Meeting notes September 2022

Peninsula Foundation School Committee Minutes  

Tuesday 20th September 2022 10.00 – 13:00. 

Plumer House, Plymouth and via MS Teams   

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

SR welcomed new members to the committee. Adam Revill, Foundation Programme Director in Torbay, Rachel Todd, Foundation Programme Director in Cornwall, Luke Brunton, Foundation Programme Director in North Devon, Emily Crehan, F2 Trainee Representative, Herkiran Kambo, F2 Trainee Representative and Basma Ahmad, F1 Trainee Representative. 

2. Agree meeting notes from May 2022 Foundation School Committee Meeting. 

The previous meeting minutes were discussed and actions points updated. 

SR informed the committee there is a covid recovery fund where funding can be applied for to support progress and prevent non-progression. The wellbeing of foundation trainees is poor and sickness has nearly tripled since before the pandemic began. SR is applying for funding for a remote and restorative course for all F2s in the Peninsula.  Any courses that are half day lectures followed by team building exercises should be treated as a regional teaching day and study leave used. Courses should be mapped to the curriculum and SR would approve the course. JG confirmed that Cornwall had submitted a funding bid for a course that included some workshops followed by activities which was declined. SR encouraged all trusts to send their funding bids through to her. 

DB informed the committee that a colleague wanted to send a survey to all trainees to establish how they were managing their sleep. SR suggested that UHPT see if the colleague would prefer to run a regional teaching session instead as trainees suffer from survey fatigue. 

A: DB to contact her colleague to arrange a regional teaching session on sleep training. 

NW confirmed that the Academic expansion in Exeter has been postponed due to funding issues.  

A: DB to liaise with Jamie Dunn and establish if any progress has been made to identify a new SFP post in Plymouth. 

SR and SA have met to discuss extra capacity in GP. The GP School are working hard to increase capacity, but the lack of supervisors and space is a national issue. It is possible that funding might become available to help with the space issue but this still in discussions. SA is aware of our need for foundation capacity.  

Exeter have created two extra Psychiatry posts. Academic trainees want to do Psychiatry and one Academic is currently in the extra post. SR confirmed that substantive posts must be the priority – trusts must not give academic trainees the preference of the community posts (GP or Psych). The SFP application form is clear that there is no set specialty they can do, and 6 months will be determined by the trusts and 6 months will include some choice (acute medicine will need to be included to ensure the doctors are able to meet the curriculum requirements). Academics do not have a requirement to complete a community placement and they should not be setting up their project in isolation with their F2 posts. Job Descriptions for Academic posts have still not been received - academic leads have been asked. SM made a plea to ensure the job descriptions are accurate which can help advertise the correct information.  
A: EC to contact the academic trainees in each trust and co-ordinate job descriptions from the trainee perspective. 

NDHT have created two extra Psychiatry posts, one for F2 2023 and one for F2 2024. RCHT confirmed their expansion plan does not include any Psychiatry posts. TSDHT have had no success after contacting their Psychiatry DMEs. 
A: NK to chase Psychiatry DMEs to establish the capacity for extra posts for expansion.  
 
There is a national agreement that expansion posts do not have to include community posts (previously stipulated by broadening the foundation programme) but the curriculum has specific community competences. SR has asked all trusts to keep it in mind when creating new posts. 

Public health posts in Cornwall have been removed for 2023. The new director for Public Health in Cornwall has confirmed that all work is being carried out remotely. If the situation changes the post can be reinstated again.  

Clinical skills regional teaching sessions have been taken over by Plymouth and provisional dates have been arranged. Meetings are taking place to confirm plans. The sessions were very popular last year with F2s but there is limited space on each one. 
A: KT to inform all other foundation administrators when the clinical skills courses have gone live on maxcourse. 

Feedback from previous trainee reps suggests that the F1 morale is low. New trainee reps felt that trainees would be keener to open up to other trainees rather than someone from the Foundation School. EC and HK are planning to have regular MS Teams drop in forums for all F2s and they will then feedback to SR. It was suggested that all trainees could attend, and BA would support this.  
A: All trainee reps to work together to co-ordinate the forums for all trainees. 

Rota co-ordinator meetings have taken place or arranged to discuss study leave being refused. NDHT asked Medical director to send communication to rota co-ordinators which has had a good response. Exeter reported that some trainees apply for study leave with short notice (last minute places on courses increases this) which makes it difficult to approve.  
 
SR confirmed that some courses on maxcourse had long hours in 2021/2022 and for this year a full days course should only equate to 6 hours of teaching.  
A: KT said that ASCERT was longer than 6 hours and would send SR a timetable to negotiate the hours.  

An Education Lead has been appointed – Sara Evans, Consultant Paediatrician from Bath who is also an F1 FPD from Severn. Sara is currently the education lead in Severn and has agreed to take on the role for the Peninsula and there were no objections from anyone on the committee to this proposal. Sara will liaise with all trusts to promote the regional teaching programme. SR will pass on all trust contact details to Sara. 

SR informed the committee that the school will have a Foundation Fellow which will be funded by the deanery and supervised by the head of school. It has not been confirmed when the advert will go out but would be an ideal position for someone who is interested in Education after completing their foundation programme. 

3. Foundation Expansion and Recruitment 

SR thanked all trusts for their work in providing the extra posts and recognised it hasn’t been an easy task. It is anticipated that there will be an increase on applications for 2023 and the process closes on Wednesday 21st September at 12 noon. SR is attending a national meeting on 21st September and will update trusts accordingly. The Department of Health do not want a reserve list for 2023 so it is likely that the Primary allocation list will need to increase. There is currently no guarantee whether the extra posts will be permanent. Funding is expected to be 50% plus tariff and SR confirmed that the request for 100% funding has already been fed back.  
Graduates from the UK are guaranteed a job under the current process which means this also applies to applicants from overseas due to legal considerations. It is known nationally that obtaining enough supervisors is a problem and there is work been conducted to establish if other team members can be a foundation supervisor. The GMC would need to approve after a pilot and needs to be agreed nationally.  
A: All trusts are asked to look at creating further posts for a 2023 start and contact SR to let her know if they have capacity.  
A: SR to confirm with the national team whether the extra posts would be permanent and would have 100% funding. 

A: SR confirmed that all trusts that have reserve posts, need to confirm their F2 rotation by 31st October. All new posts need site approval and job descriptions. 

STEP forms – RDE, RCHT, NDHT and TSDHT confirmed they have reviewed all step forms and met with trainees.  
A: Plymouth to meet with trainees who declared something on their STEP form as soon as possible. 

IMG Visas – prolonged sick leave for any doctors who are on a visa can affect their visa status. All trusts should contact SM when any trainee goes on sick leave and is expected to be off long term. The FS will then inform the HEE sponsorship team.  

SFP Interviews will be held on Wednesday 16th November via MS teams. ES and CS in each trust have been directly targeted due to small numbers of volunteers. If anyone is able to help, please contact SM. The SFP process is not being held jointly with Severn for 2023. 

4. ARCP 

The curriculum evidence document was discussed – all comments in red are lessons that were learnt from the first ARCP with the new 2021 curriculum. Please refer to the document attached to the minutes. Portfolio monitoring is the only way to ensure clinical competence before the trainee gets to ARCP. 

The curriculum evidence document should be used throughout the year and trainees and Educational Supervisors should all be sent the guidance.  

A: All trusts are asked to comment on the curriculum evidence document and send to SR. SR will then send a final version for all trusts to disseminate to their Educational Supervisors and trainees. 

A: SM to contact Horus to request the setting of SLEs is displayed to avoid clicking into each linked item on the curriculum 

It was noted that some trainees do not have a community placement. Trainees should be encouraged to notice this early in the year and make arrangements during their placements to achieve the community capabilities in the curriculum. If there is no other option outpatient clinics can be used.  

It was confirmed F2s can continue with a QI project they started in F1. 

5.Regional Teaching 

Podcasts – Trainees have asked whether they can use podcasts to count towards their non-core teaching hours. There were comments that any podcasts delivered by a royal college/ recognised body would be beneficial but there is no evidence to say the trainees have listened. If podcasts are accepted then other videos should be accepted, YouTube etc. The committee was mindful to the changing world but felt there is a risk that trainees could end up watching anything and count it as teaching.  
D: The School will not change the teaching guidelines to include podcasts but will look at it for the future (a task for the foundation fellow when they are in post). 

eLearning – the Peninsula currently does not have a cap on eLearning. 
A: NB to email all trusts to confirm if they would like to have a cap on eLearning. 

Face to face – the school is encouraging moving back to face to face for teaching sessions. The Deanery would like all facilitators to be offering a virtual option as well but understand this is not always possible. All trusts need to be supportive of those who don’t want to return face to face and are asked to meet with individuals to establish their reasons why and make a reasonable judgement call.  

All F2s who have a GP placement will attend a course of specific GP learning sets of which 5 days are taken from their study leave allowance. During the pandemic the sessions were reduced in time and the trainees are now not having 5 full days. The study leave document has been amended to reflect this and now only 4 days are taken from the allocated leave. 

There is a leadership mentor in each trust – if trusts don’t know who they are they should try to find out and ask if they can provide a regional teaching day. If any trust cannot establish who their mentor is, please contact SR.  

A: All trusts were asked to promote courses that are on maxcourse with availability. UKFPO is not resourced to do national online programme based on the curriculum. Education lead will be able to tap into other resources that are already out there.  

There are still 40 F2s who do not yet have a maxcourse account and are spread across all 5 trusts.  
A: NB to send around names of F2s who do not have a maxcourse account. 

6. LTFT  

Trainees can now apply for Less Than Full Time for any reason. The new policy has been updated on our website. There is no longer an application window. Any applications on the grounds of carers or medical reasons would be submitted to the school for approval but for any other reasons the application will go to the trusts for approval. Once the application has a trust signature the school will assume that the rota’s have all be agreed. Trusts can refuse applications but would need to provide the school with a reason in case of appeal. Trainees can apply for anything from 50% - 80% but the school will not be able to guarantee their rotation past the F1 year. In other specialties numbers of applications have been higher than expected. The school is unable to answer questions about how this will work until it is known how many applications are received. There is no extra funding for the LTFT trainees who will be out of sync so the school will have to work with individual trusts. Any F1 trainee that is out of sync should progress to F2 as soon as they have finished F1 training and gained GMC registration, even if they do not change over on the same day as their cohort. All applications for less than full time will be a permanent change, trainees cannot oscillate between LTFT or FT depending on their placements. 

7. Trainee rep matters  

EC reported that Plymouth does not provide weekly F2 teaching but some of her colleagues in other trusts have a regular F2 teaching programme. SR reminded all trusts that there is no requirement for F2s to attend any regular teaching sessions and the F2 regional teaching programme should be promoted to all. The school does not expect any trust to provide F2 weekly teaching. F2 teaching is obtained through the regional teaching programme.  Trainees do not have to be released to attend any weekly teaching that is provided. 

8. Study leave and absence from GP 

SM reminded all trusts that study leave should be taken pro rata which would avoid some F2s leaving it all in one placement. Some GP practices have reported the number of days F2s have taken in one 4-month post equating to 35 days. GP Practice Managers have been told they can push back if the number is increasing to ensure they get enough educational time in the practice. The school has heard reports of trainees saying it is too difficult to get study leave in acute settings. Trusts should be keeping a record of study leave to ensure trainees are not taking more than their allocation.  

9. General Practice update 

No representative at the meeting. 

10. Psychiatry update 

No representative at the meeting. 

11. AOB 

Quality Panels 

FB reported that it has taken the quality team seven months for their report to be sent from the quality panel that took place in February 2022. SR informed the committee that a new associate dean has been appointed, Helen Waters, so this will hopefully improve the time scales. All processes for quality panels have been changed and the school are just waiting for confirmation of how foundation fit in to the new processes. NETS survey results are not helpful for quality panels as the results are only broken down by medicine and surgery. The Foundation School team will continue to send out surveys at the end of every post. All trusts would like the end of post data as it happens to act on any urgent issues. 

Next meeting dates 

Wednesday 30th November 2022 
Wednesday 1st March 2023 (1pm – AM ARCP session for FPDs) 
Tuesday 9th May 2023 
Wednesday 20th September 2023 
Tuesday 5th December 2023 

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