Mental Health training in Foundation Programmes
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- Barnaby Mitchell
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1 Mental Health training in Foundation Programmes Paul Baker Deputy Postgraduate Dean Health Education North West
2 Overview What is foundation training? National and regional context Role of clinical supervisor Post content Meeting curriculum needs Developing trainers Foundation teaching programmes Quality assurance Hot topics
3 What is Foundation training? Created 2006 Part of Modernising Medical Careers Replaced pre-registration house officer posts and aspects of SHO posts 2 year programme usually in 6 x 4 month posts Overseen by Foundation Programmes
4 Foundation Year 1 Foundation training is a two-year programme But with two definite waypoints ARCP at end of year 1 Sign off entitles trainee to full GMC registration
5 Foundation Year 2 ARCP end of year 2 Sign off entitles trainee to foundation achievement of competence document (FACD) Requirement for entering speciality/gp training
6 National context 2006 Slow start for Psychiatry speciality Patchy
7 National context 2010 Foundation for excellence Collins Distribution of posts by specialty does not reflect current/future workforce needs of NHS Predominance of medical and surgical posts Insufficient emphasis on community work and chronic disease Workforce projections require 6% of doctors to train as psychiatrists
8 National context Speciality recruitment issues 2014 Broadening the Foundation Programme 7.5% placements in mental health i.e. 45% of trainees will experience it 100% community placements
9 National context Variation in implementation Some deaneries exceeded target Some struggling ( it can t be done! ) concerns over standards
10 NW : mental health posts
11 Foundation programmes and mental health trust posts FY1+2
12 Mental health trusts and foundation posts FY1 + 2
13 Quality
14 Quality
15 Quality
16 What s different from psychiatry? They are not trainee psychiatrists Separate educational / clinical supervisor Educational supervisors not usually psychiatrists Higher level of supervision required for clinical work
17 What s different from psychiatry? Curriculum SLEs not WPBAs eportfolio Clinical supervision group identified
18
19 Structured learning events (SLEs) Similar to WPBAs but not scored Free text comments and developmental action points
20 Structured learning events (SLEs) Reflective practice by trainee Mini CEX Directly Observed Procedural Skill DOPs Case based discussion Developing the clinical teacher Aim for 1 per month of each type Minimum 1 per placement of each type by CS
21 Role of clinical supervisor Initial meeting to discuss expectations, learning opportunities etc Undertaking and facilitating SLEs Giving regular feedback and collating feedback from the placement supervision group Discussing any concerns with Educational Supervisor (performance, health, professional conduct) Completing End of placement report and provide a summative (pass/fail) assessment on the 4 months
22
23 Content of posts Guidance documents from Royal College of Psychiatrists Enthusiastic trainer with time to supervise Old age and liaison popular Ward based allows for clearer role Community work useful for managing long term conditions Some specialist posts eg mother and baby unit
24 Foundation competencies for psychiatry Consent : Understanding capacity and best interests Legal framework: Understand and apply basic principles of Mental Health Act and use of restraint Undertakes regular patient reviews Ordering investigations, documenting reviews, understanding link between mental and physical health
25 Foundation competencies for psychiatry History and examination: Undertake a mental state assessment Understand principles of child protection Safe prescribing Manages patients with long term conditions Health promotion and public health Impact of drug and alcohol misuse Physical morbidity in severe mental illness Deprivation and health
26 Competencies and SLEs Take a detailed history including physical, psychological and social factors Carry out Mental State Examination Assess cognitive function Communication skills Summarise and document information Understand assessment of capacity, use of Mental Capacity Act and Mental Health Act
27 Developing trainers Foundation with School of Psychiatry Appointed lead Accredit trainers Accredit environments Tutors and DMEs Need for more training in foundation requirements, portfolio etc GMC Approval of trainers
28 Foundation teaching programmes Average one session per week in NW Please volunteer Good way to develop local links Skills acquisition Role play / simulation
29 Hot topics / troubleshooting Feeling left behind, first cohort of FY1s On call FY2 Prescribing What to do when things are going wrong? Close contact with FPD May need to consider moving posts
30 Summary It can be done Psychiatrists can train
31 Thanks for listening! Keep in touch
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