Meeting Notes 21st September 2021

Peninsula Foundation School Committee Minutes                                                                          

Tuesday 21st September 2021 10.00 – 13:00.

via MS Teams 

Apologies:

Sarah Ansell	SA	Head of School of Primary Care
Trudy Eddy	TE	Senior Manager of Medical Education RCHT
Tom Smith-Walker	TS-W	Foundation Programme Director FY2 RCHT
Simon Bonell	SB	Head of School of Psychiatry
Philip Reilly	PR	Foundation Programme Director FY1 TSDHT
Nina Bossa	NB	Medical Education Manager RDE
Jacqueline Easter	JE	F2 Trainee Representative

 

 

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

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

SR welcomed everyone and introductions were made.

SR confirmed the F1 simulation project has been adopted in all trusts (Torbay modified slightly).  SR announced she has been allocated a pot of money to appoint a simulation fellow to support the use of simulation to aid Covid recovery plans.  We will be working with Severn on this.

SR working with SA as there is currently pressure on GP placements.  TG confirmed the new mileage policy change has been communicated.

Issues with appointing mentors for Psych Fellowship FP. Exeter and Plymouth do not have mentors yet but it is the Royal College’s responsibility to assign one.  If the college are not able to find mentors, they have been requested to inform the trainees concerned.  SR has approached the School of Psychiatry to assist with delivering teaching on the mental health new curriculum requirements but has no response yet.

Hybrid model of face to face and online going forward for Regional Teaching.

ALS continuing as the best way of delivering the curriculum requirements in this area.

A:GMC Posters ongoing, TG.

Exception reporting system from trainees SR confirmed no report from FDAB on a more user friendly system.

AOB trusts to come back to SR on how to keep regular contact with the school re trainees.  TG suggested using an MS Form to update on a trainee but the onus would be on the trust to complete the form. TG stressed the need for TIS & HORUS etc to be kept up to date so an accurate completion date is maintained.  TG asked for comments.  SR reiterated we need to know if trainees are off sick or out of training for a significant time.  FB stated NDHT are adding trainee absence to their monthly Foundation meeting.  FB wanted to avoid additional form completion.  TG stressed that we need to know if trainees are off.  SR confirmed that it can take months to get details from trusts HR re sickness.  AC confirmed that at RDE they discuss trainees absent at monthly medical postgrad team meeting.  NW stated they were also stressing that return to work forms are key and their trust is trying to encourage their use.

A: All trusts to inform Foundation School if any trainee is out of programme due to sickness, shielding etc for a significant period of time to ensure that completion dates are accurate.

Minutes from the previous meeting were approved.

3. New curriculum 2021

SR requested Trust updates on progress and any issues re the new curriculum:

NDHT: FB so far so good, lots of roll outs 3 trainee champions, updates sent to all supervisors, SharePoint site useful.  Sample Summary Narrative would be good, AC was going to put this together.  AC is going to do some workshops with trainees to produce an example.  The UKFPO have still not produced one.

UHPT: DB said that reflective practice is already deeply embedded in some Medical Schools such as Plymouth Medical School so some F1s were already used to it and so they have welcomed the addition.  However overseas trainees and other medical school graduates who have not used reflective practice before are unsure.  UHPT is forming a working group to help trainees with no prior experience.  KT confirmed she is in the process of setting up a F1 & F2s workshop to support less confident trainees.  DB has also approached Plymouth Medical School to do a teaching session. SR requested that RDE & UHPT feedback to the FSC in December. 

A:SR will add Summary Narrative as an item to the December FSC Agenda, when hopefully some examples can be shared RDE &UHPT to share feedback in December

JW asked the benefit of a good Summary Narrative to the trainee.  SR confirmed trainees needed a good Summary Narrative to pass at ARCP but there is currently no benchmark.  DB wondered if there should be a difference between the standard of a F1 & a F2.  SR felt there should be a progression shown, and a difference in the level of capability but in terms of how it is written it should be the same.  Meeting felt there should be a greater maturity shown in F2.

FB requested the access to SharePoint deadlines be extended.

A:SM to extend access deadlines for Sharepoint site for supervisors if possible.

SR asked if anyone else in Plymouth University that could deliver teaching on reflective practice as a F2 Regional Teaching Day then some F2s could in turn help F1s.  MT suggested the F2 session could with the agreement of the facilitator be recorded for F1s.

A: DB to approach Plymouth Medical School to see if someone can deliver a Regional Teaching session on reflective practice.

RDE: NW has given F2s a talk but confirmed that the Summary Narrative is the area that is causing most concern, both amongst trainees and supervisors.  SR confirmed trainees do not have to submit at the end of every placement only one per HLO for ARCP, they need to start the Summary Narrative in the first placement and update at the end of each placement to identify any areas to focus on.  AC explained that the Summary Narrative is a form of presenting what the trainee has done and what they haven’t done, the idea being to identify deficiencies and form the basis for an individual’s PDP.  AC will ask two F2s to sit with her to complete theirs and then they can share with other trainees.  SR reminded everyone that all capabilities need to be evidenced across acute, mental, community etc. placements not just in acute settings.  The UKFPO video on Summary Narratives was not well received, but a trainee video that is available was considered the better option.

SR asked trainee reps for feedback. YM asked clarification of what is required.  SR felt we need to signpost all to Sharepoint site again, NW felt what is expected in their supervisor meeting in December is not clear.  SR confirmed that trainees need to show activity in their portfolio across each capability and have started a Summary Narrative for each of the 3 HLOs and then discuss with their ES what is good what needs to be worked on, together with the normal requirements for meetings, teaching etc.  AC agreed.  SR will send around the supervisor summary sheet to TPDs and will chase the UKFPO for an example Summary Narrative.  SR stated that the school could send an email out to all trainees and supervisors but felt unsure that it would be read. 

A: SR requested trainee reps help to inform trainees that that currently there is no set standard for the completion of Summary Narratives but the school and FSC will work to provide examples following activity in each trust and further discussion at the next FSC meeting in December.  The Summary Narrative is designed to show and aid progression.

A: SR send the supervisor summary sheet to TPDs and chase the UKFPO for an example Summary Narrative. 

SP felt that speaking to F1s everyone feels that currently the guidance is open to interpretation.  Examples of summary narratives are really needed and some communication as to what level expected sent out.

SDHT: NK stated that all the queries they have had are from supervisors, planning training. One concern is that she felt that trainees are not doing as many SLEs even though they are emphasised as a good way of demonstrating capabilities.  SR stressed that if trainees do not do SLEs they will not have the evidence to demonstrate the HLOs, supervisors therefore need to communicate this to trainees.  NK stated that she planned a session in October for ES and CS.

A: All TPDS to ensure that supervisors are still advising trainees to complete SLEs.

UHPT: KT telling trainees 5 – 10 SLEs as a guide. 

RCHT: KE: Core teaching focus.  Contacted all ES and CS about changes, waiting to see what the trainees logged on their portfolios to see what happens.  KE will revisit this now in view of the general feelings of concern expressed.

SR reminded the meeting that during the last FSC meeting collaboration on the more difficult to deliver core topics had been discussed.  The UKFPO however feel that some of the core topics can be done through online resources and does not need to be delivered as teaching. SR felt that the FSC need to decide which topics and resources will lend themselves to eLearning. 

SR suggested trusts identify those topics they thought could be covered by online resources.  NB sent all trusts admin a link to a spreadsheet on core topics following the last FSC.

KT reminded the meeting that 6 hours e-learning is the maximum for non-core if we identify core topic online and agree which ones we can use online for and this would be in addition to the 6 hours maximum limit. FB nominated Mike Mellor to look at the topics that are not yet covered to see if any can be covered online.

A: FB to ask Mike Mellor to review the core topics not covered by any teaching to establish if they can be delivered via eLearning.

KT asked where Summary Narrative is completed on HORUS– on curriculum.

TAB

TG advised that HORUS are telling trainees to start their TAB in their first post.  The school policy has previously suggested they start in January for 45 days.  The January date gave trainees more time to get to know more people etc, but still allowed enough time to repeat a TAB if their first was unsatisfactory.  TG asked if it was now the case that we have to go with the curriculum guidance to start TAB in October?  SR said the old curriculum suggested first placement as well.  KE stated: HORUS email the trainees to start in October and us emailing in January causes confusion and trainees having to repeat.   FB advised that as the new curriculum said start it, so she has asked her trainees to start it in October.  SP felt leaving it to the trainees to decide would be good, trainees felt that they preferred to get it out of the way.  YM agreed leave it to the trainee to decide.  SR reminded everyone that at least one PSG is now mandatory.  KE RCHT has asked trainees to complete a PSG in the second placement to ensure they have at least one, so would prefer TAB in first placement. FB, KT and NW recommending in each placement.  NW PSG is very helpful when they are linking to curriculum, some of the comments is exactly what trainees need and AC agreed as some specialties it would be impossible to complete an ES report without a PSG.  SR confirmed that TAB can cross cover placements.  SR asked for a show of hands in favour of first placement, second placement or keep it open to trainees and mandate 1 per year.  Overwhelmingly FSC voted to leave to the trainee.  Admins will have to make sure that by the end of March they have started a Tab as time would be an issue, particularly if unsatisfactory one done and needs to be repeated. 

A: The school will not specify when TABs are to be started but will mandate that it must be started by the end of January. All trusts to schedule a review of portfolios in February to ensure a TAB has been started by trainees. 

A: All trusts are to encourage the completion of a PSG in each placement but mandate as a minimum one must be done in 2nd placement

4. Welcome Event

NB presented the feedback from last year’s Welcome Event, slides attached.

Attendance much higher

The number of attendees completing feedback much lower

Some only logged on for a time

Some movement on 1^st choice trust after the event.

Q & A popular together with info on local areas.  Wanted more time on Q & A

Wanted more information on specific jobs

Wanted an improvement on technical platform

More standard comparative info on a slide.

Liked the SharePoint site.

Parking and local transport links and where to live info needed.

45% would not have attended a face to face session.  Preferred online, less travel costs, time, exams.

Those who preferred face to face missed networking, exploring the area, chance to have informal discussions with reps

Wanted videos of the hospitals inside.

100% recommend event with or without changes.

Less emphasis on mess and social life, they want to know the reality good and bad.

Slides and info before the event and opportunity to put questions to Q & A before event.

Moving forward NB stated that future online events would need to be thoroughly checked before hand to try and prevent the technical difficulties we experienced on the day.

All Trusts felt considering the circumstances it was very well put together.  FB felt the message from feedback is that more of the standard comparable across trust information is wanted.

SR said there is a shift of what trainees need - the emphasis is on their working life and going forward putting together some standardise format for each presentation is needed.  

A: NB to send out the Welcome Event evaluation report.

SR going forward we need to offer online that is clear but do we want to offer a hybrid of online and face to face.  It was suggested that incoming F1s could visit if they wanted to.  SP missed the face to face chance to meet other trainees.  Opportunity to look around would be welcome.

SR suggested next year to bring all trusts to Plymouth and open it to face to face, but also stream online. – meeting agreed.

FB had noticed that no one wanted to come to North Devon but when she asked the F1s post allocation there were many who had put ND as their first choice. NB confirmed only a small cohort completed the feedback and therefore the feedback was not representative of the whole cohort.

5. ARCPs

A few issues with ARCPS picked up this year.  SR highlighted:

1. There must not be a supervisor involved with the trainee on the panel.  HORUS will flag this in red and trusts must make alternative arrangements.
2. Minimum of 3 panel members will return this year post COVID.
3. Appeal paperwork – had several trainees were not given paperwork in a timely manner.  If a trainee given outcome 3 or 4 they must be given in writing how to appeal and what they need to do.  If they are not given it on the day of ARCP the clock does not start.
4. TG stated that June ARCPs are fine but the ad hoc out of synch ARCPs -  trainees are not always given 6 weeks’ notice and a document deadline by which their evidence must be uploaded and panel formed in accordance with guidance.  SR also confirmed panel should get together and not rely on email discussions.  Need to give F1s time to apply for F2 registration.
5. Out of Synch trainees will still be on the derogated ARCP requirements.  Any outcome 3/adverse outcome they should have an individually agreed ARCP criteria to progress.
6. Form R everyone needs one every 12 months regardless of whether they are off sick or not and the period covered by the Form R must not exceed 12 months.
7. Going forward currently we are reverting to the 60 hours teaching 30 hours Core and 30 hours non-core therefore the derogation has been removed.  F2s must have 24 hours Core from Regional Teaching and then an additional 6 hours.

A: All trusts to review the points raised and look at the organisation of ARCP panels to ensure that they are Gold Guide compliant and provide consistency for all trainees.

6. Regional teaching update

SR we need to get more courses onto Maxcourse.  Trainees are not engaging with Regional Teaching and if they don’t book some now there may not be the capacity to accommodate all F2s as the year progresses leading to issues near ARCP. 

A: NB will email those 13 trainees that do not yet have a Maxcourse account. 

SR has secured funding for some surgical skills courses joint with Severn at Taunton.

Human Factors course is a fantastic course – leadership covered and provided by facilitators with real expertise and SR feels it is a must have Foundation teaching but uptake is very poor.

A:SR requested all trusts to encourage trainees to book one of the available Human Factors courses.

Leadership courses are in development with Severn.  Going forward deanery will not fund leadership programmes from external providers so SR is looking at ways of providing this in house.

Clinical skills - regional offer out of Derriford coming one date provisionally agreed more to follow.

SR aware that it is a pressure and trusts are doing all they can to deliver good quality teaching and thanked all for their efforts.

Supervision

SR stated there are some trainees that still do not have supervisors.  If trusts cannot provide supervision SR needs to know email her and she will escalate.  NW concerned with expansion – struggling now and it will be an issue going forward with expansion.  SR agreed that this was the case in other trusts and schools.  JR-L confirmed the same and they were now looking at who has trainees and who provide ES and wanted thoughts of how other trusts deal with it as there were discrepancies with who have trainees.  JD now having discussions with depts how they can expand ES provision with expansion coming.

A: Trusts to email SR if there are issues with providing supervision for trainees for escalation.

7. Recruitment 2021 & 2022

TG updated the meeting.  Oversubscription has already been confirmed as a continuing problem for next year but it will be dealt with differently.  Rather than 2 timescales after primary allocation each school will be given a pot of reserve students that we will manage locally as people withdraw/exam failures.  There will be a cut-off date when we must confirm reserve list posts and that still may lead to new posts being created but it is hoped that it will be an improvement on the system we have at the moment. Currently we have been left with 6 vacant substantive posts this year which is very disappointing and TG thanked all for their patience and co-operation this year dealing with circumstances not within the Peninsula’s control. Recruitment for next year is open now but closes tomorrow.

Academic recruitment shortlisting & interviews currently being organised TG needs clinicians from Torbay/Truro particularly.

A: Clinician volunteers for Shortlisting (ONLINE) and Interviewing (ONLINE) are to contact TG if they have not already done so ASAP.

8. GP Update

SR is working with SA to try to increase capacity.

9. Psychiatry Update

NB had email from SB he hasn’t been approached by the Royal College to provide mentors for the Psych Fellowship posts.

10. Update from national FSD meeting 

SR updated the meeting.  The issue with Psych mentors is a national problem.  Viability of continuing to offer Pschiatry fellowships need to be looked at.

Expansion: 2 issues raised about planned expansion of the Foundation Programme: 1 Funding & 2 Supervision.  SR stated she had not discussed with any trust yet but the funding so far has been confirmed as tariff for F1s covering approximately 50% of salary costs and with the supervision funding on top most of the cost of F1s is covered. F2s however are different so more of a commitment from the trust is needed.  FSDs have stressed as strongly as possible nationally that unless these posts are fully funded it makes the provision of additional posts challenging.  This message seems to be getting through but no concrete agreement has been made however the message is that by the time the F2s start all funding will be agreed.

FPD/Foundation Co-Ordinator/admin funding is also being looked at considering the increased numbers of trainees.

SR has written to all trusts about the expectation of numbers required.  SR will start with RCHT, as the modelling HEE has used suggests that half of all extra posts should be in Truro.  The initial indication from RCHT though is that they cannot accommodate 50%, so SR is not expecting to use the HEE model.  SR is meeting this afternoon to firm RCHT numbers and then SR will contact the remaining trusts.  SR stressed although there is not that much time left to sort this.  Need rotations ready to go by July 2022.  Must move forward now.  There will be a deadline for rotations.  The total number of additional trainees is 81 with approximately half starting in 2023 and the remaining in 2024.

SR confirmed we can flex the numbers of how many start in 2023 and how many in 2024.  First step is to agree the distribution between trusts. 

A: Trusts and SR to discuss expansion numbers to agree distribution across the Peninsula.

11. Trainee Rep Matters

YM:  Exceptional reporting system was referred to in the last meeting minutes and she wondered if anymore had been heard from FDAB.  LE (previous Rep) was taking it to FDAB, YM will contact LE to see if there is any progression. YM confirmed that the new F2 reps will survey F2s to see if there are any issues.

SP is in the process of setting up a survey to F1s to obtain ongoing ideas/suggestions she will collaborate with her fellow rep and bring to next meeting

SR stressed to the reps that if there are any pressing issues that come to light to contact the Foundation School team and not wait until next meeting.

12. A.O.B.

GP change in indemnity for trainees going out.  Used to be under the acute trust’s indemnity but they are now under the practice indemnity SR asked TPDs to familiarize themselves with the changes.

GP – 2 trainees in GP placements recently have been found to registered at the practice where they are based this has caused some issues.  The school have consulted the GP school policy that trainees cannot be registered at trainee practice.  SR feels that we should adopt this policy for Foundation School.  Asked for thoughts from the meeting. AC deregister or send to another practice.  SR stated it needs to be part of the allocation process to make sure they are not allocated their own GP practice.  Everyone agreed to adopt this as a policy. 

A: Trainees will no longer be able to undertake a placement at the GP practice they are registered as a patient. TG/School to send out a communication to GP Practices to inform them of the changes to the policy.

A: All trusts to ensure that all trainees declare if they are a patient at any of the practices used as part of the allocation process – pre allocation.

KE asked for clarification of study leave on behalf of Trudy Eddy following a Deanery school meeting.  SR was aware now a list of courses that have been categorised cat 1 full funding courses aligned to curriculum. Cat 2 not fully funded, trainee pays, Cat3 and that some confusion had arisen due to the ASCERT course being incorrectly categorised but this has now been corrected by the Deanery.

All trusts had the spreadsheet and SR asked for caution when approving any courses not on Cat1 as the Deanery have tightened the criteria/budget.  If the TPD is in any doubt refer to SR before agreeing SR will not supportive retrospective approval if the criteria is not met.

SR asked all trusts if they had AOB

RDE: NW expressed concerns re morale and wondered if YM and SP had any insight.  In RDE he was aware lots of social activities had been cancelled.  YM confirmed RDE is trying to get F1 and F2s to interact more.

ND: FB has been asked by the surgeons re a START course for F1s but as F1s do not get funding or time wondered if it would be an option for F2 regional teaching.  Similar to ASCERT the Royal College is keen to roll out nationally.  SR would support if it can be opened out to all the Region and the training is of a good standard so she requested more detail. 

A: FB request surgeons provide more information on the START course and cost before consideration by SR.

The meeting concluded.

Future meetings

Wednesday 1^st December 2021 

 

Actions for Review:

 

Agenda Item	FSC Member	Action	By When
2	TG	GMC posters	Next meeting
	ALL	All trusts to inform Foundation School if any trainee is out of programme due to sickness, shielding etc for a significant period of time to ensure that completion dates are accurate.	Ongoing
3	SR RDE & UHPT	Add Summary Narrative as an item to the December FSC Agenda, when hopefully some examples can be shared RDE &UHPT to share feedback in December	Next meeting
	SM	Extend access deadlines for Curriculum Sharepoint site for supervisors if possible.	Ongoing
	DB	Approach Plymouth Medical School to see if someone can deliver a Regional Teaching session on reflective practice.	Next Meeting
	YM & SP	Help to inform trainees that that currently there is no set standard for the completion of Summary Narratives but the school and FSC will work to provide examples following activity in each trust and further discussion at the next FSC meeting in December.  The Summary Narrative is designed to show and aid progression.	Next Meeting
	SR	Send the supervisor summary sheet to TPDs and chase the UKFPO for an example Summary Narrative	Next Meeting
	All TPDs	All TPDS to ensure that supervisors are still advising trainees to complete SLEs	Ongoing
	FB	Ask Mike Mellor to review the core topics not covered by any teaching to establish if they can be delivered via eLearning.	ASAP
	ALL	The school will not specify when TABs are to be started but will mandate that it must be started by the end of January. All trusts to schedule a review of portfolios in February to ensure a TAB has been started by trainees.	Feb 2022 & Ongoing
	ALL	All trusts are to encourage the completion of a PSG in each placement but mandate as a minimum one must be done in 2nd placement	Ongoing
4	NB	Send out the Welcome Event evaluation report	ASAP
5	ALL	All trusts to review the points raised and look at the organisation of ARCP panels to ensure that they are Gold Guide compliant and provide consistency for all trainees.	Ongoing
6	NB	Email those 13 trainees that do not yet have a Maxcourse account.	ASAP
	ALL	All trusts to encourage trainees to book one of the available Human Factors courses.	ASAP
	ALL	Trusts to email SR if there are issues with providing supervision for trainees for escalation.	ASAP & Ongoing
7	ALL	Clinician volunteers for Academic recruitment Shortlisting (ONLINE) and Interviewing (ONLINE) are to contact TG if they have not already done so ASAP.	ASAP
10	SR & Trusts	Trusts and SR to discuss expansion numbers to agree distribution across the Peninsula	ASAP
12	TG/School	Trainees will no longer be able to undertake a placement at the GP practice they are registered as a patient. TG/School to send out a communication to GP Practices to inform them of the changes to the policy.	ASAP
	Trusts	All trusts to ensure that all trainees declare if they are a patient at any of the practices used as part of the allocation process – pre allocation.	Before the  allocation of GP posts in AUG 22
	FB	Request surgeons provide more information on the START course and cost before consideration by SR.

This page was last updated November 23rd 2021 (2 years ago)