Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING DME Self-Assessment Template Name of Trust: ASHFORD AND ST. PETERS Specialties being visited: A+E, ACCS,GP and Rheumatology Programme Name of DME: Date of visit: DR PETER MARTIN 18 TH MARCH As your Trust is due to be visited by a team from Health Education KSS, you are asked to complete a self assessment of training in your Trust in conjunction with the relevant Clinical Tutors. Please use this form to make a note of any areas of concern or notable practice. Please also describe any actions you have taken or are planning. A bundle of documents containing the most recent information from various sources about your Trust and the specialties that will be visited has been sent to you in the form of a online webpage. This webpage includes the GMC standards document, The Trainee Doctor, which should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the visiting team prior to the visit. All members of the visiting team will also be provided with the bundle of documents. They will use these documents together with your self assessment to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice Very busy A+E department with new consultants appointed 2 new paediatric consultants appointed with shop floor time at weekends and evenings to support the trainees Good trainee feedback about Rheumatology after a triggered visit in the past at ASPH in 2010 Rheumatology consultant at ASPH is currently the TPD. ACCS Posts are new to the Trust and we will need to see how the trainees have settled in along with the trainers. Good and proactive College Tutors in A+E and anaesthetics. College Tutor for Medicine is the Rheumatology TPD Good GP experience in a busy A+E
Good Paediatric experience Surgical experience may be too busy at weekends. Areas / Issues of Concern Often too busy A+E despite new consultants and resources. Previous lack of Specialty nurses in Rheumatology GP trainees in surgery very busy Previous undermining in O+G to a GP trainee has been addressed. Recent BLACK status in A+E due to increase workload leading to cancelling of educational events Actions Planned / Taken New consultants appointed in A+E More consultant out of hour shifts to support trainees New Emergency care pathway end of 2013.
Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING Pre-Visit Template Name of Trust: Ashford St Peter s Specialties being visited: Emergency Medicine, ACCS, GP Name of Visitor: Glyn Williams Date of visit: 18th March 2014 Thank you for agreeing to participate in this visit to a Local Education Provider on behalf of Health Education KSS. You have been provided with a bundle of documents containing the most recent information from various sources about the Trust and the specialties you will be visiting. As you review the bundle, please use this form to make a note of any areas/issues of concern, notable practice or issues requiring clarification/further investigation. The accompanying GMC standards document, The Trainee Doctor, should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the other members of the Visiting Team for information. The Lead Visitor will use these notes to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice EM All consultants have QESP and new consultants were put through this promptly EM Departmental teaching well attended Overall good LFG & LAB processes demonstrated High levels of support from Education Centre, MEM and faculty admin staff
Areas / issues of concern Issues requiring clarification / further investigation EM numerous vacancies & unfilled posts is this affecting supervision & experience of trainees Anaesthetics undermining in theatres has issue been addressed since LAB Jan 14 Leadership projects by trainees
Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING Pre-Visit Template Name of Trust: Ashford St Peters Specialties being visited: Emergency Medicine Name of Visitor: Geoff Bryant Date of visit: 18/03/2014 Thank you for agreeing to participate in this visit to a Local Education Provider on behalf of Health Education KSS. You have been provided with a bundle of documents containing the most recent information from various sources about the Trust and the specialties you will be visiting. As you review the bundle, please use this form to make a note of any areas/issues of concern, notable practice or issues requiring clarification/further investigation. The accompanying GMC standards document, The Trainee Doctor, should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the other members of the Visiting Team for information. The Lead Visitor will use these notes to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice Areas / issues of concern 2 red flag areas Local Teaching & Handover 2x SPA per week which includes educational supervision is given to education supervisors this is low. What is the issue with support from Anaesthetics in A&E, including Paediatric Anaesthetics? LFG 23/12/2013. Vincent O Neill is Foundation Year 2 Lead. Who is College Tutor? Lead Consultant?
Unplanned middle grade absence 3 years ago Low consultant numbers still? Issues requiring clarification / further investigation Have the changes to Local Teaching & Handover been effective Is there specified SPA time for Educational Supervision & College Tutor or is it mixed in with all 2 SPAs. What was the outcome of their internal survey? LFG 23/12/2013 What is the configuration of CT3 PEM training? Who is the PEM Clinical Supervisor? Is there adequate CT Interpretation at night? Any occasions of unplanned uncovered middle grade absence?
Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING Pre-Visit Template Name of Trust: Ashford and St Peter s Specialties being visited: ACCS/Emergency Medicine/GP Name of Visitor: Alister Seaton Date of visit: 18/3/14 Thank you for agreeing to participate in this visit to a Local Education Provider on behalf of Health Education KSS. You have been provided with a bundle of documents containing the most recent information from various sources about the Trust and the specialties you will be visiting. As you review the bundle, please use this form to make a note of any areas/issues of concern, notable practice or issues requiring clarification/further investigation. The accompanying GMC standards document, The Trainee Doctor, should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the other members of the Visiting Team for information. The Lead Visitor will use these notes to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice Areas / issues of concern Lack of regular recovery staff in the evenings in theatres Anaesthetics undermining in theatre mentioned in LAB meetings clarification? Issues requiring clarification / further investigation Issues regarding support from Anaesthetics in A&E patient safety issue? Consultant s having to sign off on diary card exercises No response from EM on involvement in simulation training
Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING Pre-Visit Template Name of Trust: Ashford St Peter s Hospital Specialties being visited: Emergency Medicine Name of Visitor: Claire McHale Date of visit: 18th March 2014 Thank you for agreeing to participate in this visit to a Local Education Provider on behalf of Health Education KSS. You have been provided with a bundle of documents containing the most recent information from various sources about the Trust and the specialties you will be visiting. As you review the bundle, please use this form to make a note of any areas/issues of concern, notable practice or issues requiring clarification/further investigation. The accompanying GMC standards document, The Trainee Doctor, should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the other members of the Visiting Team for information. The Lead Visitor will use these notes to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice Formal handover sessions in the morning and at night All consultants QESP trained LFG meetings appear to function well, well attended Areas / issues of concern Mention in LFG minutes that foundation year 2 doctors are not required for handover can this be clarified? What were the GMC flags for this year? Mention made in previous visit (2010) of difficulty obtaining CT head reports out of hours and ED doctors asked to report has this been addressed? Under attendance by trainees at teaching and possible causes. Induction for middle grade doctors Paediatrics supervision for CT3
Night shift support competencies of middle grade doctors WPBA ease of completion and training for seniors WPBA DOPS procedures especially with regard to chest drain insertion Issues requiring clarification / further investigation Departmental teaching Is it possible to get the minutes for the LFG on 24 th Feb Mention made of a benchmarking exercise at Royal Surrey is this of interest to the Deanery Visit?
Health Education Kent, Surrey and Sussex QUALITY MANAGEMENT OF SPECIALTY TRAINING Pre-Visit Template Name of Trust: Ashford and St Peter s Hospital NHS Foundation Trust Specialties being visited: ACCS, EM and GP; Rheumatology Rotation Review (Surrey) Name of Visitor: Jane Reynolds Date of visit: 18 March 2014 Thank you for agreeing to participate in this visit to a Local Education Provider on behalf of Health Education KSS. You have been provided with a bundle of documents containing the most recent information from various sources about the Trust and the specialties you will be visiting. As you review the bundle, please use this form to make a note of any areas/issues of concern, notable practice or issues requiring clarification/further investigation. The accompanying GMC standards document, The Trainee Doctor, should be used to help you focus on key areas and ensure adequate coverage of issues. Your notes will be sent to the other members of the Visiting Team for information. The Lead Visitor will use these notes to identify areas requiring further investigation, which will be followed up on the visit. Please return your completed form to quality@kss.hee.nhs.uk Please Note: This form must be typed and sent by email as a Word document. Handwritten and scanned forms cannot be accepted. Areas of Notable Practice LAB: (3/7/13) Angela Langwith-Green has pulled together a Medical Education issues report including patient safety issues raised from various sources. LAB (19/11/13): a private company has been commissioned to do a review of handover and certain Trusts to look at good practices and approaches. ASPH is one of the chosen Trusts. Rheumatology rotation (Surrey) review: I note that at the Royal Surrey, there is mention (10/4/13 LFG) of an innovative simulation programme: How to be a good Registrar, and the LAB material gives detail of other initatives. Surrey and Sussex: Very impressive trainee attendance at LFG 7/3/13
Areas / issues of concern Please see below. Issues requiring clarification / further investigation Emergency Medicine: Attendance at LFGs seems sparse; the Minutes do not give attendees roles so it is difficult to understand who was there.the Minutes state trainee reps leave meeting, but what trainee representatives were present?? LAB (3/7/13) Minutes say more medical and A & E Consultant involvement is required in simulation training What presence does HEE-KSS have at LAB meetings? It seems sparse. LAB: Trainee representation sparse; Medical Director did not attend or send apologies (3/7/13); Medical Director and Deputy Medical Director sent apologies (19/11/13); Deputy Medical Director attended 11/2/14. LAB (19/11/13): a general complaint was made about the number of different logins and passwords staff has (sic) ; a small matter but it sounds as if it is very annoying! Another small point: LAB attendance always lists doctors and surgeons with their (prefix) titles; in the interest of equality, shouldn t other attendees have titles? And another VERY small point: why does the LAB (and other ASP material) always refer to EWTD not EWTR regarding rotas?! GMC survey: ACCS one red flag (Regional training), one pink flag (feedback); Emergency Medicine one pink flag (access to educational resource). Patient safety concerns documentation: a disquieting entry regarding Emergency Medicine (and another regarding General (internal) medicine. Rheumatology (Surrey) review: As I have said in earlier submissions of my pro formas as the Lay Member, it is difficult to discern what material is of specific significance to the rotation being reviewed. I wish there were an executive summary in the bundle (? written by the TPD) to facilitate understanding of the key issues to be addressed on the visit.. Being limited in my ability to discern the key issues appertaining to Rheumatology, I can only comment on some elements of the documentation. I have raised, before, the importance of all material in the bundle being clearly headed with the Trust s name; it s a small point, but it would make understanding quicker. ASP LFG (Medicine) involvement of trainees seems allright, and I note Dr Rod Hughes was (27/9/13) working hard to ensure that attendance at the LFG is improved. Not much success seems to have been achieved by the 13/12/13 meeting. Royal Surrey LFG (10/4/13) mentions that mock interviews/st application support would be welcome LFG (10/7/13) says (regarding handover arrangements) Consultant input is disappointing.strange comment about provision of tea/coffee for Wednesday teaching being needed to improve morale and attendance Trainee attendance at LAB seems non existent. Surrey and Sussex LFG (7/3/13) mentions repeated clerking of individual patients by several members of a team.???; LFG (13/6/13) Still outstanding small group to be formed from Haematology and Rheumatology to discuss and provide solution to the issue raised at the previous LFG meeting. Repeating what I have said earlier in a different context: how active is HEE-KSS s engagement with the
several LABs? Attendance/sending of apologies for meetings seems less than might be expected..