Education and the new contract

1. Education and the new contract

2. First contract that mentions commitment to education • Mandated Guardian role and trainee forums • Exception reporting ,resolution and fines • Defined role of ES- work schedules and resolving issues around exception reporting Some Facts

4. http://www.nhsemployers.org/your-workforce/need-to-know/junior-doctors-2016-contracthttp://www.nhsemployers.org/your-workforce/need-to-know/junior-doctors-2016-contract

6. NACT UK: Clarification on roles of DME and Guardian of Safe working for the new JD Contract • Jo Szram & Shirley Remington March 2017 • This brief document sets out to provide links or information and good practice guidance on: •  The key roles of the DME and Guardian of Safe Working within the new JD contract •  The key structure and functions of a Trust Junior Doctor Forum • Comprehensive and detailed information can be found at: • NHS employers’ website: http://www.nhsemployers.org/your-workforce/need-to-know/junior-doctors-2016-contract

7. New rota rules…..

8. New rota rules NROC Other

9. Initially offer via NHS staff bank • Inform employer/host organisation • Must stay in line with rota rules • Including maximum of 48hrs/week Locums

10. No longer monitor. • Doctor should exception report where work varies from work schedule in regards to: • Hours/breaks • Educational opportunities • E.S. responsibility to review and respond to exception report. Exception Reporting

12. Areas for sharing and exploration • What has worked to educate and involve ES? • How will you engage trainees this summer? • What is current experience?

13. What has worked well to educate and support ES and CSWhere do they need most help

15. What has worked for engaging trainees?Work scheduling?Forums?Exception reporting?

17. Key messages from the guardians • The real challenges are engagement, support, software issues, time to do the work, clarity on the rules, and knowing the boundaries of the role. • Need to clarify “power” of the guardian when things aren’t happening, e.g. supervisors aren’t engaging or making wrong decisions, not dealing with exception reports properly, processes aren’t working. • Still some clarity needed on certain technical TCS aspects, e.g. TOIL around missed breaks, guardian fines • No surprises where exception reports are coming from, but guardians are good at investigating reasons and facilitating solutions • Software systems need significant improvement • Admin support is essential so that guardian time is spent on the right things • Desire for a suggested tariff of PA time depending on number of trainees, and tariff of admin support too

18. Engaging with educational and clinical supervisors Successful engagement methods: • Presentations • Podcasts • Educational sessions • Guidance documents • visiting each department • weekly meetings • involvement of divisional managers • roadshows

19. Engaging with educational and clinical supervisors Problems identified: • Lack of knowledge • Software difficulties • Culture of non-engagement/non-reporting • Vacancies (including resignations) • Lack of time in job plans • Lack of delegation • Lack of authority to grant TOIL • Lack of support from Medical Director to tackle problems • Perceived conflict between educational supervision and employment issues • Concerns from trainees about how data will be used and stored

20. Engaging with educational and clinical supervisors Solutions: • Admin support, managerial support and support from the trust (i.e. clear policies and good relationship with DME – and HEE) • Mandatory training at the update of ES training • Workshops at annual educator conference • Fewer educational supervisors with more designated PAs • Linking exception report documentation into e-portfolio • Linking activity with the ES’s own appraisal • Greater clarity around rules • Clear escalation processes • DMEs need a capability strategy for supervisors

21. Engaging with trainees Potential barriers: • Fear of being seen as “troublemakers” and creating more work for colleagues • Ability to attend forum meetings • Sense of conflict about the contract – some resistance to collaboration • Managing gapsand risks to training • Rotas not being fit for purpose • Cultural challenges • Perceived loss of autonomy • Addressing misunderstandings and misinformation

22. Engaging with trainees Ways forward: • Engagement with JD forum, including opportunities for CPD and protected time for forum attendance • Openness about health and safety issues, including involvement of occupational health • Discuss how training can be improved • Share case studies/positive outcomes and point out benefits of the contract e.g. guardian can challenge the board, real time information • Engagement with particular specialties e.g. public health, dental • Identify how to include trainees not on 2016 terms • Share information and clarification from NHSE, NACT, NAMEM • Evidence use of fine monies • Engagement on non-contractual issues

23. QUESTIONS

24. Reasons to be optimisticEducation is in the contract.Boards engagedReal lever for change