Induction, Core Training and CPD Recommendations for Doctors and Nurses providing Healthcare and Forensic Services to People in Custody A questionnaire was sent to NHS Board managers responsible for developing local services to provide health care and forensic services to people in police custody. The objective was to establish current and anticipated training requirements in relation to developing this new workforce. Five responses were received covering 9 NHS Boards. The questionnaire is included in Appendix A. This has allowed the NHS Education for Scotland (NES) and the Training and Education subgroup of the National Coordinating Network for People in Police Care to identify training needs for Scotland, both in relation to the provision of existing NES course such as the Introduction to the Forensic Medical Examiner; New to Forensic Medicine A teaching programme; and What s New in Forensics, as well as potential demand for other topics. This paper pulls together the suggested requirements, and where / how these can be accessed. 1
Induction An example from NHS Lothian includes: Corporate induction Basic life support with airway management and anaphylaxis. Workshop: alcohol misuse Workshop: medication management Workshop: drugs awareness Suicidality Domestic violence Managing personality in Police Custody Dealing with complaints: PIRC Managing suspects of child sexual abuse Understanding the trauma of rape and sexual assault. Introduction to the NHS Equality and Diversity Training Module Information Governance and Data Protection Child & Vulnerable Adult Protection Confidentiality Provided locally by NHS Boards. Lear pro modules available. Provided locally by NHS Boards. Learn pro modules available. Protecting Children & Young People: GMC (2012). Child Protection Training is offered through the Royal College of Paediatrics & Child Health www.rcpch.ac.uk General Medical Council Confidentiality 2009 - http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality.asp Consent Consent, confidentiality and ethics Age of Legal Capacity (Scotland) Act 1991 covered in An Introduction to the Role of Forensic Medical Examiner Course Consent guidance: patients and doctors making decisions together http://www.gmc-uk.org/guidance/ethical_guidance/consent_guidance_index.asp 2 Consent, confidentiality and ethics Age of Legal Capacity (Scotland) Act 1991 is covered in An Introduction to the Role of Forensic Medical Examiner Course
Introduction to the workplace Health and Safety at Work Module, including First Aid Police Standard Operating Procedures Adastra Training Infection Control Provided locally by NHS Boards Provided locally by NHS Boards Provided locally by NHS Boards. Advanced Health and Care provided initial training the trainer training. Provided locally by NHS Boards Introduction to the Clinical Requirements of the job Clinical Staff will be recruited from a variety of backgrounds but should have achieved a basic level of healthcare knowledge and skills. It is recommended that an educational needs assessment is used to establish any areas of weakness that might benefit from refresher or enhanced training. Advanced Clinical Assessment Provided by the University of Stirling. This module will provide an introduction to advanced clinical assessment. It combines the skills of clinical history taking with those of physical examination. Drug and Alcohol Intoxication & withdrawal http://www.stir.ac.uk/health-sciences/courses/cpd/modules/cpd/advanced-clinical-assessment.html Provided locally by NHS Boards Assessment of alcohol / drug intoxication & withdrawal including forensic & medical implications covered in An Introduction to the Role of Forensic Medical Examiner Course NHS Health Scotland delivers Alcohol Brief Interventions training and is looking to pilot some training with Eleanor McWhirter in police custody details tbc http://www.healthscotland.com/topics/health/alcohol/alcohol-brief-interventionscommunications-and-guidance.aspx#training and Learning School of Forensic Mental Health offer a short course on Developing a standardised approach to the assessment of substance misuse in Mentally Disordered Offending Populations - more information is available in the prospectus - http://www.forensicnetwork.scot.nhs.uk/sofmh/prospectus 3
Substance Misuse Detainees in Police Custody: Guidelines for Clinical Management (4 th edition) College Report from the Royal College of Psychiatrists http://fflm.ac.uk/newsstory/2000170 Blood Bourne Virus Management of Medical Conditions eg diabetes, asthma, ischaemic heart disease, epilepsy Managing Suicidal Crisis & Self Harm Managing Psychiatric Conditions, Behaviour & Personality Disorders NHS Education Scotland Blood Bourne Virus Programme This programme is designed to provide a brief and basic background of the nature of selected Blood Borne Viruses (BBV) including transmission, testing, progression of infection and treatment. The material can be undertaken either as a self-directed learning package or used as supporting material by appointed trainers during face-to-face sessions. The programme can be edited at local level by an "approved" staff lead e.g. sections to allow for the inclusion of additional local resources/information is provided. http://www.nes.scot.nhs.uk/education-and-training/by-theme-initiative/public-health/health-protection/blood-borneviruses.aspx The School of Forensic Mental Health have a 1 day course which covers medical conditions in a psychiatry setting. NHS Tayside deliver courses locally Act 2 Care Suicide and Risk Management Strategy developed for use within the Scottish Prison Service. John Porter has advised that the principles may be relevant however the majority of the training relates to prolonged assessment and intervention that would not be suitable in a custody setting. Assessment & diagnosis of physical & mental health status of individuals is covered in An Introduction to the Role of Forensic Medical Examiner Course The School of Forensic Mental Health have courses available that are tailored to mental health professionals, however these could be modified to meet the needs of those working in a police custody environment Relational Security elearning module This is an online learn pro learning module that has been created jointly with NES and the School of Forensic Mental Health. It is based on the See, Think, Act reference material from the Department of Health surrounding the theme of relational security. It has been developed for all staff working in secure forensic mental health services. The aim of this 4
Treatment of injuries Managing Difficult Patients Medicines Management Training for the Forensic element of the role Introduction to the Role of the Forensic Medical Examiner 5 module is to help people to understand what relational security really means and to encourage individuals to think about how they can ensure it is maintained in their place of work. Forensic MBT Skills The overall aims of this training programme are: To equip participants with a working knowledge of the theory and practice of mentalizing. To enable participants to recognise non-mentalizing and to develop clinical skills to restore mentalizing. http://www.nes.scot.nhs.uk/education-and-training/by-discipline/psychology/multiprofessional-psychology/psychologicalinterventions-team-(pit)/e-learning-zone.aspx Immediate treatment of injuries is covered in An Introduction to the Role of Forensic Medical Examiner Course Providing Pharmacy Services for Secure Environments The course is primarily aimed at pharmacists and pharmacy staff but will be of interest to all involved in delivering healthcare to those in secure environments. It introduces you to secure environments and how healthcare services differ from those provided in the community. Secure environments include open prisons, closed prisons, women s prisons, immigration centres, police custody suites and high security mental health hospitals amongst others. This course describes how medicines are accessed by offenders, practical issues to be aware of in supply of medicines, and discusses the clinical governance. After completing this programme, you should be able to: differentiate between different types of secure environments discuss the impact of a secure environment regime on healthcare describe how healthcare is delivered to patients in secure environments develop the pharmacy services you provide to secure environments. http://www.nes.scot.nhs.uk/education-and-training/by-discipline/pharmacy/about-nes-pharmacy/educationalresources/resources-by-topic/core-nhs-services/secure-environments.aspx Introduction to the Role of the Forensic Medical Examiner This four day residential course, over two week-ends, It is a joint initiative by NHS Education Scotland, Police Scotland and the Faculty of Forensic Medical Examiners.
The aim is to equip clinicians with the skills, knowledge and attitude to manage people in custody, to practice to a high standard of clinical care, identify unmet need and provide access to community services. The course is designed to be relevant to the Scottish Legal System. Introduction to Clinical Forensic Medicine New to Forensic Medicine A Training Programme Introduction to Working in Prison and Police Custody Healthcare Training in Adult Sexual Offences Examinations It uses a variety of teaching methods including practical exercises to address the competencies required of practitioners employed in this discipline. It provides preparation for the DFFLM. It has CPD accreditation from the FFLM. Details can be found at CPD Connect College of Policing, Harperley Hall This is an alternative to the Introduction to the Role of the Forensic Medical Examiner but is based on the English Legal System On-line Learning Resource Working in prison and custody healthcare can be a very different experience for many practitioners. Much of the new knowledge and skills that you may require to work in this environment, relates to the context in which this care is given. Therefore this on-line learning resource has been developed to support you to make a decision about whether working within a prison or police custody healthcare environment is for you. The learning resource is divided into two sections; one for prison healthcare and one for police custody healthcare. You can work through either or both sections as you wish and the resource navigation will help you do this. Aspects of the resource are interactive and include general information, some case studies, audio clips, activities and sign posts for further information. There is no formal assessment but we would ask you to complete a reflective log which is part of the resource. The log will be useful evidence for your continuing professional development and also demonstrates that you have given consideration to key issues with regard to working in these settings which may be helpful preparation for any interviews that you attend. In addition there is also a certificate of completion. Forensic & Medical Examination for Rape & Sexual Assault Course is being developed by NHS Education Scotland and covers the Scottish legal system. Adult Sexual Offences is covered in An Introduction to the Role of Forensic Medical Examiner Course Faculty of Forensic and Legal Medicine have published guidance on various aspects of Forensic and Legal Medicine. This includes twice yearly update on the recommendations of forensic sampling. Some recommendations are endorsed by 6
Crown Prosecution Service and ACPO and not directly transferable for use in Scots Law. Forensic Medical Examination following Rape & Sexual Assault o Commitment: x4 2 day courses o 1 hour multiple choice examination o 1 2500 word essay on practical aspect of management-title given o 1 5000 word essay on more theoretical aspects of sexual assault o Cost: 3500 non-residential o 3800 residential o Doctors successfully in their applications to work at St Mary s SARC undertake this as part of their induction process. o This is seen as preparation for examination endorsed by FFLM o A Certificate of Achievement from Manchester University is awarded on completion of the above o This course is endorsed by ACPO and FFLM http://www.stmaryscentre.org/professional-area/st-marys-training-and-events/ MFFLM and DFCASA Membership of the Faculty of Forensic & Legal Medicine (Sexual Offences) Diploma in Forensic & Clinical Aspects of Sexual Assault - recently branded as Licenciate status / minimum recommended qualification to practice in sexual offences medicine. DFCASA Part 1 400, Part 2 80 - check price Training in Paediatric Sexual Offences Examinations A portfolio needs to be collated with reflective pieces of work on cases seen. A mentoring system in place to support portfolio preparation. Training provided by Stop it Now. Stop it Now Scotland is the national programme for the prevention of child sexual abuse. Learnpro - details? Courses available through the Royal College of Paediatrics and Child Health Safeguarding children: Levels 4 and 5 - The Safeguarding Children and Young People Intercollegiate Document level 4 and 5 project aims to develop a learning resource for paediatricians holding named and designated doctor for safeguarding posts. The intention is to deliver materials through a blended learning approach (a mixture of e-learning and face to face 7
training) using a variety of interactive techniques. It is anticipated that this will go live in February 2014. http://www.rcpch.ac.uk/training-examinations-professional-development/continuing-professional-development-cpd/currentedu-2 Child Protection: from Examination to Court - level 3 ICD (open to Paediatric Trainees ST6-8, SAS doctors & Consultant Paediatricians) Every paediatrician will encounter many child protection cases during their clinical career and it is likely that a high proportion of these will require written reports, with some cases leading to legal proceedings. Paediatricians have a key role in both providing written evidence and presenting as a professional witness in family, criminal or civil proceedings. On occasion some paediatricians may accept an instruction to appear as an expert witness. The RCPCH has developed a course in conjunction with medical and legal experts. The central objective of this course is to increase knowledge of legal proceedings, develop competences in engaging with proceedings and build confidence amongst paediatricians to tackle this area of work. Content has been mapped in line with level 3 competences, ICD 2014. This is based on the English legal system and may not be directly transferrable to Scottish Legal System. A 2 day course will in March 2015 http://www.rcpch.ac.uk/events/child-protection-examination-court-level-3-icd-2-day-course Safeguarding children - levels 4 and 5 This blended learning package comprises of a 2 day face to face course which is complimented by a specific e-learning course. Together the face to face and e-learning course have been mapped to introduce key concepts relevant to the target audience of those who hold positions as named and designated paediatricians, in line with the Intercollegiate Document competences. The package comprises of 7 modules with a foundation knowledge being introduced during the e-learning. These concepts are further embellished and consolidated during the face to face course. It is intended that the e-learning will be completed prior to your taking the 2 day course to fully engage users in their learning. It is envisaged that the e- learning will be available from late October, 2014. http://www.rcpch.ac.uk/events/safeguarding-children-levels-4-and-5-blended-learning-package-named-and-designatedpaediatric Court Skills & Report Writing Report Writing is covered in An Introduction to the Role of Forensic Medical Examiner Course Expert Witness Course The School of Forensic Mental Health offer a two day course for psychiatrist trainees, psychologists and senior psychology trainees. The course offers practical in the box experience. More detail is available in the School prospectus - http://www.forensicnetwork.scot.nhs.uk/sofmh/prospectus 8
Inverness Course details to follow The Road Traffic Act The Road Traffic Act is covered in An Introduction to the Role of Forensic Medical Examiner Course Continuing Professional Development NES Annual Conference This is an Annual Forensic Update Conference organised by NHS Education Scotland. Details can be found at NES New to Forensic Medicine Teaching Programme New to Forensic Mental Health Mentors have been trained and this will be formally "launched" at the conference on 22nd November. This is the piece that Helen Walker has expertly managed through the SoFM. A joint venture between NES and The School of Forensic Mental Health the New to Forensic education programme is for clinical and non-clinical staff. The programme is designed to promote self-directed learning and is multi-disciplinary and multi-agency in approach. The programme student will be supported throughout their period of study (recommended six months to one year depending on previous experience) by a mentor who is an experienced forensic mental health care worker. The programme has 15 chapters, each of which (excluding chapter one) includes case scenarios of patients in various settings, from the community to high secure psychiatric care. http://www.forensicnetwork.scot.nhs.uk/sofmh/new-to-forensic Courses provided by the Department of Forensic Medicine at the University of Dundee Courses provided by the Faculty of Forensic and Legal Medicine 9
Appendix A - Training Requirements to Support Healthcare of People in Custody & Forensic Medical Examiner Role 23 rd December 2013 I am writing to establish your current & anticipated training requirements in relation to developing this new workforce. Since November 2012, we have successfully completed the more urgent pieces of work an Introductory Course for Forensic Medical Examiners which is provided as a face-face four day residential course and which will soon be also available as a mentored programme, suitable for individuals or small groups and which can be delivered using a practice-based approach in more remote locations. We have also established a site (portal) on NES Knowledge Network which will give access to a vast electronic library of rel eva nt res ources. In 2014 we plan to offer two more Introduction to the Role of the Forensic Medical Examiner courses at Tulliallen and an Update What s New in June. The former is suitable for both doctors and nurses who are new to the service, provides a preparatory course for the Diploma of the Faculty of Forensic Medical Examiners and a useful refresher course for those who have provided the service for some time but learned mostly on the job. The latter is suitable for those who have already attended the Introductory Course and those with experience of the job. We are also keen to explore other training needs some we can, through NHS Education Scotland design and offer, some will already be available and we can sign-post you to existing resources and some will be more suitable provided by Health Boards and be part of employment requirements and the induction process. To aid planning for the Training & Competency Subgroup, I would be grateful for your response to the following questions and would appreciate a response as soon as possible. Introduction to the Role of the Forensic Medical Examiner N.B. We have secured funding from Scottish Government to provide two courses free of course fees with places for up to 60 in 2014. This funding will not cover back-fill or travel cos ts. 1. Can you provide some estimation of the number of doctors you would like to send on this course in 2014? 2. Can you provide some estimation of the number of nurses/managers you would like to send on this course in 2014? 3. The course is residential over two weekends normally 4-6 weeks apart. Can you advise what months would suit your service requirements best? 4. Can you advise how many places you would like to reserve for spring/summer or autumn/winter da tes? New to Forensic Medicine A Teaching Programme This is a companion piece to the highly successful New to Forensic Psychiatry a teachi ng programme. It relies on a network of mentors to deliver the programme. It contains the same material covered in the residential course. 5. Can you advise how many doctors & nurses you would like to enrol on the mentored programme? 6. Can you identify an experienced FME who would, following training through NES, be able to provide locally delivered mentorship? If so, can you provide his/her name and contact details. Update What s New in Forensics The intention is to offer a one and a half day conference that will include some time to establish support networks. It is anticipated that the venue will be the Scottish Police College in Tulliallen in June. The conference cost will be supported by Scottish Government funding but there will be a small charge for dinner, bed and breakfast. Again we will not be able to offer travel or back-fill costs. 7. How many doctors, nurses and service managers would you anticipate sending to this conference? 8. Do you think June would be a suitable date and if not, when would you suggest as a better date? Other Training Requirements 10
9. Please list below any other training requirements that you have or anticipate requiring for this evolving workforce? I appreciate that some training requirements will not be immediately obvious. Please contact the training subgroup through Pauline Tollins pauline.tollins1@nhs.net or Ruth Meechan ruth.meechan@nhs.net as needs become apparent throughout 2014. Please can you identify which Health Board you are representing? 10. Name of respondent. 11. Health Board Thank you for your assistance. Best wishes, Profess or Anthea Lints (Chair and on behalf of the Training & Competency Sub-Group) PLEASE RETURN THIS BY E-MAIL AS SOON AS POSSIBLE TO: anthea.lints@nes.scot.nhs.uk 11