Health Education England working across the South West  

Peninsula Postgraduate Medical Education  

Minutes of the Foundation School Committee at RILD Building, Royal Devon and Exeter Hospital, Wednesday 25th September, 8.45 or 10.00 – 13.00. 




Sarah Rawlinson (Health Education England), Trudi Geach (HEE), Natalie Band (HEE), Suzanne Maddock (HEE), Angela Cottrell (RDE), Neil Walker (RDE), Nina Bossa (RDE), Jamie Dunn (TSDFT), Mandy Turner (TSDFT), Kirsty Elmers (TSDFT), Caroline Rawlings (NDHT), Fionn Bellis (NDHT), Andrei Brunchi (F1 Rep ABr), Alok Bahl (F2 rep AB), Kate Talmage (UPHT), Trudy Eddy (RCHT by SKYPE), Kathryn Eccleston (RCHT by SKYPE), Bill Wylie (Lay Rep) 


Trainee Support  

Discussion was held on trainees in all trusts who are requiring additional support.  This part of the meeting involved the Foundation School representatives FPDs and Lay Rep only. 


1. Apologies: 

Giles Richards (Head of School of Psychiatry), Jan Morgan (TSDFT), Steven Burr (Medical School Representative Plymouth), Andrew Kelly (Medical School Representative Plymouth), Tim Hookway – unable to join by skype due to technical issues– (UPHT), Matthew Arnaouti (F2 rep) 


2. Meeting notes from March Foundation School Committee Meeting were agreed.                        

Matters arising from the previous meeting were discussed:  

Train the trainer courses 

I: SR reported that Nikki Saulsbury has not responded to requests for further information and therefore this item will be removed from the agenda for the time being.  

Job descriptions 

I: All trusts were reminded that the Foundation School requires a Job Description for each placement. TG reported that she had received Job Descriptions from 3 out of the 5 trusts.  A template was sent to all trusts at the beginning of 2018. 

A: TG to send template and example job descriptions to FB at North Devon so that ND so that they can complete theirs.   

A: TE will resend RCHT job descriptions. 

PSA Workshop 

I: AB reported that a PSA information pack for trainees who are new to the UK has been sent out and a Buddy System is now operating.  There were more volunteers than were needed.  The well received PSA workshop will be run again in January for all those who have not yet passed.  AB requested that the FS consider the running of the workshop as the accepted Gold Standard and asked that the FS consider running it in August prior to the first sitting of the exam. 

A: FS to consider moving the date of the PSA workshop in future years.  

I: SR thanked AB for all the work he has undertaken. 


A: GR to advise on the lack of supervision in Derriford that was raised at the December 2018 meeting when he/Psych representative next attends FSC. 

I: F1s in a Psychiatry or community post had been raised as a national problem at the previous meeting SR asked all those present to confirm the plan they had implemented to ensure that trainees in a Psychiatry or Community post have a regular clinical attachment in the Acute Trust throughout their whole placement. This would be for the first placement only.  

TSDFT - there was some Psych opposition, but trainees now undertake a period of additional shadowing at the end of their Psych placement. 

RDE - trainees are now offered the chance to undertake a period of additional shadowing at the end of their Psych placement.  It is up to the trainee though.  There have been no reported problems. 

RCHT – Trainees work in MAU on Tuesdays and attend weekly teaching. 

UHPT – Trainees attend weekend shadowing. 

ND – Holding a meeting with their F1s to ascertain what they want to do although it will probably involve a period of shadowing.  

Medical School Update 

I: No Medical School Reps were present at the meeting. 

A: Medical Schools to provide an update at the next meeting about the FSC’s request for a process to oversee information provided by the student on TOIs before it is signed off by the medical school.  

Trainee rep matters – teaching 

A: MA to update the committee on the progress he has made contacting Andrew Kelly at Plymouth University to get a point of contact in the medical school for F1s to get involved with teaching medical students. Action carried forward to next meeting as MA and Medical School Reps were not present.  

Recording of Study Leave & Taster in F1 

I: The FS designed study leave record document has now been circulated. F2s need to record all study leave on this document and upload to the portfolio for ARCP. 

I: F1s also need to record if they have borrowed any study leave from their F2 allowance this then needs to be shared with the F2 trust. 

A: SR to disseminate what was agreed with regards to the recording and sharing of information re F1 study leave. 

Trainee representative matters 

I: SR reported that she had investigated whether any Financial Advice was available through the PSU.  The PSU is not permitted to give any financial advice, but they can give trainees access to resources if they request it.  Also, most high street Banks have a lot of information on their websites.  

3. Recruitment 

I: TG apologised for the significant issues with the recruitment process 2019/20 not under the FSs’ control.   

Recruitment to the 2020/2021 programme will have several different application streams, i.e., FP, AFP, Psychiatry Fellowship Posts and Foundation Priority Programmes (there will be no PP in the Peninsula this year) and information is sketchy at present as to how the process will work.  TG will let the trusts know as soon as possible when the FS has been informed.  

I: The Psychiatry Fellowship posts (supported by the School of Psychiatry) are a recommendation from the Foundation Programme review.  They are designed to appoint good quality candidates interested in Psychiatry as a career early in the recruitment process in a similar way to the AFP process.  There will be one trainee each based in UHP, RCHT and RDE (3 in total) and they will be allocated to an existing F1/F2 programme in these trusts but will have input/supervision from Psychiatry throughout.  The second F1 post in each programme will be a Psychiatry post.  There will also be no F2 option to swap.   

I: TG did state that it is known that if a trainee accepts either an AFP, Psych Fellowship or a FPP and then withdraw they will not be eligible for an ‘normal’ FP allocation and would have to reapply next year. 

I: Academic interviews will be held on Monday 16th December at Plumer House Plymouth.  TG advised that more volunteers were needed both for Interview Panels on the day and between 23 October to 11th November for shortlisting. 

A: Volunteers to contact TG as soon as possible. 

4. Regional Teaching  

This Agenda item was moved to item 9.   

5. Study Leave & Overseas Study leave claims 

I: SR was aware of some local issues with regards to inappropriate communications from trainees regarding study leave.  She stressed that the FS guidelines have not changed. The Peninsula is ahead of most schools and is generous compared to some other FS.  SR requested that the trainee reps spread this message to their colleagues. Some of the conversations/requests that have been brought to her attention are bordering on unprofessional.  In future there is likely to be a move towards a common policy for the whole of ENGLAND (not UK).  

Recent guidelines issued from the Deanery concern overseas study leave.  Requests for overseas study leave must be sent to SR on the generic Deanery overseas study leave request form.  If SR supports the request, then Geoff Smith will approve it.  The Deanery are very strict on the process so if it is not complied with then the request will be declined.   

SR must have the request 8 weeks before date of travel.  SR stated she would need a supporting statement of how the leave would support future career aspirations, evidence of paper acceptance at a conference, evidence that it is on their PDP and that their e-portfolio is on track for sign off.  If she supports the application SR will then email the Deanery, the trainee and the Postgraduate team with her decision.  

The Deanery will then email the trainee with a reference number.  This reference number must be quoted on all expenses claims or they will not be processed. 

All other requests for study leave will be dealt with in accordance to previously issued guidelines. 

A: All trusts to ensure that trainees fully understand the guidance. 

I: RDE stated that ED consultants there felt very strongly that ATLS was not appropriate for F2s.  SR said presently there are discussions ongoing nationally between HEE and the Royal Colleges regarding courses that trainees feel they need to attend so that they are not at a disadvantage when applying to specialty training verses what consultants feel is appropriate to F2s. SR stated that until agreement is reached she would be happy to support attendance on these courses so long as there are clear aspirations to go into that speciality.  It was discussed that trainees want to attend ATLS, BLS and ‘train the trainer’ to obtain the maximum number of application points.  SR encouraged FPDs to use their discretion, but she would not expect all these courses to be attended in one placement or agreed too far in advance for the rota co-ordinators to have given their agreement.  SR stressed that service provision was paramount.  NON curriculum courses should be referred to FPDs as per the guidance 6 weeks prior to course, with clear link to their PDP and future career, there should be a career statement and the trainee’s portfolio must be on track, if not refuse the trainee’s request.   

I: ALS was then discussed.  All trusts were asked to confirm that systems were in place to ensure all F1s and F2s take ALS this year.  In future ALS will be taken by F1s only.  F1s doing ALS will borrow study leave for F2 and the funding will also be top sliced – Gio from the Deanery has confirmed that this is the case.  MT flagged the need to forward information between trusts if trainees are moving trusts for F2s. 

A: SR will confirm the process.  It may be that it is added to ARCP evidence. 

I: SR drew the meetings attention to the recently issued HEE Study Leave Guidance.  SR stated that some of the guidance is incorrect for Foundation Trainees.  It implies that F1s have 15 days of study leave that they can use.  They have but this is all taken up with local teaching.  They can borrow from F2 for tasters and ALS.  The guidance also implies that F2s can take study leave for preparing for an exam or course, again this is incorrect they can have study leave for the exam only. Travel expenses and time to travel would be at the discretion of the trust. 

I: TG noted that it had come to our attention that each trust has a different Study Leave Application Form.  The meeting pointed out that the Generic form designed by the Deanery was not fit for purpose.  SR felt that a generic form would be good to ensure consistency throughout the Peninsula and BW agreed.  The MEM’s present agreed they would take this to their Forthcoming MEM’s meeting. 

A: MEM’s to discuss producing a generic study leave request form for the Peninsula at their meeting on October 8th and report back to the FSC.  

6. Trainee representative matters 

I: Trainee reps felt that the recent FS email regarding Regional Teaching had caused some comment.  SR acknowledged that there were concerns which she would address later in the meeting under Regional Teaching. 

I: AB reiterated that the feedback he had had re measures put in place to support trainees taking the PSA was positive.  

7. Psychiatry 

No representative present to give an update.  

8. Welcome Event 

I: TG confirmed that the date for the Foundation School Welcome Event has been moved to Monday 23rd March 2020 to accommodate a change in the National Recruitment timeline following the implementation of FPP and Psych Fellowship programmes.  

9. Foundation School National Review / Foundation School Directors Update 

I: SR advised that the Foundation School review had now been published.  There are no major changes.  There are 16 recommendations.  The headlines include trying to build in more flexibility to the programme. SR went on to briefly highlight some of these recommendations and headlines from the recent Foundation Directors meeting: 

New Psychiatry Fellowship posts created the aim being to produce more specialists SR discussed various points: 

  • Regular supervision from a Psychiatrist 

  • Possible issues with geography – psych posts very often not based at acute trust 

  • F1s will be expected attend conferences and CPDs when they have no study leave budget 

Priority Programmes – although we have not as a school created any this year, we will need to create some for next year SR advised: 

  • SR will work with trusts to identify possible programmes 

  • Aim to attract good candidates to hard to recruit areas 

  • They will be appointable before FP allocation round 

  • SR asked trusts to suggest ideas, they will need to be existing programmes that have incentives added on to them, examples given and discussed:  

  1. Financial incentives (Wessex offered £8500.00 to programmes that involved F2 on the Isle of Wight) 

  1. Free Accommodation 

  1. Academic element or linking the programme to a guaranteed F3 year in an attractive specialty/their choice of specialty 

  1. Leadership & Management, link to Ed. Cert. – SR already in negotiations with Exeter University to possibly link up. 

  1. GP link – GP school are very keen to do something due to recruitment issues in the South West 

I: SR stated that the priority programmes will not attract any additional HEE funding so the trust would have to fund the extra elements and they would likely be based in areas that are rural and coastal.  RDE would probably not have any as it is a popular location that does not have the recruitment issues we have in other localities. 

A: Trusts to discuss ideas for Priority Programmes and bring them to the next FSC meeting 

Changes to Less than full time rules 

  • Greater flexibility 

  • Changes to criteria 

Educational Supervision 

  • F1s to have a minimum of 10 meetings per year each ES should have 0.25 per trainee in job plan.  SR envisioned this would incorporate 4 formal meetings per year in Aug, Dec, Apr and before ARCP and then 6 informal meetings mid placement but documented on portfolio.  Meeting felt there was currently an issue recruiting enough ESs and those we have struggle to take time in their job plans.  SR stressed this is a Government led review and the trust is paid 1 hour per week per trainee so this could be used as leverage with the trusts.  SR did acknowledge that there were currently issues with the drop in SPAS though. 

A: Any trust with specific issues with ESs having less than 0.25 per trainee to provide details to the FS and they will approach the trust in question. 

Special Circumstances 

  • Currently only 3 criteria looking to increase this 

Medical School Places 

  • The 1500 new medical school places that will be created will eventually turn into FP places over the next 5 years.  These will be allocated to FS where they feel there is a greater Dr to patient ratio required and where there are geographical issues with recruitment.  SR felt confident we will be allocated some extra funded FS places in the Peninsula. 

RMT Lifted 

  • Tier 2 restrictions have been lifted as Foundation jobs have now been placed on the jobs where there are shortages 

Continuing Push to improve recruitment to GP & Psychiatry 

Creation of a new Foundation School College 

Recommendation to give protected CBD time to F2 trainees and possibly F1s for self-development/career planning.   

  • This will be time allocated at work but not clinical facing where they can meet supervisors/update portfolio and complete specialty applications etc. 

  • HEE in negotiation with NHS employers 

Trainees will be able to access ongoing Deanery support for 12 months after the completion of F2 

No further news on the moving of full registration from the end of F1 to the beginning of F1 


Move to bring in a maximum number of trainees per supervisor.  SR advised that we need to be more creative with who can supervise trainees 

  • SAS doctors can supervise 

  • Psychiatrists who are based in the acute locality can supervise 

  • A GP who is within walking distance of the Acute trust base and/or is willing to travel to the base trust can supervise 

Clinical Supervision SR advised that the level of PA allocated is down to each trust and varies from trust to trust. The Placement Supervision Group should be used to provide quality feedback from a variety of contributors.  SR felt that trainees are not getting enough positive feedback and the PSG was an ideal way to facilitate this, they are not just to be used for TID.  AB confirmed that PSG work well and he receives weekly feedback from his consultant via the PSG. 

A: Trainees should agree with their CS the members of the PSG.  Trainees can only access the feedback when their supervisor has released the PSG. 

I: SR expressed concern that nearly 8 weeks into the first placement not all initial meetings with ES and CS have taken place, whilst appreciating the pressure trusts are under, they are paid a tariff for supervision and they must happen. 

A: All trusts to follow up and ensure all meetings have taken place.  

National Directors Meeting Report 

SR reported that the Foundation School Reference Guide is being replaced by a Foundation School Gold Guide and a separate Operational Guide.  The trainee Rough Guide is also being updated and will be available online. 

TOIs: An electronic version will be available from next year.  SR had sight of the pilot version and felt it is a great improvement. 

Late Withdrawals.  The issues with National Recruitment this year were partly caused by some very late withdrawals due to some Medical Schools not releasing their final results until very late. There is now a consensus with the medical schools to work towards one nationally set earlier deadline for results publication.  This will eradicate the late withdrawal issue. 

F2 Standalone.  F1s will no longer be eligible to apply for the F2 standalone process as it became apparent last year, they were treating it as a national swaps process.  Schools are instead being asked to create a local SWAPS process which will run alongside a reviewed IFST process.  The criteria for IFST will be relaxed.  SR advised that as we already have a robust SWAPS process, we will continue to run this the same as previous years. 

A: TG to stress on the email that is sent to F1s re the SWAPS process that they will not be eligible to apply for F2 Standalone. 

CREST Forms SR advised that trainees who resign from a FP or leaves a FP before completion cannot use a CREST form to confirm Foundation competency to enter Specialty recruitment.  The trainee would have to re-apply for Foundation training and complete. 

Less than Full Time working A recent pilot in ED looking at working at 80%, 60% for no specific reason did not have a big uptake, however they are now broadening the pilot scheme to other specialities such as Obs & Gynae and Medicine. 

GMC Survey Results 2019 The Peninsula Foundation School came top for overall satisfaction for F1 and 3rd for F2.  For F1 the Peninsula were top or second in every domain and for F2 the Peninsula were either 3rd or 4th in every domain.  Overall the Peninsula Deanery were ranked 1st.   

The Deanery are now looking at ways to get the message out Nationally that we are a good place to come and work.  

10. Regional Teaching  

I: Firstly, it was noted that despite the very tight deadlines before the Regional Teaching Programme began in August 2019 overall the programme can be seen as a positive move forward which responds to Trainee feedback and requests.  SR thanked the trusts for their support and the work that has been done so far.  

SR then called for a discussion regarding the recently implemented Regional Teaching Programme to raise any concerns and problems the individual trusts or trainees may have encountered. 

The main issues highlighted were: -    

  • Some trainees have yet to register on MAXCOURSE and others had registered but not booked any teaching.   

  • Trainees are booking courses and then not attending leaving trainees on waiting lists unable to attend when they would have been able to.  

  • Some trainees are ‘carpet booking’ well in excess of the teaching that they a) need and b) have enough study leave for, the effect of this being that is not enough available teaching for all trainees to meet their minimum 4 day attendance requirement for sign off.  

  • Trainees are not securing Study Leave and Rota Co-ordinator approval prior to booking teaching which contravenes the original guidance given by the Foundation School.  

  • Some trainees are saying that there are not enough courses available to book that they want to or can attend.    


In view of these issues the following Actions were discussed and agreed by the committee: -  

  1. All trusts to look at courses they are running within the programme to see if the attendee capacity of the fully booked courses with a waiting list can be increased WITH THE AGREEMENT OF THE FACILITATOR.  

  1. All trusts to see if they can run additional Regional Teaching days to increase capacity.  

  1. Trusts will email all booked trainees 8 weeks before the course to ask them to confirm they are still able to attend AND that they have study leave and rota approval to attend. If the trust does not have this confirmation by 6 weeks before the course date, the trust will then contact the trainee and remove them from the course to allow someone else to book.  

  1. Trusts to contact all trainees who have yet to register or book courses (list given at meeting).  

  1. In view of the above the restriction on seeking approval of study leave and rota co-ordinator prior to booking will be removed going forward.  

  1. Trainees will be restricted to booking a maximum of 6 courses initially to ensure all trainees can book enough teaching hours.  The Foundation School will contact all trainees who have over booked to request they cancel excess booking.  

  1. All trainees who book onto a course and then do not attend will be contacted by their home trust to ask why they did not attend.  The first instance will be an email only however the second time this happens they will be requested to contact their FPD to explain why they did not attend.  Non attendees who have booked study leave are in risk of having their pay docked or being asked to work a day in lieu.  

  1. In future to help avoid over booking course organisers will restrict the live date on the course until 3 months before it is due to run.  So that trainees know which courses will be coming up through the year a list will be published on the Peninsula Foundation School Website.  

  1. Trusts to communicate to their trainees that all Core teaching will need to be evidenced at ARCP by either a Certificate of Attendance from MAXCOURSE or in the case of local Core teaching evidence from the local sign off sheet.  

Non-Core teaching hours will be evidenced on the Teaching form on HORUS.  

  1. The trainee Reps present at the meeting were asked to communicate with trainees that it is a professionalism issue if trainees do not follow the guidelines for booking their teaching hours.  

  1. Feedback will be collated on the courses that have proven to be popular and which were oversubscribed with a view to running more dates next year if possible.  

  1. Trainees in GP or community placements that cannot easily meet with their ES face to face can document their ES agreement to Study Leave requests via email discussions.  

  1. Foundation School to produce reports looking at the number of trainees booked onto courses and availability (see appendix1 for results of reports produced after the meeting by FS).  

  1. Trusts Postgrad education teams should support trainees’ negotiations with rota co-ordinators to prioritise Regional Teaching PROVIDING that there are o service provision issues.  

11. AOB 


I: FB asked whether the dates for ARCPs were required by FS yet and who needed to be seen.  It was confirmed that all F1s should be seen face to face and a percentage of F2s.  All T.I.D must also be seen face to face. 

A: TG to send out timeline for ARCP sign off ASAP. 

Allocation to PAs to FPDs 

I: RDE raised a query over SPA allocation for TPD roles. SR stated that HEE have reviewed all FPDs and admin support and have checked whether they are within the accepted guidelines.  As a result, the Severn Deanery have lost some, but Peninsula have stayed the same. AC expressed concern that there was no equity between Specialty schools and Foundation with the allocation of PAs to number of trainees.  In RDE FPD’s allocation seems  not enough with the increase in Foundation T.I.D.   

A: SR asked RDE for specific examples of any inequities and she will raise them with the Deanery. Also, she requested that F1 and F2 FPDs in all trusts to consider sharing workloads if one has more T.I.D than the other. 

I: BW said that the same issue had been raised in Specialty meetings he had sat in on. 

I: KT requested on behalf of TH that the TAB date be moved to earlier in the year than January, however SR referred to earlier meeting discussions when it was decided that January was the best time as the trainees had been in training for a significant period but they still had enough time to repeat a TAB if needed before ARCP.  She did however point out that trainees were still able to nominate people from their first placement. 

I: It was confirmed that F2s can sign off core procedures for F1s but not SLE.  

SR concluded the meeting by expressing her gratitude to everyone for all their ongoing work and support of the Foundation Programme.  

12. Next meeting  

10th December Plumer House Plymouth (start time to be confirmed). 












Appendix 1  

Data from MAXCOURSE 25/9/19  

Total course places available   



Total course places booked  


Free capacity  




Number of trainees booked 7 courses  


Number of trainees booked 8 courses  


Number of trainees booked 9 courses  


Number of trainees booked 10 courses  


Number of trainees booked 11 courses  


Number of trainees booked 12 courses  


Number of trainees booked 13 courses  


Number of trainees booked 19 courses  


Capacity created if these trainees are restricted to 6 courses  




Number of Trainees yet to book any courses  

                      35           (35x4)  

Number of trainees who have booked 1 course  

                        8              (8x3)  

Number of trainees who have booked 2 courses  

                      11            (11x2)  

Number of trainees who have booked 3 courses  

                      18            (18x1)  

Number of places needed to meet min 4 courses booked  


ASCERT Course Oct to be cancelled so another 16 places needed  




Existing free capacity  


Capacity created if trainees are restricted to 6 courses  


Number of places needed to meet min 4 courses booked for trainees not already booked 6 courses  


Surplus Free Capacity (181+137) – 220 =   




The actions proposed will free up more than enough capacity to ensure all trainees meet their MINIMUM regional teaching requirement for sign off.  Increasing capacity further will allow more choice for trainees and allow for more than the minimum requirement.