TRAINING SUPPORT IN HEKSS
http://kss.hee.nhs.uk/education-and-training/trainee-support/
www.kss.hee.nhs.uk
INTRODUCTION
The HEKSS Training Support Service (TSS) ensures that robust processes are in
place to support doctors, dentists and pharmacists in training who are experiencing
difficulties, or who require additional support. The TSS also provides a focus of
expertise and additional resources for trainers who are training doctors, dentists and
pharmacists.
GOVERNANCE
The TSS is led by the Deputy Postgraduate Dean who chairs the Training Support
Group (see section 3 below) which reports to the HEKSS PGME Operational Group.
Training support in HEKSS is based on a tri-partite model. This comprises:
1) Management by Trust and HEKSS educators of trainees in need of
support/with difficulties
2) External open access provision from the Practitioner Health Programme
3) Individual referral for other needs, e.g. dyslexia assessment or coaching,
usually from the London Professional Support Unit
Most issues with trainees who require additional support should first be addressed at
the local level and escalated to the relevant school/department as appropriate.
Details of the thresholds for the management of trainees requiring additional support
are included in appendix B.
Each school/department is required to maintain a local register of trainees in difficulty
(TiDs)/trainees requiring additional support which it reviews on a regular basis.
Schools/departments liaise with local education providers (LEPs) to obtain updates
on progress, monitor/review e-portfolios, meet with individuals to discuss
issues/provide additional support advice. These activities are usually supported by
departmental process/guidance documents (see appendix E for examples).
Schools/departments are also required to provide summary statistics of TiDs on a
regular basis.
Once a school/department becomes aware of a trainee in difficulty it may then seek
advice from the Training Support Service/Training Support Group. (See section 3 of
the HEKSS Trainee Support Guide for more detailed information about roles and
responsibilities.)
The Chair of the Training Support Group has responsibility for a budget to support
the provision of additional support/supernumerary training time. Usually, the
provision of supernumerary training time is limited to one-month wte in the first
instance. If more than this is proposed the Chair would escalate the request to the
postgraduate dean (in their role as chair of the HEKSS PGME Operational Group)
for further consideration.
1
Serious patient safety, probity, health/addiction issues would be escalated to the
postgraduate dean in their role as a responsible officer (RO). The RO would
consider whether the issue could impact on the trainee’s ability to receive a positive
revalidation recommendation, further investigation was required and/or the issue
should be reported to the GMC.
TRAINING SUPPORT GROUP
http://kss.hee.nhs.uk/education-and-training/trainee-support/tsgroup/
The Training Support Group oversees the support of trainees in difficulty and
governs the work of the Training Support Service within HEKSS.
Role
 Enable the effective support and management of trainees in difficulty and
trainees requiring extra support managed by HEKSS (including those within
the South Thames Foundation School).
 Act as the usual decision making body for the management and support of
trainees in difficulty managed by HEKSS
 To provide appropriate consistency and equitable decision making in relation
to trainees in difficulty and the provision of training support across all schools
in HEKSS
Members
 Head of Training Support Service (Chair)
 Postgraduate Dean
 Representatives of the Specialty, General Practice, Foundation, Dental and
Pharmacy schools/departments (including Deans, Heads of School, Trainees
in Difficulty leads and appropriate staff)
 Training Support Service and Revalidation Manager
 GMC Employer Liaison
 Human Resources Representative
 Careers Team Representative
A trainee summary template is included as appendix A.
A summary of the trainee referral process is included in appendix D.
TRAINEE SUPPORT GUIDE
http://kss.hee.nhs.uk/education-and-training/trainee-support/
The guide advises on the management of doctors, dentists, pharmacists and
pharmacy technicians in HEKSS training posts, provides links to relevant resources
and details of relevant national and local policy and information; covers both trainees
in difficulty and those with additional needs and/or in need of support; offers trainees
support and guidance.
2
The guide is for those working with doctors in training, such as educational
supervisors, training programme directors, education managers, directors of medical
education (DMEs) and clinical tutors, clinical managers, clinical supervisors,
directors of human resources (HR), medical education managers (MEMs) and
medical staffing managers, as well as trainees themselves.
SUPPORT FOR TRAINEES
http://kss.hee.nhs.uk/education-and-training/trainee-support/trainees/
HEKSS is keen to promote health and well-being for trainees by providing support
and guidance in managing any difficulties that arise, whether educational, health
related or emotional.
As some of the demands and challenges of training may feel overwhelming to
trainees a range of resources are available:
Careers
http://kss.hee.nhs.uk/education-and-training/about-careers/
HEKSS has an in-house careers service staffed by a small number of professionally
qualified careers advisers who are available by appointment for confidential
discussions about any aspect of medical training or career progression.
Trainee doctors can also be referred to the HEKSS careers team. Referrals can be
made by the LFG career lead, DME, TPD, educational supervisor, clinical tutor or
MEM. Where the referral is for a trainee in difficulty, usually the head of the relevant
HEKSS school would be informed.
She or he will manage what information is passed on to the HEKSS Training Support
Group. The HEKSS careers team may need access to some information about the
trainee and will liaise with the LFG career lead as required.
Practitioner Health Programme (PHP)
http://kss.hee.nhs.uk/education-and-training/trainee-support/trainees/practitioner-healthprog/
HEKSS has commissioned the Practitioner Health Programme to provide a
confidential consultation support service to all HEKSS managed trainees. PHP can
offer emotional, psychological and practical support for a wide range of issues and
problems that are common to trainees. PHP is accessed on a confidential selfreferral basis, although arrangements are in place to share information where there
are concerns about patient or trainee safety.
London Professional Support Unit (PSU)
http://www.lpmde.ac.uk/professional-development/professional-support-unit
AS HEKSS and the London LETBs are now part of one geography, work has been
undertaken to consider how to work more closely regarding training support issues.
Arrangements are now in place with the London Professional Support Unit for the
referral of HEKSS managed trainees who require access to additional specialist
support services e.g. communication skills, coaching & mentoring, etc.
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Bullying, harassment and undermining
http://kss.hee.nhs.uk/education-and-training/trainee-support/trainees/buh-guidance/
HEKSS views bullying and harassment as completely unacceptable, and is
committed to ensuring that workplace environments used for training are suitable for
the purpose, being free from bullying or intimidating behaviour. HEKSS has
produced guidance for trainees and trainers in this area.
Other sources of support
http://kss.hee.nhs.uk/education-and-training/trainee-support/trainees/further-support/
In addition to HEKSS provided or commissioned support details of other
organisations which could be of benefit are provided on the training support website.
SUPPORT FOR TRAINERS
http://kss.hee.nhs.uk/education-and-training/trainee-support/trainers/
http://www.etft.co.uk/
In addition to the Trainee Support Guide, HEKSS has produced an e-learning
module which includes the following topics:
 Identifying a trainee in need of additional support
 Addressing issues at an early stage
 Properly documenting their management
 And communicating with the trainee and others who need to know
The module is primarily intended for supervisors of trainee healthcare professionals
– including doctors, dentists and pharmacists but may also be of interest to those
who supervise students, as well as other clinicians such as nurses or allied health
professionals.
SERIOUS INCIDENTS
http://kss.hee.nhs.uk/education-and-training/trainee-support/serious-incidents-sis/
All local education providers (LEPs) are required to inform HEKSS immediately of
any serious incidents involving trainee doctors, either directly or indirectly. Directors
of Medical Education (DMEs) must notify the postgraduate dean using the HEKSS
serious incident preliminary notification form. The purpose of this form is to notify
HEKSS that an incident has taken place and it is expected that the full final report
would be provided in due course.
Notifications are recorded on a central database for quality management purposes
and forwarded to the relevant foundation/specialty school.
NB: The HEKSS policy regarding serious incidents is currently under review.
STATISTICS
Summaries of the number of trainees in difficulty managed by HEKSS
schools/departments and the number of trainees receiving support from PHP during
the periods August 2013-August 2014 and August 2014-February 2015 are detailed
in the tables below.
A summary of the categories used is included in appendix C.
4
TABLE 1
Summary of trainees in difficulty: August 2014 - February 2015
Training Support
Service Categories
Knowledge, Skills,
Performance
Safety & Quality
Communication,
Partnerships and
Teamwork
Maintaining Trust
Progression in Training
Pharmacy
Specialty
GP
Foundation
TOTAL
5
24
5
14
48
0
3
1
0
4
3
1
0
2
6
0
9
2
0
7
3
1
0
- Exam failure *
25
3
0
Health
2
9
3
471
Other
3
4
2
2
TOTAL
22
71
15
72
* If applicable in addition to numbers for progression in training
1 Figure includes foundation doctors whose sickness absence is being monitored but has not yet exceeded the 20 day limit
5
9
13
28
61
11
180
TABLE 2
Summary of trainees in difficulty: August 2013 - August 2014
Training Support Service
Categories
Knowledge, Skills, Performance
Safety & Quality
Communication, Partnerships and
Teamwork
Maintaining Trust
Progression in Training
-
Pharmacy
Specialty
GP
Foundation
TOTAL
11
0
16
4
15
0
15
0
57
4
0
1
0
0
1
0
6
3
7
126
17
5
179
0
1
2
9
0
27
14
0
0
33
0
62
17
14
128
69
5
294
Exam failure *
Health
10
Other
0
TOTAL
26
* If applicable in addition to numbers for progression in training
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Appendix A
STRICTLY CONFIDENTIAL
HEKSS Training Support Group
TRAINEE SUMMARY
To be completed and submitted to Training Support Service Manager at least three
working days before Training Support Group Meeting
Date of TSG Meeting:
Unique Identifier (from School TiD register):
Grade:
Current Trust:
Managed by:
Discussed at previous TSG Meeting? (if so indicate when last discussed):
Background Summary:
7
Proposed Action:
Communications:
Queries to resolve (if applicable):
Outcome (to be completed after meeting):
8
Appendix B
9
Appendix C
10
Appendix D
HEKSS Training Support Service
REFERRAL FOR EXCEPTIONAL ADDITIONAL PROVISION
The Training Support Service commissions a variety of services to support HEKSS managed
trainee doctors, dentists and pharmacists. These services can be accessed via three routes:
 self-referral
 referral only
 self-funded
The majority of support for trainees in HEKSS is available through self-referral (including some
level of PHP provision, Careers etc). Details of all services available, through all routes, can be
found here [LINK].
This policy details the process for referring trainees to referral only services that require
authorisation by the Head of the Training Support Service (Dr Jan Welch).
Referral Process
If a need for additional support has been identified (at a local or school level) which is accessed on
a referral only basis this must be authorised by the Head of the Training Support Service. The
Schools have a considerate experience in the management of, and support for Trainees in
Difficulty and therefore all requests for additional support of this nature must first be discussed and
agreed with the relevant school. Additional support which is funded by the school does not require
authorisation by the Head of the Training Support Service (however Training Support Service is
informed for recording).
Supervisor/Local
• If need for
referral only
support is
identified at
trust/supervisor
level then must
discuss with
relevant school.
School
Training Support
Service
• School to identify
appropriate
support and
where to access
it (in discussion
with TSS
Manager as
needed). Head of
School/Training
Support Lead to
complete
authorisation
form.
• Head of Training
Support Service
to authorise
additional
support. TSS
Manager to
advise school on
access
arrangements for
trainee.
All requests for additional support should be submitted using the “Request for additional support
referral form (see Appendix E).
If the need has been identified by a local/supervisor the request should be submitted to the school
in the first instance.
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Appendix E
HEKSS Training Support Service
REQUEST FOR ADDITIONAL SUPPORT REFERRAL FORM
Trainee Name
To be completed by the relevant school
Forename
Surname
Professional
Reference Number
Specialty
Grade
Current LEP
Additional Provision
Please complete If
requesting additional
time.
To be added
To be added
To be added
To be added
To be added
Educational Psychologist
Dyslexia Assessment
Additional PHP Resource
Additional Training Time
Other
Start date of additional time
End date of additional time
Full Time or Part Time
LEP (if different from above)
Reason for Deferral
Additional Information
Name of Head of School/Training Support
Lead
I confirm that I recommend the above additional support:
Date
Head of Training Support Service
I confirm authorisation of the above support:
Date
For Office Use Only
Copy to school for trainee file
Copy to Finance (Remediation approvals only)
Logged by TSS
PO Raised
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
We are the Local Education and Training Board for Kent, Surrey and Sussex
Developing people
for health and
healthcare
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
We are the Local Education and Training Board for Kent, Surrey and
Sussex
Developing people
for health and
healthcare