them. 

 DB has produced a document on reflection and narrative that is based on the year 5 medical school curriculum. Some medical schools have reflection embedded in their curriculum and others don’t include it at all so the trainees have varying experience.  

DB to forward the reflection document once complete for the Foundation School team to send on to all other trusts to incorporate in to F1 teaching.  

The word limit for the summary narrative is only 300 words which the FPDs felt was short and would be challenging for the trainees to get all evidence into that. Trainees should incorporate a beginning, a middle and an end, they should think about where their information has come from and question their own knowledge.  

UKFPO examples show progression from post 1 to post 3 but the examples are very brief and the FPDs would expect more of their trainees. Trainees need to think about the evidence they have. HLO 1 will be SLE heavy, and trainees will be required to use their SLEs to evidence all the capabilities required, mental health and clinical evidence.  

Exeter examples are more descriptive and less specific, and SR thanked AC for all her hard work. SR suggested we need an amalgamation of the two. These examples are a work in progress at the moment and will evolve as we go through the year. NW and DB agreed that the first UKFPO example was too short and would have asked their trainees to go back if this is what they had submitted.  

JE has discussed this with other F2s and have taken an approach similar to the Exeter examples so have more detail. She was concerned that as the year goes on it will be tricky to keep the description in and it will become more a list of evidence. Trainees will need to be focused on the number of SLEs they have completed to ensure that they can evidence the capabilities without being overwhelmed with SLEs that they have completed just to make up their numbers. Opportunity to look at gaps in knowledge and in next post target these areas.  

SR confirmed that if the trainees complete the first summary narrative as a list of evidence and their target areas for their next post this is acceptable at this stage. The educational supervisors need to be aware of the requirements of the summary narrative as we do not want the trainees submitting their portfolio for ARCP and the panel thinking their summary narrative isn’t sufficient. 

This is a process with the ES to target learning to cover the capabilities.  

LD to check with trainees if they are happy to share their examples around the region. The examples would be anonymised. Send to SR when happy. 

 SR will put together some examples incorporating some of the UKFPO guidance. A checklist for trainees of what is expected acknowledging it is a working progress. This cannot be a defined process for all trainees as all of the narratives will be different. SR will complete this by the end of January 2022. 

 Trainees will complete their summary narratives on the curriculum page and will need one for each HLO.  

4. Foundation Expansion & Recruitment 2021 & 2022  

RCHT have had a lot of interest for new placements. This exercise should be used as an opportunity to bring in more trainees and not just to fill departments that are currently struggling. KE reported that they would have no problems creating new medical and surgical posts, but community posts are more challenging. SR to set up a meeting with the team in RCHT to discuss possible community posts.  

SDHT would like to reduce their number from 12 – 10 but they have had a lot of interest. SR confirmed that the trust would need to have 9 or 12 due to the set up of rotations. SDHT have already done some work to split some of the current Emergency Admission Unit posts into the surgical rota and SR suggested these posts could be used for the expansion. SR also informed the trust that some of these posts have been requested to start in 2022 not 2023 as originally planned. AT to inform the team in SDHT of this.  

RDE have met with the medical director to discuss funding. They have several community posts to increase the teams in the community settings. A proposal has been made to put an F1 in a community hospital. The trust has deliberately chosen the F1 as an F2 will be called upon inappropriately due to their knowledge which would not happen to the F1 trainee. SR would like to be reassured about the curriculum coverage in this post. The trust has also agreed a split rotation with NDHT – F1 in RDE and F2 in NDHT. RDE might have extra placements if needed.  

NDHT – would like confirmation about the 2022 start. Funding has been confirmed as 50% plus tariff for the expansion.  

SR confirmed that there is a national request to start some of these expansion posts in 2022 not 2023. There isn’t a national deadline yet but we due to the process they cannot be on the recruitment system any later than January. The Peninsula have been asked to create 21 new posts which equates to7 triplet rotations across the region. Sarah hasn’t given the UKFPO any confirmation on whether we will be able to provide this. NDHT have a post they would like to start in 2022 but would like confirmation that this post will definitely be required and not withdrawn at the last minute. SR confirmed that there is a huge national over subscription and the UKFPO are required to create at least 400 posts by August to manage the over subscription. 95% sure the posts will go ahead.   

Extra posts confirmed for August 2022 start – 1 in NDHT, 2 or 3 in UHPT and possibly 1 in RDE.  

UHPT have a meeting later in December to discuss. Trying to make community placements more enticing. Derriford have the DDLC next to them but concerns about obtaining relevant SLEs.  

All trusts to ensure trainees have an academic supervisor who will guide and support them through the academic component of their post who will be able to complete an academic report at the end of the year. This could be the same as their ES. 

Joanne Watson and Nick Cooper are the Academic leads in Torbay and SR asked AT to ensure they are aware they must complete an Academic report at the end of the year.  

Steve Podd and Angus Jones are the Academic leads in Exeter. They have been in post for a while and NW confirmed they are aware of their requirements.  

6. Horus 

All trusts were reminded to look at the concerns on Horus. If a trainee has a concern it needs to be resolved. It is a trust decision who will do this, admin. FPD or ES. Trusts need to avoid a lot of unresolved concerns being on the system at ARCP.  

7. Welcome Event 

Trusts need to begin to start to recruit trainee presentation volunteers.  

The event will be held on Wednesday 16th March 2022 and will be broadcast live from Plymouth so all trust reps will be in one place. Will be a hybrid approach for trainees but will depend on any ongoing covid restrictions.  

Feedback from last years trainees indicated they would like more information from the presentations. The foundation school will develop a presentation template that trust presenters will need to use it and will be required to cover all items in their presentation. This will be sent out in the new year  

The SharePoint site will be updated for new starters in 2022 and the foundation school will be in touch with all trusts to make any necessary updates. Trainees want job descriptions for all posts and not just a sample so the Foundation School will be requesting these from all trusts in the new year. FB confirmed NDHT have worked with trainees to provide a template job description and confirmed they would be happy to share with other trusts.   

FB to send the template to SR who will review it before sending out to all other trusts.  

Slido will be used as the platform for the question-and-answer sessions. This will allow us to have questions before the event to prepare the answers.  

8. Regional Teaching 

19 trainees have not booked any courses on the system. 22, have booked 1 and 22 have booked two. 4 months into their year this is concerning. There are no known derogations for ARCP in 2022 so trainees should be encouraged to book and attend courses sooner rather than later.  

All trusts are required to provide a proportion of the regional teaching. The following are currently on the system for trainees to book: 

NDHT – 1 live course and 1 completed course 

UHPT – 2 ASCERT courses 

RDE – 4 live courses and 4 completed courses. Could increase numbers for the live course and have 2 more to add on to the system 

TSHT – 2 live courses and 2 completed courses 

RCHT – 1 live course  

Trainees need 6 weeks to apply for study leave so all trusts were reminded that the courses need to be added on to the system with plenty of notice.  

All other courses on the system are courses that have been organised by HEE. Human Factor courses have been completed and good feedback has been received. The facilitator is now on Maternity leave so there will be no further course in 2022 but SR confirmed that she hopes the course can be offered in 2023 to make in mandatory for all F2 trainees. There is also a clinical skills course being designed which will be mandatory for all F2s.  

There are 9 trainees who have not yet got an account on maxcourse. NB to send a list of trainees to all trusts to encourage them to create an account. 

SR is concerned about the current situation regarding regional teaching and can understand the pressures within the trusts, but we need continue with the teaching provision for trainees.   

JE conducted a survey for all F2s about their experience in their first post. Trainees have raised concerns about how they were going to achieve the required number of hours for core teaching as the number of courses available were low. They were also concerned about how late the courses were advertised to be able to apply for study leave in time to attend. Trainees also reported that the courses that are running by teams are filled up very quickly and couldn’t understand why there were number limits. Trainees thought that SIM teaching can count towards core teaching. SR to clarify the UKFPO stance on this. Post meeting note – SIM can count towards core teaching hours.  

LD asked the trainee reps to feedback to trainees about signing up to courses late which means they do not receive the link. This can be managed on the system so when the link is sent the number of attendees is capped to those only that have booked on and no further trainees could book on to the course from that point. LD also highlighted that trainees do not engage with the teams sessions and when facilitators are asking questions trainees do not have their cameras on and provide no response. The facilitators provide this on good will and if trainees do not engage it makes it very difficult for the facilitator to give up their time for the future courses.  

Face to face teaching is still not advised by HEE but requests can be put in to do this. Risk assessments can be completed to do this. Sessions can by hybrid with local face to face and optional online sessions. SR is concerned that there will not be enough courses offered to give all trainees the opportunity to complete their required hours.  

Regional teaching will be discussed at the next FSC and if we are still in the same position with low course numbers and lack of trainee engagement, we may have to make the decision to revert back to local teaching but this would be a last resort. 

 9. General Practice update 

Medical Schools, Foundation Schools and GP Schools are all expanding at the same time and trainees who are working lessthan full time can take up more placements so managing the capacity is going to be challenging. The GP school are training up more GPs to become clinical supervisors which will help to give more support and enable the increased capacity.  

A proposal is being made to help with room capacity which is the biggest problem the schools face.  

Integrated placements have been introduced where the trainee completes 2 days in a GP practice and 2 days in a specialty such as ED, Sexual health etc. There has been good feedback from the GP trainees in these posts.  

Minor injury units have no doctors on site. In Foundation, the trainees must have access to a doctor at all times so posts at the units would be difficult. SR has concerns over trainees being in community hospitals as there is little education to be gained and trainees would be used for service provision. GP trainees have fed back they are being asked to do things there are not capable of.  

10. Psychiatry update 

The school has 18% of psychiatry posts and the national target is 22%. 

SB has sent SR a proposal paper to present to Geoff Smith about appointing a foundation psychiatry lead in the Peninsula. Supervisors are the main problem to increasing post numbers. Any Psychiatry posts are labelled as community posts. 

11. Update from national FSD meeting 

There of lots of national discussions about expansion of posts and recruitment. There is a large oversubscription for the foundation programme in 2022 and SR has asked why we must provide placements for non-UK graduates. The government has an unwritten rule to provide a placement for all UK graduates which by default extends to all applicants from outside the UK. The UKFPO sought legal advice and were informed that UK graduates with lower scores cannot be prioritised over a non-UK graduate.  

The Foundation School will have a local reserve list of applicants that can be manage locally. The hope is this will stop substantive posts remaining unfilled.  

Additional funding has been requested for the post expansion for admin/FPD/Deanery time and discussions are ongoing.  

There have been several examples of F1 trainees who have resigned at F1 and have approached individual trusts for F2 post. This is not acceptable practice and if any trust has any contact with trainees with this request, they should pass their email on to SR.  

Tuesday 1st March 2022  

Wednesday 11th May 2022  

Tuesday 20th September 2022 

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