Agenda item 10.1(i) Research, Education and Training Committee Chair s Report from 4 September 2018 Public Board Meeting 27 September 2018 Presented for: Presented by: Author Previous Committees Information Yvette Oade, Chief Medical Officer Donna Johnstone, Research & Innovation Manager Trust Goals The best for patient safety, quality and experience The best place to work A centre for excellence for research, education and innovation Seamless integrated care across organisational boundaries Financial sustainability Key points 1. To provide an overview of significant issues of interest to the Board, highlight key risks discussed, key decisions taken and key actions agreed from Research, Education and Training Committee held on Tuesday 4 September 2018. For information 1
1. Introduction The Chair s Report for the Research, Education and Training Committee provides an overview from the draft minutes of the meeting held on Tuesday 4 September 2018 highlighting issues and risks discussed and key actions agreed. 2. Significant Issues of Interest to the Board Presentation to the RET Committee Jon Cooper presented an update on the General Medical Council (GMC) Trainee Survey. The GMC sets the standards in two areas: - Excellence by design: standards for postgraduate curricula - Promoting excellence: standards for medical education and training The annual survey, mandatory for all trainees, is an important component in the governance of postgraduate medical education. This year s survey was open from 20th March to 9th May 2018 and was completed by 726 LTHT trainees. Overall the Trust s performance is broadly in line with the rest of the UK, continuing to score well in supervision related domains; clinical supervision = 90; clinical supervision out of hours = 88, educational supervision = 84. Conversely, the scores are less good in work-related domains; work load = 46; rota design = 57 (which was a new question asked in the 2018 survey). Jon Cooper highlighted the LTHT scores ranked against other Trusts in Yorkshire and the Humber and also with Peer Trusts (Birmingham, Cambridge; Guy s; Liverpool; Manchester; Newcastle: Nottingham: Oxford and UCL) as below: Rank Trust 2018 Score 1 The Newcastle Upon Tyne Hospitals NHS Foundation Trust 81.02 2 Guy s & ST Thomas NHS Foundation Trust 80.15 3 Royal Liverpool and Broadgreen University Hospitals NHS Trust 79.84 4 University College London Hospitals NHS Foundation Trust 79.45 5 University Hospitals Birmingham NHS Foundation Trust 78.88 6 The Leeds Teaching Hospitals NHS Trust 78.32 7 Cambridge University Hospitals NHS Foundation Trust 78.16 8 Oxford University Hospitals NHS Foundation Trust 78.15 9 Nottingham University Hospitals NHS Trust 77.79 10 Sheffield Teaching Hospitals NHS Foundation Trust 77.63 11 Manchester University NHS Foundation Trust 77.06 12 Hull and East Yorkshire Hospitals NHS Trust 76.57 2
The overall satisfaction domain ranks LTHT as being 6th with a score of 78.32. Jon Cooper noted that difference in scores between Leeds to top is 2.7. Education & Training (E&T) Guardians of Safe Working hours It is now 2 years since the new contract was implemented, it remains under review including the use of exception reports. Supervisor engagement is improving but still variable and this may have an effect on a trainee s decision on whether or not to submit an exception report. Improved trainee engagement remains a priority and reaching out to new starters to have their say will be helped through the recruitment of new trainees to join the Junior Doctor s Forum. Nursing, Midwifery & AHP Education & Training Pre-Registration Education The new Registered Nurse Degree Apprenticeship has now commenced with a cohort of 17, we are the first Trust to offer this programme. Work-based learning Nursing Associate Apprenticeship programmes will commence in September/October 2018 at the University of Leeds and in December 2018 at Leeds Beckett University. Best Start Newly qualified staff are now reaching the end of their six-month preceptorship programme. The programme and support provided has evaluated well though some concerns have been raised about the impact of operational pressures on new starter support at clinical level. The education and CSU teams are reviewing the support provided in preparation for the 2018 new starters. Post-Registration Education 21 Advanced Clinical Practice (ACP) trainees have been recruited across the Trust starting in September 2018. Staff from the Trust attended the Health Education England Programme Review for ACP/Physician Associate where the LTHT programme was commended by trainees and supervisors. Postgraduate Medical Education Enhanced Monitoring in Medical Education Whenever a concern is raised through one or more routes of monitoring by Health Education England in Yorkshire and the Humber (HEEYH) and the GMC a Requirement or demand for action is placed on the Trust. Where a Requirement is seen to be the result of a repeated problem, the GMC place it on Enhanced Monitoring where they play a more active role in its management. Enhanced Monitoring has been place for the General Surgery and Trauma and Orthopaedics Foundation Programme. Enhanced Monitoring in General Surgery was the result of compounding factors over a period of years, which were exacerbated by a decision taken by HEEYH to remove 10 FY1 posts from General Surgery. However, following significant work with the CSU in changing rotas and ensuring time is built in to enable trainees to access wide education opportunities HEEYH recommended to the GMC that enhance monitoring was no longer needed in General Surgery. 3
Undergraduate Medical Education Self-Directed Practice (SDP) Room The SDP room has been a feature of the Undergraduate Student Hub since its creation and provided a space for students to safely practice clinical skills, with teacher support on hand if needed. 10,000 has been received from NHS England to purchase equipment for the room. Clinical Practice Centre (CPC) Maintenance work has started to the rear-elevation sash windows, guttering, pest control and some aesthetics on the CPC, Ashley Wing and should be completed by autumn 2018. PPM+ Access All Years 4 & 5 medical students will have read-only access to PPM+ by the time they start their placement in 2018/19 academic year. By December 2018, the roll out for third years will be completed. Multi-Professional Education Facilities A small task and finish group drawn from Organisational Learning, Corporate Nursing, Corporate Medical and Estates and Facilities has formed to work collaboratively on issues associated with meeting and training rooms. Work has commenced on the following: Identifying options to improve the room booking system Considering resources that could be pooled to establish a customer service function to maintain facilities in rooms. Exploring options and costs for web facilities to support training Pulling together a plan with costs to improve 3 identified facilities as a priority. Apprenticeship Activity In the last financial year LTHT commenced 596 apprentices across 22 programmes and 60% of our Apprentices were new recruits to the Trust. LTHT is using Apprenticeships to secure a talent pipeline for a range of roles, including Clinical Support Worker/Nursing, Administration and Biomedical Scientists. Leeds Beckett University have been commissioned to undertake a small research project which aims to identify the barriers to apprenticeship growth in health and care across West Yorkshire. As the host of both the Leeds Health & Care Academy (LCHA) and the West Yorkshire and Harrogate Excellence Centre (WYHEC), LTHT is taking a lead in engaging with organisations across the city and region to expand the use of Apprenticeships. Research & Innovation (R&I) Strategic Partnerships and major projects - Innovate UK, 10M Digital Pathology application led by University of Leeds (Chief Investigator - Darren Treanor, Consultant Pathologist) submitted in July 2018. The outcome of the bid will be known in October 2018. - UKRI Strength in Places Fund - LTHT collaborated on this expression of interest for a new government scheme to work up a potential major bid in the region of 30-40M for 4
Medical Technologies in the Leeds City Region (Chief Investigator - Professor John Fisher, University of Leeds) - Formal LTHT Partnership with Densitas. Transatlantic research partnership agreed with Canadian innovation company Densitas in July 2018. Dr Nisha Sharma clinical lead for breast imaging is pioneering the use of world-leading software that analyses screening and diagnostic images and helps identify women who may be at higher risk of developing cancer. - UK/USA Healthcare R&I Opportunities. LTHT were represented at a Leeds City Region Trade Mission to Boston USA and a UoL/LTHT visit to Texas Medical Centre in 2018. The aim of the mission was to identify opportunities for Leeds to leverage its position as a leading centre for health informatics, finance and medical technology research and education. - NHS 10 Year Plan. Jacqueline Andrews, Director of Research & Innovation has been asked to join Department of Health & Social Care/NHS England working group to develop a new innovation pathway for the R&I section of the NHS 10 year plan. Research Performance The league tables for the National Institute for Health Research (NIHR) studies during 2017/8 were officially launched on the 18th July 2018 and the headline figures are summarised below: LTHT was top nationally for increase in recruitment in all studies, with 19179 in 2017/18 compared to 12,431 in 2016/17 LTHT was 2nd national for number of patients recruited to clinical research studies LTHT was 4th nationally for number of clinical research studies conducted in a NHS organisation at 451. Advance Notice of Medicines and Healthcare Products Regulatory Agency (MHRA) Statutory Inspection This was received by UoL and LTHT in August 2018. The governance teams are required to submit a clinical trials dossier and trial spread sheet by the 6th September. Work is ongoing to prepare for the inspection, which could occur at any time within the next 6 months. NIHR Leeds Clinical Research Facility (CRF) Leeds hosted the UK CRF Network Annual Conference July 2018 at the Royal Armouries with the theme of conference Imaging and Digital Technologies in the 21st Century arising from and showing key research strengths in Leeds. Excellent feedback from both the NIHR and attendees has been received. Workforce - Facilitating Change The Chapel Allerton Action Plan to address research delivery issues are now complete and the task and finish group responsible for overseeing completion has now been closed. New studies adhering to set criteria receive additional levels of governance and assurance to ensure there is sufficient workforce capacity and Principle Investigator oversight before approval is given. Training and education has now been undertaken by the majority of Chief, Principle and subinvestigators, with the remaining few being mandated to attend. Clinical Research Nurses and Clinical Trials Assistants are required to attend a greater number of training sessions due to the breadth of their roles. All these groups will have completed training by the end of October 2018. 5
Non-Medical Clinical Research Careers Strategy The Collaborations for Leadership in Applied Health Research and Care, CaRDiNAL Doctoral Training Partnership PhD opportunity has been awarded to a new UoL nursing graduate related to tissue viability. The individual has also been appointed to a part-time clinical post ensuring synergy between clinical practice and the area of chosen study. HEE research internships (pre-master) have been awarded to two LTHT non-medical professionals (ODP and radiographer). Five LTHT staff (AHPs and pharmacists) has been awarded HEE/NIHR Pre-doctoral Clinical Academic Fellowships. Two AHPs have been shortlisted for the NIHR Clinical Doctoral Fellowships and will attend an interview in October. Two members of staff have reached the second stage of NIHR Clinical Lectureship, and one Senior Clinical Lectureship. Finance Training Training sessions have been delivered to research staff in conjunction with the NIHR CRN Yorkshire and Humber and to date 60 research staff have received training on the NIHR Industry Commercial Costing Template. 3. Key Risks Discussed E&T Guardians of Safe Working hours Paediatrics, Clinical/Medical Oncology and General Surgery has seen a rise in exception reports due to gaps in rotas and rota redesign in these areas is being discussed with the CSUs. Post-Registration Education There is still no indication from Universities of the Continuing Professional Development (CPD) programme available, so it is difficult to plan the co-ordination. It was noted that funding has been made available for an evaluation of the CPD requirements across West Yorkshire, linking with programmes being delivered in Universities. OSCE (2018) The loss of J32 as an OSCE venue created a number of problems this year. Whilst a planning group aims to meet in early October, a longer term solution to accommodating these important end-of-year exams needs to be addressed if the OSCEs are to remain in the Trust. Enhanced Monitoring in Medical Education Trauma and Orthopaedics Foundation Programme is subject to Enhanced Monitoring by HEEYH and as a result are conducting and Urgent Risk Review (URR) on the 22nd October 2018. In the run up to the URR a task and finish group is being established. Following the visit an action plan will be in place which will need to be completed to the satisfaction of the GMC. Failure to do so will result in the loss of junior training posts. 6
R&I The NIHR CRF will be subject to a two year review before any further funding is released. It was noted that during the last meeting with the NIHR, it was expected that the refurbishment of the Bexley Wing CRF will be complete before the two year review. Unfortunately significant delays have meant that work has not started yet and whilst regular meetings are taking place to facilitate it s commencement, it should be noted this will be difficult to explain to the NIHR. Finance R&I are still awaiting confirmation of the funding from Leeds Cares, which is currently underpinning the revenue costs of the CRF. 4. Key Decisions Taken E&T Following a discussion regarding utilising mixed models of care it was agreed that a list of permanent clinical roles including their responsibilities would be made available to avoid any confusion. 5. Publication Under the Freedom of Information Act This paper is exempt from publication under the Freedom of Information Act 2000 as it contains information that is in draft form. 6. Recommendation The Board is asked to receive and note the Research, Education and Training Committee Chair s Report. Yvette Oade Chief Medical Officer Research, Education and Training Committee September 2018 7