Undergraduate
Medical Training
Financial
Accountability &
Quality
Enhancement
Annual Report’
2013/14
UCL Medical School
UCL Medical School is committed to excellence in undergraduate and postgraduate education
and has a strong reputation for teaching informed by cutting-edge research. The School has a
distinguished cadre of academic staff who are at the forefront of international research in
biomedical sciences, medical education and clinical medicine.
The Medical School aims to provide the seamless high quality education of medical students
from admission to graduation; to enhance the status of learning and teaching within the
Medical School; and to support and advise on the relevant facilities and resources
underpinning medical education.
It also provides postgraduate education locally, nationally and internationally and promotes
scholarship and excellence in medical education delivery and research.
2
Status of this report
This report has been prepared for the sole use by HE NCEL, and no responsibility
is taken by the Medical School to any director / member or officer in their
individual capacity, or to any third party.
3
Contents
Summary
Introduction
Detailed Report
A. Student number time series information to highlight future bulge and fallow intakes
Student population as at 1 December 2013
Forecast for Autumn 2014 intake
Number of qualifiers in summer 2013
B. Summary of SIFT expenditure against budget
C. Reporting of quality assurance exercises
QA of Clinical Placement Providers
QA of the MBBS Programme
D. Summary of developments, innovations, best practice to include significant future changes
to the curriculum or any other important achievements
Developments and innovations
Appendix 1 - Management Plan arising from the last QABME visit
Appendix 2 - Internal Quality Review 2013-14 (not yet available, deadline December 2014)
Appendix 3 – Medical School governance – organograms
-
MBBS Academic Leadership
-
MBBS Vertical Modules Leadership
-
MBBS Leadership Clinical Placements
-
MBBS Faculty Tutor, Student Support and Foundation Training
- MBBS Committees and Chairs
Appendix 4 - Medical School governance - statements
-
MBBS Academic Leadership
-
MBBS Vertical Modules Leadership
-
MBBS Leadership Clinical Placements
-
MBBS Faculty Tutor, Student Support and Foundation Training
- MBBS Committees and Chairs
4
5
Introduction
Detailed Report
A. Student number time series information to
highlight future bulge and fallow intakes
Student population as at 1 December 2013
Table 1
Student Population by year group and by Home / EU and
Overseas as at 1 December 2013
Year Group
Home/EU
Overseas
Total Population
Year 1
303
23
326
Year 2
303
19
322
New Year 3 (IBSc)
259
28
287
New Year 4
334
36
370
New Year 5
325
11
336
New Year 6
358
16
374
6
Forecast for Autumn 2014 intake
Table 2
Forecast for Autumn 2014 intake by year group and by Home /
EU and Overseas
Year Group
Home/EU
Overseas
Total Population
Year 1 TARGET FIG
298
24
322
Year 2
314
23
337
New Year 3 (IBSc)
298
18
316
New Year 4
356
30
386
New Year 5
330
36
366
New Year 6
334
12
346
Number of qualifiers in summer 2013
Table 3
Number of qualifiers in Summer 2013
Number qualified, repeating or failed
Qualified
367
Repeating ( from Jan 2014)
3
Failed
0
Did not complete / withdrew
0
Total
370 comprises 355 in Final Year from Sept 2012 and 15 re-sitters from Jan 2013.
7
370
B. Summary of SIFT expenditure against budget
Table 4
Summary of SIFT expenditure 1 April 2013 to 31 March 2014
Budget Elements
FTE
BUDGET
ACTUAL
VARIANCE
IN LONDON SIFT SLA Trusts
Barking, Havering and Redbridge University Hospitals
NHS Trust
7.85
319,081
319,081
£0
Barnet and Chase Farm Hospitals NHS Trust
29.98
1,242,804
1,242,804
£0
Barnet, Enfield and Haringey Mental Health NHS Trust
11.85
492,470
492,470
£0
Camden and Islington NHS Foundation Trust
47.78
2,023,597
2,023,597
£0
0
0
0
38.74
1,628,548
1,628,548
5.91
263,084
263,084
Moorfields Eye Hospital NHS Foundation Trust
5.2
227,612
227,612
£0
North East London NHS Foundation Trust
0.22
8,934
8,934
£0
North Middlesex University Hospital NHS Trust
32.40
1,347,328
1,347,328
£0
Royal Brompton and Harefield NHS Foundation Trust
1.31
56,859
56,859
£0
197.18
8,509,861
8,509,861
£0
1.02
1.12
41,580
48,017
41,580
48,017
£0
223.42
158.50
10,037,611
6,658,640
10,037,611
6,658,640
Central London Community Healthcare NHS Trust
Central and North West London NHS Foundation Trust
Great Ormond Street Hospital for Children NHS
Foundation Trust
Royal Free London NHS Foundation Trust
Royal National Orthopaedic Hospital NHS Trust
Tavistock and Portman NHS Foundation Trust
University College London Hospitals NHS Foundation
Trust
Whittington Hospital NHS Trust, The
£0
£0
8
£0
£0
£0
Sub Total
Budget Elements
762.48
32,906,026
£0
32,906,026
FTE
BUDGET
ACTUAL
VARIANCE
45.53
1,770,036
1,770,036
24.64
972,940
972,940
44.99
1,745,024
1,745,024
1.34
50,408
50,408
0.27
10,376
10,376
0
0
0
£0
17.18
696,396
696,396
£0
133.95
5,245,180
5,245,180
£0
431,845
431,845
£0
1,707,135
1,707,135
£0
856,500
856,500
£0
2,995,480
2,995,480
£0
OUT OF LONDON SIFT SLA Trusts
BASILDON AND THURROCK UNIVERSITY
HOSPITALS NHS FOUNDATION TRUST
EAST AND NORTH HERTFORDSHIRE NHS TRUST
LUTON AND DUNSTABLE HOSPITAL NHS
FOUNDATION TRUST
NORTH ESSEX PARTNERSHIP NHS FOUNDATION
TRUST
SOUTH ESSEX PARTNERSHIP UNIVERSITY NHS
FOUNDATION TRUST
Surrey and Sussex Healthcare NHS Trust
WEST HERTFORDSHIRE HOSPITALS NHS TRUST
Sub Total
£0
£0
£0
£0
GP Education and Infrastructure (inc Small and Tasked
GP)
GP Clinical Placement
£0
143.06
GP Facilities
Sub Total
9
Other (Non Recurrent)
4.33
173,117
158,717
14,400
Medical School Direct*
1.79
71,563
59,841
11,722
6.12
244,680
218,558
26,122
Sub Total
NB: * Providers may claim after the end of the budget year.
CLINICAL TOTAL
Clinical Total
1,045.61
41,391,366
FTE and income data based on what providers’ received according to information from HENCEL.
10
41,365,244
26,122
Budget Elements
FTE
BUDGET
ACTUAL
VARIANCE
ADMIN BUDGET
SIFT Co-ordinator
158,478
158,478
£0
Training for Teachers
117,837
117,837
£0
Patient Database administrator
15,173
15,173
£0
Simulated patients
26,778
26,778
£0
Clinical Skills Tutors
140,018
140,018
£0
£0
£0
Admin Total
458,284
458,284
£0
Total
41,849,650
41,823,528
26,122
11
C. Reporting of quality assurance exercises
QA of Clinical Placement Providers
i. Executive summary of the Medical School’s QA of Clinical Placement Providers in 2013/14
Quality Assurance Unit
The purpose of the Quality Assurance Unit (QAU) is to ensure that high standards within teaching and
learning processes for undergraduate medical programmes are recognised and rewarded, and
problems identified and addressed. The Unit has oversight of all quality assurance and enhancement
of the MBBS programme, including clinical placements. It was established in 2006 in response to
recommendations made by the GMC, recognising that the area of quality assurance was not
adequately resourced within the Medical School. The QAU employs a range of strategies to create a
picture of the students’ educational experience across the whole curriculum. The QAU works in
conjunction with the SIFT Office to ensure financial accountability.
A Quality Assurance Project Officer was employed to carry out a full review of the School’s QA
processes during 2013-14 and the recommendations of this review relating Trust QA visits have been
implemented. The implantation of the recommendations to student feedback take place during
2014/15 and details of those recommendations are provided below.
Student Feedback
The QAU gathers feedback from students throughout the programme using a bespoke, on-line student
evaluation questionnaire for each module. Data can be analysed by module and NHS site or GP
practice. Status reports are produced using this data and are supplied at regular intervals to various
Teaching Committees.
Following the aforementioned QA review, the on-line student evaluation questionnaires will be
conducted at more timely intervals in order to ascertain more meaningful and relevant data. The use
of new survey software is also being piloted as a means of trialling a more intuitive system with greater
reporting functions.
Trust QA visits – summary
The QAU workload has expanded; in particular the mandatory QA reporting processes, and the
resources associated with the historic visiting procedures was viewed as excessive. The GMC
encourage a process of self-evaluation for both medical schools and providers of clinical placements.
The Medical School follows a structure similar to that of the GMC; an annual, self-assessment
exercise by trusts, triangulated with online student feedback and focused visits. This self-assessment
tool, the Medical Education Providers’ Annual Return (MEPAR) was previously completed by our main
DGHs and providers. A recommendation of the QA review was to roll out the MEPAR to all of our
providers, including our 3 main central sites. The QA will visit any Trust that do not submit their
MEPAR.
In line with the QA review, the QAU has started a process of attending the Undergraduate Teaching
Committees of their DGH education providers as a means of visiting Trusts in a resourceful way. It is
anticipated that this will take place ever three years.
12
Informal, light touch visits to some of the DGH education providers have been conducted by the Final
Year lead, which include discussion of feedback on fourth year placements and resources. (see
below, section ii.)
The Academic Lead for Year 5 also conducted curriculum so cued visits to four site during the summer
term of 2013/14.
The aims of these visits are to:

share developments and review feedback

ensure the quality of educational provision meets the requirements laid out in the Learning &
Development Agreement, Tomorrow’s Doctors 2009, QABME report and any other guidelines
issued by the School, the GMC, the SHA, College and the QAA;

promote good relations with the Trust through dialogue, feedback, and support

share good practice
ii. Description of the process used
Attending the Undergraduate Teaching Committees has enabled UCL and its providers to sustain
positive working relationships and is a suitable vehicle for ensuring a constructive dialogue continues
between both parties. This approach differs from the light touch visits which take place for years 5
and 6 and are a way of encompassing all years, with a more strategic focus.
The light touch visits have been carried out by the Final Year Lead and team. These visits aimed to
offer support to our NHS partners and maintain good relations. They followed a standard structure:
meeting students to gather feedback, followed by a meeting with the Undergraduate Tutor, key clinical
teachers and administrative staff. The Medical School Librarian and Academic Support Manager
attended these meetings, and carried out a comprehensive review of library and IT resources.
The MEPAR submission deadline has recently passed the results are currently being collated and
analysis carried out. Initial findings indicate that the DGHs are meeting the required standards in
teaching and supporting our students. Much of the information gathered has been useful in identifying
areas of good practice and/or concern.
The MEPAR for 2013/14 was refined and tailored using the data from the previous MEPAR, enabling
us to check the progress made within Trusts and to understand where further enhancements have
been made using the last year. Information gathered within the MEPAR has helped the School to
inform the 2013/14 MSAR.
13
Table 5
Overview of status of site visits and reviews of hospital trust
Site
Date last visited
Type of visit
Luton and
Dunstable
Summer term 2014
Extended
Luton and
Dunstable
Spring term 2014
Focused
Luton and
Dunstable
Summer term 2014
Focused*
Lister
Spring term 2014
Focused
Lister
Summer term 2014
Focused*
Barnet
Autumn term 2013
Focused
Barnet
Summer term 2014
Focused*
Queens
Summer term 2014
Focused*
North
Middlesex
Spring term 2014
Focused
Basildon
Spring term 2014
Focused
Watford
Spring term 2014
Focused
Comment
Extended = continuation of the Trust Undergraduate Teaching Committee led by the QA SIFT team
Focused = final year with limited review of fourth year
Focused* = Year 5 visit to discuss curriculum matters
14
iii. Strengths and areas in need of improvement in each trust visited
The following information is derived from the information provided by the sites at the visits in combination with online student feedback for sites and
MEPAR submission.
Table 6
Overview of status of site visits and reviews of hospital trust
Trust visited
Luton and
Dunstable
(Extended)
Luton and
Dunstable
(Focused*)
Lister
Strengths
Areas in need of improvement
Strong relationship between the Undergraduate Tutor,
Undergraduate Administration and students.
To implement the consent form for use by medical students
(e.g. for intimate examinations under anaesthetic)
Medicine attachment is really good; teaching always happens as
planned, consultants are very keen to teach, there is a lot of
bedside teaching
Experience on ward rounds with some FY1s was variable
Informal teaching is very good; no timetable clashes and
timetabled sessions have all gone ahead as scheduled
Main concern of students is wifi access
(Focused*)
‘Excellent’ teaching
Barnet and
Chase
Farm
(Focused
and
MEPAR)
Queens
Student Evaluation Questionnaires are used and
disseminated to relevant areas. Feedback sessions take
place with Undergraduate Tutors, Undergraduate
Administrators and students. They have an FY1 Buddy
system in place.
Administration on the Barnet site is noted to be very good
Travel between the two sites is provided by a shuttle bus
with extended timetable and improved public transport
system. We need to review whether this is sufficient for the
students (especially working later/early shifts)
A strong awareness of the Medical School policies and full
compliance with UCLMS IT Standards. Feedback from
Consent form for use by medical students (e.g. for intimate
examinations under anaesthetic) is not used at present
15
(Focused*
and
MEPAR)
North Middlesex
students is used, particularly to inform the timetable
Additional bedside teaching in Surgery
Some students are having trouble contacting their
Educational Supervisors for their Initial meeting
Accommodation provision has improved. Wifi is now in the
accommodation and there is wifi access across the whole site,
students have a password to access the EMR (swipe cards are
not required)
Continued management of student expectations of some
areas of bedside teaching
(Focused)
Basildon
(Focused)
Really useful induction day
Watford
(Focused)
IT and accommodation were flagged as areas for
improvement although work is was clearly underway to
rectify this
Excellent Clinical Skills teaching and A&E attachment
16
iv. Strengths / Areas in need of improvement for each Trust not visited
The following information is derived from the information provided by the sites in combination with online student feedback for sites from the MEPAR
submission where provided.
Table 7
Strengths / Areas in need of improvement for each Trust
Trust / date of
last visit
Strengths
Areas in need of improvement
Camden and
Islington
Foundation
Trust
Frequent presentations by Clinical Advisory Groups to
consultants to ensure they are up to date with the Medical
School curriculum and matter
Strong ward teaching
Suggestion of variable experiences. More teaching
requested
Royal Brompton
Patients are informed about the presence of medical students as
part of their standard literature
Strong teaching
IT upgrade although this is being updated
Whittington
Focus groups take place with the students to get additional
feedback (outside of the Student Evaluation Questionnaires)
More scheduled teaching requested by students
University
College Hospital
Obstetrics & Gynaecology Organisation and scheduling was
highly praised. Students valued the consultant and registrar led
teaching.
More bedside teaching requested
Barnet Enfield
and Haringey
Mental Health
Trust
Students are granted access to the Trusts’ CPD activities whilst
on placement
Site-specific induction is provided
UCL consent form needs to be used more widely
CNWL
Strong and clear relationship with students and patients- always
introduced by name
Positive student evaluation feedback
Royal Free
17
More bedside teaching requested
v. Common issues / Good practice
As part of its review and reporting activities the QAU generates an annual summary of all good practice which will be made available on the
website.
Table 8
Common issues / Good practice
Site
Subject/Department
Good practice
CNWL
Student Evaluation
Questionnaires
 Always uses that feedback from students and ensures that is incorporated and embedded in changes
and enhancement to its teaching
Royal
Brompton and
Harefield
Teaching
 High student to teacher ratio
Barnet and
Chase Farm
Feedback
 Administration on the Barnet site is noted to be very good
 Medical students reported a general improvement in teaching since the reorganisation and following
their feedback.
North
Middlesex
Teaching
Basildon
Teaching and
Administration
 The FY1 and FY2 doctors are very helpful to the students, and Radiology teaching was mentioned as
“excellent”
 Twilight teaching is excellent
 Students report that administration is excellent
18
Watford
Teaching and
Administration
 FY doctors are very keen to teach
 Excellent admin, friendly and approachable
19
20
QA of the Medical School
i.GMC: Medical Schools Annual Return (MSAR) 2013-14
All medical schools in the UK were again required to submit an Annual Return in December 2013.
The General Medical Council has the statutory responsibility to set standards for basic medical
education and to ensure that these standards are met.
iii. Description of the internal governance processes of the Medical School
The MBBS programme is managed through UCL Medical School, which is responsible for the
leadership of MBBS educational strategy; curriculum development and planning; assessment policy
and organisation; the setting and monitoring of standards and quality assurance; and for the MBBS
Student Load Exercise and SIFT allocations.
MBBS leadership roles within UCL Medical School include MBBS Sub Deans, Site Sub Deans and
Student Support Tutors, each with responsibility for specific areas of MBBS management.
Administrative support is provided by Medical Student Administration.
MBBS teaching is commissioned from the School of Life and Medical Sciences (SLMS) divisions and
funded through HEFCEt and tuition fee income. Faculties and divisions are responsible for managing
local delivery of teaching in accordance with UCL Medical School guidance, and for appointing MBBS
module and assessment leads to manage the delivery of education within the Division. Administrative
support for Faculty and Divisional roles is provided by Faculty and Divisional Teaching Administrators.
SLMS faculties and divisions are responsible for co-ordinating and supporting teaching delivery by
NHS colleagues, and for ensuring consistency of teaching and assessment across Hospital Trusts and
PCTs. Teaching provided by trusts is funded through SIFT. Administrative support is provided by
divisional Teaching Administrators and/or trust administrators.
The new organisational structures and management roles for the MBBS programme can be seen
clearly via the organograms in Appendix 3. Appendix 4 contains the booklets which explain the
structures are subject to updates, final review and approval.
D. Summary of developments, innovations, best
practice to include significant future changes to the
curriculum or any other important achievements
Developments and innovations
We introduced an entirely new curriculum in 2012 and so changes for 2014 are mainly final
steps in planned implementation, revisions in response to evaluation and feedback and
reviewing the priorities declared at the time of implementation, namely:
•Having clear overall aims and objectives for the MBBS course
•Improving integration across the course
•Ensuring the programme takes a patient centred approach
•Ensuring preparation for practice is a key feature of the course
•Ensuring planned delivery is mindful of educational objectives and changes in
the provider landscape
Changes therefore have mainly been in these domains:
Improving Integration: year 2 sees a new module called Reproduction, Genetic, Cancer
which brings together isolated topic areas in the domain of the burgeoning field of genomics
and personalised medicine.
Improving patient centred care: there are a number of new developments: the ‘Ask one
question’ intervention and taking part in NHS Change Day across the school which both
concern small acts of kindness and patient orientation in contributing to the quality of the
care patients receive; partly with the support of a grant by HENCEL a project to integrate
people with experience of FGM and abortion into the women’s and men’s health
curriculum; again partly supported by a grant from HENCEL, the introduction of Schwartz
Rounds into the later years of the undergraduate curriculum.
Preparation for practice: we have moved Finals to March to provide the opportunity for an
‘in-year resit’ and to introduce a preparation for practice SSC for 4 weeks for all students
focused on day 1 competencies. We have also introduced a Leadership Activity for all final
year students.
Deliver mindful of objectives and provider landscape: the reconfiguration of the Royal Free
Trust and the impending loss of acute cardiology services in the sector has required a rethink of what cardiology we teach and where. From January 2015 all students will attend the
Royal Free Hampstead to experience acute cardiology ‘takes’ including acute
catheterisation and students allocated to UCLH for cardiology will spend part of each week at
the Royal Free Barnet site.
As a medical school we have maintained our high student satisfaction in the National Student
Survey despite radical changes to the curriculum and the consequent period of upheaval,
have risen to 8th worldwide in the QS rankings of medical schools, have won a UCL Beacon
Award for our work in patient engagement and have been awarded a prestigious Athena
Swan Silver merit Award for championing the careers of women in STEM subjects.
Dr Deborah Gill MBBS MRCGP EdD SFHEA
Interim Director
UCL Medical School
Appendices
Appendix 1 – Management Plan arising from the last QABME visit
Appendix 2 – Internal Quality Review 2013-14 (not yet available, deadline December 2014)
Appendix 3 – Medical School governance – organograms
-
MBBS Academic Leadership
-
MBBS Vertical Modules Leadership
-
MBBS Leadership Clinical Placements
-
MBBS Faculty Tutor, Student Support and Foundation Training
- MBBS Committees and Chairs
Appendix 4 - Medical School governance - statements
-
MBBS Academic Leadership
-
MBBS Vertical Modules Leadership
-
MBBS Leadership Clinical Placements
-
MBBS Faculty Tutor, Student Support and Foundation Training
- MBBS Committees and Chairs
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Undergraduate Medical Training Financial Accountability &