Better Training
Better Care
Patrick Mitchell
Director National Programmes – Medical Education
Aims to improve the quality of training and learning for
the benefit of patient care
Commissioned by DH Ministers with SoS approval
Professor Sir John Temple: Time for Training
Professor John Collins: Foundation for Excellence
Similar findings from other reports: Wilson, PMETB survey, Lord
Patel review, QAFP reports
Medical Education England, now HEE, is taking forward the work
with the establishment of the National Taskforce
Two aspects of the programme
• Identification, piloting, evaluation and dissemination
of good education and training practice
• Improvements to curricula and the underpinning
education and training frameworks
Time for Training
Sir John Temple’s Time for Training called for
better use of the expanded consultant workforce,
not only to ensure improved training for junior
doctors but also in terms both of efficiency savings
for the service, as well as enhanced safety and
higher quality care for patients.
Foundation for Excellence
• Evaluated the Foundation Programme in the context
of the needs of patients and trainees and the
changing healthcare environment.
• Identified Trusts that were doing well, having changed
practices to cope with reduced working hours.
• 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
Bringing different bodies together in joined up
thinking to deliver national positive change to the
way medical education and training is delivered,
directly effecting patient care and safety.
Cohesive small changes = large improvements
Professional and clinical
Secretary of State
HEE Board
Medical Professional Board
BTBC Taskforce
NHS Employers
Royal Colleges
Trainee groups
Our workstreams
Local implementation and pilots
Role of the trainee
Role of trainers
Workforce planning
Improving careers guidance and availability
Integrated technology enhanced learning
Harmonising and improving training
Regulatory approach to supporting Better Training Better
9. Funding and education quality metrics
1. Our pilots
16 Trusts piloting 16 projects
Sustainable and adoptable
Improve training and education
Improve patient care
Meet recommendations from Temple and Collins
Pilot success - Southern
East Kent Hospitals University NHS Foundation Trust
Introducing emergency ‘hot’ and ward-based ‘cold’ teams to
improve training and supervision out of hours and on weekends.
North Bristol NHS Trust
Video-recording trainee consultations to use as a training tool in
the outpatients department.
Royal Berkshire NHS Foundation Trust
‘Making Every Moment Count’ by embedding quality
improvement as normal practice and using every learning
Pilot success – Northern
The Pennine Acute Hospitals NHS Trust
Using innovations in technology for improved handover and better
training and education in emergency medicine
Tees, Esk and Wear Valleys NHS Foundation Trust
Putting supervision in the spotlight and supporting training
opportunities with ‘on the job’ training and education across the
multi-disciplinary team
Airedale NHS Foundation Trust and Western Sussex
Hospitals NHS Trust
Working together using telemedicine to overcome geographical
barriers and transform education and learning
Next steps
• Working on adoptability plans
• Looking for trusts to adopt successful
• Holding events for trusts to share knowledge
• Implement pilot projects across England
6. Integrated technology enhanced
• Framework for Technology Enhanced Learning (TEL).
• Now seeking to develop simulation standards for
simulation providers.
• Showcase TEL and simulation that supports medical
education at an event in late 2012.
7. Harmonisation and improving
foundation training
Largest project with 17 recommendations from Collins
Three main components:
- Curriculum Development
- Improving Selection into the Foundation Programme
- Harmonisation and Improved Delivery
Project focus now shifting into third phase “Harmonisation and Improved
Delivery” which aims to meet recommendations for more trainees to
undertake broader based training including community based and
community facing placements.
Harmonisation Task & Finish Group
- Better Training sub-group
- Better Care sub-group
Key stakeholders engaged from across the education and provider
Benefit to patients
• Improved quality of care, clinical outcomes,
and patient experience through improved
supervision and training and better systems of
• Greater consultant involvement in the delivery,
and supervision of care
• Improved and more immediate support of
Benefit to providers
• Maximise return on training investment
• Trainees work better across different settings
and ensure continuity along care pathways
• Training more responsive to needs of service
• Improved quality of care and patient safety
• Improved patient satisfaction
• More efficient use of resources
Benefit to trainees
• Improved and more accessible supervision
• Improved learning, mentoring and support
• Opportunities for technology enhanced learning
• Less stress and greater job satisfaction
Benefit to consultants
• Mentoring and support for newly-appointed
• Recognition of education and training in job
• Framework for the training, accreditation and
re-accreditation of trainers
• Improved clinical outcomes and patient
Patrick Mitchell
Director National Programmes – Medical Education