Peninsula Foundation School Committee Minutes 

Tuesday 3rd March 2022 10.00 – 13:00. 

via MS Teams   

Present: 

Sarah Rawlinson 

SR 

Peninsula Foundation School Director 

Trudi Geach 

TG 

Peninsula Foundation School Manager 

Natalie Band 

NBA 

Peninsula Foundation School Co-ordinator 

Suzanne Maddock 

SM 

Peninsula Foundation School Co-ordinator 

Bill Wylie 

BW 

Lay Representative 

Angela Cottrell 

AC 

Foundation Programme Director FY1 RDE 

Fionn Bellis 

FB 

Foundation Programme Director NDHT 

Caroline Rawlings 

CR 

Medical Education Centre Manager NDHT 

Kathryn Eccleston 

KE 

Foundation Programme Director FY1 RCHT 

Trudy Eddy 

TE 

Senior Manager of Medical Education RCHT 

Matt Metherell 

MM 

Foundation Programme Administrator RCHT 

Neil Walker 

NW 

Foundation Programme Director FY2 RDE 

Nadia Khatib 

NK 

Foundation Programme Director FY2 TSDHT 

Mandy Turner 

MT 

F1 & F2 Admin support & HR TSDHT 

Kate Talmage 

KT 

Foundation Programme Co-ordinator UHPT 

Daranee Boon 

DB 

Foundation Programme Director FY1 UHPT 

Summer Popplestone 

SP 

F1 Trainee Representative 

Jacqueline Easter 

JE 

F2 Trainee Representative 

Nina Bossa 

NB 

Medical Education Manager RDE 

Jamie Dunn 

JD 

Foundation Programme Director FY2 UHPT 

Yachna Mehta 

YM 

F2 Trainee Representative 

Tom Smith-Walker 

TS-W 

Foundation Programme Director FY2 RCHT 

 

 

Apologies: 

Nick Toms 

NT 

Peninsula Medical School 

Will Denford  

WD 

Medical Education Manager 

Jeremy White 

JW 

Medical Education Manager 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

SR opened the meeting and introductions were made. 

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

The previous meeting minutes were discussed and actions points updated.  

TG confirmed the quality team were going to review the ‘you said, we did posters’ to show the trainees that something productive comes from the quality panels. TG will update with further information at the next meeting. No update from Quality.  With the panels taking place currently.  TG keen to follow up and pursue – review at next meeting  

FB to ask Mark Mellor to review the core topics not covered by any teaching to establish if they can be delivered by eLearning. MM contacted SR but not as anticipated.  SR looked for a volunteer to take further.  No volunteer forthcoming so the school will take this further and report at the next meeting.  

SB has sent SR a proposal paper to present to Geoff Smith about appointing a foundation psychiatry lead in the Peninsula. SR this has not been progressed SR will chase.  

Trusts to ensure trainees have an academic supervisor who will guide and support them through the academic component of their post who will be able to complete an academic report at the end of the year. This could be the same as their ES. Complete for all trusts apart from RDE TG informed NW Angus Jones covers the research trainees.   Steve Pod clinical but difficult to pin down NW revisiting to ensure meetings happen on a regular basis.  Will advise TG of outcome.  

F2s were surveyed about their experience in their first post and the trainees have reported a low moral due to low staffing. Rotas are under core staffing levels which impacts on trainees being able to take study leave and good stretches of annual leave. The majority of feedback was from Plymouth and Exeter. JE to share results with SR. - Feedback presented to Quality Panels.  JE will send a summary.  There were inadequate responses to produce feedback from RCHT, TSDHT and ND.  

3. Foundation Expansion and Recruitment  

  • Update from each trust  

NW raised the possibility of expanding academic posts (SFP)SR reported that UHP are exploring the possibility of more and Tim Hookwaywas talking to Camilla at Plymouth Medical SchoolFunding however is an issue, there is not full clarity around who funds the F2 year, some funding commitment would be needed from trusts (would not have a trainee for 33% of the time).  NW stated thatexisting posts were oversubscribed and attracted the good quality candidates we would like to attract to the Peninsula.  

SR confirmed funding would be 50% tariff for trainee but 66% time for 2x6 months then the university would have to agree to take them on.  NW felt it was timely to be looking at expanded the SFPs.  NW will take discuss with Ray Sheridan.  TG will further investigate funding and programmes. 

JD informed the meeting that he had not heard further from Tim Hookway and he will also chase the contact from Plymouth University.  

Community Posts.  NW and AC have been trying to meet to discuss the expansion of FP, but wondered if there was any leniency with the requirement for the expansion programmes having a community postSR stated that ideally each new programme would have a community post but she was appreciative that in reality this was proving difficult.  However the end aim should be to have a community post in all FPs and we would need to work towards thatNBA informed the FSC that the current responses received from GP practices this year indicated that RDE, ND and TSDHTall had potentially extra capacity in GP. TheFS will take this forward.  Plan for 2 new rotations to have GP in Exeter. 

 SR has contactedthe 3 Psychiatry DME’s who have stated that psych can expand, but this is a different message to that being heard by the trustsSR confirmed LiaisonPsych in F1 does not count as community.  COE and Older people mental health posts in RDE are being looked at.  

SR will establish which Psych trusts actually have capacity.  SR pointed out that expansion was an opportunity to attract new specialtiesFor example the hyperbaric medicine centre in Plymouth, which is GP led, conducts medical assessments for diving, but also deals with some acute admissions/treatments.  

SR has also been approached by Public Health to increase posts across the PeninsulaTE is very keen to reinstate the Public Health post in RCHT but they have not communicated with the trust.  SR will engage with Public Health in Truro to find out further information.  

SR confirmed GUM would be community.  

Dermatology is worth looking at as this is clinic based; however care would be needed to ensure posts can cover the curriculum requirements, SR said it may be worth exploring possible hybrid posts.  

Pallative care, was confirmed as a good opportunity for a community post as a variety of different medical presentations are seen in palliative care.  

F2 Microbiology in RDE gets really good feedback, inpatient ward rounds are included.  NW confirmed it is a pure micro based post not linked to MAU.  NK will contact NW to discuss how it works in RDE.  

FB stated that ND have a Micro and medicine post which includes oncalls.  

SR said that HEE are very keen to increase Pathology specialties as there are currently specialty recruitment issues.  Histopathology in UHP - JD had not thought about combined post with oncalls, so will talk to them again.  

KE reported really negative feedback about split posts in RCHT so they are avoiding creating anymore split posts in the future expansion.  NW a lot of these posts are semi supernumerary.  Obs & Gynae is popular with trainees and SR asked trusts to be mindful that expansion is not just about medical, surgical and ED.  

TS-W stated that F2 works well in Obs & Gynae as they overstaff the rota to allow time to release trainees for good educational opportunities.  The point was made that Specialty and GP schools do not ask for tariff where the Foundation school does, so Specialties are going with the other schools and not expanding their FP trainee numbers. 

SR shared spreadsheet of the proposed expansion numbers in which trust and when.  SR talked the FSC through the figures for each trust and asked them to confirm.  

ND and RDE were clarified.  

TSDHT should read 3,3,3, not 3,6,3.  

RDE agreed to take the extra, change RDE to 6,6,6    6,9,6  

ND 3,3 3 F2 from 24  

SR will send out the amended spreadsheet for trusts to confirm.  

SR reported that there will be a review of funding for admin and FPD time in the trusts.  This is an opportunity to think about the structure of Foundation teams in the trusts.  

Quality Panels – strong feedback has been received for the RCHT Community Healthcare posts and F2s are reportedly very unhappy - it was service based, lack of supervision and not many opportunities for SLEs TE felt COVID had impacted these posts.  TS-W confirmed that the QP feedback he had received was that there was not a consultant there every day.  (Always someone to contact, but physically not in building all the time).  It was felt that the feedback was not so bad in view of the pressures they are under therefore they are hoping it is a short term issue.  It was felt that it was a safe environment but possibly lacking education short term.  SR asked RCHT to limit further expansion of these posts.  

4. Welcome Event  

NBA said the deadline for the school to receive trust presentations for the Welcome Event had passed.  UHP is the only trust who had not respondedNBA asked UHP for a recorded presentation ASAP and assistance was offered should they need the FS to help them record itA list of trust attendees was requested before 7th March.  The FS were meeting a communication team member re using Slido and agenda time slots have been disseminated.  If trainees cannot attend all day,it would be acceptable that they just attend during their time slot.  

NBA will resend the agenda.  Sharepoint updates, job descriptions are needed ASAP by the school ASAP.  

UHP responded that they were recording a video Friday and will send to the schoolA number of trainees have volunteered to attend. FB felt that enthusiasm seems to be lacking this year from trainees.  

SR thanked everyone for their perseverance it is an important day in the calendar.  SR stated that the FS had discussed not running it but feedback is very positive and it is a very valued event, however whether it continues is open for discussion. 

5. Regional teaching  

NBA took meeting through slides attached.  There is some concern that trainees are not going to meet the curriculum core teaching requirement.  

30 trainees have no hours recorded yet. 

34 trainees have already met the hours logged. 

3 trainees in RCHT have not yet set up a Maxcourse account. 

21 courses are still to come but some are fully booked.  

UHP have added no regional teaching sessions to Maxcourse apart from ASCERT.KT stated she was struggling to get faculty on board and many courses were cancelled under trust winter pressures measures. UHP have a remote medicine course planned for May. NBA reminded KT to plan obtain face to face authorisation from HEE under COVID guidelines.  SR whilst acknowledging the difficulties, asked trusts to think about contingencies as it is vital that we have enough capacity in the teaching programme to accommodate trainees.  

 NW had several emails from 3 senior consultants saying they will not participate in online teaching again because of the lack of engagement from trainees.  NW asked reps to go back to their colleagues to stress that they need to engage.  JE has discussed this with trainees in UHP and sent out messages but not much feedback has been forthcoming.  The overall feeling is that trainees want to return to face to face teaching. 

KT reported that in UHP all non-mandatory teaching was cancelled in January.  YM, felt that the consensus amongst trainees is that they are hoping for more face to face teaching in the third rotation.  SR reiterated that HEE were still not opening up face to face and it is not going to happen in time for ARCPsThe Clinical skills courses were very well received.  NBA confirmed still some spaces are available.  

SR stated that if trusts apply to HEE for face to face teaching to be authorised the school will do all they can to get it approved.  

FB said ND also tried to cancel FS teaching but she pushed back and stated it was a mandatory curriculum requirement and the trust cannot cancel it – this strategy worked and the trust allowed the teaching to continue.  

SR emphasised that it was up to all trainees to be responsible to ensure they can attend enough teaching to meet ARCP requirement.    

If there are going to be issues SR needs to know before the ARCPs.  

NK referred to a GMC session that TSDHT organised which even included lunch but only 2 trainees were coming.  TE confirmed similaroccurrences in RCHT.  A number of the FSC felt it was becoming a professionalism issue.  SP felt that there was poor understanding within ward teams that FDs need to attend teaching.  

JE did say that sometimes a delay in study leave being approved was a legitimate reason for not going to teaching.    

SR once again emphasised that teaching is a key requirement and they will not be signed off without it.  There will be no derogations for teaching this year for ARCPs.  

JE requested that the FS email trainees who are short on their teaching hours.  

SR felt that YM made a good point when explaining that full days were easier to attend than half days because it was more difficult to swap with colleagues to accommodate half days.  SR therefore requested that for the 22-23 programme trusts look to provide more full day face to face teaching.  

6. General Practice Update  

No representative present.  No update received.  

7. Psychiatry Update 

No representative present.  No update received.  

8. ARCP refresher session  

SR gave a short presentation on ARCP procedures and administration in view of the forthcoming ARCP window.  (Slides attached).  

SR stressed that terminology when communicating about ARCPs is very important.  SR reiterated that ARCP panels are conducted without trainees being present (in absentia).  Panel membersreview portfolios and award outcomes.  The outcomes must be communicated with the trainee in a post ARCP discussion.   Trainees awarded an adverse outcome should be strongly advised to attend a post ARCP discussion. All other trainees should be offered this as a choice.  

SR asked trusts to be mindful of the timeline, F1s need sufficient time to apply for full GMC registration and F2s need time to apply for specialty training.    

Outcome 5s need to be converted within a maximum of 10 working days 

 3 or 4 outcomes must also be communicated in writing using the agreed standard adverse outcome letter.  Trainees have 10 working days to appeal from the point of receiving the written outcomeAny delay in the trainee receiving the letter will delay the appeal process clock.  

SR recommended that F1 trainees are invited to a post ARCP feedback discussion as they find it a hugely positive experience,also a random 10% of F2s and all trainees in difficulty, however they do not have to have a meeting if they do not want one.    

Panels should now return to the pre COVID composition of 3 panel members, however if there are difficultiesfinding sufficient panel members a panel can convene with only 2 members if necessaryPanels should be chaired by a Foundation programme director.  

The GMC state that all trainees must have an ARCP every year. 

All trainees include all trainees on OOP, LTFT, etc.  If a trainee is not at a transition point an ‘other outcome should be given.  

All resignations also need to be given an ARCP if they have not had a recent ARCP and they should be given a N21 or N22 outcome.  

BW pointed out that the ARCP process is a good way to highlight good practice.  

TOOT days on Form Rs should equal no more than 365 days and a minimum of 0 (cannot be left blank)  

Panel composition 

Min 3 

FPD & 2 others (e.g. ES) can be MEMs if struggling 

Lay rep 10% - TG will contact to find out which day trusts want a lay rep 

HR rep for outcome 4 (consider for outcome 3) 

Anticipated outcome 3 or 4 – PG dean or deputy. 

Panel chair must ensure no conflicts of interest 

  • NO ES & CS on panel for an individual trainee 

  • TID – consider role of DME carefully 

 BW asked if everyone was happy with the feedback system lay reps currently use – or would they prefer that they feedback to the trust.  TG confirmed that the lay rep feedback was disseminated to the trusts.  

SR then presented her paper on guidance re curriculum mapping and ARCP checklists for F1s and F2s. Both checklists are based on UKFPO published guidance.Previously there were local variations on requirements around the country which led to unacceptable disparities for trainees.  It is clear from the GMC what is required for progression so this is why the checklist is missing previously required elements e.g. initial CS & ES meetings and PDP. 

 SR stated that it was agreed as a school that we would continue to offer ALSto demonstrate FPC 2 and trainees should link their ALS certificate (iLSacceptable for F1s). 

Audits/ QIP required to be linked to FPC 9 for F1 and F2.  

Teaching FPC10 evidence involved in teaching in F1 and F2.  

Trainees in Difficulty - CS Reports – trainees can have one unsatisfactory placement and still progress SR asked trusts to reassure CS about thisSR continued to present her paper on curriculum linking guidance (copy attached)and checklist guidance (attached).  

The following were discussed: 

TAB/PSG Feedback 

Meeting records vs meeting records  

SR stressed to FPDs that if they receive an email re trainee feedback, they should cut and paste into a general meeting documentShe informed them that although you can have emails submitted for consideration at an ARCP it is easier if evidence is on a meeting form in the trainee’s portfolio.   

SR reminded the FSC that trainees should be aware of their likely outcome before the ARCP panel sits.  

Appealstrainees can only appeal against the process only and not educational based decisions.  

SR asked FPDs to ensure all what they have done holds up to scrutiny.  

COVID sick leave – SR has discretion at panel, but COVID absence comes into the 20 days allowance, it is not exempt, but a judgment will be made in context of the whole picture portfolio etc.  

JE half day here and there waiting for COVID tests – SR not sure how this is recorded at the trusts, but it may be recorded as sick leave but trusts are not using this absence as triggering HR processes.  It is absence from the training programme and will count within the 20 days allowed.  BW observed thatoften ARCP panels considering unsatisfactory outcomes find it difficult to establish the amount of time trainees have had, but it is very important.  

TE: RCHTis working hard to improve COVID absence -if a trainee is due in work but is absent then it is counted.  

SR asked for feedback on the documents presented.  

FSC members requested that the checklists are made as explicit as possible.  

JE enquired what evidence is required re completing a QIP.  SR replied upload something to prove taken it through to the end e.g. presentation slides for an F2. 

KT SIM training – in FPC 2 SR will review and add to the guidance. 

SR will send out copies of all documents by the end of the week. The FS team will amend the checklists and guidance following the feedback receivedand ask for comments from the FPDs before they sharing to ES and CS and trainees.  

DB asked what do you give for outcome 3 TG confirmed there is a HEE Outcome 3 letter template to use which should be handed to the trainee, but if this is not possible it should be sent by email with a read receipt but on the SAME DAY.  

9. Trainee Rep Matters 

Not discussed at this meeting  

10. AOB  

BW asked in view of the current conflict whether Ukrainian nationals had been identified in aFP.  All the trusts confirmed that this had been discussedin their teams and any trainees have been identified and additional support offered.  

JE and YMasked what they can do to help to spread the message about the need for engagement with regional teaching – a general discussion took place.  

Confusion exists re whether ATLS courses are able to be agreed for Foundation Doctors.  SR reiterated that Funding is set by HEE and FPDs need to consider the appropriateness of courses for foundation trainees.  Therefore if the course is not category 1 FDs it will not attract full funding.  Category 3 - will cover 50% expenses.  

SR has intervened for full expenses for presenting at a conference.  If a course is abroad SR may intervene and agree time only.  

NW raised the issue of membership fees which are not funded by HEE.  In this example the only reason the trainee joined was to receive a substantial discount on the attendance fee so this would have saved HEE money.  SR offered to raise this at SLOG.  

SR confirmed that tasters should be done in trainee’s own trust, however if the specialty is not available at their acute trust trainees can go to other trustswithin Peninsula.  SR would not support travelling outside of the Region in the current COVID pandemic.  SR also urgedcaution when agreeing tasters in niche specialties.  

The meeting concluded. 

 

Next Meeting Dates: 

Wednesday 11th May 2022 

Tuesday 20th September 2022 

Wednesday 30th November 2022  

 

Actions for Review: 

 

Agenda Item 

FSC Member 

Action 

By When 

2  

(Follow up actions from last FSC) 

TG 

TG confirmed the quality team were going to review the ‘you said, we did posters’ to show the trainees that something productive comes from the quality panels.  

No update from Quality.  With the panels taking place currently.  TG keen to follow up and pursue. 

 

Next meeting 

School 

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

MM contacted SR but not as anticipated.  SR looked for a volunteer to take further.  The FS will take further. 

Next Meeting 

NW 

Trusts to ensure trainees have an academic supervisor who will guide and support them through the academic component of their post who will be able to complete an academic report at the end of the year. This could be the same as their ES.Complete for all trusts apart from RDE TG informed NW Angus Jones covers the research trainees.   Steve Pod clinical but difficult to pin down NW revisiting to ensure meetings happen on a regular basis.  Will advise TG of outcome. 

Next meeting 

SR 

SB has sent SR a proposal paper to present to Geoff Smith about appointing a foundation psychiatry lead in the Peninsula. SR not been progressed SR to chase. 

Next Meeting 

JE 

F2s were surveyed about their experience in their first post and the trainees have reported a low moral due to low staffing. Rotas are under core staffing levels which impacts on trainees being able to take study leave and good stretches of annual leave. The majority of feedback was from Plymouth and Exeter. JE to share results with SR. F2s - Feedback presented to Quality Panels.  JE will send a summary.  There were inadequate responses to produce feedback from RCHT, TSDHT and ND. 

Next Meeting 

 

3 

 

 

 

 

3 (cont.) 

NW/TG/JD 

Academic Posts Expansion.  NW to speak with DME at RDE and TG to investigate the funding and programme possibilities.  JD to chase Plymouth University and DME. 

Next Meeting 

School 

Continue to nurture possible extra capacity in GP placements.  

Ongoing 

SR 

Contact Psychiatry School contacts to establish the capacity for expansion of community Psych posts across the 3 Psych trusts. 

ASAP 

SR 

Contact Public Health in Truro to establish when they may be in a position to reinstate Public Health posts specifically and discuss expansion generally across the Peninsula. 

Next Meeting 

NK 

Contact NW to discuss how microbiology posts work in RDE. 

ASAP 

4 

NBA 

Resend agenda for Welcome Event. 

ASAP 

UHPT Team 

Record and send Welcome Event presentation to school. 

ASAP 

ALL Trusts 

Send in Job Descriptions and any Sharepoint updates.  

ASAP 

5 

ALL Trusts 

Look at regional teaching capacity to ensure that trainees will have enough opportunities to meet their curriculum requirements.  Add any courses planned to Maxcourse.  If there any issues let SR know ASAP.  Consider seeking authorisation from HEE for face to face teaching. 

ASAP 

ALL Trusts 

Begin to think about 22-23 regional teaching programme – look to return to full days rather than half days. 

Ongoing 

8 

ALL Trusts 

Ensure ARCP panels are ‘Gold Guide’ compliant and that timelines allow sufficient time for F1s to apply for full GMC registration before starting F2.  Aim for 3 panel members. NO conflicts of interest. 

ASAP 

SR & school  

Review the F1 & F2 ARCP checklists and curriculum linking guidance. Make explicit, send to FPDs for review before sending to trusts for dissemination to trainees. 

ASAP 

FPDs 

  • Use General Meeting forms on trainee portfolios to record, emails and trainee discussions. 

  • Trainees to be informed of likely adverse outcomes before ARCP panels – it should not be a surprise to them. 

  • Ensure adverse outcome trainees receive the standard HEE letter informing them of their outcome on the day of the decision (effects appeal process). 

Ongoing 

10 

SR 

 

Raise the subject of membership fees being covered by the study leave budget at SLOG where these would save HEE significant amounts of money on the cost of a full price conference/course. 

Next SLOG meeting