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Workstreams: Phase 1

The programme aimed to improve the quality of training and learning for the benefit of patient care by enabling the delivery of the key recommendations from Sir John Temple’s Time for Training and Professor John Collins’ Foundation for Excellence reportsThe programme now aims to promote the spread and adoption of the projects which were implemented in workstreams 1 and 2 share the learning from these pilot sites.

Time for Training called for better use of the expanded consultant workforce, to ensure improved training for junior doctors as well as enhanced safety and higher quality care for patients. Foundation for Excellence echoed Temple’s report, and evaluated the Foundation Programme in the context of the needs of patients and trainees and the changing healthcare environment. Collins’ review identified trusts that were doing well, having changed practices to cope with reduced working hours. However, it also highlighted concerns that in some cases some of the junior trainees are asked to practice beyond their level of competence and without appropriate or adequate supervision. Health Ministers commissioned both reports and the Secretary of State asked us to take forward the work as a priority.

In order to meet the reports’ recommendations, we developed a series of workstreams with an emphasis both on the need for local and national activity. They are:

1. Local implementation and pilots: the BTBC team awarded funding to 16 NHS trusts to pilot projects that aimed to improve education and training and therefore patient safety, results from the independent evaluation will be shared shortly. This workstream has been transitioned into BTBC phase 2.

2. Role of the trainee: this project looked at the role of the trainee in terms of trainee supervision and the principles required to ensure an appropriate level of trainee supervision. Our Inspire Improvement project was launched to fund and support trainees in implementing trainee-lead projects to improve education and training, and therefore patient care. The positive outcomes that have ensued for these projects is being pulled together into an evaluation report, more information on this will be following shortly. This workstream has been transitioned into BTBC phase 2.

3. Role of trainers: the GMC and Academy of Medical Educators (AoME) have been working alongside HEE in the role of trainers project, which aimed to support the development of an implementation guide for the recognition and approval of trainers. HEE implemented the following UK wide initiatives:

  • The Essential User Guide to Recognition of Training in Secondary Care 2013 developed by the AoME
  • A ‘how-to’ guide for secondary care doctors to implement the GMC’s Recognising and Approving Trainers: The Implementation Plan’ framework six
  • NACT UK has developed their Faculty Guide that addresses the impact of the workplace environment and the role of the faculty on the success of training and education, and therefore patient care, within the NHS.

The role of the trainer workstream has been transitioned into a national programme in its own right.

4.Workforce planning: the first Workforce Plan for England was published in December 2013 followed by an updated 2014 Workforce Planning Guidance. As part of this, call for evidence material has now been received centrally and is currently being reviewed. LETBs are due to submit workforce supply and demand forecasts and subsequent investment plan proposals to HEE central during August-September 2014 for a process of triangulation, moderation and challenge, with a view to publishing the 2014/15 Workforce Plan for England in December 2014. The workforce planning workstream has been transitioned into a national programme in its own right.

5Improving careers guidance and availability: the careers guidance portal has been developed by the MDRS programme to support trainees with their career choices to define good practice for the provision of careers information and advice. It also seeks to address perceptions of particular careers, encouraging an even distribution of trainee placements across all disciplines. This workstream is still ongoing and is awaiting further updates on its development. This piece of work has been transitioned into a national programme in its own right.

6. Integrated technology enhanced learning (TEL): Following the Temple and Collins recommendations and the publication of the Framework for Technology Enhanced Learning (TEL), the BTBC team engaged with key partners and stakeholders nationally to look at opportunities for the sharing and spread of TEL technologies and techniques that support high quality training and education in healthcare. The TEL strategy was put together with  the Higher Education Academy as partners to devise the TEL programme of work. This is initially focussed on the promotion and sharing of three key TEL areas: simulation, e-Learning and m-Learning (mobile learning). The TEL workstream has transitioned into a national programme in its own right.

7. Broadening the Foundation Programme: This project consisted of a number of components such as to review the Foundation Programme Curriculum and to address specific Collins recommendations including; more trainees to undertake community-facing placements and to support a more even distribution of trainee placements across specialities particularly emphasising on GP, psychiatry and other community placements. The work of three groups tasked to do this piece of work is now complete and the final report on the Broadening the Foundation Programme has gone through a formal authorisation process. The ‘Broadening the Foundation Programme – recommendations and implementation guidance’ report can be found in the documents section below.

8. Regulatory approach to supporting Better Training Better Care: the GMC worked with HEE to meet specific Collins recommendations. Some of the work either finished or underway includes:

  • A definition of the outcomes required to complete Foundation Year Two (F2)
  • A review of the 2011-13 GMC Education Strategy
  • An updated GMC Good Medical Practice Guide
  • Exploring opportunities to share data among partner organisations in an effective and appropriate way.

9. Funding and education quality metrics: the BTBC team have been exploring opportunities with partner organisations to support effective commissioning and delivery of quality training. This was facilitated by the introduction of the Education Outcomes Framework, which defines and initiates new educational outcome measures. Further work included the development of a clinical supervisor framework, which was done in conjunction with the UK Foundation Programme Office.

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