Health Education Thames Valley, Educational Supervision & other issues

1. Health Education Thames Valley, Educational Supervision & other issues Michael Bannon Postgraduate Dean, Health Education Thames Valley

2. Why is 8th May 1945 important?

5. PG Medical Education Committee: Issues 1945-55 • Education of demobilised medical officers • Need for structured general practice training • Concerns about quality of house officer training (and about training in general to include supervision) • “Problem of married women who wished to become house officers”

6. What is Health Education England? Health Education England is the new national leadership organisation responsible for ensuring that education, training, and workforce development drives the highest quality public health and patient outcomes.

7. Ian Cumming, CEOHealth Education England (BMJ, 9/11/12) “Health Education England exists for one reason alone, and that one reason is to improve the quality of care delivered to patients” “Deaneries themselves are not being abolished...” “.. they are simply being subsumed into LETBs”

8. More from Ian Cumming “Each of our LETBs will have an annual agreement with HEE that is very clear about what their responsibilities are and what they have to deliver” “.....spending money on the education and training agenda, not on the delivery of service agenda” “If we have got poor standards of education, poor standards of training, we need to find a way of turning the tap off” “The absolute number one thing is safe transfer of functions so that nothing goes wrong”

9. What is a LETB? • Local Education & Training Board • What will it do (from 1st April 2013)? • take on responsibility for workforce planning and development and education and training of the healthcare and Public Health workforce • this includes deanery functions, non medical education and workforce planning • put providers of NHS services - NHS Trusts, local authorities, GPs, in the driving seat

10. Population of around 2.3 million people • Nine NHS Trusts, 11 CCG’s, 9 LA’s, TV Area Team • 40,717 WTE NHS employees • 244 apprenticeships • Major contracts with 10 universities • Dental Deanery and Leadership Academy • Home to Oxford Medical School and HEI’s & FE’s • Collaboration and strong alignment with OAHSN • Engagement with local authorities, and a diverse stakeholder community • 1,560 GPs and 438 practice nurses • 20,000 social care staff • 1,797 post-graduate medical education trainees • 61 post-graduate dental education trainees • 3,500 students on non-medical education programmes at any one time Thames Valley Profile

11. Health Education Thames Valley - Senior Leadership Team Supported by an Integrated Workforce and Shared Service function

13. So what have we done so far? • Three major workforce projects underway: • Emergency Medicine • Adult Nursing • Midwifery • £7 million investment support for projects agreed that meet HETV objectives • Emphasis on promotion of culture and values • Public Health has seat on Board!

14. Importance of basic “educational infrastructure” Paice, E et al BMJ. 2000 March 25; 320(7238): 832–836. • Induction: • Organisational • Department • Supervision: • clinical • Educational • Feedback

15. Timetable for full implementation by July 2016

16. AoME domains

17. Responsibilities of Local Education Providers

18. Responsibilities of the Local Education Organisation (Deanery; now Health Education Thames Valley)

19. Trainee satisfaction: Oxford Deanery

20. Trainee Satisfaction: Public Health

22. Specific objectives • Enhancement & recognition of educational supervisor role • Development of Training programme director role • Process issues: • ARCPs • OOP • IDTs

23. Why bother? ↑ Confidence ↑Performance ↑ Morale → Faster and better service delivery More appropriate professional attitudes Self education

24. Don’t have time? Ward rounds Out patients Sitting in to observe Who is watching whom? Service delivery with follow-up feedback (eg checking care plans and / or letters) Mini C-ex CbDs • Business round or teaching round? • Mini C-ex • Case based discussions

25. Shape of trainingWhat it might say • PGME must be sensitive to patient needs and local demography • Clear advice to medical students about what to expect in the future ie 50% for GP

26. Training • Only occur where there is high quality supervision • Must include general themes linked to patient care • Broad curriculums (Broad based training currently being piloted) • Transferable competencies (e.g. acute medicine experience count towards emergency medicine training)

27. Training • Must be relevant to local need bit also in keeping with national standards • Flexible approach to academic training! • Include CPD as part of maintenance • Credentialed programmes • Remove barriers for those outside of training

28. Conclusions This organisational change is significant There will be more change We are not going back to where we were Must acknowledge & embrace current change and influence future change (Bye the way...money is likely to be very tight from 2014)