Educational Solutions for Workforce Development Medicine Shape of Training Review Rowan W Parks Deputy Director of Medicine, NES 11 September 2013

Educational Solutions for Workforce Development Medicine

Educational Solutions for Workforce Development Medicine Background 2007, Tooke report, made a number of recommendations about the shape & structure of PGMET –More flexible and broad based approach –Integration of training and service objectives into workforce planning –Raised issues regarding the role of trainees, SAS doctors and consultants within the health service

Educational Solutions for Workforce Development Medicine Sponsoring Board AoMRC COPMeD GMC MEE / HEE MSC NHS Scotland NHS Wales NI Dept of Health, Social Services & Public Safety

Educational Solutions for Workforce Development Medicine Drivers of Change The last thirty years have seen rapid social and technological change completely redefine the context in which healthcare is delivered. Things will move more quickly in future. Advances in medical science have increased life expectancy but also increased the complexity and cost of care. Our population is older, more overweight and medically more complex than ever before and we face significant challenges managing the impact of disruptive innovations in genomics, diagnostics and ICT on patient care. Managing all of this whilst improving the quality, affordability and equity of healthcare for patients, will need a new breed of doctors: doctors capable of leading and managing complex change across constantly shifting institutional boundaries. There isn’t much about my training thus far that leaves me feeling ready to meet this challenge. Anas El Turabi, ST4 GP trainee

Educational Solutions for Workforce Development Medicine Purpose of the Review The review will look at potential reforms to the structure of postgraduate medical education and training across the UK. The aim is to make sure we : –Continue to train effective doctors who are fit to practise in the UK –Provide high quality and safe care –Meet the needs of patients and service now and in the future

Educational Solutions for Workforce Development Medicine Themes Patient needs Balance of the workforce Flexibility of training Breadth and scope of training Tensions between service and training

Educational Solutions for Workforce Development Medicine Timeline of the Review  The Review will produce a final report with recommendations for the Sponsoring Board in Autumn  The report will set out the rationale behind and recommendations for:  Any immediate changes  Changes in the medium term (2-5 years)  Changes in the long term (5-10 years and beyond)  How any changes may be implemented

Educational Solutions for Workforce Development Medicine  Literature review – of research and other literature  Descriptive analysis of themes, ideas, and feedback to the call for written evidence (400 submissions)  Site visits  Educational seminars  Focused workshops - students, trainees, academics, patients and employers  Draft of the principles and models  Oral evidence (April – June)  Evidence Gathering

Educational Solutions for Workforce Development Medicine Principles  The overarching objective of the system of medical education and training must be to equip doctors, and instil in them the professionalism needed to deliver safe and high quality care which will meet the future needs of patients and the service.  Any new model of training must be designed to deliver this objective through the minimum structural change necessary.  Education and training should be based upon the demonstration of capabilities, not simply time served.  Any new model of training must reflect the need for doctors to continue their learning and development throughout their working lives.

Educational Solutions for Workforce Development Medicine Principles  Any new model of training must incorporate the elements of flexibility which acknowledge the uncertainties of future healthcare and workforce needs and the aspirations of trainees.  The outcomes of training must provide transparency for patients, the public and the service about the levels of capability doctors have attained.  The principles for implementation of any new model should enable the existing workforce to be incorporated into the new system so as to avoid co-existence of parallel systems. 12

Educational Solutions for Workforce Development Medicine Possible Approaches  The following diagrams describe a series of possible models for medical education and training which emerged from the feedback received.

Educational Solutions for Workforce Development Medicine

Educational Solutions for Workforce Development Medicine

Educational Solutions for Workforce Development Medicine

Educational Solutions for Workforce Development Medicine (Personal) Predictions Increased flexibility Broader and longer core training More than one end point Limited opportunity for RTT More focused training for academics Subspecialty training will become “post-CCT” Apprenticeship / Longer training placements

Educational Solutions for Workforce Development Medicine Other challenges / opportunities Managing expectation Career guidance Enhancing training Recognition of trainers Approval of educational environments Service redesign / reconfiguration Shaping a consultant career

Educational Solutions for Workforce Development Medicine Summary See current challenges as opportunities Retain what’s good of what we have got Recognise that we may need to change Emphasis on initiatives to enhance quality of training

Educational Solutions for Workforce Development Medicine “Excellent training now, is patient safety for the next 30 years.” Dr Vicky Osgood, GMC