Health Education England working across the South West Peninsula Postgraduate Medical Education

Minutes of the Foundation School Committee held virtually via Teams meeting, Wednesday 2nd December 2020 10.00 – 13:00. 

Minutes 

Present:  

Kate Talmage (UHPT), Kerry Dungay (UHPT), Neil Walker (RDE), Mandy Turner (TSDHT), Caroline Rawlings (NDHT), Kathryn Eccleston (RCHT), Daranee Boon (UHPT), Jan Morgan (TSDHT), Fionn Bellis (NDHT), Sarah Rawlinson (HEE), Trudi Geach (HEE), Natalie Band (HEE), Suzanne Maddock (HEE), Nina Bossa (RDE), Bill Wylie (Lay rep), Nadia Khatib (TSDHT), Gerens Curnow (F2 Trainee rep), Leila Ellis (F1 Trainee rep), Angela Cottrell (RDE), Thomas Smith-Walker (RCHT), Amber Pankhurst (F1 Trainee Rep),

Guy Rousseau (NDHT), Trudy Eddy (RCHT), Katherine Martin (RCHT), Connor Tuffs (F2 Trainee Rep), Sarah Ansell (HOS GP Peninsula), Nick Toms (deputy Head of Peninsula Medical School

 

 

1. Apologies:

 

Simon Bonell (Psych), Jacqui Rees Lee (TSDHT), Connor Tuffs (F2 Trainee Rep), Jamie Dunn (Interim F2 UHP)

 

 

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

SR welcomed all to the meeting and introductions were made.  Guidelines for recording minutes were discussed and SR confirmed with all those present that there were no objections to the meeting being recorded.

Minutes from September’s FSC meeting were discussed and reviewed for accuracy and outstanding actions.

Matters arising/Follow up actions

PSG use has increased but there is still work to be done – the new curriculum 2021 includes PSG and SR stated she will discuss this later in the meeting.  Self-development time would be discussed in A.O.B as it is being implemented in varying degrees and the FS have produced data on the implementation.

NT from the university and DB to work together to improve the preparation and transition of DA (Doctors Assistant) posts in Derriford. -  NT has asked the University’s clinical liaison team to contact DB, DB confirmed she had not heard from them yet.

A: Action carried forward - NT to chase the University Clinical Liaison team to contact DB, although it is doubtful that these posts will happen this year.

FiY1s what they can and cannot count has been clarified. 

No national feedback shared but SR will discuss in FSD update in this meeting.

SB is not at the meeting but has sent a Psychiatry update which includes the assertion that all is well with Psychiatry Fellowship posts.

No issues with the deferred September starters.  SR reminded everyone the December starters started in trust on 02.12.20 and to let her know if there were any issues, although she remarked that she was aware that 1 trust had already cancelled trust induction.

A:  Carried forward - Feedback to trainees to be discussed further outside the meeting by the FS team and a decision made.

Careers sessions have been quite well received by trainees.

The Trainees Reps sent updates out re induction meetings following the last meeting.

Simulation was raised at the Senior meeting by SR and FB but nothing helpful was agreed upon other than recognition that there are staffing challenges this year.  The Deanery are aware of challenges, but we must do as much as we can to continue to deliver everything that is required.

The Minutes for the previous meeting were approved.

3. Site Approvals

TG informed the meeting that the FS have been made aware that some trainees are being moved to different sites especially in Psychiatry without letting the FS know.  TG asked trusts to ensure they inform the FS if this happens so GMC approval can be sought for the sites if needed.  If a trainee works in a site for more than 2 sessions a week (2 half days) in a non-approved site, then the training cannot count for the trainee.  Site approval is now managed through the quality team.  TE made the point that in a recent case in RCHT the trust was not told the trainee had been moved by CPT.

NW clarified the process to go on the GMC register.  TG also said trusts need to monitor supervision in these sites.  NW raised a query regarding a GP Practice where trainees get induction for the practice site, but they go next door to a community setting with a GP supervisor available on the phone if needed but no in person supervision.  SR confirmed with SA that if they have access to supervision whether this would be satisfactory.  The practice in question also has received poor feedback. SA responded that if supervision is properly accessible it was fine for F2s to go to the community setting.  SA said she was also aware that the GP School has also received poor feedback for a practice in RDE.  SR stressed that supervision is adequate the feedback is poor re service provision not supervision.

A: SR and SA to discuss outside the meeting to establish if the practices that have received poor feedback from Foundation trainees and GP trainees is in fact the same practice.

SM confirmed the EPM for School of Psychiatry has also reminded DPT, CPT and Livewell of the need for site approval for each programme.

JM asked for list of approved sites.

A: TG will send the link to the ODS list to trusts and ask all trusts to check all their posts/sites have site approval and appropriate supervision is in place.

4. Welcome event

TG stated that in view of the ongoing pandemic next year’s Welcome Event will be held online and not face to face.  She invited ideas for the best way of delivering this.  She suggested that rather than all trust staff having to be involved on the day they could record a presentation and then a couple of trusts representatives could be available to answer any questions as part of a live Q & A session.  TG confirmed that the FS are looking at producing a Welcome Event SharePoint site which would be accessible to all trainees allocated to the Peninsula.  The trust videos and information on rotas, the local area, brochure and handouts could be added to the SharePoint site for all.

The Welcome Event will be on Monday 22nd March. 

A general discussion ensued and these ideas were positively received.

It was suggested that the trust MEMs be invited to the Admin catchup meeting held every 4 weeks and the Welcome Event be added to that agenda.  MEMs to feedback to FPDs on progress/requirements.

A: TG to invite MEMs to Admin Meeting and add Welcome Event to the agenda. MEMs to feedback to FPDs on progress/requirements for the Welcome Event.

TE then announced that KM would shortly be going on Maternity Leave and Matthew will be covering her role. 

5. Psychiatry Update

Simon Bonell (SB) sent his apologies and sent an update which was read to the meeting by NB.  The current Foundation Psychiatric fellows are in post and SB has not been made aware of any issues, so he assumes all is going well. Recruitment has started for a further 3 Foundation Psychiatric Fellows starting in August 2021 with weekly access to Psychiatric supervision and mentoring and with access to additional CP funding for travel.

There were some issues in South Devon which SR alerted SB to and the trust is looking into this but there is nothing further to report at present.

6. General Practice Update

SR welcomed SA to the meeting.  SA reported that there is continuing expansion happening within GP recruitment next year which puts pressure on practices accommodating trainees.  In addition to this from August 2021 trainees spend 24 months of their 36 months training in General Practice.  The GP school is looking at making a lot of the additional time in GP into integrated training posts.  This would mean trainees spend half their time in practice and half in a specialty to reduce demands on the practices.  The School have also been running educational supervisor courses constantly to increase capacity in the number of supervisors. Andrew EL is looking to see how we map capacity in the practices out there.  This will involve more senior colleagues meeting to streamline the approaches and ensure all the schools (including Medical Schools) are working collaboratively.  SR said this is important as previously when the Medical Schools increased their posts the Foundation schools lost several F2 practices.  SR expressed a wish to be invited to any meetings where this is discussed.  SA confirmed that as yet no meetings had taken place but they would also involve the quality side of things to approve practices for all clinical learners.  SR talked of the possible F2 expansion programme from 2021.  Nationally it has been suggested that Foundation use the vacated trust posts no longer needed by GP trainees (because of the change in time spent by them in trusts) and back fill them with F2 programmes and this would also need collaboration across the schools.  SR did however state that there is now some doubt around the funding of this expansion.  SA confirmed she had not been aware of these plans and found this useful as DMEs were already looking at what the loss of GP trainees in their trust will mean to them.  SA said it was important to let the rota co-ordinators know the skill level changes that the changes will bring.

A: SR to let SA know if there is any further news of the F2 expansion programme.

A: SA to invite SR to any higher level collaborative meetings re GP placements.

NB stated that any GP supervisor must have a meeting with the Foundation School and the appropriate training in place before supervising F2s.  There have been a couple of instances recently where practices have changed trainees’ supervisors and told the trust and not the Foundation School.  NB asked that if trusts are told of GP supervisor changes please let the FS school know so the FS can check they have the appropriate training.

A: All trusts to inform FS if they are made aware of a change to a GP Supervisor.

FB asked that GP administrators be reminded of the change in travel policy for F2s in GP where they get the difference in travel time between home to the GP Practice and home to the hospital base. SA was not aware of this travel policy – SR explained the policy to her and asked her to reinforce the message as she was aware that some trainees were getting more travel time than they were entitled to.

SA informed the meeting that the Friday before the meeting the GMC and the BMA agreed to a changed policy on mileage reimbursement and talked about the implications of the new policy to the meeting.  SA said there was need for a communication to go to all practices about this change and it would be a good idea for collaboration on a joint message to go out in a single communication.

A:  SA to send a copy of the new policy to SR and TG for circulation

A: SR and SA to compose a joint communication to go to all GP practices on Travel Policy and mileage.

BW expressed a view that it was odd that mileage was treated differently to time.  SR could not comment until she had sight of the new GP policy.  Some discussion was then had as to where this policy had come from.

JM confirmed she had received an email the day before with a link to the NHS employer’s website where it explains everything and does stipulate that it includes F2 doctors.  NW expressed the concern that many F2s do not own cars and the location of the GP practices are quite often a long distance away from their base hospital.  SR agreed and confirmed that this was the case across the Peninsula.

AP asked where we can signpost trainees to the policy.  SA provided link in the meeting chat.  SR requested that we communicate with trainee reps anything that trainees need to know. 

TE was concerned that GP trainees were aware this was coming whereas F2 trainees have no idea that this was going to happen. If implemented, Aug – Dec trainees will be paid differently to Dec – April trainees.  She confirmed that Karl Westgarth (HR RCHT) thinks that it is applicable to F2s. 

SR confirmed the FS will look at it as a priority and requested that trainee reps not circulate the policy until we know how it impacts F2 trainees.

A: As a priority the Foundation School team to read the new policy and discuss before seeking clarification from the Deanery on the implications for F2s. Trainee Reps will then be informed and asked to help with communicating any changes.

7. Medical School Update (item added to Agenda by SR)

NT stated there was nothing specific to report other than they have had to increase their Medical Student intake to 206 from 156.  SR advised that discussions held at a National Level about FiY1s/Doctors Assistants made it clear that they will not happen this year in view of the disruption to Medical Student’s training because of the pandemic.  NT confirmed that was their understanding.  SR advised a lot of research is being done on the FiY1 role by the GMC and the Medical School’s Council on how this effected the transition to F1.   A report has just been published by the GMC on the state of Medical Education.  In this report there is a section summarising where FiY1s were placed, what they did, and what their motivation was for taking an FiY1 post. Interesting conclusions which will lead into other research.  SR is part of group looking into the FiY1 role and what they will do in the future.  FiY1s felt they successfully integrated into the team more successfully than when shadowing. 

A:SR to circulate GMC report on Medical Education.

8. Regional teaching update

NB every F2 now has an account on Maxcourse but at least 40 trainees have not booked on anything and similar numbers only booked on 1 or 2 courses.  As some are only 1 hour long this is concerning.  There are now a lot of courses on there and there are plenty of spaces because they are being held online which has increased capacity.  The success of the career’s talks was mixed but overall, well received.  Severn shared 16 hours of courses and we need to look to reciprocate.  NB asked for feedback re online teaching.  KM has some more courses to be put on for RCHT which can be shared with Severn.  KM has had really good feedback from trainees on teaching online – they were able to interact. NB confirmed that by Christmas MS Teams will be launching break out rooms. 

FB expressed concern about teaching this year.  At trust level teaching is being cancelled across the board as soon as there is pressure on the system.  The amount of teaching logged in her trainee’s portfolios is very low.  Even though she keeps reinforcing to trainees that they need to attend and to report it if they cannot, but she never receives any feedback.  She asked for the Foundation school to send something out to tell trainees they must prioritise teaching and let us know if there are barriers to teaching.

SR confirmed that absolutely the message needs to go out that teaching is a priority the message from the Deanery is that education should continue and currently the ARCP requirement for next summer is 60 hours teaching with 30 hours Core.  SR confirmed that the Dean Geoff Smith (GS) has on numerous occasions delivered the message to Medical Directors, DMEs etc. at a very high level that if teaching is cancelled it should only be postponed and alternative dates offered.  He is putting this message out on a regular basis to DMEs.

FB stated it is not happening at trust level, teaching is being cancelled often at short notice by Chief Execs under pressure to keep service provision going.  SR stated that the school was not aware FS teaching was being cancelled on a frequent basis and if the message is not getting through to us from trainees the school cannot flag it with the Dean and GS will think all is okay. 

SR said absolutely trainees should be exception reporting if unable to go to teaching so we have evidence. She stressed she needs to know if there is a problem so that she can address the issues and raise it with the Dean.   FB stated it is not just core that is affected it is the non-core such as Grand Rounds and departmental teaching as well that is cancelled.  GC felt that the point of Regional Teaching was that whole days were offered not the 1 hour and 3 hours currently offered which were not rota friendly.  SR agreed this is the plan and generally Regional Teaching will be whole days in the future, but it was deemed to be too hard to teach a whole day online for both facilitators and trainees.  NW agreed Grand Rounds and department teaching non-core is the problem.  NW said that in the RDE the surgery days have been broken up into one-hour chunks so that trainees can attend for one hour if they can.  SR asked NB whether it was technically possible to break courses down like this on Maxcourse. NB did not think it would be an issue.  SR reiterated if things are being cancelled tell her and SR will take to GS and he will address it.  SR requested that all share good practice and ideas and keep doing all we can to facilitate teaching.

SR announced that ARCP requirements for summer are not set in stone yet re derogations. Derogations for out of synch trainees already have been confirmed until March 2021 and this now looks to have been extended until September 2021 but it is not yet clear what is expected of in synch trainees for June 2021 and she was expecting communications today.  SR will share as soon as it is published. 

PR near peer teaching for F2 and F1s by doctors recently completed Foundation training has been well received by F1s and they have been willing to attend out of hours teaching.  The facilitators like it as it is good for their CV.  SR told the meeting about trainees in Severn conduct ‘Smile’ lectures on Facebook which have been well received and gained national recognition.  TG confirmed details of this initiative have been sent to the trainee reps and academics.  LE has expressed interest.  CT heard feedback is very good.  AC confirmed John Pascoe a Urology Reg of PHT set them up.

A: SR will find a link and send out to all trainees –an option for non-core teaching for F1s and F2s

NW asked if there was any progress towards appointing a FPD for training. TG confirmed there have been no applicants.  SR said it was disappointing that no one had applied it is worth 0.5 PA and it would be very useful to have someone who could mould the job to what they want it to be and co-ordinate teaching.  A general discussion felt that 0.5PA is not enough and may be worth readvertising next year when things are hopefully quieter.

CT left the meeting at 11:40 as he was post nights.

9. Update from national FSD meeting

SR As discussed earlier the F2 expansion programme that was expected is now looking unlikely to happen, but she is awaiting further communication on funding.  The original plan was to transfer the funding from the unsuccessful WAST programme and convert it into F2 posts which would have been a significant expansion. 

There is now a new document that will clarify what is core and what is non-core teaching.  SR shared the document with the meeting and clarified that it is not the final version but is the most up to date from UKFPO.  The Table within the document confirms that core teaching is any specific to FDs and available to all FDs in the trust or school, i.e., F2 regional teaching and F1 weekly sessions.  It also includes simulation that is FD specific. E-learning referred to in the document is not applicable to the Peninsula (some schools insist on ScripT).  All exclusions are on the document.  Study leave taken for the regional teaching qualifies as core teaching.  The study leave exclusion in the document relates to study leave taken for external courses.  As soon as the final version of the guidance is approved SR will send it out to all. FB sought clarification re the F2 GP Learning sets.  SR confirmed they are non-core as they are not available to every FD. GC highlighted that simulation training for F2s currently counts as non-core, but this guidance puts it as core.  He therefore requested that trainees be told to change all simulation logged as non-core to core ASAP.  SR confirmed that as soon as it is adopted it will be circulated.  LE asked whether an online European Society of Intensive Care Medicine COVID course they are advertising at her trust would be core or non-core.  As it is not FD specific SR stated it would not be core, however she would need further details to determine if it could be classed as non-core.  LE explained that they had feedback from trainees that they had not had specific COVID-19 training, and this was the reasoning behind advertising this course.

SR confirmed that Simulation training can be converted from non-core to core and back dated.

A:SR to send out Core and Non-core guidance document when it has been approved by UKFPO.

A: LE to send details of the online European Society of Intensive Care Medicine COVID course to SR

Medical ethics.  SR advised there is an initiative in the north currently, a PhD Dr is looking at teaching medical ethics to FDs.  They are putting together a package of training resources to be used by other FS on a range of topics for example: self-discharge against medical advice, sedating patients and decision making in emergency care. They are mapping the training to the new Foundation Curriculum. SR has expressed an interest in being involved in the next round of trying this teaching.  Other trusts may be approached for volunteers try out teaching materials.  FB expressed an interest in being involved.

ARCP requirements for summer 2021.  There is currently a dispute nationally, some favouring no derogations and some favouring derogations.  SR will send out asap when it is decided but continue to work to the current standard criteria in the meantime.

LTFT There has now been agreement to category 3 for LTFT in FS.  W.e.f. August 2022 FD can request LTFT for 1x4 month post for no reason.  Initially this will be for 1x4 months post only and then w.e.f. 2023 it will possibly expand to a longer period.  This will be challenging to manage in a time-based programme.  There will be a limited number of trainees that will be able to be accommodated.  The details have not yet been confirmed.

Recruitment The Foundation Programme for 2021 start is oversubscribed by 700 nationally and the Peninsula may be approached to provide extra posts.

NW asked whether the extra one-year rotation created last year with extra funding will continue to be supported with funding.  SR when we agreed to create the post the understanding was that funding would be ongoing, they have now implied that it may not be, but SR has pushed back providing the information sent last year but at present she is waiting for confirmation and cannot be 100% sure at this time.

10. New curriculum 2021

SR shared slides on the new curriculum 2021.  This will be implemented from August 2021 and will apply to all new F1s and all current in synch F1s going to F2.  It is yet to be decided re out of synch F1s although SR suspects it will be a local decision.

The new curriculum is not yet signed off by the GMC but on the slides, SR had put together a summary of the main changes.  Information will start coming out in March 2021 and will need a programme of communication to disseminate the changes and how they will affect FDs and supervisors.  A copy of the presentation slides is attached to these minutes.

Main highlights discussed: HORUS mapped and links. Pulled back lower burden of providing linking.  Equitable achievement for all FDs overseas, disabilities & LTFT.  Reduced sections 4 to 3 higher level outcomes (HLO) and 13 Professional Capabilities (FPCs) instead of current 20.  SR shared slide on how trainees will map the new capabilities.  No specific number of SLEs required previously 16 across the year broken down into CEXs etc but will have to have sufficient quality evidence you can demonstrate capabilities.  Importance of PSG mandatory 1 per year but recommend 1 each placement.  Introduces the concept of direct observation in the workplace to demonstrate the higher-level objective. 

LE asked is there is any clear guidance on what higher quality evidence is and whether there is any training planned for supervisors on PSGs as evidence suggests they are being pulled together at the last minute and not being used to inform the CS reports.  SR responded that she has been trying to get the PSG message out there for the year but now up to individual trust follow up.  The CS and ES guidance has been sent out to trusts. 

A:TG send out ES and CS guidance on PSGs again to all trusts for them to ensure all supervisors receives a copy. 

The hierarchical evidence is one of the ways to demonstrate capabilities and they are introducing the concept of experiential learning (learning on the job), the more senior the professional that observes the FD the more weighted the evidence.  Self-directed learning (e.g., e-learning) is lowest level of evidence.  

SR continued with the presentation.  Curriculum specifies what should be included as core for F1s and F2s.  Personal learning log for core and non-core teaching.  New emphasis on mental health knowledge and how it links into general health with a specific syllabus linking to this.  SR to seek help from SB in delivering this at trusts.  Each FD trainee will have to put together a summary narrative - max 300 words before the ES completes EOP Report to set out how and why they have achieved.  It is a suggestion this is started in the first placement added to in the 2nd and finished in 3rd

ARCP checklist shared min 1 PSG - provide evidence 13 capabilities- min 5 clinical encounters and specific life support capabilities specified in FPC2.  ALS is no longer specified - every behaviour must be evidenced in life support.  Demonstrate a contemporaneous developed portfolio throughout the year- PSA is now required for F1.  Mental Health emphasis. Simulation is embedded-3 sessions per year.  All FPCs have examples of behaviours.  All behaviours for FPC2 – urgent treatment of the deterioration in Physical and Mental Health must be evidenced- replaces ALS.  This can be delivered through ALS but does not have to be a Resus Council recognised course.

SR concluded the presentation.

SR highlighted the significant amount of work that will be required to communicate the changes to all.  SR will advise when the curriculum has been signed off and will send it to trusts.  LE asked re ALS funding.  SR thinks ALS will continue to be funded but it has been removed from the curriculum.  LE queried specialty application points for ALS and will there be a way of demonstrating these competencies?  SR stated we need to discuss this as a school so we can decide with all stake holders involved. There needs to be consistency across the Peninsula, so no trainee is disadvantaged.  SR confirmed that first the FSC will discuss and then the other stakeholders will be involved.  BW is aware of transitional difficulties experienced in other specialties moving to a new curriculum and wondered how difficult it will be for FDs to transition.  SR replied we do not know yet but in principle the day-to-day changes would not be huge.   The main concern is getting the message to the CS and ES.  In terms of evidencing the curriculum the burden is less, but she does not underestimate the massive change and work ahead.  SR invited further comment.

NW – Not easy to give up time to do ES roles and this is quite complicated.  They will need some meetings, training has been stepped up for ES which has been good, but there are less people wanting to be CS and ES and he was concerned this would discourage people from taking on these roles. SR did not feel this was adding complexity just change.  From March 2021 there will be a roll out and she will need a representative in each Trust to be the Lead responsible for communicating to the trainees and supervisors.  If this is not to be the FPDs each Trust will need to think who it will be. 

A: Each trust to decide who will be the Lead to disseminate information and training on the new curriculum.

FB agreed with NW she has been pushing PSGs locally, but supervisors are still not doing – a lot of work on top of COVID catch up, job plans are over stretched, and the challenge must not be underestimated. SR agreed absolutely but nothing we can do about it.  FB asked whether the GMC had considered deferring the implementation, but SR stated it had already been deferred by a year and it will not be deferred again.  PR reiterated comments already made and asked the FS for understanding of how ES and CS are being treated by the trusts.  They take on the duty but are not recompensed with time in an effective way. SR has asked that all senior leader visits to trusts cover this with the DMEs and Chief Executives and the answer they give is that it is all in their job plans.  SR stressed that HEE pay the trusts an enormous amount of money for them have the time in their job plan and it is written into the curriculum and has been on the agenda at the most senior level for some time.  PR called for HEE to have direct oversight over whether supervisors are receiving their allocated time, he feels that ES are not being supported by their trusts to do their job.  SR stated this is a trust issue - 0.25 SPA- 1 hour per week - 42 hours per year paid for by HEE if this is not happening in the trusts SR needs evidence and she will raise it with the Deanery. 

NW confirmed he has escalated the fact supervisors should receive 0.25 SPA to the RDE medical director and it has been confirmed supervisors will continue to be allocated 0.125.  NW wondered if PR points related to the fact that job plans are set up differently in SDHT. SR therefore asked PR and NW to email her with their issues and she will take matters further as we need the ES on board.  TE shared good news that the DME went to all consultants last year and lots have expressed interest in becoming ES and confirmed that supervisors are also allocated 0.125 pa in RCHT but is under discussion.  SR said the Dean is willing to go right to the top of the trusts to tackle the issues.

10. Study leave – life support courses

A few weeks ago, SR sent all an email from the Deanery re the decision on ALS courses. SR stated this has been very controversial.  The Task and Finish study leave group has been formed which has representation from across all levels who have a vested interest in the study leave policy. They have not yet published their full recommendations but she wanted to communicate their stance on Life Support courses.  SR stated it had proved very difficult to get the group to support any ATLS or APLS courses for any trainees at any level.  The conclusion being that for certain specialties it is a clear requirement and therefore will still be supported but not true for all specialties.  No refresher courses will be funded.

SR shared the email to remind everyone of its contents to inform a discussion. SR felt it was very difficult to support APLS and ATLS for foundation trainees as it is always been aspirational.  SR has asked Severn to agree a SW approach but has not yet received their response. Severn currently have the same policy as Peninsula.

SR asked the meeting to decide what the Peninsula’s policy should be.

FB clarified whether Speciality trainees only were being funded or FD who wanted to apply for a career in a specialty needing one of these courses?  FB felt we should continue to fight for equity across the region but there was not a lot to be done.  DB stated that having been a facilitator on courses it is a shame as they are well received by trainees and involves team building, decision making, human factors etc. but our hands are tied.  As a facilitator of APLS courses for over 10 years SR led a discussion about whether it is better to wait until doctors are more senior and there are other ways of getting leadership experience. SR also clarified that specialties are no longer going to give points for ATLS and APLS at specialty application.  GC  agreed with everything, F2s like them as they are good learning opportunities and he pointed out that points are still being offered on the anaesthetics applications this year – but maybe they will be removed wef next year.  GC agreed if the points offered on applications were removed, he did not see the need for trusts to spend vast sums of money on them.  LE could see the benefit of doing these courses later in her career. AP agreed with the other Reps comments and appreciated it is a difficult call to make. LE asked for confirmation that this was a national move.  SR confirmed it was definitely a SW move motivated by the national move to reduce the monopoly of the Resus Council but cannot guarantee that all FS will be the same.

FB stated there was a need for national parity else if we are an outlier may affect people applying for foundation in Peninsula if they can get funding for these courses elsewhere.

SR felt that there was agreement generally from the FSC not to fund ATLS and APLS in foundation, but she will continue to seek regional parity and national clarification before this policy is confirmed and adopted.

 11. ARCP criteria post March 21 – TBC if the document has come through

 12. Trainee Rep Matters

LE:Thedeadline for SWAPs and TOFP is approaching and she asked if more needed to be done to promote further?  TG confirmed that no applications had been received for TOFP so far, but SWAPs applications are coming in.  SM confirmed that it is on the information update every week.  The reps confirmed they will also circulate.

LE also sought clarification re a message sent about supervisors supporting trainees who had been redeployed, as the last message they had heard was that there would be no redeployment.  SR stated there was a general agreement not to redeploy FDs but this could not realistically be guaranteed. SR reported that a small number of FDs from PHT & RDE redeployed for short periods-longest 7 days.  It is being minimised and FDs will not go to the Nightingale.  There is clear guidance regarding trainees moved more than 48 hours – they will need induction and more than 7 days they will need named supervisor who contributes to CS report at the end of placement.

LE asked if the changes to curriculum will mean Horus is adjusted and will Reps be involved with the design?  SR did not know & TG confirmed she had not heard anything yet but she will let the Reps know if she does.

AP: SDT are there any plans to formalise the recording of it.  SR advised that a question was added on the last EOP survey re rota time and that the FS were formally looking at figures so far.  The numbers of trainees receiving their SDT were better than expected with the exception being RCHT:

UHP    97% F2s                      82% F1s

RDE    90% F2s                      86% F1s

ND       70% F2s                      44% F1s

SDHT  76% F2s                      55% F1s

RCHT 41% F2s                      37% F1s 

TE confirmed RCHT’s was being addressed by the Guardian and should improve going forward.

SR reported these were encouraging figures, but trainees must exception report if not receiving their SDT.  Also, SR said there was a FDAB survey and follow up also in the pipeline.  AB stated the Reps will encourage trainees to exception report.  FB requested a copy of the FS data as she has been assured by the rota co-ordinators that all ND have it built into their work plans.

NB clarified that the data is only based on trainees who completed the EOP survey.

A: FS to send trusts the data on SDT

DB is aware of exception reporting and is encouraging trainees – they are finding half days hard to take in one specialty if the rota is short staffed patients come first.  SR stressed it was a work in progress and encouraged all to share best practice. 

GC nothing to add CT had asked him to raise SDT time but this has been covered.

13. AOB

ALS / COVID: FB has 1 F2 could not do ALS due to COVID and no other courses are available. SR wondered if the local Resus team could deliver some sort of teaching if not a specific statement from ES to say Trainee is competent in dealing with acutely unwell patient.

Self-isolation time – SR does form part of the 20 days but there will be a reasonable stance at ARCPs.

FB raised the issue of taster days. SR confirmed the policy is taster days should be done within the home trust if possible but can be taken elsewhere in the Peninsula if the experience is not available in the home trust.  They should not be taken outside the Peninsula. SR asked whether should we allow FD outside trust in COVID climate?  After general discussion it was agreed that while Devon is in tier 2 there should be no movement between trusts.  This would be reviewed if Devon moves into tier 1.

December deferrals FB sought clarification re the 3rd placement for the FDs starting in December would it be their original 1st placement?  SR stated no this could not be guaranteed and would depend on any vacancies and to inform trainees it is TBC.   TG confirmed these were still fully funded programmes so the 3rd placement would be funded.

Outstanding F2 of the year award.  FB advised they have an out of synch F2 and wondered if they can be nominated for outstanding trainee awards.  SR asked TPDs to email with their thoughts.

A: TPDs to email SR with thoughts on whether out of synch trainees should be considered for Outstanding Trainees of the year awards

PR asked whether Foundation numbers would increase next year. SR said she had not heard but the last couple of years the Peninsula have been asked to increase numbers at short notice but cannot give a definite answer now.

JM asked whether funding arrangements for ALS courses already booked will be funded.  SR confirmed that up until August 2021 ALS is still part of the curriculum and will continue to be funded.  However, before the next FSC SR requested that all talk about what they would like to do in their trusts after August 2021 and consult with their local Resus teams. 

A: SR to put ALS on Agenda for next FSC.  Trusts to discuss with local teams how to provide ALS training post August 2021 in the new curriculum.

SR confirm there is a push to deliver training in a different way than through the Resus Council.

DB Raised the difficulties IMG trainees encountered when starting UK training.  Could there be a Regional approach to improve how these trainees are supported?  SR confirmed that funding has been secured for prolonged induction next year this was cancelled due to COVID.  This will be open to IMG and those graduates who have had a significant gap since gaining their qualification.  Also, SR said the ‘Welcome to UK’ seminar run by the GMC regionally in September. 

A:TG to confirm when the GMC seminar is running and whether F2s will also have extended induction. 

CR congratulated FB on gaining her PG Cert with multiple distinctions.

BW welcomed news of the vaccine.

The meeting concluded.

 

NEXT MEETING DATES

Tuesday 2nd March 2021

Wednesday 12th May 2021

Tuesday 21st September 2021

Wednesday 1st December 2021