1. What are the Deans thinking about?
Professor Sheona MacLeod
Postgraduate Dean and Chair COPMED
Deputy Medical Director for Education Reform
Health Education England

2. The doctors in Training - Our Future workforce
Morale
Professionalism
Professional pride, value and self esteem
Improving working lives
Freedom to speak up
Leadership training
The ‘modern firm’

3. Health and wellbeing Time to think Time to reflect and learn
Time to relax
GoSW
Enabling Flexible working
Champions of flexible working

4. Demographics

5. The working environment -
Workload
Rota gaps
Patient expectations
Pressure on both learners and Educators
The GoSW
The Multi-professional team
Quality reviews
The regulators

6. Shape of Training Training to respond to patient/service needs
Service requires generalists and specialists
Training should be more flexible
Blurring the specialty / primary care/ secondary care interface
four UK Health Departments, GMC, HEE and worked as the UK Shape of Training Steering Group.
Report on Implementation published
Early pilots in Surgery and a Liaison psychiatry credential

7. GMC Curricular review
All medical curricula will need to be revised to fit with the new GMC standards
Internal Medicine Proposals Surgical training pilots
The definition of the credential is still being discussed
Excellence by design
Standards for postgraduate curricula.

8. Future career pathways

9. How to support Educators
Capacity
Capability
Motivation and inspiration
Connecting across the system
Learning with and from others
The need to protect time
Regulation

10. The Gold Guide
There is specific reference to bringing forward a CCT date.
LTFT trainees can undertake part time working whilst undertaking LTFT training. The reasons to consider going LTFT have been expanded.
Pausing training is essentially the ‘no fault’ extension to training.
ARCP Panels should consider and factor in any pauses in training meaning that a shorter period of time than expected has been available to make progress.
Any pauses in training should be agreed with the trainee, and sent to the Postgraduate Dean for approval. This should be clearly documented.

11. The Gold Guide
There is recognition of concern over whistleblowing; HEE will provide guidance and signposting for trainees to raise concerns when it is not appropriate to do so with the employer.
Reasons for considering OOPE have been expanded:
Gain professional skills that would enhance a trainee’s future practice.
Enhance clinical experience and skills related to the curriculum so the individual may experience or gain specific experience in an area of practice.
Support the recommendations in Global Health Partnerships.
There is clarity around: managing outcome 5s; managing OOPC, extensions to training.

12. Funding Brexit Climate of financial constraint
Recognising the value of education

13. Working across organisational boundaries
DMEs Clinical tutors
HoS and TPDs
Colleges and Regional Advisors
CQC and NHSI

14. Workforce Strategy for consultation
Draft Health and Care
Workforce Strategy for consultation

15. Facing the Facts
With over 350 the NHS has greatest range of roles in world, inc: non clinical
The Social Care workforce is larger than the NHS workforce
4m, 13.5% of all employed people work health or social care
The population has grown 2.1m (4%) since 2012, and aged
There are 40k NHS clinical vacancies, 92% covered by Agency/Bank
Nurses leaving the NHS grew from 7.1% to 8.7%
If retention had stayed the same there would 16k more nurses today

16. The Six System wide principles
The Six System wide principles
Securing the supply of staff the health and care system needs to deliver high quality care in the future.
Training, educating and investing in the workforce to give new and current staff flexibility and adaptability.
Providing broad pathways for staff so they have careers, not just jobs.
Widening participation in NHS jobs.
Ensuring that the NHS, and other employers in the system, are model modern employers.
Ensuring that in future service, financial and workforce planning are properly joined up.

17. The Draft Strategy Facing the facts, The NHS workforce in 2017
There are 40,000 more clinical staff substantively employed in the NHS now than in 2012;
Growth rates differ between professions and regions, but almost all professions and all regions have seen growth;
There are around 40,000 vacancies, mostly covered by Bank and Agency staff;
The NHS needs to do more to attract newly qualified staff and retain current staff because the current rate of growth is not as fast as it could be;

18. The Draft Strategy
Growth comes from three areas: new graduates; return to practice and recruitment from outside the NHS, alongside retention of current staff;
Education will grow to deliver nurse; AHP and medical graduates over the coming years;
New roles will grow the NHS and improve skill mix, but Retention of current staff has the most immediate impact on growth and quality of care;
We need to move towards self sufficiency for staff but also play our part in the wider world as a world class provider of education and training.

19. The Draft Strategy Workforce requirements beyond 2021/22
Workforce, finance and service planning must be better aligned to deliver the future we want and patients need;
If we do not reduce demand, change services or increase productivity the NHS will need 190,000 more staff by 2027;
On current rates the NHS will only grow by 72,000 over that period,
The system needs to reduce demand from 190,000 new staff and increase supply from 72,000 to find the best way of delivering a sustainable NHS.
Trusts will require further support to manage retention and productivity;

20. The Draft Strategy Shaping the future
The NHS needs better data and intelligence to deliver better planning;
A greater focus on public health will require development of public health workforce and support for the rest of the health and care workforce;
Only an engaged workforce can reduce variation and really delivery productivity that lasts;
Support, education and training, upskilling, and advanced clinical practice is vital

21. Education and Training
The future?
Education and Training