CONTENTS - Northern Deanery
advertisement
JRCPTB HIGHER MEDICAL TRAINING IN PALLIATIVE MEDICINE INDUCTION INFORMATION FOR HEALTH EDUCATION NORTH EAST Congratulations on attaining a training post within HENE. Who are the key people involved in the rotation and how do I contact them? Role Name Contact Training Programme Director Dr Eleanor Grogan eleanor.grogan@nhct.nhs.uk Specialty Trainee Committee Chair Dr Eleanor Grogan eleanor.grogan@nhct.nhs.uk Trainee Representatives to the STC 2014-15 Dr Donna Weiand donnaweiand@nhs.net Dr Rowan Walmsley rvwalmsley@doctors.org.uk Flexible Training Advisor Dr Anne Pelham anne.pelham@nuth.nhs.uk Quality Lead Dr Lucy Lowery (SpR) lucylowery@doctors.org.uk Registrar Education Link Consultant Dr Leena Srivastava l.srivastava@ghnt.nhs.uk Registrar Research Link Consultants Dr Deepta Churm deepta.churm@nhct.nhs.uk Dr Katie Frew katie.frew@nhct.nhs.uk Rep for trainees in difficulty Dr Mary Comiskey mary.comiskey@nuth.nhs.uk Specialty Programme Coordinator Dave Roxborough david.roxborough@ne.hee.uk HR officer Sarah Tully sarahtully@nhs.net JRCPTB Frequently asked Questions Please click on the links to be taken to information on some of the more commonly asked questions. ? How do I find out where my placements are in the rotation? See ‘STRUCTURE OF TRAINING IN THE REGION’, Page 9 ? How do I get a copy of my on-call rota and what are the handover arrangements? See ‘Hospices’, Page 9 ? How do I enrol on the payroll and which medical personnel departments do I need to contact before starting? See the list of HENE contacts ? Who will issue my contract(s)? See ‘Your Contract’, Page 7 ? How are ARCPs organised? See ‘ANNUAL REVIEW OF COMPETENCE PROGRESSION (ARCP)’, Page Error! Bookmark not defined. ? How is annual leave organised and approved? See ‘Annual Leave’, Page 24 ? What is my annual study budget and how do I organise and approve study leave? See ‘Study leave’, Page 25 ? Are there any mandatory curriculum courses? See ‘Mandatory and Recommended Courses’, Page 26 ? Do I require local clinical governance training? This will be covered within each training site induction ? When and where is Palliative Medicine curriculum teaching? See ‘ EDUCATIONAL MEETINGS’, Page 28 ? Am I entitled to travel allowance? See ‘ Travel Expenses and Accommodation Claims’, Page 8 2 Version: Published 09/02/2016 05:17:00. JRCPTB CONTENTS HIGHER MEDICAL TRAINING IN PALLIATIVE MEDICINE ................................................................ 1 Induction Information For Health Education North East ................................................................ 1 Who are the key people involved in the rotation and how do I contact them? ............................. 1 Frequently asked Questions ............................................................................................................ 2 CONTENTS ................................................................................................................................. 3 STARTING OUT IN THE REGION ................................................................................................... 6 Important information and Websites .............................................................................................. 6 National Training Number (NTN) .............................................................................................................. 6 The Northern Deanery website ................................................................................................................. 6 JRCPTB enrolment ..................................................................................................................................... 6 NHS ePortfolios (see page 14 for more information) ................................................................................ 6 Association for Palliative Medicine (APM) ................................................................................................ 7 LAT post .................................................................................................................................................... 7 DBS ............................................................................................................................................................ 7 Meeting with Educational Supervisor ....................................................................................................... 7 Your Contract ............................................................................................................................................ 7 Removal costs ........................................................................................................................................... 7 Travel Expenses and Accommodation Claims ........................................................................................... 8 Paperwork ................................................................................................................................................. 8 STRUCTURE OF TRAINING IN THE REGION................................................................................... 9 Hospices ........................................................................................................................................... 9 Hospice on call .......................................................................................................................................... 9 Hospital & Community Palliative Care Teams ................................................................................. 9 Oncology (6 months part time or 3 months full time) ................................................................... 10 Oncology at NCCC ................................................................................................................................... 10 Oncology at James Cook University Hospital (JCUH) .............................................................................. 12 Other Attachments ........................................................................................................................ 13 Flexible Options.............................................................................................................................. 14 Sample Rotation(s) ......................................................................................................................... 14 SUPERVISION ........................................................................................................................... 15 Educational Supervision ................................................................................................................. 15 Clinical Supervision ........................................................................................................................ 15 Mentors .......................................................................................................................................... 15 E-Portfolio in Palliative Medicine ................................................................................................... 15 Home Page .............................................................................................................................................. 16 Profile ...................................................................................................................................................... 16 3 Version: Published 09/02/2016 05:17:00. JRCPTB Curriculum ............................................................................................................................................... 17 Reflection ................................................................................................................................................ 19 Appraisal ................................................................................................................................................. 19 Progression ............................................................................................................................................. 20 Messages ................................................................................................................................................ 20 Help ......................................................................................................................................................... 20 ANNUAL REVIEW OF COMPETENCE PROGRESSION (ARCP) ........................................................ 21 Key Points ....................................................................................................................................... 21 The ARCP panel .............................................................................................................................. 21 ARCP outcomes ....................................................................................................................................... 22 Hints and Tips.......................................................................................................................................... 22 PYA (PENULTIMATE YEAR ASSESSMENT)................................................................................... 23 Online CPD ..................................................................................................................................... 23 LEAVE ENTITLEMENT ................................................................................................................ 24 Annual Leave .................................................................................................................................. 24 Study leave ..................................................................................................................................... 25 Tips on Study Leave ................................................................................................................................. 25 Mandatory and Recommended Courses ................................................................................................. 26 Budget ..................................................................................................................................................... 27 EDUCATIONAL MEETINGS ......................................................................................................... 28 Northern Regional Palliative Care Physicians Group (NRPCPG) .................................................... 28 Journal Clubs .................................................................................................................................. 28 Specialty Registrar Training Days ................................................................................................... 29 Specialty Registrar Research Meetings .......................................................................................... 29 Other educational meetings .......................................................................................................... 29 Royal College of Physicians Northern Regional Office ............................................................................ 29 Oncology SpR teaching ........................................................................................................................... 30 RESEARCH, TEACHING AND RESOURCES ................................................................................... 30 Research ......................................................................................................................................... 30 Teaching ......................................................................................................................................... 30 Library facilities .............................................................................................................................. 31 Electronic journals.......................................................................................................................... 31 Registrar Shared Resources – Cloud Storage ................................................................................. 32 FLEXIBLE TRAINING .................................................................................................................. 33 Applying for flexible training .......................................................................................................... 33 Maternity Leave ............................................................................................................................. 33 Out of Programme Experience....................................................................................................... 33 4 Version: Published 09/02/2016 05:17:00. JRCPTB Contacts .................................................................................................................................................. 34 STRESS AND BURNOUT............................................................................................................. 35 THINGS TO DO IN THE REGION ................................................................................................. 36 Social .............................................................................................................................................. 36 Cinemas................................................................................................................................................... 36 Theatres .................................................................................................................................................. 36 Music Venues .......................................................................................................................................... 36 Shopping ................................................................................................................................................. 36 Art/Galleries ............................................................................................................................................ 36 Restaurants/ Places to Eat ...................................................................................................................... 37 Pubs......................................................................................................................................................... 37 Gyms ....................................................................................................................................................... 38 Other Places to see / go ................................................................................................................. 38 CONSULTANT PROFILES ............................................................................................................ 39 SOME TIPS WHEN YOU START (FROM THE CONSULTANTS) ....................................................... 44 CONTACT INFORMATION FOR PALLIATIVE CARE TEAMS ........................................................... 47 Hospices ......................................................................................................................................... 47 Community Teams ......................................................................................................................... 48 Hospital Teams ............................................................................................................................... 50 Other Useful Hospital Contact Numbers ....................................................................................... 51 APPENDICES ............................................................................................................................. 52 Appendix 1 – Further links ............................................................................................................. 52 Appendix 2 – Further information on Study Leave ........................................................................ 53 Appendix 3 - Reflection .................................................................................................................. 55 Guidance notes for Trainee and Trainer in Palliative Medicine for the Record of Reflective Practice.... 55 What is reflective practice? .................................................................................................................... 55 Why reflect as a palliative medicine trainee? ......................................................................................... 55 What should be reflected on? ................................................................................................................. 56 How to formally reflect ........................................................................................................................... 56 IDEA......................................................................................................................................................... 57 References ............................................................................................................................................... 57 5 Version: Published 09/02/2016 05:17:00. JRCPTB STARTING OUT IN THE REGION Welcome to Palliative Medicine training at Health Education North East! Important information and Websites National Training Number (NTN) Will be sent to you by the postgraduate department following completion of Form R (this will be found on the HENE website see Appendix 1). If you have come to Palliative Medicine though Core Medical Training, your previous NTN is no longer valid and will need to be changed by completing Form R. The Northern Deanery website http://www.northerndeanery.nhs.uk The HENE website has been updated and contains all the information you need to start off on the right foot. You will also find contact details of key people within HENE particularly the Specialty Programme Coordinator for Palliative Medicine who will assist you further should you have any query regarding any of the issues listed below. There are also links to important websites e.g. JRCPTB, PMETB, RCP, MMC, NICE, GMC etc. JRCPTB enrolment http://www.jrcptb.org.uk/enrolment Register online as a matter of priority. It can take some time to process the form, which you have to get signed by the Postgraduate Dean’s office before sending down to the RCP in London, so get started early. If you are experiencing delays contact Dr Eleanor Grogan (Training Programme Director) for the generic information to help you get started. NHS ePortfolios (see page 15 for more information) www.nhseportfolios.org You will need to apply for an e-portfolio online if you do not already have one. There is a fee involved. In your e-portfolio you will find the Palliative Medicine Curriculum. As you achieve the various learning objectives you will have to sign them off electronically with your supervisor. You need to complete a number of assessments (DOPS, mini-CEX, MSF CbD etc) and get them electronically signed-off with your supervisor. It’s best to plan ahead to complete these in good time and not leave it all to the month before your ARCP! See ‘E-Portfolio in Palliative Medicine’, Page 15. 6 Version: Published 09/02/2016 05:17:00. JRCPTB Association for Palliative Medicine (APM) www.apmonline.org This is worth joining at this stage if you haven’t already – keeps you up to date with courses, etc. and e-mail updates. Contact Becki Munro (becki.munro@apmonline.org, £150/year) LAT post If you have done a LAT post before getting your NTN you need to make sure you get a form signed by your educational supervisor/programme director before you leave the post in order to get the time in the LAT accredited. This form will be in your electronic information from JRCPTB from when you first enrolled with the LAT appointment, or you can download it from the JCHMT website. You need to send this off, together with another enrolment form, again to the RCP in London. DBS Will be sent to you by the postgraduate deanery but can take up to 10 weeks to process and may delay your start date if not done in time. Send it off early. Meeting with Educational Supervisor When you start you will need to meet with your educational supervisor to plan your learning objectives. These objectives will be guided by your curriculum in the e-portfolio. Depending on whether you are familiar with e-portfolio you may wish to have some time with your educational supervisor to navigate the e-portfolio site. Your Contract You will be sent your contract after you start. This will contain the usual information about annual leave entitlement, travel expenses and removal expenses. However, it is more useful to look at the Postgraduate Deanery website for more details (under Policies and Procedures) and to search for the necessary forms. Removal costs If you have moved to a new region for your rotation you are entitled to claim expenses for removal costs and various other expenses (there is a limit!), which add up in the process. You need to register your claim within 18 months of starting your post. 7 Version: Published 09/02/2016 05:17:00. JRCPTB Travel Expenses and Accommodation Claims The Lead Employer Trust re-imburse travel expenses, or can pay accommodation (plus 2 return journeys a week) if you have to relocate for your work. Currently travel expenses are submitted monthly via a paper form although work is underway on an electronic system. The relevant expenses policies can be found at http://www.northerndeanery.nhs.uk/NorthernDeanery/lethuman-resources/policies/payroll-expenses-policies-and-procedures TRAVEL EXPENSES CLERK Contact: Location(s): Leslie ROBINSON Tel: 0191 275 4726 Lead Employer Trust Paperwork Most forms are now submitted electronically but if you send off hard copies of anything make a copy for your own records and keep it safely in case you need to resend it. 8 Version: Published 09/02/2016 05:17:00. JRCPTB STRUCTURE OF TRAINING IN THE REGION The Training Rotation is broadly split into two geographical areas, the North and South. The distribution of the training posts mean that for a 4 year programme, on average 2 years will be spent with a hospice base in Newcastle, 1 year in Sunderland and 1 year in Teesside or Hartlepool. Rotation sites include Newcastle, North Tyneside, Northumberland, Gateshead, Durham, Sunderland, Hartlepool and Middlesbrough: Rotations between hospices and attachments normally take place on the first Monday of the new month and would normally run from March to September and September to March, however there may be some variation here. At the start of each attachment, you should formulate learning objectives for the period relevant to your own learning needs. This should reflect your increasing experience and responsibility and may include clinical and managerial training. Hospices Through the course of the training programme, you will be attached to a hospice and normally provide on-call cover there. If you are off-site when on-call, you must telephone for a detailed handover before 5pm. A minimum of 2 years must be spent in specialist palliative care, working with a full multiprofessional specialist palliative care team as defined in the NICE Guidance on Supportive and Palliative Care (2004). At least 1 year of this will be in an inpatient specialist palliative care unit with a minimum of 10 beds. At least 1 year will be spent at Marie Curie Hospice Newcastle or St Oswald’s Hospice. Trainees will work in a minimum of 2 hospices over the training period. Training hospices in the region are: Marie Curie Hospice Newcastle, St Oswald’s Hospice, Teesside Hospice, St Benedict’s Hospice and Hartlepool Hospice. Eden Valley Hospice Carlisle is currently seeking approval to be a training site. There are several other hospices but at present, they are not approved for training. Hospice on call On call is non-resident but depending on where you live and your hospice base, you may need to negotiate with the individual hospice as to how the on call system will work. Hospital & Community Palliative Care Teams Trainees will spend at least 6 months in a hospital palliative care team and will also gain at least 6 months cumulative experience working in a community specialist palliative care team. Training in community palliative medicine may or may not be done as a continuous block and includes outpatients, day hospice, home visits and work with a community specialist palliative care team. Hospital attachments: Northern Centre for Cancer Care (at Freeman Hospital), Royal Victoria Infirmary, Freeman Hospital, North Tyneside General Hospital, Queen Elizabeth Hospital, University Hospital North Durham, University Hospital of North Tees, Sunderland Royal Hospital, Wansbeck General Hospital, James Cook University Hospital and Hartlepool Hospital 9 Version: Published 09/02/2016 05:17:00. JRCPTB Community options: Newcastle, Gateshead, North Tyneside, Northumberland, Sunderland, Durham Community and Hartlepool Palliative Care Services. It is strongly advisable to contact the trainer within the relevant department well in advance of your time there in order to arrange the attachments beforehand. Oncology (6 months part time or 3 months full time) This takes place at either the Northern Centre for Cancer Care or James Cook University Hospital and is normally done in Year 1 or 2 and there may be an option of continuing to do weekly Oncology clinics following the training block. It is recommended that you cover a broad range of cancer regions and spend approximately 4 weeks in each and attend the relevant Multidisciplinary Team Meetings. Oncology at NCCC Clinical Oncology Urology Dr Rhona McMenemin Dr Ian Pedley Dr John Frew Dr Shahid Iqbal Breast Dr Daniella Lee Dr Anthony Branson Dr Wendy Taylor Dr Rebecca Goronova Upper GI Dr Paula Mulvenna Dr Philip Atherton Dr Fiona McDonald Lower GI Dr Ian Pedley Dr Tim Simmons Dr Philip Atherton Head and Neck Dr Charles Kelly Dr J Kovarik Dr Rebecca Goronova Lung/Mesothelioma Dr Paula Mulvenna Dr Philip Atherton Dr Shahid Iqbal Dr Fiona McDonald Dr Rhona McMenemin Dr J Kovarik Dr Tim Simmons Thyroid Dr Ujjal Mallick CNS Dr Jo Lewis Dr Emma Lethbridge Paediatrics Dr Jo Lewis Dr Daniella Lee Sarcoma Dr Daniella Lee Gynaecology Dr Anthony Branson Dr Wendy Taylor Dr Ghazia Shaikh Lymphoma Dr Jo Lewis Dr John Frew Upper GI Dr Fareeda Coxon Dr Kate Sumpter Lower GI Dr Fareeda Coxon Dr Ashraf Azzabi Skin Dr J Kovarik Dr Charles Kelly Medical Oncology Breast Dr Mark Verrill Dr Nic Cresti Dr Rhada Todd 10 Version: Published 09/02/2016 05:17:00. JRCPTB Lung/Mesothelioma Dr Jill Gardiner Dr Andrew Hughes Dr Chris Jones Dr Alistair Greystoke Sarcoma Dr Mark Verrill Dr Rhada Todd Urology Dr Ashraf Azzabi Gynaelogical Dr Graham Dark Dr Andrew Hughes Dr Yvette Drew Skin Prof Ruth Plummer Dr Nic Cresti CUP Dr Chris Jones Bobby Robson Trials Unit Prof Ruth Plummer Dr Yvette Drew Dr Alistair Greystoke 11 Version: Published 09/02/2016 05:17:00. JRCPTB Oncology at James Cook University Hospital (JCUH) The Cancer Centre at JCUH has 9 Clinical Oncologists and 2 Medical Oncologists. All have particular interest areas but also, in their peripheral clinics, cover all tumour groups. There are opportunities to attend all of the tumour site-specific group MDTs and the Oncologists welcome Palliative Medicine Registrars. There is plenty of access to clinics and continuity of clinical experience with the Oncology Consultants. Dr. Nicola Storey is the lead for Registrar training. Her Secretary, Denise Cook can be contacted on 01642 282468 Clinical Oncology Urology Dr John Hardman (prostate) Dr Hans van der Voet (bladder at Friarage) Dr Dev Shakespeare (N. Tees and Hartlepool) Breast Dr Adrian Rathmell Dr Nicola Storey Dr John Hardman Dr Hans van der Voet Dr Eleanor Aynsley Dr Sarah Lawless (N. Tees and Hartlepool) Upper GI Dr Nick Wadd Dr David Wilson Lower GI Dr Hans van der Voet Dr Nick Wadd (Bishop Auckland) Dr Clive Peedell (Bishop Auckland, Darlington) Dr David Wilson (N. Tees and Hartlepool) Dr Madhavi Adusumali Head and Neck Dr Peter Dunlop Lung/Mesothelioma Dr Clive Peedell Dr Eleanor Aynsley (N. Tees and Hartlepool) Dr Dev Shakespeare Dr Sarah Lawless Thyroid Dr John Hardman CNS Dr Peter Dunlop Lymphoma Dr Adrian Rathmell Testes Dr Adrian Rathmell Gynaecology Dr Adrian Rathmell Dr Madhavi Adusumali Skin Dr John Hardman (melanoma) Dr Sarah Lawless Acute oncology (N.Tees) Dr Nicola Storey Holistic Cancer Care Centre Dr Peter Dunlop Medical Oncology Breast Dr Alison Humphreys Upper GI Dr Syed Zubair Lower GI Dr Syed Zubair Lung/Mesothelioma Dr Fathi Azribi (Friarage) Hepatobiliary Dr Syed Zubair Renal Dr Alison Humphreys (renal) Ovary Dr Fathi Azribi Skin Dr Alison Humphreys (melanoma) CUP Dr Syed Zubair 12 Version: Published 09/02/2016 05:17:00. JRCPTB Other Attachments Neurorehabilitation Dr John Macfarlane or Dr Elizabeth Davis. Walkergate Park Centre for Neurorehabilitation and Neuropsychiatry. Neurology/Motor Neurone Disease Dr Tim Williams, Consultant Neurologist at Royal Victoria Infirmary, Janine Evans at JCUH HIV Dr McCarron at JCUH, Dr Ashley Price at RVI Heart failure Dr John Baxter, Sunderland GP Walker Medical Group Psychiatry Prof Turkington RVI, Dr Gash JCUH, Dr Temple Darlington Memorial Hospital Crisis Assessment Team Ravenswood Clinic, Heaton: Dr Mary-Jane Tacchi Paediatric Oncology and Palliative care POON Nurses at RVI, Dr Yifan Liang, RVI Chronic Pain Dr Ian Jones / Dr Paul Wilkinson, RVI, David Laird at UHND Chris Coe at NTGH, Gwenda Cavill and Dr Bamigbade at Wansbeck, Dr Eldabe at JCUH, Middlesbrough. It is also possible to arrange time in other medical specialties. It may be worth negotiating this yourself at your hospital where you have attachments. 13 Version: Published 09/02/2016 05:17:00. JRCPTB Flexible Options Acting up experience in final year Research Module Day or block release for higher qualification Rural attachments (Durham Dales, Northumberland, Cumbria) Sample Rotation(s) Depending on the stages of the programme trainees are at, there may need to be some rearranging in the order of clinical attachments. Year 1: The first 3 months at the hospice base is compulsory at the start of the programme and should also include an induction to the training programme. Year September to March March to September ST3 Full-time hospice (ST3 commences in August) Part-time hospice with Oncology ST4 Part-time hospice with NCCC Part-time hospice with Community ST5 Part-time hospice with Hospital Part-time hospice with Option (See page 13) ST6 Senior hospice experience 14 Version: Published 09/02/2016 05:17:00. JRCPTB SUPERVISION Educational Supervision All trainees have an Educational Supervisor to support them through training placements. The supervisor is usually a consultant the trainee is working with during a placement. The educational supervisor helps the trainee to work towards specific goals outlined in the curriculum and provides advice and guidance on how best to achieve those goals. The areas covered by educational supervision include clinical skills, management skills, continuing personal development and careers advice. All trainees should arrange to see their Educational Supervisor prior to, or early on in an attachment to plan learning objectives and then meet regularly to ensure objectives are being achieved. A meeting should take place at the end of the attachment to review progress, plan for the future and complete necessary documentation for ARCP/RITA e.g. the Educational Supervisor’s report (see ‘Progression’, Page 20). It is important to make timely appointments with your Educational Supervisor. You hold your learning agreements/contracts from your Supervision sessions. It is your responsibility to ensure that these are met and if not, they will be picked up at appraisals and ARCP/RITAs. Clinical Supervision All trainees have a Clinical Supervisor. The Clinical Supervisor may be the same person as the Educational Supervisor. The role of the Clinical Supervisor is to support the trainee through areas of clinical practice. The Clinical Supervisor is usually the consultant the trainee is working directly with during a placement. Clinical supervision may be formal, informal or both. Mentors A personal mentor is an experienced colleague who facilitates personal development by providing an opportunity for non-judgmental reflection. Ideally your mentor should not be your Clinical or Educational Supervisor and need not be from the same department or specialty. A mentor does not meet regularly with the trainee but may meet sporadically when problems or issues arise or when the trainee is faced with a difficult decision or new opportunity. You choose your mentor and make contact as and when required. There are many trained mentors in the northern region, including several of the consultants in palliative medicine. Trained mentors in the region can be found in ‘CONSULTANT PROFILES’ on Page 39. There is also a list of all trained mentors outside palliative medicine within the region, available from the deanery. E-Portfolio in Palliative Medicine The e-portfolio has been introduced to provide a paperless record of your achievements and development as you progress through specialty training. Initially it is quite daunting and overwhelming, but with time the acronyms and cross-linking become much easier. This section has been written as a beginners guide to the e-portfolio, however the best tutelage in e-portfolio is trial and error. Spend some time navigating around the site and exploring the different forms 15 Version: Published 09/02/2016 05:17:00. JRCPTB before formulating your own take on how to record the evidence of your learning and experience. The best source of answers to how to use/where to find/what to record is probably the other STs. Home Page This gives a brief overview of your current post. In the left bottom corner there are alerts from both the JRCPTB as well as more regional issues. These alerts cover things like changes to the eportfolio and courses and teaching sessions in the region. This is by no means a complete or comprehensive list of the region’s educational events. Profile Personal Details: Contains basic details such as GMC number, address and e-mail. You can change your password to something a little easier to remember via one of the tabs in this section. Post/Supervisor Details: Lists your grade, location, specialty and dates of posts as well as previous posts and your associated supervisors. Declarations and Agreements: Educational agreements need to be ‘signed’ by both you and your supervisor. Probity and health agreements require only your ‘signature’ and will direct you to appropriate GMC literature. Certificates: You can record completion of certificates such as BLS, ALERT and IMPACT. Your record then needs to be confirmed and ‘signed’ by your supervisor. Personal Library: Can be used to upload items such as documents, PDFs and images which can be used as supportive evidence e.g. presentations, letters, or copies of certificates etc. You should also upload here three logs, which can be prepared as Word documents and saved as PDF files: Sickness and Absence Log: Dates from and to and reasons where appropriate. Total at bottom Annual and Compensatory Leave Log: List of dates from and to and whether leave was annual or compensatory. Give a total for each at the bottom. Out of Hours and Emergency Log: To show that you are undertaking out-of-hours work and dealing with emergencies, you need to create a log. This should contain times and dates of any advice calls or emergency cases and an activity category (e.g. inpatient advice, emergency admission, on-call ward round etc.). Clinical information should be anonymised and brief: “Called in to see patient with low blood pressure. Became increasingly unwell. Melaena on assessment. Low Hb. Diagnosed UGIB and care escalated via 999.”) i Keep your Personal Library organised in folders so evidence pertaining to your training year is easy for the ARCP panel to find. Download Portfolio: Allows you to create a PDF of parts of your e-portfolio for easy storage as a backup. However, it only incorporates the curriculum, work-based assessments (MSF, DOPS, MiniCEXs and CbDs) and the appraisal forms- it does not include any reflective practice. Absences: You can use this to record study leave, annual leave and various other types of leave. Courses and Seminars: Often reads ‘No Courses and Seminars have been created yet.’ 16 Version: Published 09/02/2016 05:17:00. JRCPTB Curriculum This outlines the major topics and expected level of achievement in each section of the Palliative Medicine Curriculum. Unlike the CMT curriculum, this covers all four years of ST training and your progress during this time. It is described as a ‘spiral curriculum’ in that you are likely to be gaining experience in many areas doing all of your attachments, but will build on each aspect over the course of the 4-year programme. By clicking on each sub-topic it will take you to a page that gives more in-depth description of each topic. There, you can rate yourself: ‘Not Achieved’, ‘Some Experience’, ‘Achieved’ and write comments. How you use this is up to you. In the comments section you can record your understanding and experience of each of the points of the sub-topic. You can add to this to create a more in-depth record of your progress. Linking Items Going back to the Curriculum Overview page, you will notice small blue icons at the right hand side of each item. By selecting a competency and clicking on this item allows you to link this topic to any of you WBAs, reflective practice items or any other entries you have made. In this way you build up the evidence to support your self-rating and allow your supervisor to see this evidence prior to them rating you. As you link items to the curriculum, they will appear as a list underneath the topic to show the related evidence in your e-portfolio. The number of curriculum items with evidence beneath them should be proportional and appropriate to your year of training and indicate that clear progress is being made against the curriculum: as you progress through your training, you will accrue more evidence to link with curriculum outcomes. i An individual CBD or Mini CEX may be linked to no more than 2 curriculum items. An ACAT may be linked up to six times. Try to have no more than 2 pieces of evidence added under each curriculum item per year. Curriculum sign-off It is also necessary to be ‘signed off’ for your full curriculum over your years of training. ‘Sign off’ can be done by a consultant in a supervisory role (e.g. educational or clinical supervisors as listed on the e-portfolio) and provides an indication that you are making satisfactory progress. The proportion of curriculum items signed off and the level of sign-off will vary according to your stage in training (for example, a supervisor may sign-off a first year trainee as having ‘Some Experience’ across a broad range of curriculum outcomes).Assessment Work-based placed assessments information http://www.jrcptb.org.uk/assessment/workplace-based-assessment The best way to understand these forms is to have a look around them- they fall into a similar layout and wording. The numbers of each Work Based Assessment (WBA) vary with each ARCP year and you need to check with the SAC as to how many of each are required for completion of each year (“ARCP decision aid” on JRCPTB website). 17 Version: Published 09/02/2016 05:17:00. JRCPTB MSF (Multi-Source Feedback) Ideally to be completed by colleagues from various backgrounds e.g. doctors and nurses of various grades, allied health professionals (physio, OT, pharmacists, social workers) and others (secretarial staff). You should agree a list of colleagues with your educational supervisor before starting. A satisfactory MSF requires 12 responses and results cannot be released by your supervisor until 12 have been completed. You should submit a self MSF, though this does not contribute to the required number of responses. Once your supervisor releases the results you will see the aggregate of tick box scores, but scores and free text comments are not attributable to individuals. Effective feedback is best delivered during a face-to-face meeting with your supervisor. Mini-CEX (Mini-Clinical Evaluation Exercise): Required topics to be covered in Mini-CEX assessments are provided by the SAC however, these topics are not currently shown on the e-portfolio. DOPS (Directly Observed Procedural Skills): The list of required DOPS is provided by the SAC, though some of these have been debated by both the trainees and our trainers. CbD (Case Based Discussion): Again, compulsory topics are provided by the SAC but not recorded on the e-portfolio. The approach to CbDs varies with assessors but can be a very valuable and informative way of reviewing difficult symptoms or cases. ACAT (Acute Care Assessment Tool) Although this WBA is not a required assessment in your e-portfolio, it can be a great way of capturing some of the behaviours of a palliative medicine physician that aren’t covered by the other WBAs: e.g. time management, prioritisation of care and management of a clinical team during an observed ward round. Audit Ass. Under “Others” on assessment tab. One to be completed by the end of ST4 and another by the end of ST6. Teaching obs. One observation of clinical teaching is to be completed per year. RRP (Record of Reflective Practice) This is a more extensive piece of reflection than the day-to-day e-portfolio reflections (see below), and should be completed twice a year. It involves identifying a challenging situation (clinical or non-clinical) and providing a written synopsis (500 words) to a facilitator. After reflecting upon the situation, it should be discussed with the facilitator to agree action/learning points. The assessment form is available on the e-portfolio and your written synopsis can be uploaded in the personal library. As the reflective practice may relate to a personal or confidential issue, specific details of the scenario need not be recorded on the assessment summary sheet. Requesting an external assessment You can have all assessments recorded through your own log-in to the e-portfolio, the assessor’s position and professional body number is required. However, to improve impartiality, if you 18 Version: Published 09/02/2016 05:17:00. JRCPTB request an external assessment a log-in code (‘ticket’) is provided which allows the assessor to login to www.nhseportfolios.org independently. Reflection Reflective Practice This section can be used almost as a CPD diary as well as for reflection on your learning, teaching, cases and governance issues. The different types of logs have slightly different layouts differing between simple recording of dates of meetings to thought provoking questions with free text answers. This component can be a useful place to record educational events that you can link to curriculum items. The types of logs are as follows: Reflection on Clinical Event: attachment, interesting case, clinical incident or new clinical experience Reflection on Learning during an Attachment Reflection on Learning Event: research (seminal paper), lecture, course, grand-round, self-study, clinical/bedside, tutorial Reflection on your Teaching: presentation, clinical teaching Audit Assessment Research Publication Attendance at organised teaching Record of Reflective Practice (for RRP description, see above) The use of reflection is one of the best ways of demonstrating that your knowledge and skills are developing. Your supervisor should sign off each of the reflective practice entries and there is also a free text box for them should they have any comments. More guidance on how to structure your reflection can be found in ‘Appendix 3 - Reflection’ on page 55. Careers Management: This section of free text can be used to record meetings with your supervisor or mentor as to your career plans and direction. Appraisal Appraisal: Incorporates induction appraisal, mid-point review, end of attachment appraisal and supervisors. These are semi-structured forms to help guide and review your personal development plan to aide progress. They can be completed by you but need to be confirmed and ‘signed’ by your supervisor other than the End of Attachment and Supervisor’s Report, which are entirely completed by your supervisor. 19 Version: Published 09/02/2016 05:17:00. JRCPTB Personal Development Plan: This form guides and encourages you to formulate a plan for each attachment in terms of objectives and how they are to be achieved. Again, this is written by you but should be signed off by your supervisor. At the end of an attachment you should review your PDP and decide if you feel you have achieved your objectives. There is a tick box to ‘sign’ when you feel you have completed it. When completing a PDP it is important to use SMART objectives. Progression Summary Overview: This page gives you a quick overview of the number of WBAs completed and also appraisal reports that you can view. Educational Supervisor’s Report: This gives an overview of what the report is for and what aspects should be covered. For a report to be entered, your supervisor must log in and the form is found under the Appraisal heading. ARCP: Gives factual information about what an ARCP is and links to the Gold Guide and JRCPTB website. Your ARCP grade and report will be entered by the panel and is available to you to view. Messages Messages from JRCPTB and the Deanery are relayed via this system. Help Covers areas such as access rights, FAQs and support. This has some helpful areas that are worth a browse, although the regional support can be more personal and timely in their help. For further help with e-portfolio, please feel free to discuss with other trainees or trainers, TPD or the Specialty Programme Co-ordinator at the Deanery. There is online e-portfolio guidance available http://www.jrcptb.org.uk/eportfolio-information/user-guides. via the JRCPTB website 20 Version: Published 09/02/2016 05:17:00. JRCPTB ANNUAL REVIEW OF COMPETENCE PROGRESSION (ARCP) The ARCP is the yearly process of assessment for all Speciality Trainees and it replaces the Record of in-training assessment (RITA). It provides an overall assessment of progress in Specialty Training, and is informed by evidence of work-based assessments as well as the supervisors report. The RITA process has been replaced by the ARCP, which is intended to be based on more explicit use of evidence to inform the annual assessment outcome of progress. The assessments currently take place in December- January, Full details of the process and principles of the ARCP can be found in Section 7 of the “Gold Guide” http://specialtytraining.hee.nhs.uk/news/the-gold-guide/. Key Points The assessment process is mapped out against the requirements of the curriculum. The curricula are themselves referenced to all areas of the GMC’s Good Medical Practice. The assessment strategies which map the curriculum, in work and real-time assessments, provide evidence of progress of the individual trainees. Assessments include directly observed procedures (DOPS); mini clinical exercises (mini-CEX); Case – based discussions (CbD); Multi-source feedback reports (MSF); as well as evidence of achieving curriculum objectives. There are requirements set out by the GMC for the numbers of these assessments which are expected to be completed by trainees each year, and the ARCP panel are rigorous in determining whether the required number are evident in the trainees portfolio. There should also be the Educational Supervisor’s structured report available to the ARCP panel which should be used to provide a summary of the outcome of the above assessments. Evidence to support satisfactory progression may also include audit & research; evidence of teaching etc. The ARCP panel The objectives of the panel are: To consider and approve the adequacy of the evidence and documentation provided by the trainee. To provide feedback and comment to the trainee. To make a judgement as to whether the trainee may progress to the next stage of their training or confirm that training has satisfactorily been completed. The panel usually consists of 3 or 4 of the Palliative Medicine consultants, an external assessor from a different deanery along with a lay member and a deanery representative. ARCPs usually take the following format: Portfolio folders are made available to the panel a couple of weeks in advance of the ARCP date. It is worth noting that you cannot add additional evidence after this deadline as it will not be viewed by the panel. On the day, the panel reviews the recorded evidence without the trainee present. An outcome decision is made and the trainee is informed of this. 21 Version: Published 09/02/2016 05:17:00. JRCPTB The trainee can either make a short presentation of future plans (1 slide may be used if desired), or may simply wish to talk more informally about their plans going forwards. This does not form part of the assessment. Any recommendations are agreed, particularly related to unsatisfactory outcomes but can be useful for everyone. This process is undertaken in a calm and relaxed manner! ARCP outcomes Outcome Explanation 1 Achieving progress and development of competencies at the expected rate. 2 Development of specific competencies required. Additional training time is not required. Progress assessed at next ARCP. 3 Inadequate progress. Additional training time required (max one year). 4 Released from training programme. (with or without specified competencies) Lose NTN 5 Incomplete evidence presented. Additional training time may be required. Trainees with outcomes 2, 3 & 4 will meet with the panel to discuss their position and have the right to appeal. Hints and Tips It is worth starting work-based assessments early on to avoid last minute panics to get the correct number completed. For trainees having their first ARCP which falls within only a few months of training, there is not a specific number of assessments which should have been completed – it is a good idea to have made a good start on these however, and should generally be counted pro-rata. See appendix for preparation for ARCP document. ARCP Decision Aid for Palliative Medicine http://www.jrcptb.org.uk/sites/default/files/2010%20Palliative%20Medicine%20 ARCP%20Decision%20Aid%20(revised%2016.10.14).pdf 22 Version: Published 09/02/2016 05:17:00. JRCPTB PYA (PENULTIMATE YEAR ASSESSMENT) This is an assessment similar to an ARCP/RITA involving an external SAC representative (a palliative care consultant from another region), who sets your final training targets. It takes place between 12 and 18 months before your CCT (for both full and part-timers). If you are set a PYA date please check that it is less than 18 months, otherwise it cannot take place. About 6 weeks prior to your PYA, the JRCPTB will request an up to date C.V. and a completed Summary of Clinical Experience (SOCE) Form (in Section 8 of your training file). You may also need to send extra info to the external assessor, depending what they want – you will be instructed. The key to less stress is to keep your training file and C.V. up to date! At your PYA, the external assessor will run through a list of training targets - you will almost certainly not have done them all. Those you have not done will be set as targets in the coming year. If you do not achieve these you will not be able to complete training. Very rarely your CCT can be delayed at your PYA. You may also be asked to prepare a brief presentation in a similar manner as for other annual assessments. Further information available at: Penultimate Year Assessment http://www.jrcptb.org.uk/training-certification/penultimate-year-assessment Online CPD With the last 2 years of training you are required to register online with the RCP for CPD. This is accessed via the RCP website. It is free to register as a registrar. It is worth getting used to putting all your CME points onto this as it is compulsory before the end of training. Register for CPD https://www.rcplondon.ac.uk/cpd/manage-your-cpd/cpd-diary-registrationtrainees 23 Version: Published 09/02/2016 05:17:00. JRCPTB LEAVE ENTITLEMENT On e-portfolio you need to document all absences except annual leave & study leave (ePortfolio – profile – absences). This includes sick leave, maternity leave and any other leave. It is also helpful to produce PDF logs to upload to your Personal Library (see Page 16). Annual Leave You should be allocated an Annual Leave Card when you commence your job. If you haven’t please contact: HR OFFICER Contact: Location(s): Sarah TULLY sarahtully@nhs.net Tel: 0191 275 4664 Fax: 0191 210 6401 Lead Employer Trust Your allocation is written on the front for the annual leave year, which runs from your start date. Allocation increases with each salary scale point Point 2: 27 days Point 3: 32 days Part time: Annual leave & bank holidays are calculated pro rata. It may be helpful to speak to HENE, TPD or see BMA handbook for advice The card must be completed and signed by your supervisor. You will almost certainly need to complete a work base annual leave form too and make sure you discuss annual leave requests with your colleagues first. The card should be returned to HR at the end of each leave year, with any requests to carry days over into the next year. Only 5 days can be carried forward. Northern Deanery Annual Leave Policy http://www.northerndeanery.nhs.uk/NorthernDeanery/let-humanresources/policies/AnnualLeaveandPublicHolidays.pdf 24 Version: Published 09/02/2016 05:17:00. JRCPTB Study leave The entitlement is 30 days study leave per year full time. This includes SpR training days/half days. Part-time is pro rata. Budget allocation £950 Full time, part time is pro rata. What you need to do: At least 6 weeks before the course 1. Educational supervisor to sign study leave request form 2. Send signed form to TPD for counter-signing, including pre-paid envelope addressed to Dave Roxborough at the Deanery so it can be posted on for you. 3. Send form to Dave Roxborough – TPD happy to do this for you if you include an envelope addressed to Deanery 4. Dave will send pink & white copies of study leave form back to you, along with form to claim expenses. After the course 5. Send your expense claim form along with tickets, receipts etc. and the pink copy of the study leave form to TPD plus envelope addressed to Dave Roxborough at Deanery. 6. TPD will sign the expenses form and post to Deanery. 7. Dave Roxborough will send form to payroll at deanery and you will get re-imbursed. It is worth looking at mandatory courses first and then planning what budget you have left on other courses, on an annual basis. At present, the budget cannot be transferred to the following year. Flexible trainees may be able to claim more than their annual allowance for mandatory courses e.g. Regional Management Course. When applying for study leave, please do so as much in advance as possible (recommended at least 6 weeks before course). Discuss intended course with educational supervisor Inform your current workplace of proposed study leave (to check you can be off). You may have to fill in study form at your base hospice or current workplace. Fill in one of the Postgraduate Institute Study Leave Forms (A3) Supply of forms - Contact Dave Roxborough, Specialty Programme Co-ordinator on 0191 275 4689 for a supply. Forms may also be available at your base hospice or from the TPD’s secretary. Tips on Study Leave Keep a total of days taken throughout training in a word document and upload this to your ePortfolio prior to ARCP. Further info on accommodation allowances, etc. is on Appendix 4 (paper form) (e.g. night allowance £55). In general it is best to overestimate as if you underestimate they may not give you the difference. 25 Version: Published 09/02/2016 05:17:00. JRCPTB Keep all original receipts (travel, accommodation, course fees etc). Section aims of course just lift from course flyer/info. You may wish to photocopy this. Section on addressing learning needs. Quote from the curriculum. Also state in this section if this is a mandatory course. Discuss with Educational Supervisor appropriateness (but it is usually a 5!) Further advice on completing can be found on the back of the forms Remember to photocopy EVERYTHING before sending off!! In theory you should receive your expenses in your following pay cheque. Good Luck! Mandatory and Recommended Courses The Specialty Training Committee has listed the following courses: Course Information Requirement Advanced Course in Pain and Symptom Management (or similar course e.g. Guildford / Manchester course) The Advanced Course is run annually by the Sobell Study Centre at three locations (Newcastle, Nottingham and Oxford). Course details and application forms can be obtained by emailing ssc@orh.nhs.uk Cambridge Calgary Communication Skills Training (or another recognized communication skills course) A two-day course usually organised locally (dependent on demand), updates are then organised on an annual basis as part of the inhouse SpR study days. MANDATORY Must attend once during training Management Course During senior training years. There is a locally run management course through HENE that many trainees have attended. MANDATORY Must attend once during training APM Study Day These run twice a year. Details via the Association of Palliative Medicine (www.palliativemedicine.org). MANDATORY Must attend twice during training Palliative Care Congress / World congress of European Association of Palliative Care Recruitment and Selection Course Training the Teacher Training or other recognised teaching course MANDATORY Must attend twice during training MANDATORY Must attend once during training Free online via HENE website MANDATORY Must attend once during training (see contacts under “Teaching”) MANDATORY Must attend once during training often run through the APM MANDATORY Must attend once during training Ethics/Law Study Day 26 Version: Published 09/02/2016 05:17:00. JRCPTB MANDATORY Must attend once during training Educational Supervision Course Research Basics Course Children’s Bereavement Training Presentation Skills see the Clinical Research Facility’s website for study days and free, regular seminars (www.ncl.ac.uk/crc/crf.php) Also run by the APM, check their website Courses are held at Marie Curie Hospice Available via the Northern Deanery as well (or contact Fiona Setch) Postgraduate Certificate in Clinical Education Completed at University of Newcastle Spirituality training at St Oswald’s Hospice Contact Pauline McLane. MANDATORY Must attend once during training RECOMMENDED RECOMMENDED RECOMMENDED RECOMMENDED See Appendix on page 53 for clarification of Study Leave and the links below for the Northern Deanery Study Policy and procedures. Northern Deanery Study Leave Policy and Guidance http://www.northerndeanery.nhs.uk/NorthernDeanery/specialtytraining/information-for-specialty-trainees-with-the-exception-of-gptrainees/study-leave Budget The use of pharmaceutical company support in funding education very much lies with your own personal views. There is a broad range of opinion among individuals in the region and the decision to use this is left to you. 27 Version: Published 09/02/2016 05:17:00. JRCPTB EDUCATIONAL MEETINGS Northern Regional Palliative Care Physicians Group (NRPCPG) The Northern Regional Palliative Care Physicians Group (NRPCPG) holds six educational meetings a year (on the second Monday afternoon of September, November, January, March, May and July), two of which have a research theme. All Palliative Care Physicians in the Northern Region are welcome. A different hospice/hospital (which has previously included St Oswald’s, Butterwick, St Benedict’s, North Tyneside, Hartlepool and Marie Curie) hosts each meeting and is responsible for identifying an organiser to arrange a programme. The afternoon often consists of linked talks/cases/presentations from internal or external speakers and the organisers apply for CPD points from the Royal College, book a suitable room and equipment, arrange a lunch and distribute the programme to invitees, take an attendance register and supply CPD certificates. The overall rota is written by the same registrar who is in charge of the North of Tyne Journal Club Rota and is distributed by Catriona Johnson, medical secretary at Marie Curie Hospice. If you are not on the mailing list already, please e-mail Catriona.Johnson@mariecurie.org.uk Journal Clubs The North of Tyne Journal Club takes place on the second and fourth Monday lunchtimes of each month (except on NRPCPG meeting days and during the month of August) and the venue alternates between Marie Curie Hospice and St Oswald’s Hospice. All Palliative Care Physicians and Specialist Nurses are invited from the North of Tyne (including Gateshead) area. The host hospice is responsible for booking a room. Please bring your own lunch. Presentations are from 12:30pm - 1:30pm. There are two presenters at each meeting. One presents a recent article of relevance to palliative medicine, the second either presents a brief journal overview (bullet point summary of one complete journal, e.g. Palliative Medicine or European Journal of Pain and Symptom Management), or a case history. Each presentation should last approximately 20 minutes. They can be related topics or separate (presenters to decide themselves who does what on each occasion, the rota will specify case or journal overview). The presenters for each meeting have been a Consultant and either F2, registrar or Staff Grade Physician, but this may include Specialist Nurses in future. Again, the rota is written by a registrar and distributed by Catriona Johnson, Medical Secretary at Marie Curie Hospice as early in the year as possible. Please make any swaps directly with other presenters if unable to do your assigned slot and e-mail Catriona.Johnson@mariecurie.org.uk once the swap is confirmed. St Benedict’s Hospice runs a Journal Club session weekly on Friday lunchtimes (bring your own lunch). You are also welcome to attend the General Internal Medicine grand round at Sunderland Royal Hospital on Tuesdays at lunchtime. During your hospital attachments, there may also be opportunities to attend Departmental or Directorate Journal Clubs, meetings and Grand Rounds. 28 Version: Published 09/02/2016 05:17:00. JRCPTB The Teesside journal club runs monthly, on the second Tuesday of each month (12:30-13:30 – bring your own lunch). This meeting rotates between Hartlepool, Butterwick and Teesside Hospices Specialty Registrar Training Days Peer support and gaining from others experiences is a key aspect of being a trainee. The group of trainees works well as a team and more established registrars are happy to provide a ‘buddy system’ for new starters. Palliative Care Registrar training days are held on an alternate monthly basis. The registrar group plan teaching sessions based on learning needs of the group over the months ahead. Outside speakers are often asked for input. The day is usually split into 2-3 teaching sessions, business, group project work, case-reflection and peer-support. There is a nominated consultant link for the registrars’ educational programme. The meetings are minuted and each session is evaluated. Sometimes in-house feedback from a course or attachment is shared with the group. Minutes of both training days and research meetings are sent to the respective consultant link, as well as TPD to contribute to the annual Q.A. process. The Registrar Group appoints roles within the group, usually rotated on an annual basis. These include Education Chair and Secretary, Research Chair and Secretary, Specialist Training Committee (STC) Rep, Journal Club and NRPCPG Rota Rep, Deanery Website Link Rep, Trainee Induction Pack Rep, Nominated Project Lead and Social Secretary. The rotating roles within the group provide good experience of organising, attending and chairing meetings, organising teaching sessions and we hope that with the additional dedicated time that the group could work on a project, e.g. designing a peer-led teaching day and that this would also be a useful experience for the group members. Specialty Registrar Research Meetings These are held 6 times a year, during the month without a training day. These meetings are an opportunity to discuss and develop research ideas, present protocols, give updates and practice presentation of results. They also involve literature searched and reviews of recent research. There is a named consultant link (currently Drs Katie Frew and Deepta Churm, Katie.frew@nhct.nhs.uk and Deepta.churm@nhct.nhs.uk). See also ‘Research’, Page 30. Other educational meetings Royal College of Physicians Northern Regional Office RCP Northern run teaching days for SpRs in General Internal Medicine at Freeman Education Centre, usually on a Wednesday afternoon every other month; some topics may be relevant - for programme details or to be added to the mailing list, contact Anne McSweeney at anne.mcsweeney@nuth.nhs.uk 29 Version: Published 09/02/2016 05:17:00. JRCPTB Oncology SpR teaching This happens on a Friday afternoon at NCCC and it may be possible to ask to attend (especially if attached to Dr Mary Comiskey and NCCC Palliative Care Team). RESEARCH, TEACHING AND RESOURCES Research As carrying out a research project forms part of specialist registrar training, a research group has been set up by registrars to develop research ideas and support current projects. The research group meets six times a year and is open to all who have an interest in research who are working in the region. We review various journal articles of interest, give updates on our current research projects and discuss ideas for future work. The registrar research group is supported by a nominated consultant. Further support for research can be sought from research and development offices in most hospitals. The Clinical Research Facility at the RVI (http://www.ncl.ac.uk/crp/training/) runs an education programme available to all NHS staff such as research training days and hour long sessions run over Friday lunchtimes (see website for more details). More recently, registrars have taken 2 years out of programme to complete an MD or PhD. This has involved working as a Teaching and Research Fellow based at North Tyneside General Hospital and completing the Certificate of Clinical Education (see Certificate of Clinical Education below). With modernising medical careers, the future of this type of post is uncertain, however it is hoped there will be still opportunities to undertake research degrees. It is not necessary however to do this level of research, but if interested the research lead for the SpR/ST3s can give you more information. Teaching Numerous opportunities for teaching exist during SpR training. Most hospices run a variety of teaching sessions for nursing staff and junior doctors which you may be asked to help out with. Teaching of medical students occurs in 2 main areas: The third year medical students complete a course entitled “Chronic Illness, Disability and Rehabilitation” (CIDR) which usually entails learning about Palliative Medicine at some point in the course. Each base unit (4 units within Newcastle Medical School) will organise the teaching slightly differently, you will probably be asked to help out with some of the teaching or even helping out with exams (this may help to fulfil curriculum requirements). The first and second year students have teaching on various aspects of communication skills, many of us have become involved in this teaching. It’s usually well organised and enjoyable to participate in. The main contact for this is Phil Diggle (Phil.Diggle@ncl.ac.uk). In addition there are often 4th year students attached to units during their special interest study, this again this may provide teaching opportunities. The Northern Deanery runs a variety of training sessions to develop teaching skills (such as giving effective feedback and small group teaching). 30 Version: Published 09/02/2016 05:17:00. JRCPTB Up to date programmes can be obtained through the Northern Deanery website. If a more formal teaching qualification interests you, the Certificate of Clinical Education can be completed at Newcastle University. This is run as a series of study days and tutorials, with a case based essay and portfolio of evidence needing to be completed to gain the certificate. It is expensive (£2335 in 2012/13) but most have found it worthwhile: the details of the course can be found through the university website. School of Clinical Education http://www.ncl.ac.uk/sme/study/postgraduate/clined/ Email: sme@ncl.ac.uk Library facilities Most hospices have a small library; the largest is at Marie Curie Hospice where there is also a part time librarian. Regional Trainees are entitled to use the Marie Curie library even when not working there. Other libraries in the region may have volunteer librarians who may be able to order you articles from libraries in the region, or inter-library loans. If in doubt please contact the Marie Curie librarian who will try to help. As an NHS employee, you are also entitled to use the University library facilities. You need to take your wage slip (from the previous 3 months) to join and you will be issued with a library card. The Walton Library is the medical library and it is on the 5th floor of the Medical School, which is attached to the Royal Victoria Infirmary. It is possible to access electronic journals from within the library but unfortunately unless you are registered with the university remote access to electronic journals is not possible. The university has switched to a different provider and so Athens access is not available through the university sites. You should also be able to have access during your rotations to local Hospital Libraries and resources with your ID badge. From both of these facilities inter library loans can be arranged for a small fee (normally £1 per journal article). For more information see http://www.ncl.ac.uk/library/walton/nhs/ Electronic journals Accessing journals is possible electronically via an Athens username and password. You can register for NHS access as a NHS employee (go to www.athens.nhs.uk). Click on Self Registration and follow the instructions. We are in the North East SHA and depending on where you work (North/South), choose the relevant area (i.e. NHS Northumberland, Tyne and Wear or NHS County Durham and Tees Valley) and then the Voluntary organisations/charities option. This gives you access to the Electronic Library of Health facilities at www.library.nhs.uk and all the NHS Core Content (databases, Medline, electronic journals, Zetoc/tdnet, etc). There are some useful journals (Palliative Medicine, The Lancet, BMJ, NEJM) but the University library has a far larger range. Please make yourselves aware of the relevant copyright regulations. 31 Version: Published 09/02/2016 05:17:00. JRCPTB Registrar Shared Resources – Cloud Storage The registrar group have independently created a shared folder, which is provided by Dropbox and can be accessed from your home computer, tablet or smart phone. This folder contains shared resources such as meeting schedules, minutes, induction materials and files pertaining to shared projects to allow collaborative work to take place easily without the need for endless emailing of attachments. This is becoming a valuable resource and access is recommended. “Dropbox is a home for all your photos, docs, videos, and files. Anything you add to Dropbox will automatically show up on all your computers, phones and even the Dropbox website — so you can access your stuff from anywhere. i Dropbox also makes it super easy to share with others, whether you're a student or professional, parent or grandparent. Even if you accidentally spill a latte on your laptop, have no fear! Relax knowing that your stuff is safe in Dropbox and will never be lost.” – Dropbox.com To get access to the shared folder, you will need a Dropbox account (free via http://www.dropbox.com) and you will need to ask the registrars if they can invite you to this folder. You will then receive an email with instructions on how to accept the invitation and be given access to the shared files. Dropbox provides free apps for PC and Mac (recommended) that allow you to easily manage shared files simply by putting them in a folder on your home computer. As other people do the same, these files are synchronised between all members of the group so that they can all view or work on them without the need for email or memory sticks. There are apps for Android and iOS so you can access files from your phone or tablet. You can also log in via Dropbox.com to get access to the files. Maintenance of this folder is a combined effort – keep it tidy and remember its content is shared with others. The whole process is very straightforward and well-described on their website. Dropbox itself is a safe, secure and wellestablished service. Note that some trust computers will block Dropbox (as a cloud storage website) for the same security reasons that would disallow use of an unencrypted memory stick from home. Note also that if you use Dropbox already, joining the shared folder will not share anything else you may have in your own personal Dropbox, which remains private. ! The ‘Palliative Medicine Registrars’ folder is to be used only for the storage of shared registrar resources. Although Dropbox is secure, confidential and encrypted cloud storage, it is NOT TO BE USED for the transfer or storage of patient identifiable, sensitive or potentially offensive material as this is in direct contravention of Information Governance protocols. 32 Version: Published 09/02/2016 05:17:00. JRCPTB FLEXIBLE TRAINING Flexible training is available for those for whom full time training would not be practical for wellfounded individual reasons. Common reasons include caring for small children (or other dependents) or ill health/disability. Applying for flexible training You will need to fill in a flexible training application form in conjunction with the Programme Director in order to apply for flexible training. There is also a separate form to send to the JRCPTB to apply for recognition of flexible training. The Deanery has a policy on ‘managing trainees with differing needs’ which can be found on the Northern Deanery website. You may need to speak to payroll about your new arrangements early on. Some registrars have encountered difficulty being paid at the correct rate. Information about pay scales and pension can be found on the deanery website. Contact the HR Department, Sarah Tully sarahtully@nhs.net, Phone 0191 275 4741. Maternity Leave When to apply: You should state your intention as soon as possible, but in any case it should, if reasonably practicable, be at least 21 days before your leave is due to begin. See website & BMA website for more details on maternity and paternity leave. While on maternity leave you can get reduced rates from the GMC and suspend your MDU (or presumably other indemnity), but remember to reinstate it. Coming back to work – remember YOU have to inform everyone. The, payroll and the JRCPTB do not communicate with each other! Less than Full Time Training (LTFT) http://www.northerndeanery.nhs.uk/NorthernDeanery/let-humanresources/policies/less-than-full-time-training Out of Programme Experience This includes time out for research, experience in ‘acting up’ and aspects of training outside the as well as career breaks. Please see the JRCPTB website for further information. Out of Programme experience http://www.jrcptb.org.uk/training-certification/out-programme 33 Version: Published 09/02/2016 05:17:00. JRCPTB Contacts The HR/payroll officers responsible for Palliative Medicine registrars/flexible training registrars have been changing recently. It is best to check the deanery website in order to find out the most appropriate person to contact. Northern Deanery Contacts http://www.northerndeanery.nhs.uk/NorthernDeanery/let-humanresources/contacts 34 Version: Published 09/02/2016 05:17:00. JRCPTB STRESS AND BURNOUT There are several sources of support for those who feel they are struggling or have concerns of any nature. Remember, if you feel you’re struggling with a particular issue, it is very likely that others have had similar experiences/concerns. We are generally an approachable group of people! It is recommended that trainees have a mentor. This can provide a more structured way of discussing concerns and developing ways of coping. There is a list of mentors included in this booklet. If you feel that, despite the above sources of support, you feel that stress and burnout are impacting on your wellbeing a visit to your GP might be a good step. There are also organisations that offer support, such as the BMA BMA Health and Wellbeing http://bma.org.uk/practical-support-at-work/doctors-well-being The Northern now offers a trainee support service provided by County Durham and Darlington NHS Foundation Trust. The team have experience of supporting doctors and dentists in a number of areas including: Sickness/ill health (physical, mental, emotional) Personal factors (dealing with stress and anxiety, family concerns, career uncertainty, bereavement) Environmental issues (workload, bullying and harassment, difficulties with programme) The team also have access to GP advisors who can provide confidential support and advice in particular to drug and alcohol concerns. 35 Version: Published 09/02/2016 05:17:00. JRCPTB THINGS TO DO IN THE REGION Social Cinemas The Gate, The Empire Cinema, Newcastle The Odeon, Silverlink The Odeon, Metrocentre The Tyneside Cinema, Newcastle Side (Quayside gallery, café, cinema) The Vue, Gateshead Cineworld (Boldon Colliery, Sunderland, Middlesbrough Gala Cinema, Durham UGC Marton Road, Middlesbrough Theatres Theatre Royal, Newcastle The Tyne Theatre, Newcastle Live Theatre, Newcastle Sunderland Empire Northern Stage, Newcastle Gala Theatre, Durham Music Venues Metro Radio Arena, Newcastle The Sage, Quayside, Newcastle The City Hall, Newcastle O2 Academy, Newcastle The Cluny, Byker, Newcastle Shopping Eldon Square, Newcastle The Metrocentre, Gateshead The Royal Quays Outlet Shopping, North Shields Jesmond – Clayton Road, Brentwood Avenue, Acorn Road Gosforth High Street Corbridge Hexham Durham Dalton Park Retail Outlet Art/Galleries The Baltic, Quayside, Newcastle The Biscuit Factory, Sandyford, Newcastle Seven Stories, Ouseburn, Newcastle 36 Version: Published 09/02/2016 05:17:00. JRCPTB Laing Art Gallery MIMA (Modern art) Middlesbrough Sunderland Glass Centre Restaurants/ Places to Eat £££ Jesmond Dene House Hotel, Newcastle Café 21, Quayside. Newcastle Bistro 21, Durham The Pump House, Durham The White Room, Seaham Hall Hotel du Vin, Quayside Artisan, Newcastle House of Tides, Newcastle Quayside ££ The Gate – chain type restaurants Wagamamas, Old Eldon Square, Newcastle Blackfriars, Newcastle Rockafellas, Newcastle Loch Fyne, Gosforth Pizza Express, High St, Gosforth, Saddler Street Durham Raval, Gateshead (near Tyne bridge) ARLO, Brentwood Av, Jesmond Peace and Loaf, Jesmond Dene, Newcastle Stowell Street, lots of Chinese restaurants Skye Apple Café, Heaton Oldfields, Durham Vujons, Satchins, The Komal (Indian) Newcastle Six restaurant, top floor of the Baltic Rasa, Quayside Sage Bistro Silk Room, Quayside Lane 7, Newcastle (can go bowling) The Botanist, Newcastle Dabbawal, Newcastle centre or Jesmond Quilliam brothers, Newcastle –tea and coffe open late Olive and Bean, near Eldon Leisure Broad Chare, Newcastle Quayside Café Vivo, Newcastle Quayside Pubs Central Newcastle Crown Posada, Bodega, Bacchus, Tyne, Bridge Hotel, Cooperage, The Forth (all mainly drinking pubs) 37 Version: Published 09/02/2016 05:17:00. JRCPTB Other Newcastle Lonsdale (Jesmond), Gosforth Hotel, The County (Gosforth), The Cluny/The Cumberland Arms/The Bridge (Byker), As you like it (Jesmond), Mr Lynch’s (Jesmond) Northumberland The Rat (Alnwick), Black Bull, Angel (Corbridge), Feathers (Hedley on the Hill), Hermitage (Warkworth), Sun (Morpeth), Jolly Fisherman (Craster), Milecastle Inn (Hadrians Wall), Cook and Barker (Newton on the Moor) Durham Victoria, Dun Cow, Seven Stars (Shincliffe), Red Lion (Plawsworth) County Durham The County (Aycliffe Village), Fox and Hounds (Cotherstone), Rose and Crown (Romaldkirk) Gyms David Lloyd, Jesmond Greens Dance City, Newcastle Bannantynes, Durham, Chester-le Street, Newton Aycliffe Freeman’s Quay, Durham FX Leisure, Team valley The Hilton, Gateshead Freeman hospital Gym Other Places to see / go Northumberland Coast (Bamburgh, Warkworth, Dunstanburgh) Alnwick Gardens/Castle Hadrian’s Wall, Northumberland Local Tourist Office, Nr. The Monument, Newcastle Beamish open air museum Kielder Forest Cragside Wallington Hall Hartlepool Marina (surprisingly good!!) Angel of the North Gibside 38 Version: Published 09/02/2016 05:17:00. JRCPTB CONSULTANT PROFILES Dr Lisa BAKER Contact: Location(s): Areas of interest: Mentor: lisa.baker@stft.nhs.uk South of Tyne & Wear Community Team St. Benedict’s Hospice, Sunderland Heart Failure Learning Disabilities Not formally trained but happy to help if I can Dr Jane BENTLEY Contact: Location(s): Areas of interest: Mentor: jane.bentley@nth.nhs.uk University Hospital of Hartlepool Hartlepool Community team Steroids, primary brain tumours and patient held records Also diabetes and palliative care and clinical lead for spinal cord compression in the Trust. No Dr Deepta CHURM Contact: Location(s): Areas of interest: Mentor: deepta.churm@northumbria-healthcare.nhs.uk Northumbria Healthcare NHS Foundation Trust Marie Curie Hospice, Newcastle Medical Education No Dr Alexa CLARK Contact: Location(s): Areas of interest: Mentor: alexa.clark@nuth.nhs.uk Newcastle Community Palliative Care Team Palliative Care in the Community No Dr Mary COMISKEY Contact: Location(s): Areas of interest: Mentor: mary.comiskey@nuth.nhs.uk or contact via Kerry Halliday (NCCC Secretary), 0191 2138606 Northern Centre for Cancer Care (Freeman Hospital) Pain, value of respite Yes Dr Katie FREW Contact: Location(s): Areas of interest: katie.frew@nhct.nhs.uk Northumbria Healthcare Foundation Trust (community, Hospital and inpatient unit) Not specified 39 Version: Published 09/02/2016 05:17:00. JRCPTB Mentor: Not specified Dr Eleanor GROGAN Contact: Location(s): Areas of interest: Mentor: eleanor.grogan@nhct.nhs.uk Northumbria Healthcare Foundation Trust (community, hospital, inpatient unit) Newcastle University Medical School Northumbria Base Unit Ethics and prognosis Medical Education Association for Palliative Medicine No Dr Hannah GUNN Contact: Location(s): Areas of interest: Mentor: hannahgunn@nhs.net Marie Curie Hospice, Newcastle Northumbria Healthcare NHS Foundation Trust Ethics and metastatic spinal cord compression No Dr Colette HAWKINS Contact: Location(s): Areas of interest: Mentor: colette.hawkins@cddft.nhs.uk University Hospital of North Durham Cachexia, spiritual care Yes Dr Andrew HUGHES Contact: Location(s): Areas of interest: Mentor: andrewhughes@stoswaldsuk.org or contact via Ellen Wallbanks (Secretary) SOH 0191 285 0063 ext 275 St Oswald’s Hospice Newcastle Gateshead Community Gateshead Health NHS Trust Lymphoedema, consultation skills, breathlessness, death rattle Yes “I'm very interested in delivering effective training but registrars may need to be pro-active and pin me down! They have my permission!” Dr Alice JORDAN Contact: Location(s): Areas of interest: Mentor: ajordan@hartlepoolhospice.co.uk Hartlepool Hospice Not specified No Dr Mark LEE Contact: mark.lee@stft.nhs.uk 40 Version: Published 09/02/2016 05:17:00. JRCPTB Location(s): Areas of interest: Mentor: St Benedict’s Hospice, Sunderland Sunderland Royal Hospital Parkinsonian disorders No Dr Alex NICHOLSON Contact: Location(s): Areas of interest: Mentor: alex.nicholson@nhs.net James Cook University Hospital, Middlesbrough Pain (including methadone), education. Yes Dr Cate O’NEILL Contact: Location(s): catherineoneill@stoswaldsuk.org St. Oswald’s Hospice Areas of interest: Mentor: Palliative Care in Motor Neurone Disease Not specified Dr Paul PAES Contact: Location(s): Areas of interest: Mentor: paul.paes@nhct.nhs.uk Northumbria Healthcare Foundation Trust (community, hospital, inpatient unit) Newcastle University Medical School Northumbria Base unit Decision making, service models, medical education, non-malignant conditions (especially heart failure) Yes Dr Tim PEEL Contact: Location(s): Areas of interest: Mentor: tim.peel@northumbria-healthcare.nhs.uk Northumbria Healthcare Foundation Trust (community, hospital, inpatient unit) Breathlessness Yes Dr Anne PELHAM Contact: Location(s): Areas of interest: Mentor: anne.pelham@nuth.nhs.uk NCCC St Oswald’s Hospice Newcastle (CBT Clinic, on-call) Cognitive therapy in life limiting illness, communication Yes Dr Rachel QUIBELL Contact: rachel.quibell@nuth.nhs.uk 41 Version: Published 09/02/2016 05:17:00. JRCPTB Location(s): Areas of interest: Mentor: Royal Victoria Infirmary Ketamine, Palliative care for non-malignant conditions (CF, neurological conditions) No Dr Claud REGNARD Contact: Location(s): Areas of interest: Mentor: claudregnard@stoswaldsuk.org St Oswald’s Hospice Newcastle Learning Disability North & South of Tyne Identifying distress, CPR decisions, palliative care pharmacology, dysphagia No Dr Lucy ROTH Contact: Location(s): Areas of interest: Mentor: lucyroth@teessidehospice.co.uk Teesside Hospice Education, communication Yes Dr Helen ROWE Contact: Location(s): Areas of interest: Mentor: Telephone: 01900 705200 Mobile: 07887651243 Email: Helen.Rowe@cumbria.nhs.uk Workington Community Hospital, Park Lane, Workington CA14 2RW West Cumbria Community West Cumberland Hospital (hospital support team, Loweswater Suite) Education, communication Not specified Dr Trish SEALY Contact: Location(s): Areas of interest: Mentor: trishsealy@nhs.net Consultant for the Community in Middlesbrough and Redcar/Cleveland Not specified No Dr Leena SRIVASTAVA Contact: Location(s): Areas of interest: Mentor: l.srivastava@gtnt.nhs.uk Gateshead Marie Curie Hospice Not specified Not specified Dr Teresa STORR 42 Version: Published 09/02/2016 05:17:00. JRCPTB Contact: Location(s): Areas of interest: Mentor: Teresa.storr@cumbria.nhs.uk Hospice telephone: 01228 810801 Work mobile: 07748623876 Eden Valley Hospice, Durdar Rd, Carlisle CA2 4SD Cumberland Infirmary Carlisle Community in Carlisle and surrounding area. Not specified Not specified Dr Paul TAYLOR Contact: Location(s): Areas of interest: Mentor: paul.taylor@stft.nhs.uk Secretary: 0191 5128432 St Benedict’s Hospice Sunderland Royal Hospital Prognostication Recognising dying Clinical Decision-making No Dr Ruth TING Contact: Location(s): Areas of interest: Mentor: ruth.ting@mariecurie.org.uk Gateshead Marie Curie Not specified Not specified 43 Version: Published 09/02/2016 05:17:00. JRCPTB SOME TIPS WHEN YOU START (FROM THE CONSULTANTS) “I think it would be very helpful for new registrars to have a buddy - say Registrar in 3rd or 4th year of training. For people arriving new to Northern Deanery to have a more extended induction to include site visits to all other Palliative care providers in the area - this is probably partially relevant to local appointees too. It takes time to settle into a new role and establish exactly how your responsibilities have changed. Keep asking questions! Who, where, what, when!” “Training is a 2 way process - the amount you get out is proportionate to what you put in - it doesn't just happen! You get most from being pro-active - don't be embarrassed about asking questions - either clinical or organisational - both you and we learn from the questions that are asked!” “Do regular appraisals and meet regularly with other SpRs in Palliative Care” “Where places are? Who to contact for practical issues e.g. study leave, expenses. What do I need to do for ARCPs?” One of the most important things when starting a rotation is to get to know the other SpRs wellplace huge importance on the social side and the work issues will fall into place!” “Start thinking about research and planning almost from the start. Don't be too perfectionist about it or you'll never get anything done. Try to link with another trainee for research so that you can encourage each other. Do develop your own special interests.” a) Open a cake shop instead. b) More seriously, I wouldn't have done anything very differently, but sometimes think an induction course could usefully include a communication skills 3 days, covering everyday issues, with contributions from the consultants to whom one will be attached gets to know people and also how they do things” “Exposure to research methodology training as an SpR would be useful – it is hard to slot it in once in a consultant post” Plan ahead and be pro-active Say “YES” Go to conferences and get on committees Be assertive about your training needs Remember you have RIGHTS and RESPONSIBILITIES “At the start of the training programme sit down with your educational supervisor and sketch out in your mind and on a single sheet of A4 what the priorities for each of the four years of the programme are going to be, what fits in where for example, so that you can begin to plan in advance (sometimes well in advance) the support and assistance you will need.” “To think early on about what they want to gain from training and to make the most of various opportunities/placements-to certain extent training is what trainee decided to make of it. Also to ask for help/support if they need it.” 44 Version: Published 09/02/2016 05:17:00. JRCPTB “Keep at it, it’s a good job at the end of it.” “Hospital palliative care support team work is fascinating and challenging. There is a mix of cancer and non-cancer diagnoses and a wide range of ages of patients. In addition to the traditional holistic palliative care model of care for patients and their families, hospital support teams get involved in staff support and education, medical ethics, treatment withdrawal decisions, and also support the end of life care programme in hospital.” “Relax, be yourself, enjoy the role, the teams and the challenges. Remember, the consultants picked you in the first place, so they must think you have great potential! Wherever you work during training, you'll be part of a team so don't feel you have to know it all and do it all from day one. Ask a friendly medical secretary to train you in working with a secretary during your training. After that, ask another one. Get lots of perspectives: this relationship will be one of the most important of your consultant career. When you become a consultant, get a mentor as early as possible (any specialty) to help you to maximise your professional development. “Good luck!” “With research – start early and pair up if you don’t have opportunity to have time out. It definitely helped me to work” “Training goes quickly. There will be strengths and challenges associated with every training post and every trainer will have their strengths and weaknesses. Use each of these experiences to shape the sort of consultant you would like to be.” “Make the most of induction – it’s your chance to really settle in. Think widely about induction and grab every opportunity to visit other training units throughout the region at an early stage in your training.” “When rotating, visit your new training unit well in advance of starting and have a chat with one of the Consultants there about the training opportunities available at that particular site. Also ask other Registrars for advice on training opportunities at different sites so that you don’t miss out.” “Step out of your comfort zone – if you are grounded in general practice get stuck into hospital palliative care; if you are a hospital trained person, actively seek an early attachment in the community.” “Plan your study leave – some courses cost quite a lot and it’s a good idea to plan them across the course of your training so that you spend your allocation for study leave which is approximately £900 annually.” “Get to know your strengths and weaknesses. Take time during your training to tackle your weaker areas, but don’t expect to be uniformly good, or comfortable, at everything. Knowing and 45 Version: Published 09/02/2016 05:17:00. JRCPTB accepting your strengths will be valuable in identifying future consultant posts – you will be most fulfilled if you are doing what you do well.” “When starting as a new consultant, don’t miss the opportunity to build relationships in the first 6 months. Your credibility and influence depend heavily on building bridges with your colleagues – go out of your way to meet them face to face and you will reap the rewards.” “It’s a bad week if everything gets to you, but it’s a bad week if nothing gets to you.” and… “In all your doing don’t forget about being.” 46 Version: Published 09/02/2016 05:17:00. JRCPTB CONTACT INFORMATION FOR PALLIATIVE CARE TEAMS Hospices Middlefield Road Butterwick Hospice Stockton-on-Tees TS19 8XN www.butterwick.org.uk Macmillan House Butterwick hospice Woodhouse Lane at Bishop Auckland Bishop Auckland DL14 6JU Hartlepool and District Hospice Marie Curie Hospice Alice House Wells Avenue Hartlepool Cleveland TS24 9DA 01388 603003 01388 603630 (fax) www.hartlepoolhospice.co.uk 01429 855555 01429 855556 (fax) www.mariecurie.org.uk 0191 2191000 0191 2191099 (fax) Marie Curie Drive Elswick Newcastle upon Tyne NE4 6SS St Bede’s Unit Queen Elizabeth Avenue Gateshead NE9 6SX St Benedict’s Hospice St Benedict's Hospice St Benedict's Way Sunderland SR2 0NY Primrose Terrace Jarrow St Clare’s Hospice Tyne and Wear NE32 5HA St Cuthbert's Hospice Park House Road Merryoaks Durham DH1 3QF St Oswald’s Hospice Regent Avenue Gosforth Newcastle upon Tyne NE3 1EE 01642 607742 01642 617641 (fax) 0191 4456526 0191 4456408 (fax) www.hospice.co.uk 0191 5699191 0191 5699253 (fax) www.stclareshospice.co.uk 0191 4516378 0191 4516381 (fax) www.stcuthbertshospice.com 0191 3861170 0191 3831698 (fax) www.stoswaldsuk.org 0191 2850063 0191 2848004 (fax) 47 Version: Published 09/02/2016 05:17:00. JRCPTB Darlington and District Hospice Movement The Woodlands St Teresa's Hospice Woodland Road Darlington DL3 7UA www.darlingtonhospice.org.uk 01325 254321 01325 254325 (fax) www.teessidehospice.org 01642 816777 01642 823034 (fax) Teesside Hospice Care Foundation 1 Northgate Road Linthorpe Middlesbrough TS5 5NW Tynedale Community Hospice 19 Battle Hill Hexham Northumberland NE46 1BA 01434 600388 01434 600384 (fax) Willowburn Hospice Maidenlaw Hospital Lanchester Durham DH7 0QS 01207 529224 01207 529303 (fax) Community Teams Foreman, Chris Karen Richardson Diane Stout (Physio) Bondgate Clinic, Alnwick Infirmary, Alnwick, Northumberland, NE66 2NL 01665 626713 01665 510581 (fax) Liz Dochar Clare Raffel Tynedale Macmillan Service Dene Park House, Hexham, NE46 1HN 01434 612932 01434 612930 (fax) Philippa Green Amanda Platt Heather Connolly Sue Coates Angela Thompson Tracey Wilson Macmillan Service, Nursery Park, Nursery Park Road, Ashington. NE63 0HP 01670 857635 Joanne McKenna Margaret McKie Macmillan Nurses St. Teresa's Hospice, The Woodlands, Woodlands Road, Darlington, DL3 7UA 01325 465564 01325 254325 (fax) Dawn Owen Palliative Care Team, Blaydon Primary Care Centre Michelle Purvis Melanie Fogg Claire Walton Victoria Armstrong Carol Moore 0191 283 4586 0191 283 2632 (fax) 48 Version: Published 09/02/2016 05:17:00. JRCPTB Sarah Allport Lesley Robson Julie Warwick Ann Halcrow Gillian Fenwick Catherine Hogg Michelle Stuart Diane Scott Specialist Palliative Care Team Arthurs Hill Clinic, Douglas Terrace, Newcastle upon Tyne, NE4 6BT 0191 2261315 0191 2195204 (fax) Karen Robinson Lynn Forsyth Nikki Shieber Tracy Fox Peter Fenwick Isobel Constable North Tyneside Palliative Care Team 0191 2205905 Sir GB Hunter Memorial Hospital, Wallsend, Tyne and 0191 2205901 (fax) Wear, NE28 7PB Chris Allison Karen Gilson Barbara Myers Shirley Routledge Andrea Carpenter Macmillan Service, Butterwick Hospice Bishop Auckland, Macmillan House, Woodhouse Lane, Bishop Auckland, Co. Durham, DL14 6JU 01388 607301 01388 603630 (fax) Jan Armitage Community Macmillan Service, Chester-le-Street Celia Murch Hospital, Chester-le-Street, DH3 3AT Hiliary Riseborough Lorraine Gordon 0191 387 6533 0191 3876534 (fax) Fiona Perry Stacy Stockdale Tess Craig Denise Villiers Sue Gent Alison Heneaghan Tanya Dunill Barbara Ndlolovu Macmillan Community Palliative Care Team Guisborough General Hospital, 66 Northgate, Guisborough, Cleveland, TS14 6HZ 01287 639100 01287 284023 Karen Gillespie Tony McCoy Lynne Stead Community Macmillan Nursing Service , Centre for Health, Trainer Way, Whitehouse Business Park, Peterlee. SR8 2RU 0191 5692875 fax to be confirmed Feb 2013 Julie Richardson Heather Parkin Vivienne Watson Sara Symonds Jennifer Jones Macmillan Service Shotley Bridge Hospital, Outpatients Department, Shotley Bridge, DH8 0NB 01207 594608 01207 594599 (fax) Sue Burke Jason Black Hilary Sadler Vanessa Cox Macmillan Nurses , Room 135, First floor, Ward 2, University Hospital of Hartlepool, Hartlepool, TS24 9DA 01429 522154 01429 406559 (fax) 49 Version: Published 09/02/2016 05:17:00. JRCPTB Mel McAvoy Sue Smith Mags Lundberg Judith Spink Macmillan Specialist Palliative Care Team 2nd floor, Farndale House, University Hospital of North Tees, Hardwick Road, Stockton-on-Tees, TS19 8PE 01642 383895 01642 308218 (fax) Dorothy Matthews Macmillan Nurse Palliative Care – Learning disabilities 01670 394808 Northgate hospital NHS trust, Morpeth, NE 61 3BP 01670 394002 (fax) Dawn Townsley Dawn Orr Bev Ferguson Sue Whitehead St Clare’s Hospice, Primrose Terrace, Jarrow, Tyne and Wear NE32 5HA Maureen Wilson St Benedict’s Hospice, St Benedict’s Way, Sunderland. Lynn Stronach SR2 0NY Catherine Goodwin Sam Bland Wendy Johnston Tracey Land Michelle Bramwell Tori Burns 0191 4516396 0191 4516364 (fax) 0191 5699195 0191 5699649 (fax) Community team 0191 5656256 Ext 49193 Hospital Teams Leonie Armstrong Sharon Hillock Wansbeck General Hospital, Woodhorn Lane, Ashington, Northumberland NE63 9JJ 01670 529050 01670 529270 (fax) Karen Hertwick Angela Laybourne Karen Harrison Tracey Cuthbert Tara Riches Andrea Piggott Palliative Care Team Northern Centre for Cancer Care, Freeman Hospital, Newcastle 0191 2138606 0191 2137680 Michelle Muir Jo Isbister Zoe Booth Jacqui Stuart Palliative Care Support Team Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP 0191 2824019 0191 2825466 (fax) Susan Besford Helen Merlane Denise O’Neill Macmillan Palliative Care Team Room 134 Education Centre, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN 0191 2137221 0191 2231430 (fax) Clare Walton Carol Moore Dawn Orr Michelle Henderson Vicky Armstrong Palliative Care Team, Queen Elizabeth Hospital, Gateshead St Bede Unit Queen Elizabeth Hospital 0191 282 0000 Bleep 2336 50 Version: Published 09/02/2016 05:17:00. JRCPTB Noeleen Hunter Jane Walker Lorraine Gordon Pamela Yeates Specialist Palliative Care Team The James Cook University Hospital, Marton Rd, Middlesbrough, TS4 3BW 01642 854938 01642 282721 (fax) Mel McEvoy Helen Clarke Sue Smith Mags Lundberg Sue Whalley John Sheridan 2nd Floor, Farndale House, University Hospital of North Tees, Hardwick, Stockton, TS19 8PE 01642 383895 01642 383239 (fax) Lauren Shepherd Gaynor Matterson Specialist Palliative Care Team University of Durham Hospital, North Road, Durham, DH1 5TW 0191 333 2338 0191 333 7139 (fax) Tracy Lindsay Hospital Macmillan Office (formerly child and family unit), District General Hospital, Harton Lane, South Shields, NE34 0PL 0191 202 4105 bleep 105 0191 202 2162 (fax) Caroline Wills Sonia Thompson Specialist Palliative Care Team, Sunderland Royal Hospital 0191 5656256 Ext 47337 Other Useful Hospital Contact Numbers Bishop Auckland General Hospital City Hospital Sunderland Darlington Memorial Hospital Freeman Hospital Newcastle Hexham General Hospital James Cook University Hospital Middlesbrough Newcastle Hospitals Trust North Tyneside General Hospital Queen Elizabeth Hospital Gateshead Royal Victoria Infirmary South Tyneside District Hospital University Hospital Hartlepool University Hospital North Durham Wansbeck (Ashington) General Hospital 01388 455000 0191 5656256 01325 380100 0191 2336161 01434 655655 01642 850850 0191 2336161 0844 8118111 0191 4820000 0191 2336161 08448 113030 01429 266654 0191 3332333 0844 8118111 51 Version: Published 09/02/2016 05:17:00. JRCPTB APPENDICES Appendix 1 – Further links ARCP Decision Aid for Palliative Medicine http://www.jrcptb.org.uk/sites/default/files/2010%20Palliative%20Medicine%20 ARCP%20Decision%20Aid%20(revised%2016.10.14).pdf Work-based placed assessments information http://www.jrcptb.org.uk/assessment/workplace-based-assessment Form R - Revalidation http://www.northerndeanery.nhs.uk/NorthernDeanery/specialtytraining/information-for-specialty-trainees-with-the-exception-of-gptrainees/form-r Northern Deanery Contacts http://www.northerndeanery.nhs.uk/NorthernDeanery/let-humanresources/contacts 52 Version: Published 09/02/2016 05:17:00. JRCPTB Appendix 2 – Further information on Study Leave CLARIFICATION REGARDING STUDY LEAVE CLARIFICATION regarding STUDY LEAVE & SPA TIME for Northern Deanery Palliative Medicine Trainees and Trainers December 2012 This document aims to clarify what constitutes study leave as there has been some confusion. For more info please refer to the deanery policy: Study Leave Policy http://www.northerndeanery.nhs.uk/NorthernDeanery/specialtytraining/information-for-specialty-trainees-with-the-exception-of-gptrainees/study-leave/StudyLeavePolicyUpdate2013.pdf Study Leave Procedure http://www.northerndeanery.nhs.uk/NorthernDeanery/deansoffice/information-team/all-finalised-policies/specialty-training/studyleave/StudyLeaveProcedureSpecialtyFeb12.pdf STUDY LEAVE 1) Some principles – a) study leave is an essential part of educational programmes b) trainees are responsible to prioritise their use of study leave and funding c) study leave should be used to support the trainee in achieving essential competencies. d) Study leave should be planned with the educational supervisor 2) Budget 2012 – 13: budget is £950 pa (pro-rata). This can only be used within the allocated year and not carried forward to subsequent years. Funding is pro rata for flexible trainees (should work out the same across training). Exam fees will not be reimbursed. 3) Allocation Max of 30 days per year (pro-rata). Year runs April to March. Pro rata for flexible trainees. 4) Application process Plan study leave with educational supervisor Complete sections 1 & 2 of study leave form then get educational supervisor to sign Submit application to TPD at least 6 weeks in advance of study leave TPD will then send onto deanery once approved All study leave should be formally requested even if funding not required (see below) 5) Study leave includes: a) Regional teaching sessions – eg i) NRPCPG, (half day - currently 6 per year) 53 Version: Published 09/02/2016 05:17:00. JRCPTB ii) iii) b) i) ii) iii) registrar teaching sessions (full day, 6 per year) Registrar research meetings (half day - currently 6 per year) Courses and conferences – eg Leadership and Management training Communication skills training eg Calgary Cambridge Advanced course in Pain and symptom management iv) Medical Update for Palliative Medicine v) Palliative Care Congress vi) APM Trainee Committee study days vii) APM research study days (“where possible these should be attended within the northern region”- not always easy!) c) Leave to sit an exam (conditions may apply to re-sits of same exam) d) Regional half day courses put on for exam preparation eg regional MRCP teaching e) Private study leave – this is only granted immediately before an approved exam with a maximum of 6 days for each exam (12 days max per year). 6) Excluded from study leave a) Learning / skills development for clinical governance purposes eg induction / mandatory training b) Delivering teaching, or audit, risk management and clinical governance activities within the trainees trust (or hospice). Going on a course about audit = study leave; doing an audit is not! 7) All ‘study leave’ should be requested on deanery forms even if funding is not required to ensure there is a record of study leave taken, the supervisor has forewarning, & that trainee negotiates leave with their clinical team, ensuring patient care is not compromised. This therefore includes NRPCPG, and registrar training days which should be submitted through the usual deanery mechanism REGISTRAR’S HALF DAY PER WEEK This is not study leave but should be considered as SPA (supporting professional activity) time, akin to a consultant job plan. 1. Registrars do not have a ‘study half day’ or ‘CPD’ session per week, despite these being commonly used phrases in the region! It does not fit in with the deanery study leave policy. 2. SPA session should be used for non-clinical work, such as admin., working on e-portfolio, audit, research, teaching preparation. It is not “study leave” as it is part of what is needed to be ‘doing the job’! 3. SPA session per week applies to both ‘full time’ and ‘less than full time’ trainees (unlike ‘study leave’ which is pro-rata.) 4. If a registrar is undertaking a larger project or piece of work that will need more ‘non-clinical time’ then, after negotiation with the educational & clinical supervisor, further non-clinical time can be built into the timetable for a defined period. 5. SPA session should be a planned session once a week that coordinates with other team members to ensure that clinical care is not compromised. This session is not set in stone – flexibility is needed from both the trainee and the service to make this work. This whole process of prioritisation and ‘management of workload’, together with ‘effective membership / leadership 54 Version: Published 09/02/2016 05:17:00. JRCPTB of teams’ are themselves areas of the curriculum for which evidence needs to be demonstrated. Examples of this might include: a. Cancelling or postponing a non-clinical session when there is an acute clinical need / staffing crisis on a particular day. b. Negotiating within a team to take time for ‘non-clinical’ work on occasions where there is a plethora of medics in a service on a particular day, c. Where you have been away on study leave and would normally be taking the following morning for a ‘non-clinical half day’ then it is expected that you work clinically on return rather than take yet a further session away. 6. As with all such things, the balancing of ‘training needs’ with care of patients is key. It is made very clear within GMC ‘good medical practice’ and statement 1 of PMETB training standards that “…..the trainee must make the needs of patients their first concern” yet at the same time we must strive to achieve effective training. 7. It is expected that you are available for clinical work if required. Appendix 3 - Reflection Guidance notes for Trainee and Trainer in Palliative Medicine for the Record of Reflective Practice Dr Clare Rayment, Dr Jane Wale, Dr Fiona Hicks (Oct 2011), on behalf of the SAC in Palliative Medicine. Since the inclusion of the RRP form on the ePortfolio, minor amendments have been made by Dr Jonathan Pickard (SpR) (May 2015) This replaces previous guidance What is reflective practice? Reflective practice is an educational idea which has had a large impact on professional training. It is viewed as an integral component in a competent professional and important in medicine in the western world (Australian Medical Council 2009; National Alliance for Physician Competence 2009; General Medical Council 2006, 2009). There is a considerable body of work discussing reflection including a journal dedicated to the subject (Reflective Practice, published by Routledge). Reflection helps professionals understand the theories, values or assumptions underlying what they do, recognising that individuals are not impartial self observers, that language and power influence reflection and that it can challenge organisations and assumptions: doctors are not robots managing patients but individuals influenced by surroundings and internal workings (Fook 2007). If experience is not to be ‘making the same mistakes with increasing confidence over an impressive number of years’ (Driessen 2008) doctors need to learn from professional experience within palliative medicine so that in a similar situation in the future they are able to act, think or feel differently (Tate 2004). Reflecting is one way to do this. It is not simply discussing what happened, it is critically examining why something was done and what may be done differently in the future. Why reflect as a palliative medicine trainee? Palliative Medicine has unique challenges, which may focus thoughts and actions on subjects that might not have been confronted previously. Dilemmas are not uncommon and individuals often 55 Version: Published 09/02/2016 05:17:00. JRCPTB have to cope with strong emotions from their patients and themselves. The speciality is based on individual care; what is right for one patient may not be right for another. This messiness of clinical practice can be demanding. Reflective practice is one way to recognise and explore these difficulties to enable more effective learning from experience and perhaps prevent burnout and stress (Novack 1997). Informal reflection does occur, the discussion of the difficult patient in the corridor or quick conversation between patients on the ward round, but it is difficult to critique and hard to know if it impacts on learning or practice. What should be reflected on? What is useful to be reflected on will vary between individuals but the most valuable scenarios are ones which are difficult or have left individuals feeling uncomfortable or unsure of the best management or best response to a situation, a ‘disorientating dilemma’ (Mezirow 1981). How to formally reflect There are many tools used to enable professionals to reflect but key to all are the importance of being guided - to challenge and support there needs to be a facilitator (Artherton 2010; Johnson 2010; Mann 2009; Sandars 2009, Snadden 1998; Hatton 1995). This can be your supervisor but does not have to be, it could be someone approved by them such as an experienced nurse. It is hoped this may help some trainees reflect on scenarios that they feel highlight poor performance but are likely to have a large number of useful action and learning points. It is expected that trainees will be ‘wise, compassionate, non - judgemental observers of their own experience’ (Tate 2004) The guide that is being used is IDEA; this is based on a discussion of a scenario with a facilitator leading to a definitive action plan or learning points. These are the steps in the process. Step 1 of IDEA: Identify a ‘disorientating dilemma’ Step 2 of IDEA: Synopsis written and given to facilitator, max 500 words Step 3 of IDEA: trainee reflects alone and writes supporting notes then meets with facilitator and discusses 30-45mins Step 4 of IDEA: action/learning points agreed with facilitator during the discussion Synopsis and action/learning points go on ePortfolio to support curriculum sign off Trainees are required to do two scenarios a year. They can be used to highlight learning needs, show skills to meet specific curricula competencies, direct training and inform appraisal. They can be on any aspect of practice - not just clinical cases. There is now a form on the ePortfolio called the Record of Reflective Practice (RRP), which is used to record such formal reflections. This form, together with the IDEA format both serve to provide structure in this exercises. The format will be reviewed and feedback welcomed. 56 Version: Published 09/02/2016 05:17:00. JRCPTB IDEA These questions are a guide to support facilitated reflection. All of the questions will not be appropriate all of the time. Identify an event or situation which has caused you to have uncomfortable thoughts or feelings: a disorientating dilemma (Mezirow). Describe the situation What happened? Who was involved? What were you trying to achieve? Evaluate the situation What thoughts and feelings did you have at the time? What did you think and feel afterwards? Why did you think and feel that way? What sense can be made of the situation? What caused you to act in the way you did? What other factors affected the outcome? What sources of knowledge did you use? What other knowledge would have been useful? Analyse any learning which has occurred Form a list of ‘things I have learnt’ and an action plan What would you do if you were in that situation again? References AUSTRALIAN MEDICAL COUNCIL. 2009. Assessment and Accreditation of Medical Schools: Standards and Procedure [online]. [accessed 30th November 2010]. Available from: http://www.amc.org.au/images/Medschool/standards.pdf ATHERTON, J. S. 2010. Learning and Teaching; Reflection and Reflective Practice [online]. [Accessed 12 December 2010]. Available from http://www.learningandteaching.info/learning/reflecti.htm DRIESSEN, E., TARTWIJK, J., DORNAN, T. 2008. The self critical doctor: helping students become more reflective. British Medical Journal. 336, pp 827-941. FADE, S. (2004) Reflection in the Dietetic Curriculum. In: S. Tate, M Sills eds.The Development of Critical Reflection in the Health Professions. The Higher Education Academy Occasional Paper 4 pp. 76-81. 57 Version: Published 09/02/2016 05:17:00. JRCPTB FOOK, J and F GARNDER. 2007. Practising Critical Reflection. Oxford University Press: Oxford GENERAL MEDICAL COUNCIL. 2006. Good Medical Practice. London: GMC. GENERAL MEDICAL COUNCIL. 2009. Tomorrow's doctors: recommendations on undergraduate medical education. London: GMC. HATTON, N and D. SMITH. 1995. Education. 11(1), pp33-49. Reflection in teacher education. Teaching and Teacher JOHNSON, C. and BIRD J. How to teach reflective practice. School of postgraduate medical and dental education. [online]. Cardiff University [accessed 1st December 2010]. Available online at http://www.cardiff.ac.uk/pgmde/resources/howtoreflective.pdf MANN, K., GORDON, J., MACLEOD, A.2009. Reflection and reflective practice in health professions education: a systematic review. Advances in Health Science Education 14, pp 595-621. MEZIROW, J. 1981. A Critical Theory of Adult Learning and Education. Adult Education 32, pp 3–23. MOON, J. A. 1999. Reflection in learning and professional development. Routledge Falmer: Oxon. MOON, J. A. 2004. A handbook of reflective and experiential learning: theory and practice. RoutledgeFalmer: Oxon. NATIONAL ALLIANCE FOR PHYSICIAN COMPETENCE. 2009. Guide to Good Medical Practice – USA Version 1.1. [online]. [accessed 30th November 2010]. Available from http://www.amaassn.org/ama1/pub/upload/mm/377/ggmp-usa.pdf NOVACK, DENNIS, H., SUCHMAN, W., C., EPSTEIN R., M. 1997. Calibrating the physician: personal awareness and effective patient care. Journal of the American Medical Association. 278(6) pp 502509. SALTIEL, D. 2010. Judgement, narrative and discourse:a critique of reflective practice. In: H. BRADBURY, N.FROST, S. KILMINSTER, M. ZUKAS, eds. Beyond reflective practice: new approaches to professional lifelong learning. Routledge: London, pp 130-143. SANDARS, J. 2009. The use of reflection in medical education: AMEE guide no 44. Medical Teacher 31, pp 685-695. SNADDEN, D. THOMAS M. 1998. The use of portfolio learning in medical education. Medical Teacher. 20(3), pp 192-199. TATE, S. 2004. Using critical reflection as a teaching tool. In: S. Tate., M. Sills, eds. The Development of Critical Reflection in the Health Professions. The Higher Education Academy Occasional Paper. 4, pp 8-18. 58 Version: Published 09/02/2016 05:17:00.
