Minutes of the Obstetrics & Gynaecology and Paediatrics Specialty Training Board held at
12.00 noon on Friday 13 September 2013, in Rooms 3 and 4, Westport, Edinburgh
Present:
Jane Montgomery (JM)
Claire Alexander (CA)
Laura Armstrong (LA)
Maya Chetty (MC)
Andrew Ecclestone (AE)
Ailsa Gebbie (AGe)
Kevin Hanretty (KH)
Chris Lilley (CL)
Peter MacDonald (PMacD)
Hilary MacPherson (HM)
Ronald MacVicar (RMacV)
Kate McKay (KMcK)
Alastair McLellan (AMcL)
Philip Owen (PO)
Rowan Parks (RP)
Katrina Shearer (KS)
Chair
Videoconference
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Item 3 only
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In attendance:
Helen McIntosh (HM)
Paola Solar (PS)
Apologies:
Graham Eunson (GE), Catherine Calderwood (CC), Colin Malcolm (CM), Phil Booth (PB), Kerry Kasem
(KK), Moya Kelly (MK), Adam Gordon (AG)
1.
Welcome
The Chair welcomed all attendees to the meeting.
2.
Apologies
Apologies were noted.
3.
GP Training – Dr Ronald MacVicar
Dr MacVicar had been invited to the meeting to inform the group about the progress of the GP
Paediatric Fellowship. He gave some background information on the creation of the Fellowship,
the aim of which is to enhance the role of the GP in developing Children’s Services in primary
care. RMcV indicated that the fourth cohort had just started and that the evaluation report
distributed was based on the first and second cohort. There will be another evaluation in 2-3
years, when there will be more robust data.
KMcK noted that although she was personally supportive of the Fellowship, she had serious
concerns about the final broad impact of the project. RMcV noted that this Fellowship was not
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Obstetrics & Gynaecology and Paediatrics STB 13.09.13
designed to make such a wide impact in Primary Care and in any case it was still too early to
take a definitive view.
RMcV pointed out that the project is fully funded by NES, but if any Health Board is interested
in joining in, it would be a very welcome move. It was noted it might be worth starting
discussions with Tayside on this project, as the Service was already seriously looking at this kind
of solution.
KMcK and RMcV agreed to have a conversation outside this meeting regarding how to show the
Health Boards the benefits of the project on population.
RMcV was thanked for his contribution and then left the meeting.
4.
Minutes of meetings held 21 March 2013
It was noted that in para 3 of page 2, the West 10% gap was due to maternity leave. With that
amendment the minutes were approved as a correct record.
5.
Matters Arising /Action points
5.1.
Inequality of Study Leave (deferred from previous meeting)
There was nothing to report regarding this item.
5.2.
Dunhill Report – Developing a CCH Service for the 21st Century
KMcK said the report regarding Community Childcare Health Service was published at the end
of December. There will also be paper produced on early years care, and a Bill was going
through Parliament that would establish the right of every child under 5 years in concerned
circumstances to have a named person in charge of his/her healthcare.
The report had already been discussed; there were different models and posts for future
delivery: some consultants, other trainees or Specialty Doctors, who would be replaced by
nurses. There was a perceived need for clear guidance from the Service about how much this
was an issue for training.
A letter was sent from the STB to MDET concerning this but no response received.
RP noted the Greenaway report may result in a review of the College proposals so there was
potential for Scotland do something different – however this would have to wait for the report
to be published.
AMcL confirmed that there had been some discussion about this at MDET last year. He would
talk to Stewart Irvine and get back to the group.
Action: AMcL
PMacD noted that the English process was suitable for large cities but not for rural areas. The
West region had tried to get Community placements for Paediatrics to start in August but in the
end this had not happened and they were still at 12/13%. He felt that the training programme
needed to be expanded to accommodate CCH, but there was no source of funding. PMacD
advised that there were two possible proposals:
1. The Health Board agreed to fund additional ST posts by increasing training number. That
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Obstetrics & Gynaecology and Paediatrics STB 13.09.13
way they could cover maternity leave gaps without recruiting LATs.
2. Salaries of people in OOP were largely used to get LATs, but they could be used to recruit
ST. In this way they would expand ST numbers without needing more salaries. It was
noted that if there were OOP, appointing new posts was at the Deans’ discretion. PMacD
noted that currently there were 10-12 OOPs, mostly overseas, in the West of Scotland.
Those numbers did not change year on year. They were looking at using those salaries to
fund 50% for LATs and 50% for STs. AMcL pointed out that this could create lots of
problems with workforce planning and reshaping, so they would need their ok first. This
proposal will be taken forward.
5.3.
NES Vacancy Policy
PO highlighted the struggle to provide positive and complete training experience in the West of
Scotland since the LTFTs salaries don’t go back to the specialties. The West region is down by 5
WTEs. It was important to acknowledge the inequality in specialties, when taken as percentage.
For example Anaesthesia had 200 trainees and 12 LTFTs, while O&G had 84 trainees and 14
LTFTs. AMcL confirmed that he had committed to take this forward at MDET and Alison Graham
will take it to the Reshaping group.
5.4.
LAT policy
AMcL reported that England had dismissed recruitment of LATs in principle, due to the calibre
of the candidates. There was some concern about poor processes for appointment of LATs. It
was highlighted that the Gold Guide says that if they do appoint to successive LATs there has to
be a substantive career progression. They had to make sure that people appointed to successive
LATs do not get stuck. If there were successive annual appointments AMcL observed that the
panel would decide the progression levels. CL also noted that it was important to provide for
remedial time if needed. And if a LAT had had remedial training but was not progressing, they
should consider employing them as LAS. It was agreed that these issues would have to be taken
to MDET for discussion.
Action: AMcL
6.
Notification of Any Other Business
 Pilot of Situational Judgement tests for recruitment
It was reported that this test existed for GP and Foundation, but it was not very
discriminative at that level. It would be challenging if, for example, a Foundation trainee did
not pass a later test. PMacD observed that the test would have to be introduced and then
evaluated in 10 years time, at the end of the training
Reports: Obstetrics & Gynaecology / Paediatrics
CA reported that there were ongoing problems with gaps and this was affecting training. The
LTFT issue was very problematic and perhaps disproportionally disadvantageous for this
specialty. The Obs&Gynae subgroup also had decided to focus on Quality at future meetings.
It had been noticed that the Service and the regions had taken different approaches to solve the
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Obstetrics & Gynaecology and Paediatrics STB 13.09.13
gaps issue. There was a need to increase the consultant body to provide 24/7 service, but
workforce prediction was unreliable. PO noted that calculations have already been done by a
Clinical Director and JM would contact him.
Action: JM
PMacD reported that the Paediatrics subgroup expected more discussions with CCH about how
to expand the programme. The College had proposed some changes in the recruitment of ST4
which would make it more detailed. They also wanted to hold them centrally as well as ST2 and
ST3. So only ST1 recruitment would be done locally. PMacD indicated that there were about 12
LATs in Scotland who were eligible for ST2, and a few others for ST3 and ST4. The Paediatric
Cardiology Training programme was very small, only delivered in the West region.
7.
Recruitment
RP asked whether recruitment was done at all levels at the same time and through the College.
The trainees apply for a single level, there were linked applications and it was done through the
College but with a choice of deaneries.
It was noted that there were enough applicants willing to come to Scotland but if they were not
given their first choice they might end up in England.
There was no problem recruiting to ST posts but it was noted that the number of posts available
were about 50% of the ones available in England for a similar area.
8.
Regional Workforce Update
9.
Report from Sub groups
10.
Report from Liaison Dean
AMcL reported that the NES’ direction of travel was s single deanery model by 2014. There will
be 5 regional offices to link with trainers and trainees. But the work with the STBs will be as
usual.
AMcL also informed that Professor Philip Cachia was leading the NES response to the Francis
report. There were four main headings: Sharing intelligence with other statutory bodies;
Developing Directorate response to Patient Safety issues; Developing QM visits to LEPs; and
Further development of Professionalism & Excellence agenda. All these points are under way.
AMcL further informed the group about the StART Alliance, which involved NES working in
partnership with others to work on attracting and retaining trainees in Scotland. StART were
looking to create a training ambassadors cohort, with trainees willing to talk in a positive way
about training, the regions, etc.
11.
Academic reports
There was no academic report.
12.
Updates
12.1.
Royal College of Obstetrics & Gynaecology (RCOG)
CA informed that there was a new curriculum to be adopted by all but those in the last year of
training. She would be attending the Heads of Schools meeting next week.
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Obstetrics & Gynaecology and Paediatrics STB 13.09.13
12.2.
Royal College of Paediatrics & Child Health (RCPCH)
AE noted that the Scottish RCPCH had met with the Minister of Health and Wellbeing and one
of the items on the agenda was the workforce crisis. There was a clear commitment to work
together.
There was also a meeting coming up with the CMO, when the workforce issues would also be
discussed.
AE informed that the College census was about to start and they would provide the exact
number of consultants to the Reshaping Board
12.3.
Report from Heads of Schools
CL noted that the Colleges were doing an in depth review of WPBA. They were looking at setting
target levels, and there was indication that trainees will be asked to complete more of WPBA at
all levels.
12.4.
TPDs report including Subspecialty/GRID
Clare MacKenzie was going to arrange a meeting with the Subspecialty Leads but it had not
happened. The Paediatrics Subgroup had not had a chance to discuss GRID in the morning
meeting.
13.
Paper for information
13.1.
Delivering CCH Training For Senior Paediatric Trainees
This was sent for information as a follow up to last meeting’s discussion. If they were going to
train people to cover CCH then trainees would need more community training in later years and
more training capacity. 1/6 of middle grade posts would need to be in Community placements.
KMcK commended PMacD for this project and noted that if this was not highlighted to the
Health Boards they would not take notice.
14.
AOCB
There was no other business.
15.
Date of next meetings:

12pm Thursday 14 November 2013, Westport, Edinburgh (Note: Subgroups meet
immediately beforehand at 10:30am)
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Obstetrics & Gynaecology and Paediatrics STB 13.09.13