aspiring to excellence
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Aspiring to excellenceTo deal with many of the deficiencies identified and to ensure the necessary concerted action, the creation of a new body, NHS:Medical Education England (NHS:MEE) is proposed. NHS: MEE will relate to the revised medical workforce advisory machinery and act as the professional interface between policy development and implementation on matters relating to PGMET. It will promote national cohesion in England as well as working with equivalent bodies in the Devolved Administrations to facilitate UK wide collaboration. The Inquiry has charted a way forward and received a strong professional mandate. The Recommendations and the aspiration to excellence they represent must not be lost in translation. NHS:MEE will help assure their implementation
The NHS Next Stage Review describes a visionfor the NHS that delivers high quality for all andgives staff the freedom to focus on quality.Achieving this vision requires us to provide thebest possible education and training for futuregenerations and to ensure that our existingstaff get the support they need to continuouslyimprove their skills.
Chapter 3 A high quality workforce
We will improve key aspects of workforce planning at national level by establishing an independent advisory non-departmental body, Medical Education England (MEE)
Sir John Tookes response to A high quality workforceI am particularly pleased to see the creation of Medical Education England which will give the profession the strong voice and the scrutiny function that it needs
Structure of MEE
29 members 6 meetings per annumBoard
Structure of MEEBoardMedDPHS
NHS NSR:A high quality workforceMEE agenda 1Suggest more valid and reliable selection methodsCommission a formal evaluation of the 2 year Foundation programme and consider an alternative model linked to wider reform of postgraduate medical educationLook at the balance between generalist/core training and specialty trainingReach a consensus on PGME and training structure by August 2010Continue discussions with Royal Colleges, deaneries, junior doctors, patients, employers, trade unions, SHAs and other stakeholders on how to take PGME and Training forward.
NHS NSR: A high quality workforceMEE Agenda 2Work with the Royal College of General Practitioners to develop cost- effective proposals for training at least half of doctors going into specialty training as GPs.Strengthen the public health workforce and produce a system of dual accreditationBe responsible for the development of modular credentialingAdvise on how the training of dentists should reflect the changing pattern of dental needsDevelop modular training for healthcare scientists leading to the post of accredited specialistPromote the incorporation of leadership and management training into undergraduate curricula
NHS NSR: A high quality workforceMEE Agenda 3Ensure that educational supervisors in secondary care undergo mandatory training and review of their performancePromote the incorporation of academic pathways as per the Walport report.Develop the modernising scientific careers programme (Life Sciences, Physiological Sciences, Physical Sciences and Engineering each with a rotating training programme)Take responsibility for the development of the training programme for pharmacists with the new emphasis on promoting health and well-being and giving life-style adviceTake on the responsibility for low volume specialties that require national planningTake on the job of working with the newly established HIECs to develop a model interface between universities and the NHS for innovation in education, training, certification, local workforce development and translational research.
Additional items suggested by Board membersQuality of training agenda; developing trainers; metrics and incentives; effect of EWTDDisseminating information on workforce planning; working with CoEDevelopment of a national simulation strategy including collaboration with MoDEnsuring that all final year medical students have an opportunity to shadow in the hospital in which they will be working
The 2007 / 08 PMETB survey showed the following implementation rates for F1 shadowing. Lowest HighestWarwick 48%Cambridge 45%Oxford 42% Keele 42% Birmingham37%
Belfast 96%Glasgow 86% Aberdeen81% Barts 78% Dundee78%
Definition of the standardised admission ratio for applicants to medical school
No of admissions from a particular population subgroup as a proportion ofall admissions___________________________________Proportion of the general population that belongs to that subgroupKieran Seyan et al BMJ 2004
Kieran Seyan et al BMJ 2004Asians Social Class 1 6.07Whites 0.73Blacks Social Class IV 0.07No black people from Social Class V were admitted to Medical SchoolFemales 1.15
Data from 1996-2000
In our year the ratio is about 2:1, females:males. In my seminar group of 20, for example, 14 are female and 6 are male. This is the same with the majority of seminar groups.__________________ Third year Medical Student at Newcastle University, Tyne Clinical Base UnitI could not find any information on male to female ratio of current medical students at Newcastle medical school . Grateful for any informationGender balance in Medical Schools
Graduate entry into MedicineNormal mode of entry in USA for many years1997 Four Australian Medical Schools changed exclusively to graduate entryIreland has now changed to graduate entry
GP Analysis:There is a clear risk of an undersupply of GPsAnalysis with impact of supply side variation*Not intended for publication*The magnitude of the likely GP undersupply depends on supply assumptions, e.g.:
Future participation; Future attrition; Future retirements.
The GP age profile suggests an imminent retirement bulge.
Early indications from modelling development suggest the higher end scenarios may be more likely as supply assumptions are updated
Not intended for publication
Specialist Analysis:There is a clear risk of an oversupply of CCT holders Analysis with impact of supply side variation*Not intended for publication*The magnitude of the likely CCT oversupply depends on supply assumptions, e.g.:
Future participation; Future attrition; Future retirements.
The demand profile is dependent on skill mix: moving towards a trained doctor delivered service may result in increased CCT holder demand in the short term.
Not intended for publication
HIECsHealth Innovation and Education Clusters (HIECs) are aimed at more rapidly translating research and innovation into clinical practice, and linking workforce planning to a quality framework of education.HIECs could be one of the key ways in which MEE is plugged in at a local level
HIECsA partnership betweenNHS organisations (primary, secondary and tertiary)HE sector (universities and colleges)Industry (healthcare and non-healthcare)
Principles of HIECsSpan settings (Trusts, FTs, private sector; primary, secondary and tertiary care)Span sectors (NHS, HE, Industry)Span professions (i.e. Multi-professional)Deliver measurable impact in innovationFocus on qualitySupport the purchaser-provider split in education and training
HIEC 2009 timetableMay distribution of national prospectus to outline HIECs concept, application processMay- July regional stakeholder events run by SHAEarly September completion of pre-qualification questionnaireOctober submission of formal applicationsNovember presentations to National selection panelDecember first wave of HIECs announced
I explained that a general reduction to a 48-hour week would in our view have profound consequences for the provision of local services and training. Many medium-sized and small hospitals would not have sufficient staffing levels to maintain rotas. Surgical services would become unsustainable and of course without surgical cover accident and emergency departments would have to close. The increasing demands on consultants to keep emergency services going would inevitably have a serious impact on elective surgery, with little hope of meeting government targets on waiting times. EWTD: John Blacks February Newsletter Carpe Diem
EWTD: ASiT survey Jan 2009ASiT suggest that to ensure optimal training, with adequate time for exposure and high quality patient care with increased continuity, it is necessary to return to a working week of approximately 65 hours. For higher specialty trainees (ST3 and above), on-call rotas rather than shift working would best protect training opportunities, and would be the optimal arrangement where workload permits.
Professor Michael ErautUniversity of Sussex
JCST discussion document of the Eraut report..disturbing insight into the current condition of surgical training in the UK. Many factors are identified as being responsible for this unwelcome state, not all of them obviously remediable.Allowing for the environmental factors identified in the Eraut report is the ISCP fit for purpose as a curriculum for surgical training? (these factors included the EWTD and the MTAS disaster)
Annual Specialty Report Overview JCSTISCP: despite its many strong points, the ISCP continues to generate a degree of discontent amongst some trainees and trainers, and engagement with both groups, in some areas, is less than the JCST would wish to seeOpportunities for training in operative surgery: 29% ST1 trainees have access to less than two operating sessions per week; JCST would like to see a commitment to innovative training methods such as simulation to help offset this reduction in clinical experienceSupport for tra