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Changing patient needs• 42% have a long‐term condition• 23% have multiple conditions• 23% have multiple conditions• Onset 10‐15 years earlier if
socioeconomic deprivationsocioeconomic deprivation
Ch i T h l iChanging Technologies
Th t tThe constants
Ability to:• work in teams and lead them• work in teams and lead them• manage risk and explain risk to our patients• measure and improve quality• explain treatment options clearly and fairlyp p y y• empower patients to take responsibility for their own healththeir own health
• motivate and inspire the next generation
Th t tThe constants
K l dKnowledge
• Population medicine• Determinants of health and
ll b iwell being• Healthy communities• Healthy communities• Patient empowerment• Patient empowerment
SkillSkills
Making a diagnosis in contextA i t l i t tAgreeing management plans in contextGiving autonomy to the patient to manage their own condition◦ Negotiation◦ Listening ◦ Empathy
Values and beliefsValues and beliefs
The workforce will have adaptable skills responsive to evidence and innovation toresponsive to evidence and innovation to
enable ‘whole person’ care, with specialisation driven by patient rather thanspecialisation driven by patient rather than
professional needs.
Respect and dignityWe value every person – whether patient, their families or carers, or staff – as an individual, respect their aspirations and commitments in life and seek to understand theirand commitments in life, and seek to understand their priorities, needs, abilities and limits. We take what others have to say seriously. We are honest and open about our point of view and what we can and cannot do.
Collaboration across boundaries andCollaboration across boundaries and agencies
Tower HamletsTower Hamlets
H Cit d lHope Citadel
Learning professional values andLearning professional values and qualities
Patient based narrativePeersMentorsMentorsDiscussion and testing of ethical principlesCulture and learning environmentCulture and learning environment
Living our values
If we toleratef i• unfairness
• rudeness• inequity
how will our juniors learn our professional value of respect?
Living our values
If seniors are • hierarchical and aloof• hierarchical and aloof• disrespectful of others’ opinions
and contributionsand contributions
how will our trainees learn the importance of valuing the opinion ofimportance of valuing the opinion of patients and carers?
Good decision makingg
Decision making is hampered when we are:• Tired• Tired• Stressed• Treated unfairly• Working in an environment where the culture is ghostile
Heffernan
Doctors who consult effectively reduce b bantibiotic prescribing
Paul LittlePaul Little
Patient Preferences Matter – The silent misdiagnosismisdiagnosis. Mulley Trimble Elwyn
The Academy of Medical Royal Colleges said that too many needless
t t t i dtreatments were carried out and urged doctors to spend more time listeningspend more time listening to what their patients
wanted.
Our Barriers
Our Barriers
S ti lSupporting learners
Time and space to explore with the patient what impact their illness has on their life and their life on their illness.Time for trainees to share and discuss with teachers their thoughts about the patient and their illnessClinical placements/posts which offer a full range of patient encounters
S ti lSupporting learners
W ki h ll f d h hWorking patterns that allow for deep thought
S ti d tSupporting educators
Support and challenge• Time and willingness to seek and value trainees’Time and willingness to seek and value trainees opinions
• Skills in critical listeningSkills in critical listening• Skills in delegating (not dumping)• EnthusiasmEnthusiasm• Skills in delivering difficult messages clearly and kindly with a plan to move onkindly with a plan to move on
G i P f i l C bilitiGeneric Professional Capabilities
…and finally
Assessment drives learning.
Resources
• Five Year Forward View• HEE Mandate• HEE Mandate• GMC Developing a framework for generic
professional capabilitiesprofessional capabilities• Margaret Heffernan ‐Willful Blindness, Beyond
MeasureMeasure• Wendy Levinson ‐ Understanding Medical
ProfessionalismProfessionalism• Mulley Trimble Elwyn ‐ Patient Preferences matter
