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

Minutes of the Foundation School Committee held virtually via Teams meeting, Tuesday 22nd September 2020,  10.00 – 13:00. 



Simon Bonell (Psych) Kate Talmage (UHPT), Kerry Dungay (UHPT), Neil Walker (RDE), Mandy Turner (TSDHT), Caroline Rawlings (NDHT), Kathryn Eccleston (RCHT), Daranee Boon (UHPT), Philip Riley (TSDHT), Jan Morgan (TSDHT), Fionn Bellis (NDHT), Sarah Rawlinson (HEE), Trudi Geach (HEE), Natalie Band (HEE), Suzanne Maddock (HEE), Nick Toms (Plymouth Uni), Nina Bossa (RDE), Bill Wylie (Lay rep), Nadia Khatib (TSDHT), Tim Hookway (UHPT), Gerens Curnow (F2 Trainee rep), Leila Ellis (F1 Trainee rep)


1. Apologies:


Trudy Eddy (RCHT), Jacqui Rees Lee (TSDHT), Katherine Martin (RCHT), Amber Pankhurst (F1 rep), Tom Smith Walker (RCHT), Angela Cottrell (RDE)



Minutes from May 2020 meeting agreed

2. Matters arising

I: SR liaised with the BMA and agreed to run the swap process in June 2020. A low number of requests were received, and the school was limited on what could be facilitated.

I: TG received a response from one trust with details of an F3 year.

I: A trial online regional teaching was run in June by Mark Mellor in North Devon. A feedback session was held in July. Positive feedback was received and provided a lot of tips for online regional teaching sessions.

I: Lead for education – an advert to fill this role has gone out this week and was sent to DMEs. Trusts were all asked to ensure the information gets disseminated as appropriate. Applications close on 2nd October and interviews will be held on 21st October. Candidates will need experience of working in the foundation programme and the main responsibilities will be to oversee and advise on teaching across the Peninsula.

I: ARCP requirements for out of sync and LTFT trainee’s requirement have been sent to trust. The criteria will apply to anyone who has an ARCP up until March 2021. Trainees who are on an extension from previous year (started F2 December 2019) will need to follow the out of sync criteria which will take the restrictions imposed by the COVID-19 pandemic into consideration. The expectation for ARCPs in June 2021 is normal but this is continuously under review. Trainees should expect to be assessed on the full criteria for their ARCP in June 2021. The requirement to have 10 ES meetings across the year will not be in the ARCP criteria for this year. Placement Supervision Group (PSG) will be a mandatory curriculum requirement from August 2021. For June 2021 the PSG will be desirable and trainees should be encouraged to complete at least one across the year.

A: All trusts are asked to speak to all clinical supervisors to increase the frequency of when the PSG are completed and should encourage the use of PSG for one per placement. Trusts should also encourage trainees to discuss using a PSG with their clinical supervisors at their induction meeting.

I: A new process has been introduced for checking the training of any new supervisors. The medical education managers in each trust have a list of those supervisors who have completed the training and are encouraged to work with the faculty team to ensure all supervisors have the required training in place.

3. Self-Development Time

I: RDE reported that the trainees are having a significant amount of time dedicated to self-development and their portfolios remain empty, so questions had been raised as to what the trainees are doing with their time. There is no expectation to document this time and it is not another piece of evidence.
I: Self-development time should be built into the trainee’s rota and trainees should be reporting if this is not happening through exception reports. Educational Supervisors should pick up on it if the trainee’s portfolio is not up to date. If trusts can document that time been given to the trainees an outcome 5 at ARCP will not be acceptable and would suggest there are professionalism issues if the portfolio is empty.
I: Some departments have struggled to give trainees a couple of hours for this time and find it is easier and more productive for trainees to have a full day off. Other problems include the days trainees have been rotared in to SDT, but the ES is not available.
I: This realistic expectation is a work in progress and due to covid-19 and winter pressures etc. the school need to be flexible in our approach to ensure this process is implemented for all trainees.

4. Outstanding trainee award

I: SM reported that there would be no monetary award from HEE going forward for this award. There was a discussion between the trusts and all still felt it was worthwhile certificate.
D: The outstanding trainees award will continue, and individual trusts can decide how to reward their trainees.

5. Review of ARCP process

I: SR gave the trusts the opportunity to feedback on the 2020 ARCP process that was changed due to the COVID-19 pandemic.
I: All trusts reported that it was a very efficient process and the use of teams was positive and reduced the time panel members were needed. There was a heavy burden on the admin team reviewing the portfolios and some concerns of adding too many trainees to the panel for review. Sarah reassured the trusts that this was exactly what should have happened, and the admin team were not expected to make decisions they were checking if the trainees had all evidence within their portfolio. All trusts reported that there was no final chance to see everyone face to face and felt they lost the personal touch and chance for feedback.
I: Reintroduction of lay reps – decision taken at peak of pandemic to not include lay reps in the ARCP process. Going forward the need for lay reps is important and should remain in process.
I: SR thanked everyone for all their hard work making this successful. SR will consider all feedback and ensure there is guidance well in advance for June 2021.
A: If any trust already has a plan on how they will run 2021 ARCPs please let Sarah know.

 6. FiY1s Core Procedures / portfolios

I:SR thanked everybody for all the work that went in to placing trainees in the Peninsula. The posts have been very well received and all trainees who completed one found it useful.
I: SR is involved in research to look at what benefits the FiY1 post had.
I: POST MEETING NOTE – The UKFPO have changed their guidance and all assessments and teaching that trainees completed during their FiY1 post can be considered at ARCP.
A: SM to add a note to the bulletin to explain the change.
I: Nick Toms asked if there was any feedback for medical schools on what can be improved if the FiY1 posts were used again.
A: SR to share the national feedback she has received. Research project should hopefully give more detailed feedback.
I: There is a possibility of the FiY1 posts becoming more formal.
I: UHPT reported that they took on medical students as Doctors Assistants before the FiY1 process which did not work out as well as the FiY1 role. The hospital was a difficult environment and the students were in a role that caused some confusion over appropriate tasks.
A: NT and DB to work together to improve the preparation and transition of the DA posts in Derriford.
I: LE reported that there was confusion over who the trainees should go to for support. If the FiY1 posts become a permanent position the medical school could still have contact with medical students during their FiY1 post.
I: SR advised the trusts that if any trainees were affected by the Exeter medical school student known to lots of trainees in the region there is support available and they should get in touch with SR.

7. Psychiatry

I: Two F1 Psychiatry fellows started in August 2020, one at Plymouth and one at Exeter. SB was not aware of these trainees so was not able to update the committee on their progress. As a minimum the trainees should be in touch with a mentor and should be completed psychiatry related activities across the year. NB reported that Angela Cottrell in Exeter is aware of the trainee and is working with the psychiatry team.
A: SB to contact the mentors and ensure the trainees are given the best experience.
I: There is an expectation for the number of trainees in psychiatry to remain as it is, but this could become difficult if there are any more problems with supervisors which means the placements have to cease.

8. Deferred starters

I: Any trainee that deferred their start date to September will have to use their 20 days leave in order to have done this and any further leave could put them into an extension. There were concerns that this will put pressure on a trainee to come to work even when unwell. SR reported that the trainees were aware of this and they made the choice. 20 days is only point of reference and the odd extra day would be considered by Sarah at ARCP and each trainee would be treated individually.
I: All September starters contracts will have started on 5th August.
A: All trusts were asked to ensure all the education supervisors of these trainees were aware of the 20 days and possible extension.
I: Any trainees deferred until December will need to be here 2 weeks (quarantine period) before their start date and will need to have completed their induction before they start in post on 2nd December. If visas are an issue the induction will need to be flexible to how the trusts can manage this in these exceptional circumstances. Trusts will need an accurate record of when they do actually start and must inform HEE of the exact start date for each trainee.
A: All trusts were asked to ensure their Medical HR and post grad teams communicate regularly with these trainees. December is the last possible start date for these trainees and if there unable to start they will need to withdraw from the programme.

 9. Sickness record management

I: TG reported that the foundation school are not always informed if a trainee is on long term sick.
A: All trusts were asked to communicate to the school as soon as a trainee goes on a prolonged period of sick leave. At ARCP there were examples of trainees who had unclear sick leave.
A: All trusts were asked to introduce a process to record trainees sick leave to ensure there are no surprises at ARCP.
I: In any 7 day period only 5 days are classed as a working week (40 hours) for long term sickness. There is clear guidance for any trainee that is required to self-isolate and how it will affect the trainee’s sick leave. For any trainee that has over 20 days the FSD will have discretion at ARCP if self-isolation forms part of the leave. SR reported that it is unlikely that an extension would be needed but would be discussed on an individual basis.

10. Study leave

I: HEE study leave rules changed in March 2020. Any claim over £300 needs to be referred to HOS. I: APLS and ATLS is not a curriculum requirement so trainees may only get time and not money to attend the course. Royal Colleges have been asked to remove points for ALS courses from specialty applications.
D: Anything that has been approved under current policy will be supported by Sarah.
I: A significant proportion of foundation schools have agreed trainees can attend 1 non curriculum aligned course during their foundation programme. SR proposed we make this change to the foundation study leave policy which will enable the school to support more courses.
A: SR to look at amending the study leave policy for implementation August 2021. Will bring to the December meeting.
I: PR commented that the school should support ALS courses as they are valuable transferrable skills and as a principle we should be encouraging as much as possible. Political and financial climate is changing and is difficult to justify a course that is not really relevant to the curriculum. It was suggested that the committee should make a statement to highlight how vitally important it is the foundation training/ teaching should be prioritised within the trust.
A: All trusts were asked to ensure that they are following the current study leave policy for foundation trainees. If the guidance in the foundation study leave policy has been followed it will be agreed. Please do not approve any that the guidance hasn’t been followed as SR will not be able to support this if it comes up at HEE.

11. End of year feedback/ teaching feedback

I: Report discussed. 245 – 59% of trainees completed the survey that was sent in July 2020. The survey was shortened this year due to the pandemic. 82% of trainees know how to access welfare and counselling services and 86% of trainees know how to obtain career advice. 89% of trainees rated the support offered by the PGME team as good or excellent. 89% of F1 trainees rated the quality of the teaching sessions a good or excellent. 89% of F1 trainees said that the programme supported and enhanced them clinically. 52% of F2s think that the regional teaching programme has been a good change. 89% of F2s reported that the teaching programme supported and enhanced their clinical work. 96% said they would recommend being a trainee in the Peninsula.
93% would recommend their trust to a colleague/ friend.
I: The report was overwhelmingly positive. LE suggested that the Foundation School shares the results with trainees to encourage engagement with surveys amongst trainees.
A: NB to look at attachment to send on the weekly bulletin for trainees.
A: NB to send individual trust comments out.

Regional Teaching
I: Some trainees reported that they had issues travelling to teaching. For all future teaching trusts are asked to consider the possibility of a hybrid approach combining face to face for local trainees and Microsoft teams’ access for other trainees in the region.
I: Courses available on Maxcourse is low. Some of this is due to the outline of sessions not being confirmed. Trusts can add the dates of confirmed sessions to the system without the outline and add to it as soon as they are able to.
A: All trusts were asked to update Maxcourse as soon as possible even just the date and title and if there are particular difficulties please contact SR.
I: The Foundation School are arranging Specialty career sessions which will include and overview of the specialty and the application process.
A: GC was asked to advise F2s of these sessions.
A: NB to invite all F1s if there is space available for them to attend.

Teaching hours – The number of hours for teaching will revert to 60 for ARCPs in June 2021. Trainees are now able to add more e-learning to the Horus portfolio. A discussion was held to consider putting a cap on the number of e-learning hours a trainee can use.
D:  Trainees should not record any more than 15 hours to their portfolio. At ARCP the trusts can use their discretion if a trainee has between 15-20 hours.
A: SM to add the change to the weekly bulletin for trainees.

12. Supervisor meeting data

I: Educational and Clinical Supervisors Induction Meetings for post 1 August 2020







Completed all requirements​











Signed off 1 meeting ​











Started at least 1 meeting​











No meetings at all started​











Ownness is on trainees to contact supervisors to arrange these meetings. There are still a number of trainees who have not had a meeting with their supervisors at nearly half way though their posts A: Trainee reps to send out an email to their cohort to remind them of the induction meeting requirements. 
I: Annual leave in August could be a contributing factor. Supervisors should be encouraged to arrange the meeting before they go on leave or have it booked in for when they return. Meetings can take place via teams. From 2021 it is likely to be a curriculum requirement to have 10 Educational Supervisor meetings across the year.

13. Trainee reps matters

I: Nothing to report.


I: FB reported that delivering simulation training in the trust is very challenging and the foundation review recommended the number of sessions increased from 2 per year to 3.
A: SR will raise concerns at the next HEE senior meeting and report back.
I: Will self-development time for F2s change from 3 – 2 for 2021? This was changed during the covid-19 pandemic and there has been no national update on this.
I: ALS to be removed from the curriculum for August 2021. Trainees will still need to evidence advanced airway competencies, but this gives the trust the opportunity to deliver in house – not through resuscitation council. This change needs to be finalised nationally. For all current F1s trusts are advised to put as many as possible on an ALS course. F2s must have completed ALS by the end of their programme. If F1s can’t do ALS they must do ILS.
I: PR reported that F1 rotations in Torbay contain ad hoc duties in other services. Paediatric trainees do a week of surgical clerking for example. No other trust has this.
A: PR to contact SR to discuss this further.

Next meeting 2nd December via teams.