Regional review of medical education and training in Kent, Surrey and Sussex:

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1 Regioal review of medical educatio ad traiig i Ket, Surrey ad Sussex: Geeral Medical Coucil 1

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3 Itroductio This report draws together the overall themes of medical educatio ad traiig across Ket, Surrey ad Sussex i The fidigs come from our visits to four local educatio providers (LEPs), oe medical school ad oe local educatio ad traiig board (LETB) i the regio. Why did we choose Ket, Surrey ad Sussex? I 2014, we published a schedule of regioal visits, with the aim of visitig each regio ad coutry withi the UK over a seve-year period. * We visited Ket, Surrey ad Sussex i the early part of this schedule because of the legth of time sice we had last visited orgaisatios i the regio. What do we kow about the regio? Brighto ad Sussex Medical School (BSMS) is the oly medical school i Ket, Surrey ad Sussex. It had a total of 700 studets durig the academic year. The LETB, Health Educatio Ket, Surrey ad Sussex (HEKSS), is the body resposible for maagig postgraduate educatio ad traiig across the regio, ad is accoutable to Health Educatio Eglad (HEE). HEE has recetly itroduced four atioal directors ad four directors of educatio ad quality, each resposible for several differet LETBs. HEKSS is part of the Lodo ad South East geographical regio, alog with Health Educatio North Cetral ad East Lodo, Health Educatio North West Lodo ad Health Educatio South Lodo. * You ca read the schedule at Visit_Schedule_ pdf. Wales, the West Midlads ad Lodo are ot listed as they were visited i ad We last visited Brighto ad Sussex Medical School, ad HEKSS (formerly Ket, Surrey ad Sussex Deaery) i Geeral Medical Coucil 01

4 Itroductio What did we do? To better uderstad the experiece of medical studets ad doctors i traiig i Ket, Surrey ad Sussex, ad to esure that their experiece meets our stadards, we visited four LEPs as well as BSMS ad HEKSS betwee May ad Jue Our regioal reviews cosider several specialties ad stages of postgraduate traiig i more detail. We choose the areas for focus, based o our evidece as outlied below. For this review, we focused o the followig traiig programmes: foudatio The maps o pages 4 5 show the locatio of these orgaisatios. emergecy medicie We chose the four LEPs based o our ow evidece ad o iformatio from our etwork of regioal liaiso ad employer liaiso advisers. * We have well-developed evidece about postgraduate traiig, ad our aual survey of doctors i traiig has a very high respose rate. This survey gives us a great deal of iformatio o the quality of postgraduate traiig across the UK. I additio, the LETBs ad deaeries routiely update us o their progress i addressig cocers they have idetified through their local quality maagemet processes. We also receive a aual report from each medical school which helps us pla our visits, ad we udertake a survey of studets before each such visit. geeral surgery trauma ad orthopaedic surgery geeral iteral medicie (GIM). Durig the visits, we spoke to medical studets, doctors i traiig, their teachers ad supervisors, ad the maagemet teams of the orgaisatios. We also asked each orgaisatio we visited to give us further iformatio, before our visit, to help iform our review. * Regioal liaiso advisers work with doctors, patiets, medical studets ad others across Eglad to make sure we uderstad their eeds, ad to explai ad discuss the work we do. Employer liaiso advisers work with employers across the UK to create closer workig relatioships with the Geeral Medical Coucil (GMC). 02 Geeral Medical Coucil

5 Itroductio Evidece used to establish the focus of visits We survey all doctors i traiig across the UK oce a year. We looked at the results for Ket, Surrey ad Sussex ad how they compare atioally, to help us idetify areas to explore durig the visits. I this report, we ve summarised the regioal themes ad listed areas that are workig well ad those where improvemets are eeded. We ve also produced separate reports for each orgaisatio we visited. You ca read these detailed reports at Other sources of evidece we used to idetify which LEPs to visit ad which specialties to ivestigate durig the visits icluded: scheduled reports from HEKSS ad BSMS evidece collected through ehaced moitorig * self-assessmet by BSMS ad HEKSS data held by other regulators, icludig the Care Quality Commissio. * Ehaced moitorig is the process by which we support medical schools, deaeries ad LETBs to resolve safety ad quality issues i medical educatio ad traiig. Issues that require ehaced moitorig are those that we believe could adversely affect patiet safety, doctors progress i traiig, or the quality of the traiig eviromet. Geeral Medical Coucil 03

6 Itroductio Lodo Redhill Ashford Worthig Brighto 04 Geeral Medical Coucil

7 Itroductio Health Educatio Ket, Surrey ad Sussex* East Surrey Hospital William Harvey Hospital Royal Sussex Couty Hospital Worthig Hospital Brighto ad Sussex Medical School LETB Medical school * Please ote that Health Educatio Ket, Surrey ad Sussex is based i Lodo, outside of the Ket, Surrey ad Sussex geographical regio. LEP Geeral Medical Coucil 05

8 Regioal themes This report has a greater focus o postgraduate educatio as there is oly oe medical school i Ket, Surrey ad Sussex. Studets spoke highly of the curriculum delivery ad metioed early exposure to cliical practice ad patiets as positive aspects. The medical school is resposive to feedback ad cotiues to revise its curriculum based o the feedback from its medical studets. The support that studets receive at the school is also reflected i their resposes to the Natioal Studet Survey, where the school has cosistetly scored above 95% for studet satisfactio. Overall, HEKSS has robust quality maagemet systems ad maitais a good overview of the state of postgraduate medical educatio i the regio. However, we foud that there was a eed to re-evaluate the impact of requiremets ad recommedatios i visit reports. At our visit to the Royal Sussex Couty Hospital, doctors i traiig i GIM reported difficulties with receivig feedback from cosultats o their cotributios to the maagemet of patiets whom they admit overight. This related to a recommedatio made by HEKSS o a triggered visit i May 2014, which stated that the trust should review post-take arragemets to maximise educatioal opportuities. This was still a problem a year later at the time of our visit, suggestig that work eeds to be doe to make sure that requiremets ad recommedatios are followed up appropriately by HEKSS. May of the themes we idetified i postgraduate traiig across Ket, Surrey ad Sussex were the result of a heavy workload, with service pressures havig a impact o educatio ad traiig. 06 Geeral Medical Coucil

9 Regioal themes Safety of patiets ad doctors i traiig Withi Ket, Surrey ad Sussex, three areas are curretly subject to our ehaced moitorig process. * A additioal item was recetly closed, where chages made have resolved the issues. These chages have bee show to be sustaiable. Of the three ope items, oe relates to the safety ad effectiveess of the cliical service ad the educatioal experiece of doctors i geeral surgery traiig at William Harvey Hospital, part of East Ket Hospitals Uiversity NHS Foudatio Trust. Although the purpose of the visit to William Harvey Hospital as part of the regioal review was ot focused etirely o these issues, we did hear that there had bee a improvemet i the level of cliical supervisio for doctors i traiig i geeral surgery rotatios. The item will remai uder ehaced moitorig, to make sure that the chages made are sustaiable. Durig our regioal review, we idetified oe ew cocer at William Harvey Hospital, relatig to cliical supervisio of Foudatio Year 1 (F1) doctors i GIM over the weeked, ad limited access to educatio ad traiig, also i GIM. We heard that at the weeked i GIM there was a team cosistig of a seior urse, a more seior doctor i traiig ad a F1 doctor. Sometimes the more seior doctors i traiig were t available to supervise the F1 doctors, owig to a heavy ad upredictable workload, with limited backup at busy times. * Publishable ehaced moitorig cases ca be foud o the followig page of our website There was also a gap i shifts whe the more seior doctor o duty durig the day fiished at 5 pm ad the more seior doctor o the ight shift bega at 9 pm, which meat there was o support for the F1 doctor betwee these hours. We did hear that this was a improvemet o how out of hours had previously bee maaged at the weeked. But we foud that lack of supervisio is still a issue. Although the F1 doctors we met kew there was a cosultat o call, they were reluctat to cotact them directly. Owig to the heavy workload ad service pressures, there is also a lack of o-the-job traiig i GIM for F1 doctors ad more seior tiers of doctors i traiig. Cliical ad educatioal supervisors do recogise the impact that workload has o traiig, ad we heard that additioal doctors were beig recruited (i o-traiig posts) to help relieve the workload pressures. East Ket Hospitals Uiversity NHS Foudatio Trust wrote to us, statig that the rota has bee chaged to esure adequate cover betwee 9 am ad 9 pm at weekeds. Nie additioal o-traiig grade doctors have also bee recruited to help with capacity. We heard from both the trust ad HEKSS that there are log-term plas to trai ad recruit more physicia associates to support doctors across the regio. The trust iteds to survey doctors i traiig periodically, to make sure that their workload is reasoable ad supervisio arragemets are robust. At this stage, we have ot referred the matter to our ehaced moitorig process. However, with the help of HEKSS, we will cotiue to moitor progress. Geeral Medical Coucil 07

10 Regioal themes Termiology used i postgraduate educatio Durig our visits to the four LEPs, we foud that, at all sites, most doctors i traiig, educatioal ad cliical supervisors, ad members of the educatio maagemet team frequetly used terms such as seior house officer (SHO) or registrar. These terms do ot specify the level of doctor traiig, which makes it very difficult to differetiate betwee F1 doctors, Core Medical Years 1 ad 2 or geeral practice specialty doctors i traiig. The use of this termiology could lead to cofusio, as cosultats, urses ad other team members may ot be able to idetify the level of the doctor i traiig. We have idetified cotiued use of the term SHO through a umber of our regioal reviews ad it cotiues to be a issue across the UK. We are workig with orgaisatios, such as the Coferece of Postgraduate Medical Deas, to make sure that locally used termiology does ot have a detrimetal effect o educatio ad traiig or patiet safety. Variatios i hadover processes We leart that hadover was variable at three of the four LEPs we visited durig the review. From our meetigs with doctors i traiig ad cosultats, it seems that arragemets for hadover are more formalised i some specialties tha others. We heard that ofte there was o dedicated resource room for hadover. The seior maagemet teams at LEPs gave us some reassurace that improvemets to hadover across specialties were ogoig, as the trusts are workig with HEKSS o a iitiative called Quality ad Iovatio i Educatio (EDQUIN) i this area. The aim of this iitiative is to improve the atioal traiig survey results. As hadover was a below outlier i several programmes, this is a key area of focus for improvemet. HEKSS expects progress will be apparet i the results of the 2016 atioal traiig survey. Although East Surrey Hospital was oe of the sites where hadover was recogised as beig variable, the iitiative appears to be havig a positive effect already, as this LEP had below outliers for hadover i medicie i the 2014 atioal traiig survey but oe i Geeral Medical Coucil

11 Regioal themes Hadover at Royal Sussex Couty Hospital The doctors i traiig we met told us that there is variatio i hadover across differet departmets. Foudatio Year 2 (F2) doctors were positive about hadover ad iformed us that although hadover processes eed more formalisatio, especially i the afteroo, ad improvemets are eeded i tertiary specialties, they do geerally work. F1 doctors ad higher grades of doctors i traiig reported that hadover processes seem to be a cocer i geeral surgery posts. The curret hadover system is ot robust eough to esure that patiets are always reviewed i a timely fashio. Limited access to supervisio We heard of challeges i providig appropriate supervisio, especially for foudatio doctors. This was largely due to rota gaps ad service pressures. A umber of doctors i traiig we met told us that access to supervisio was limited at times, ad that they ofte had to search for supervisors who were busy attedig to patiets. Some doctors i traiig thought that the lack of supervisio ecouraged them to use their iitiative; however, workig beyod competece has the potetial to compromise patiet safety. We heard that the majority of issues regardig hadover related to the iefficiet electroic system used by the trust. Doctors i traiig have to iput iformatio electroically oto the system, but the use pritouts ad hard copies for trasfer of patiets. This type of procedure poses a risk to patiet care, as patiets may ot be see i a timely maer. For the same reasos, the hadover betwee differet uits ad sites is also ot effective ad ca make patiet trackig difficult. Geeral Medical Coucil 09

12 Regioal themes Seior support for doctors i traiig i surgical posts at East Surrey Hospital Foudatio doctors i surgical posts did ot feel fully supported durig o-call ight shifts. We heard that, at ights, a F2 doctor was usually the most seior doctor coverig four or five surgical wards as well as ew admissios. A cosultat was available for support o site, ad a higher grade doctor i traiig was available o the phoe, but ot always preset o site. The foudatio doctors we met told us that the workload is usually maageable, but there are times whe it gets very busy with ew admissios ad they eed further support. Seior doctors i traiig were reported to be sometimes reluctat to come ito the ward at ight. The trust maagemet is aware of these problems i surgery wards ad has bee workig o solutios to support doctors i traiig. It has recetly appoited a advaced urse practitioer to support service work o the wards. The trust has also issued a ew policy o appropriate bleepig, to make sure doctors i traiig are t disturbed uecessarily durig their shift. I additio, the trust maagemet has icreased the umber of F2 doctors from two to three, to cover the surgical wards durig ight shifts. The surgical doctors i traiig we met told us that, although there was always someoe available to supervise, it was ot always clear whom they should cotact for seior support ad the situatio could become overwhelmig whe they were very busy. The foudatio doctors we met told us that they had ot come across ay patiet safety issues. The potetial problem was greater durig weekights rather tha weekeds, whe there was always a cosultat available to support. The workload was also reported as a below outlier i the 2014 atioal traiig survey. 10 Geeral Medical Coucil

13 Regioal themes Feedback from icidet reportig With the exceptio of East Surrey Hospital, we foud that there was a lack of feedback from icidet reportig across the regio. Whe doctors i traiig report cliical icidets through Datix (a healthcare risk maagemet applicatio), they seldom receive feedback o the resolutio of issues. LEPs are missig a importat learig opportuity, as doctors i traiig could beefit from aalysig the icidets. However, doctors i traiig at East Surrey Hospital reported that they do receive feedback o the icidets they report. Service pressures impactig o educatio Service pressures also impact o learig opportuities, either by reducig opportuities for o-the-job learig or by reducig the time available to atted teachig. I additio, the workload at some LEPs is particularly high, which meas that doctors i traiig are too tired to make the most of the learig opportuities that take place followig their shifts. Icidet reportig at Worthig Hospital We heard o several occasios that whe doctors i traiig report cliical icidets through Datix, they rarely receive feedback o these issues. The Director of Medical Educatio said that he reviews Datix reportig o a mothly basis ad decides whether the icidets have ay educatioal ramificatios. He stated that it is ormal ot to report back o each case, as the educatio team would first eed to triagulate the evidece with the local faculty groups ad data held o the doctor ivolved. He also told us that the educatio team has a good awareess of what the risks are ad makes every effort to aalyse treds. While the educatio team may be aware of the issues beig reported through Datix, doctors i traiig of all grades felt that Datix was ot beig used to its full potetial. They told us that lessos could be leart from aalysig the icidets to see how they could be preveted i the future. Geeral Medical Coucil 11

14 Regioal themes Workload itesity at William Harvey Hospital We had cocers about workload itesity ad its impact o traiig. We heard examples of doctors i traiig beig uable to access traiig ad supervisio, ad some said they were workig 60 hours i a week this is beyod the legal maximum accordig to the Workig Time Directive. We met with foudatio doctors i traiig from a umber of differet specialties, who were uimpressed by the lack of opportuities for educatio ad traiig at William Harvey Hospital. They told us that they were beig used almost exclusively for service, ad whe traiig opportuities arose they were ofte too tired to atted. F2 doctors o surgical rotatios said that they were rarely able to go ito theatre. They attributed this issue to the problems the trust was havig recruitig middle grade surgeos, which meat that they were left staffig the wards ad rarely able to atted protected teachig. We heard that teachig sessios are badly plaed, with agedas beig set out o the same day as the sessios occur ad that they are ofte subject to last-miute cacellatio. Sometimes whe sessios are cacelled, the foudatio doctors i traiig deliver presetatios that do ot cover curriculum requiremets. Furthermore, the sessios are ot bleep free ad doctors i traiig ca ofte be called out to atted to patiets. F1 doctors were of the opiio that their educators had little time for teachig, owig to their workload, ad as a result they felt ill-prepared to progress to F2. Workload patters ad itesity of work at Worthig Hospital The majority of the doctors i traiig we met stated that their workloads ofte prevet them from accessig educatioal opportuities. Doctors i traiig o GIM placemets reported that their ight shifts should be from 9 pm to 10 am. But they are ofte still fiishig jobs or doig the post-take ward roud at am. This meas that they are tired ad uable to assimilate learig. Some doctors i traiig stated that they are eve too tired to drive home after their shifts. This issue was recogised by the cliical ad educatioal supervisors we met. But they felt that doctors i traiig fiishig their shifts at am was the exceptio rather tha the rule. 12 Geeral Medical Coucil

15 Good practice ad areas where there have bee improvemets Regioal reviews are largely risk based we idetify where there might be problems ad our visits ca help to resolve these issues. But we do hear of good practice ad areas where risks have bee idetified ad successfully maaged locally, leadig to improvemets, which we have observed durig our visits. The positive fidigs from our regioal review of Ket, Surrey ad Sussex are detailed below. Geeral Medical Coucil 13

16 Good practice ad areas where there have bee improvemets More supervisio of doctors i traiig Durig our visit to William Harvey Hospital, we heard that there had bee a improvemet i the level of cliical supervisio for doctors i traiig i geeral surgery rotatios. Oe of the below outliers i the 2014 atioal traiig survey related to supervisio i geeral surgery. This o loger appears to be a issue at William Harvey Hospital, as foudatio ad other doctors i traiig i geeral surgery we met praised the support available to them from supervisors. Doctors i traiig advised that, eve late at ight, cosultats will come i whe a doctor i traiig feels out of their depth with a critically ill patiet. The 2015 atioal traiig survey supports this assertio, ad cliical supervisio at William Harvey Hospital is o loger listed as a outlier. Educatio maagemet We foud that the Chief Executives ad the seior maagemet teams at Surrey ad Sussex Healthcare NHS Trust ad Brighto ad Sussex Uiversity Hospitals NHS Trust play a importat part i educatio. There is represetatio for educatio at board level ad it features i both trusts future plas. This was highlighted as a area of good practice at Surrey ad Sussex Healthcare NHS Trust, as we heard that the Chief Executive ad seior maagemet team had bee successful i their efforts to keep educatio i focus. This was oted as a area of improvemet at Brighto ad Sussex Uiversity Hospitals NHS Trust. However despite their best efforts, there are still some areas that require the trust s attetio. These are detailed withi the idividual site report for Brighto ad Sussex Uiversity Hospitals NHS Trust. 14 Geeral Medical Coucil

17 Good practice ad areas where there have bee improvemets Educatio maagemet at Surrey ad Sussex Healthcare NHS Trust Durig our visit, we leart that the trust s Chief Executive ad seior maagemet team have a kee iterest i educatio ad are very well iformed about educatio matters. They provide excellet support to the educatio faculty ad the Postgraduate Medical Educatio Cetre ad have prioritised educatio i their ageda. The Chief Executive ad seior maagemet team uderstood educatioal matters i detail. They make sure that educatio is represeted at board level ad that problems related to educatio get the attetio ad resources they require. Through various meetigs with doctors i traiig ad educatioal supervisors, we heard that the Chief Executive has made himself visible ad accessible. The doctors i traiig told us that they meet regularly with the Chief Executive ad he is aware of the problems ad challeges they ecouter ad is committed to resolvig them. Doctors i traiig told us that the seior maagemet team is egaged ad supportive ad always willig to work with them towards fidig solutios for problems related to their educatio. Overall educatioal experiece ad educatio maagemet at Brighto ad Sussex Uiversity Hospitals NHS Trust Doctors i traiig ad medical studets we met were geerally satisfied with the overall educatioal experiece at the Brighto ad Sussex Uiversity Hospitals NHS Trust. They appreciated the support they got from seior doctors ad the educatio maagemet team ad the kee iterest that the Chief Executive has take i their traiig ad experiece i the trust. Medical studets also reported that their placemets i the trust have a positive educatioal value. This was oted as a area of improvemet for the trust, as the atioal traiig survey data show that, for doctors i traiig i GIM, the overall satisfactio has improved from 2014 to 2015 ad we recogise this as a positive step forward. However, fidigs from our visit suggest that there are still some areas that require the trust s attetio, such as further improvemets i GIM. Some of these issues iclude support from seior doctors for doctors i traiig, ad feedback, as highlighted i the trust s idividual report. Geeral Medical Coucil 15

18 Good practice ad areas where there have bee improvemets Improvemets i icidet reportig Although icidet reportig was highlighted as a issue at three of the four LEPs visited, we foud there had bee a improvemet i icidet reportig at East Surrey Hospital. The doctors i traiig we met at this hospital told us that they are ecouraged to report ay icidets they come across. They also told us that their icidet reportig forms are straightforward ad easy to fill i ad that they have geerally received timely feedback o the cases they have reported. The improvemet i the mechaisms regardig patiet safety is also supported by our evidece, as there has bee a reductio i the umber of patiet safety commets i the atioal traiig survey from 2013 to Operatio gree flag Operatio gree flag is a iitiative at Wester Sussex Hospitals NHS Foudatio Trust to tackle the red flags from the 2014 atioal traiig survey. The trust is workig with HEKSS o a iitiative (EDQUIN) of which oe of the aims is to improve the results i the atioal traiig survey. There is clear improvemet for the trust whe comparig the results of the 2015 atioal traiig survey with those of the 2014 survey. The results of the 2015 atioal survey show that the trust has reduced the umber of red flags ad has almost doubled the umber of gree flags compared with the results of the 2014 survey. This meas that the perceptio of doctors i traiig of the quality of the educatio they are gettig at this trust is sigificatly better tha it was. Oe of the areas where there had bee red flags previously was iductio, ad we heard how the trust had made chages to improve these results. Further iformatio o this ca be foud i the idividual site report. 16 Geeral Medical Coucil

19 Good practice ad areas where there have bee improvemets Friedly pharmacist iitiative Pharmacists i the Brighto ad Sussex Uiversity Hospitals NHS Trust have bee usig various prescriptio cases reported o Datix to teach ad provide feedback to doctors i traiig. F1 doctors are each liked with a pharmacist, with whom they have regular meetigs to discuss cases reported o the icidet system. The pharmacists also use these meetigs to track the progress of each F1 doctor. Other departmets i the trust would beefit from adoptig this approach to usig the feedback o cases reported o the icidet system as a tool for educatioal purposes. The friedly pharmacist iitiative is a good example of usig feedback successfully as a learig tool. Durig our visit, we explored the cooperatio betwee the two uiversities ad heard from the seior maagemet team at BSMS, that they feel that the two paret uiversities have bee very syergistic ad cosistet. The school has a ew Dea, who has bee i post sice December He ad the school maagemet team are very committed to ad supportive of studets ad their educatio. We idetified two areas of good practice durig our visit to the school. The school s ew Time for Demetia programme, which allows studets to egage with various support groups ad commuity settigs that deal with patiets with demetia. Udergraduate educatio ad traiig BSMS was formed as a partership of the Uiversity of Brighto ad the Uiversity of Sussex i As part of our ew school quality assurace process, we visited BSMS each year from 2002 util 2008, whe it was added to the list of bodies that ca award UK primary medical qualificatios. The BrightMed programme, which is a outreach programme that egages with secodary school studets i the local commuity. The aim of the iitiative is to idetify youg people with the potetial to become future doctors ad who ca cotribute towards icreased diversity withi the medical professio. The programme is a good example of the school egagig with the local educatioal cotiuum ad wideig participatio i medical educatio by ecouragig studets from a variety of backgrouds to apply to medicie. Geeral Medical Coucil 17

20 Good practice ad areas where there have bee improvemets Maagemet of postgraduate educatio ad traiig Accordig to our 2015 atioal traiig survey, there were 3,525 doctors i traiig ad i a post maaged by HEKSS across the regio at time of the survey cesus (24 March 2015), icludig 1,691 i foudatio traiig. There are 27 Local Educatio Providers (LEPs) withi the boudaries of Health Educatio Ket, Surrey ad Sussex, of which 11 are acute trusts, three are metal health trusts, oe is a specialist hospital, ad 12 are geeral practice traiig providers. I additio there are 10 LEPs i the South Lodo geographical area. Of these 37 LEPs, 36 provide foudatio traiig maaged by the South Thames Foudatio School ad 10 provide specialty traiig. We met with a group of lay represetatives from a variety of backgrouds who were recruited to represet the public iterest ad provide a exteral view. Lay represetatives routiely participate i recruitmet, ARCP paels ad visits, ad are cotracted to work for the LETB for betwee three ad five years. The lay represetatives advised us that they felt well supported by HEKSS ad that this was due, i part, to the learig ad developmet opportuities available to them, which iclude equality ad diversity, assessmet ad aual refresher traiig combied with feedback o performace. We idetified the followig area of improvemet at HEKSS. We idetified the followig areas of good practice at HEKSS. The traiig programme directors of the Schools of Medicie, Surgery ad Emergecy Medicie coduct iterim reviews approximately four to six moths ito a placemet, to track the progress of doctors i traiig ad esure that they are prepared for their Aual Review of Competece Progressio (ARCP). This is a useful progress check ad has the potetial to reduce the umber of outcome 5s (which meas additioal traiig time is required) at the ARCP. Due to cosistet low scores i the NTS, i December 2014, HEKSS itroduced a iitiative called EDQUIN which is a framework that supports excellece i multi-professioal educatio ad traiig. The aim for EDQUIN i 2014/15 is to target the NTS scores i 2015/16 ad at the time of our visits there were already some idicatios that this iitiative is begiig to have a effect. We are kee to moitor progress of EDQUIN as it clearly has the potetial to improve the educatioal experiece for doctors i traiig. 18 Geeral Medical Coucil

21 Next steps for Ket, Surrey ad Sussex Followig our visits to BSMS ad to HEKSS, we have set out requiremets ad recommedatios for each orgaisatio i our detailed visit reports, which you ca read at Geeral Medical Coucil 19

22 Next steps for Ket, Surrey ad Sussex Through scheduled reports, BSMS ad HEKSS will update us o their progress towards meetig these requiremets ad recommedatios. HEKSS will moitor updates o the requiremets ad recommedatios from the LEP visits ad will report back to us. We ll also look at how to share the areas of good practice with other stakeholders. Part of this sharig will be a regioal day that we ll host i October 2015, to which we have ivited represetatives from BSMS, HEKSS ad the four LEPs we visited i Ket, Surrey ad Sussex. We look forward to workig with the ewly appoited Dea of HEKSS, ad cotiuig to support all our stakeholders i Ket, Surrey ad Sussex. We ll meet regularly with them to give advice ad assistace to make sure that ay challeges i meetig the requiremets ad recommedatios of the regioal review ca be addressed. We will also take our learig from this review ad apply it to the regioal reviews of East of Eglad ad South West, which are scheduled for Geeral Medical Coucil

23 Regioal themes Geeral Medical Coucil 21

24 Website: Telephoe: Geeral Medical Coucil, 3 Hardma Street, Machester M3 3AW Textphoe: please dial the prefix the to use the Text Relay service Joi the likd.i/gmcuk facebook.com/gmcuk youtube.com/gmcuktv To ask for this publicatio i Welsh, or i aother format or laguage, please call us o or us at publicatios@gmc-uk.org. Published October Geeral Medical Coucil The text of this documet may be reproduced free of charge i ay format or medium providig it is reproduced accurately ad ot i a misleadig cotext. The material must be ackowledged as GMC copyright ad the documet title specified. The GMC is a charity registered i Eglad ad Wales ( ) ad Scotlad (SC037750) Code: GMC/RRKSS/1015

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