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Quality Education for a Healthier Scotland
NES Medicine : Looking back & Looking Forward
Stewart Irvine Medical Director NES
4th National Scottish Medical Education Conference
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
NHS Education for Scotland
Medicine
Dentistry
Nursing & Midwifery
Allied Health Professions
Pharmacy
Psychology
Healthcare Science
Optometry
Source : NES – Fast Facts http://www.nes.scot.nhs.uk/media/2550555/FastFacts2014.pdf
Quality Education for a Healthier Scotland
NHS Scotland Workforce
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
Female
Male
Headcount - Source : ISD Scotland http://www.isdscotland.org
Quality Education for a Healthier Scotland
NHS Scotland Medical Workforce
Consultant 22%
Staff and associate specialist
grades 7% Other trained
grades 2%
Undergraduates 20%
Doctors in training
25%
GPR 2%
GP 18%
GP Salaried 3%
GP Retainee 1%
Head count, Source : ISD : http://www.isdscotland.org/
Quality Education for a Healthier Scotland
Education and training matters…..
Properly planned and carefully conducted medical education is the essential foundation of a comprehensive health service.
Goodenough, 1944
Training is patient safety for the next 30 years. Temple, 2010
You should be prepared to contribute to teaching and training doctors and students.
GMC, GMP, 2013
Quality Education for a Healthier Scotland
NES Strategic Framework : 2014 - 2019
•Vision
•Mission
•Values
•Ways of Working
•Principles
•Themes
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
East 39 Programmes 604 Trainees £33m
South East 54 Programmes 1402 Trainees £79m
North 44 Programmes 870 Trainees £45m
West 84 Programmes 2890 Trainees £160m
NES Medicine : Overview
Approx 4,600 Undergraduates, 5,700 postgraduate trainees, 1033 LEP x Specialty Environments
Quality Education for a Healthier Scotland
Aspiring to Excellence and Efficiency
Quality Education for a Healthier Scotland
Workstreams …
Quality Education for a Healthier Scotland
Workstreams
Workstream + Accountable Leads Sub-Workstreams
Training Management Bill Reid, Philip Cachia, Moya Kelly Anne Dickson
Programme Management Recruitment Systems Administration Trainee Management Trainee Support
Quality Alastair McLellan, Ronald McVicar Duncan Pollock
Quality Management Quality Improvement Medical ACT PFPI Research
Professional Development Gillian Needham, Anthea Lints Adrian Dalby
Pre and Post CCT Training Faculty Development Continuous Professional Development Career Support Deanery Development
Strategic Planning + Directorate Support Rowan Parks, David Bruce Duncan Pollock
Directorate Operational Support Facilities Management Finance People Strategy and Planning Local – Directorate / Corporate / Regional National – Scottish / UK
Quality Education for a Healthier Scotland
NES Medicine : Overview
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
Recruitment 2013
Quality Education for a Healthier Scotland
Applications to Medical + Dental School
0 2 4 6 8 10 12 14 16
K Northern Ireland
F Eastern
L Scotland
J Wales
G Greater London
C North West
A North East
All
B Yorks & The Humber
E West Midlands
I South West
D East Midlands
H South East
Source : UCAS – applications to medicine + dentistry http://www.ucas.com/data-analysis/data-resources
Quality Education for a Healthier Scotland
Origins of Medical Undergraduates
0%10%20%30%40%50%60%70%80%90%
100%
England Scotland Wales NI
School
RoWEUNIWalesScotlandEngland
Source : UCAS – applications to medicine + dentistry http://www.ucas.com/data-analysis/data-resources
Quality Education for a Healthier Scotland
First choice location for Specialty Training
First Choice ST Location by Country of Birth
0%
20%
40%
60%
80%
100%
Scotland RUK Overseas
Country of Birth
Outside UKOther UKScotland
Source : SMCCS
Quality Education for a Healthier Scotland
Trainee Destinations at CCT
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
ES NS SES WS All
Training Region
Unknown
Scotland
Rest of UK
Overseas
Quality Education for a Healthier Scotland
Strategy for Attracting and Retaining Trainees (StART)
Post Group Establishment Vacancies Filled Unfilled Fill Rate
Foundation 1608 804 804 0 100%
Core 588 289 288 1 99.6%
Run Through 1792 411 372 39 90.5%
HST 1741 345 236 109 68.4%
LAT 139 70 69 50.0%
Total 5729 1988 1770 218 89.0%
Recruitment 2013
3.8%
Quality Education for a Healthier Scotland
Strategy for Attracting and Retaining Trainees (StART)
Key Elements of StART : • Informing • Connecting a. Research and Market Research b. StART and ScotMT Website Redesign c. Careers Fairs d. Trainees – the T in StART – Trainee Ambassadors e. Keeping in Touch f. StART & Social Media g. Trainers – make me want to train in Scotland
Quality Education for a Healthier Scotland
Issues Considered when Choosing Deaneries (CT2 Trainees)
0% 20% 40% 60% 80% 100%
Cost of living in that area
Ease of entry
Good social life/night life
Job opportunities/no of vacancies
Previous familiarity with geographic area
Proximity to home/friends
Reputation of the Deanery
Your long term specialisation plans
City living
Outdoor recreational
Recommendations (family)
Recommendations (lecturers)
Recommendations (other trainees)
Recommendations (others)
Reputation of Foundation schools
Rural living 1
2
3
4
5
Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
Gaps in Programmes
OOP Maternity CCT Unfilled Other 0
5
10
15
20
25
30
35
Quality Education for a Healthier Scotland
GMC : Revalidation
Quality Education for a Healthier Scotland
Revalidation : SOAR
Quality Education for a Healthier Scotland
Revalidation
UK Scotland
# % # %
Defer 6,746 16.62% 371 11.71%
Revalidate 33,829 83.35% 2,797 88.26%
Non-engagement 12 0.03% 1 0.03%
Total 40,587 100.00% 3,169 100.00%
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
Sources of Evidence for Quality Management
Surveys - GMC
Surveys - NES
Outcomes - ARCP
Outcomes Exams
Visits – GMC & NES
Deanery Reports
College Reports
TPD Reports
LEP/DME Reports
Regulator Reports
Quality Education for a Healthier Scotland
GMC : National Training Survey
Quality Education for a Healthier Scotland
GMC NTS 2013 : Overall Satisfaction
Quality Education for a Healthier Scotland
GMC NTS 2013 : Educational Supervision
83 84 85 86 87 88 89 90 91 92
London Deanery Defence Postgraduate Medical Deanery
Oxford Deanery NHS Education for Scotland (East Region)
Severn Deanery NHS Education for Scotland (West Region)
NHS Education for Scotland (South-East Region) South West Peninsula Deanery
East of England Multi-Professional Deanery East Midlands Healthcare Workforce Deanery
Wales Deanery Northern Ireland Medical & Dental Training Agency
Kent, Surrey and Sussex Deanery Wessex Deanery
NHS Education for Scotland (North Region) Mersey Deanery
NHS West Midlands Workforce Deanery Yorkshire and the Humber Postgraduate Deanery
North Western Deanery Northern Deanery
Quality Education for a Healthier Scotland
GMC NTS 2013 : Patient Safety Concerns
Quality Education for a Healthier Scotland
GMC : Review of Quality Assurance and Standards
Quality Education for a Healthier Scotland
Quality
Educational Governance Supporting research in medical education – SMERC Supporting undergraduate medical education – Medical ACT
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
Professional Development
Recognition of trainers Supporting staff, associate specialists and specialty doctors Forensic medical examiners Approved medical practitioners Professionalism and Excellence in Medicine - Leadership training LAMP Launchpad for leadership Scottish Senior Clinical Leadership Fellows Remote and Rural Healthcare – RRHEAL and SSRHW Quality Improvement / Patient Safety / Clinical Skills / Human factors
Quality Education for a Healthier Scotland
Recognition of Trainers : Scope
The roles covered The arrangements relate to: a. named educational supervisors in postgraduate
training b. named clinical supervisors in postgraduate training c. lead coordinators of undergraduate training at each
local education provider d. doctors responsible for overseeing students’
educational progress for each medical school. Recognition will not be necessary for other doctors whose
practice contributes to the teaching, training or supervision of students or trainee doctors.
Quality Education for a Healthier Scotland
Recognition of Trainers : Standards
GMC will use the existing standards for postgraduate training set out in The Trainee Doctor and for undergraduate education in Tomorrow’s Doctors. GMC will use the seven areas originally set out by the Academy of Medical Educators to provide a structure: a.ensuring safe and effective patient care through training b.establishing and maintaining an environment for learning c.teaching and facilitating learning d.enhancing learning through assessment e.supporting and monitoring educational progress f.guiding personal and professional development g.continuing professional development as an educator.
Quality Education for a Healthier Scotland
Recognition of Trainers : Scotland
Criteria for Trainer Recognition : 1. Comply with all legal, ethical and professional obligations including completion of
mandatory training requirements. 2. Comply with all aspects of GMC’s Good Medical Practice. 3. Be currently practising within their field. For undergraduate trainers this may include
academic practice or health professionals in disciplines other than medicine. 4. Have appropriate time allocated for their role. 5. Demonstrate awareness of their role and how that role fits with other educational
and clinical roles. 6. Know how to get support if needed and know about the relevant EOs’ quality
management procedures. 7. Demonstrate awareness of the curriculum and level of students/trainees. 8. Demonstrate an appropriate level of teaching competence. Scottish arrangements for Meeting these criteria The Scottish Trainer Framework
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning
Quality Education for a Healthier Scotland
UK Shape of Training Review
Securing the future of excellent patient care: Final Report of the independent Shape of Training review led by Professor David Greenaway was published on 29 October 2013.
• The final report offers an approach
which will ensure doctors are trained to the highest standards and prepared to meet changing patient needs.
• It offers an approach which will be fit for
purpose for many years to come and a framework for delivering change and for doing so with minimum disruption to service.
Quality Education for a Healthier Scotland
Undergraduate Foundation Broad Specialty Credentialled
Shape of training : Proposed Structure
Quality Education for a Healthier Scotland
Shape of Training : Next Steps
To establish a 4 Nation Co-ordination Group to provide oversight, co-ordination and direction to post-Greenaway implementation activities. Remit and Accountability • provide policy oversight, co-ordination and direction for implementation
activities arising from the Shape of Training report • commission specific activities, and individual workstreams where required,
that will inform and contribute to implementation of the Shape of Training recommendations, and to receive progress reports and recommendations from commissioned activities
• report to Ministers on progress, and on issues requiring Ministerial approval.
Quality Education for a Healthier Scotland
Health Education England
Quality Education for a Healthier Scotland
Outline
NHS Education for Scotland
Single System Working
Training Management
Quality
Professional Development
Strategic Planning