Minutes of the meeting of the Mental Health Specialty Training Board held at 10.30 am
on Friday 14 June 2013 in Room 5, Floor 1, Westport, Edinburgh
Present: Susan Miller (SM) Chair, Margaret Bremner (MB), Sandra Duke (SD), Stephen
Lawrie (SL) part meeting, Kathy Leighton (KL), Robin McGilp (RMcG), Siobhan Murphy
(SMu), Norman Nuttall (NN), John Russell (JR) part meeting.
By videoconference: Aberdeen (Forest Grove House) - Dik Athawes (RA), Gillian
Needham (GN); Aberdeen (Royal Cornhill Hospital) - Sally Winning (SW); Inverness –
Ronald MacVicar (RMacV).
Apologies: Geraldine Bienkowski (GB), Roger Blake (RB), David Brown (DB), Tom Brown
(TB), Ashley Catto (AC), John Channon (JCh), Stella Clark (SC), Alastair Cook (AC), John
Crichton (JC), Euan Euston (EE), Linda Findlay (LF), Tracey Hicks (TH), Paul Hudson (PH),
Johan Leuvennink (JL), Michelle McGlen (MMcG), Seamus McNulty (SMcN), Rowan Parks
(RP), Rhiannon Pugh (RP), Karen Shearer (KS), Laura Sutherland (LS), John Taylor (JT),
Judy Thomson (JT), Adele Warrilow (AW).
In attendance: Qudrat Ullah (QU) observing, Helen McIntosh (HM).
1.
Apologies and welcome
SM welcomed all to the meeting and in particular Dr Qudrat Ullah who was
observing to gain management experience. Apologies were noted.
2.
Minutes of the meeting held on 3 May 2013
The following amendment was noted:
Item 4.3, Page 4, Challenges, second bullet point, second sentence to read
‘Psychotherapy Faculty must consider that there were significantly fewer UK
training posts than previously.’
With this amendment the minutes were accepted as a correct record of the
meeting and will be posted on the website.
3.
3.1
Matters arising
Knowledge Network Subscriptions Advisory Panel: academic nominee
SM confirmed David Christmas has accepted the role.
3.2
NES response to Scottish Government Engagement Paper on the
Prevention of Suicide and Self-Harm
The response lined to that from the College and has been submitted.
4.
4.1
4.2
Recruitment
Recruitment team update
UK national recruitment 2013

Survey responses

Fill rates

Core numbers

Eportfolio presentation – feedback to National Recruitment Office

Numbers for clearing and candidate information
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All CT1 posts filled; there were significant gaps in ST4 as only 21 of 63 posts
filled. Psychiatry was not the only specialty in Scotland experiencing difficulty
in filling posts eg CMT/Emergency Medicine. HM will circulate the Scottish and
English fill rate information to the STB; to note England did not include posts it
had not expected to fill in the recruitment round. A request has been made to
join the College’s Autumn recruitment.
HEE has stated it would like regions to assume responsibility from Colleges for
recruitment. This would be acceptable as the North West Deanery was the
suggested Psychiatry lead however HEE had not been aware the College also
ran Scotland’s recruitment process. SM will discuss this further with Stewart
Irvine. GN noted discussion with Professor Jacky Hayden and the Medical
Director of HEE at the recent COPMED conference who acknowledged HEE
was floating many different ideas but not all were likely to be put into practice.
Additionally although core fill this year has been very good Professor Hayden
did not favour expanding numbers. However it was felt Scotland could make a
good case for increasing its core numbers, survey evidence suggested a
significant drop off in progression to ST4 and it has never recruited to the
numbers suggested by manpower planning.
With one or two exceptions, most specialties were happy to continue UK
national recruitment, including Psychiatry, and this has been SRDB’s
recommendation to SMTB.
Seven deaneries in England piloted recruitment to the broad based framework
however only 2 candidates in the UK had chosen this as first preference and
only 50% of posts filled. It was felt likely broad based training was likely to
become the norm following the Shape of Training Report.
JR noted a CT2 trainee in Lothian has been accepted to the Psystar
programme and will seek information from Professor Reid regarding deferring
entry to ST4.
SM confirmed Psychiatry in Scotland will participate in clearing.
Actions:
 HM to circulate information on Scottish and English fill rates to STB
members.
 JR to seek information from Professor Reid regarding deferral for research.
5.
5.1
5.2
Workforce
Meeting to discuss reshaping for 2014
First thoughts on numbers 2014 and beyond
SM and AC met Professor Padfield as arranged and a meeting for the
workforce group and STB chairs has been arranged for 9 July at which MB will
deputise for SM. SM asked STB members to provide MB with up-to-date
retirement figures for each of the Psychiatry specialties for that meeting. Not
all responses have been received as yet - DA will consult a colleague for Old
Age Psychiatry retirement figures; SMur has emailed Psychotherapy
colleagues and KL will supply CAMHS information. RMcG noted College
returns now requested MHO status and this could make these returns more
reliable.
SW represented the BMA on the Reshaping Board and reported it will meet
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immediately after the pre-meeting 9 July. As discussion at the pre-meeting will
influence the later meeting it was essential to make all relevant information
available to the group.
SM will liaise with AC prior to the meeting on 9 July.
Actions:
 DA to provide OAP retirement information; SMur to provide Psychotherapy
information; KL to supply CAMHS information.
 SM to liaise with AC prior to 9 July meeting.
6.
Scottish Learning Disabilities posts – review
No ST4 posts filled this year and as a number of posts have been lost over the
last few years’ consideration was being given to establishing a national training
programme. RMcG, JR, SM and FH have discussed this by email and agreed
to establish a working group, including trainee representation which will
consider pros and cons, hosting and TPD arrangements. JR will arrange a
meeting date and invite a trainee representative. It was agreed HM will
circulate SMur’s Psychotherapy presentation to assist discussion.
Actions:
 JR to arrange a meeting date for the working group by email and invite a
trainee representative.
 HM to circulate Psychotherapy presentation from previous STB.
7.
Quality Review – Tayside Pilot
SM will ask RB whether the item should carry forward to a future meeting.
Action:
 SM to ask RB if item will carry forward.
8.
ARCP sub group update
SES was half way through ARCPs. The process was almost paperless
although they still reviewed paper reports. There were 13 panellists including 3
externals and 50 trainees reviewed with a high proportion of Outcome 5s. Mini
PATs were the main issue which was very disappointing as they have made
considerable effort to increase the number of workplace based assessments.
They will interview all trainees who had not undertaken sufficient workplace
based assessments. One trainee who had not self-declared on SOAR has
been given an Outcome 5. SD said there were few Outcome 5s in EoS.
Overall SOAR has worked well. However, the biggest issue has been the slow
speed of the eportfolio system and although all 50 ARCPs were completed in
one morning this had been irritating. JR reported the issue to the College and
asked for it to be cascaded to the Chair of the ESTC. It appeared the College
server was the problem and the College has apologised and hoped access to
the website and eportfolio will improve after the installation of a new server in
October. Meantime all trainees/trainers were encouraged to report any issues
to the College. It was felt that if the system worked well the process would be
good although some refinement was still required. SM reported the College
had discussed whether to launch the new website in August for new trainees or
to delay until it was fully functioning. JR agreed to produce information on the
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process for the STB.
Externality was provided differently in each of the Deaneries eg WoS provided
Scottish externality.
RMcG noted last year’s report on the process confirmed the ARCP process
was being fairly and well applied.
Action:
 JR to produce information on ARCP process for STB members.
9.
Foundation
SM reported a number of FY1 posts in Psychiatry have been confirmed of
which 5 were in WoS. The most recent Heads of Schools meeting had
discussed Foundation posts and one member of the group stressed the
importance to educate all trainees in core competences and not just as a
recruitment exercise. GN said COPMED sought robust recruitment to core
training and she felt this was a positive message. SM stressed the need to
ensure experience for Foundation trainees was of a high standard.
9.1
EoS & N information
Noted: 3 conversions from FY2 to FY1 in EoS; 2 new FY1 posts in NoS.
10.
START Alliance
The circulated paper was presented to MDET and reported the workshop held
at the PGMET conference. There was increasing recognition of the issues of
recruitment and retention resulting in the establishment of the START Alliance
between NES, Colleges, Health Boards, Medical Schools and others. The
initiative was not just to market Scotland but to understand the factors
influencing decisions on where to train. The Alliance was currently
concentrating on gathering data and commissioning new research. Alastair
McLellan, Anne Dickson, Rowan Parks and RM were leading the work for NES.
There has always been competition between specialties and areas within
Scotland however they were now competing against one another in a smaller
pool. The aim of the Alliance was to create and retain a bigger pool of
applicants to Scotland and it will target the 2014 recruitment round. There
appeared to be 2 chief factors – junior trainees at Foundation level were
influenced by where they came from and testimonials from friends and peers.
This could provide an opportunity to use trainees as champions and advocates
for training and living in Scotland.
SM participated in the START Alliance workshop at the conference and
subsequently sent the group information relating to Scottish Psychiatry
trainees. She and AC have also notified the group they wish to be actively
involved in its work.
The item will remain on the agenda as a standing item.
Action:
 Standing agenda item.
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11.
GMC Educational Environments
This was discussed at the most recent MDET meeting. There was much
discussion at UK level regarding consistent Quality Management visits and the
GMC was seeking to set standards which may result in more College
involvement/role in visits. Comments on the document to be sent to SM.
Action:
 All to send comments on the document to SM.
12.
SAPE requirements for Higher Trainees
The expectation was that the curriculum required some Psychotherapy for all
HSTs in Psychiatry training in the broadest context. There were slightly
different descriptors depending on the specialty and evaluation and guidelines
for ARCPs using workplace based assessments. The College was clear this
must be done not ‘would be good practice’. An issue in SES regarding
availability to Psychotherapy experience was noted. SM will send her audit tool
and presentation to the STB and JR will speak to the English ARCP external
next week for information on the situation in England.
RMcG said a minimum of 6 good quality Reflective Practice Notes were
required. JR confirmed he was cascading this information which will also feed
into the revalidation process and map to ILO life-long learning but not in all
curricula. Much work has been done on by College on ILO 19 reflective
practice and the North West Deanery was also developing a pilot on how to
assess quality. ILO 19 will go to the GMC for approval via Psychotherapy and
possibly also via General Adult. It was likely this will soon form part of the
curriculum.
Actions:
 SM to circulate audit tool and presentation to STB.
 JR to seek information on situation in England from English external ARCP
panellist.
13.
Heads of School meetings
Issues discussed at the most recent meeting:
 Exit exam at the end of ST6 – to comprise an exam in addition to the
present exam and a reflective log which will not be knowledge based.
College solicitors were considering whether to apply this prospectively or
for all trainees currently in programme. GMC approval will have to be
given however this was likely as it was the chief driver for exit exams. The
GMC had made exit exams a requirement several years ago although it
has taken some specialties a long time to develop these. It was not clear
whether this would add anything to the current exam however it was clear
the public supported exit exams. The cost to trainees was high and
generated much anxiety which was not the original intention and pass
rates varied. GP’s knowledge based test had 4 components and
individuals could not work in UK unless they have passed it, other than as
a trainee, and there was a significant failure rate. However GP felt this
was an important element in ensuring CCT holders met the required level.
JCST also required exit exams and allowed 6 maximum attempts although
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there was not a significant failure rate. Some Colleges set a lower
maximum number of attempts.
 English issues – reduction in consultant numbers/posts not being
filled/disempowerment of consultants, supervisor standards and
experience and competency base.
 Study leave – the level of leave was being re-stated.
14. Updates
14.1 Liaison Dean/MDET update
Issues discussed:
 Francis Report – Professor Cachia was leading the response based on
discussion at the conference workshop. Some chief points in the response
– fewer recommendations would have provided a better focus, stress on
education, patient safety, management and compassionate care as a way
of embedding patient safety. If appropriate, HM will circulate the NES
response to the STB for information.
 AMTF – Professor Parks was working to revise this process. To note the
model did not fit Psychiatry requirements. HM will circulate the final paper
on request.
 20:20 vision.
 HEE.
 Shape of Training review response – previously circulated; developments
on hold until the report was issued.
 GMC – visits in London and Scottish visits planned for 2015.
 Clinical Academic training – some disquiet about distribution and paper
was going to SCREDS for discussion.
Actions:
 HM to check whether NES response to Francis Report could be circulated
to STB.
 HM to circulate AMTF final paper on request.
14.2 Deanery and Specialty updates




WoS will review ARCP processes.
NoS – will meet next week to discuss LAT and LAS recruitment to attempt
to fill gaps.
CAMHS – recruitment main issue and KL will speak to Karen Shearer to
attempt to progress LAT and LAS appointments.
Deferral of programme for a Psystar post was discussed. The particular
issue related to short notice which had been unplanned and unanticipated.
Following discussion it was agreed deferral for 6 months could be
considered in future with prior notice and programme detail.
Old Age – to note loss of posts in NoS.
Action:
 KL to speak to Karen Shearer regarding CAMHS LAT and LAS
appointments.
14.3 College update
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Noted AC has replaced PR as College representative.
14.4 Service update
SM will contact service representatives to confirm membership of STB.
Action:
 SM to contact service representatives re membership.
14.5 Academic update
SL reported:
 Medical Students Psychiatry School to be held in Dundee in the last 2 days
of August.
 Psystar – 4 appointed in General or Forensic to start in August this year.
One appointee will undertake clinical training in Oxford which will be
accommodated as best as possible; one core trainee who should be fine in
terms of service delivery. The next recruitment round was likely to offer 3
spaces and they have up to 2 years to recruit.
To note the survey issued by the Dundee consortium has been re-issued.
14.6 Regional planning update
No update was received.
14.7 Trainee/Specialty doctor update
SW reported ongoing difficulties in recruiting to SAS posts and hoped the SAS
development fund will make such posts more attractive. Employment Advisers
will target Psychiatry and Emergency Medicine to promote flexible career
pathways.
14.8 STARG
SM highlighted:
 Teaching skills course for HST in November in Glasgow.
 Careers Fairs.
 Guidance on College website on how to facilitate school student
placements.
 Recruitment strategy.
 Feedback from University Psychiatry societies and in particular good
feedback from Glasgow and Edinburgh.
SL highlighted:
 Psystar Summer School for clinical trainees interested in research.
 Scottish Medical Student awarded the William Darling Student of the Year.
 School Student access to Psychiatry work placement week run by
Professor of O & G in Edinburgh to provide access to different specialties;
a centralised process was also run in Dundee.
To note some overlap in membership of STARG with STB; links considered
beneficial.
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15.
Received for information
No additional information was received.
16. AOB
16.1 Exchange Programme
NN reported 2 core trainees were seeking permission to undertake 2-6 weeks
observerships in France. GN said it would be helpful to receive additional
information ie why the trainees have requested this and what was the added
value. If it was agreed this would provide a good opportunity the trainees
should annual leave/study leave. GMC did not allow OOP at this stage of
training and in this way and if OOPE were used this would use up their future
allocations. The STB agreed the trainees should use annual or study leave.
16.2 Helping Trainees in Difficulty at RCPsych Postgraduate Education
Conference
SD will present at the College conference and seeking input from RP; JR will
supply ARCP data. Scotland and specialty specific comments or information
was welcomed.
Action:
 JR to supply ARCP data for SD’s presentation at College conference.
17.
Date of next meeting
The next meeting will take place at 10.30 am on Friday 23 August 2013 in the
Calman Room, 2 Central Quay, 89 Hydepark Street, Glasgow (VC available).
Actions arising from the meeting
Item no
Item name
4.
4.1
4.2
Recruitment
Recruitment team update
UK national recruitment 2013
5.
5.1
5.2
6.
7.
Workforce
Meeting to discuss reshaping for
2014
First thoughts on numbers 2014
and beyond
Scottish Learning Disabilities
posts – review
Quality Review – Tayside Pilot
Action
Who
To circulate information on
Scottish and English fill rates to
STB members.
To seek information from
Professor Reid regarding deferral
for research.
HM
To provide OAP, Psychotherapy
and CAMHS information.
DA,
SMur,
KL
SM
To liaise with AC prior to 9 July
meeting.
To arrange a meeting date for the
working group by email and invite
a trainee representative.
To circulate Psychotherapy
presentation from previous STB.
To ask RB if item will carry
forward.
JR
JR
HM
SM
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8.
ARCP sub group update
10.
11.
12.
START Alliance
GMC Educational Environments
SAPE requirements for Higher
Trainees
14.
14.1
Updates
Liaison Dean/MDET update
14.2
Deanery and Specialty updates
14.4
Service update
16.
16.2
AOB
Helping Trainees in Difficulty at
College Conference
To produce information on ARCP
process for STB members.
Standing agenda item.
All to send comments to SM.
To circulate audit tool and
presentation to STB.
To seek information on situation in
England from English external
ARCP panellist.
JR
To check whether NES response
to Francis Report could be
circulated to STB.
To circulate AMTF final paper on
request.
To speak to Karen Shearer
regarding CAMHS LAT and LAS
appointments.
To contact service representatives
re membership
HM
To supply ARCP data for SD’s
presentation at College
conference.
JR
SM/HM
All
SM
JR
HM
KL
SM
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