NHS Education for Scotland
Minutes of the meeting of the Scottish Specialty Board for Training in Diagnostic Specialties held
at 10.45 am on Tuesday 16 June 2015 in Meeting Room 1, Level 8, Postgraduate Medical Office,
Ninewells Hospital, Dundee
Present: Dr Peter Johnston (PJ) (Chair), Dr Ralph Bouhaider (RB) part meeting, Dr Clair Evans (CE), Dr
Peter Galloway (PG) part meeting, Dr John Hood (JH), Dr Wilma Kincaid (WK), Dr Marie Mathers
(MM), Dr Fiona Payne (FP) part meeting, Dr Jonathan Weir-McCall (JWM).
By videoconference: Inverness – Dr Emma Watson (EW).
In attendance: Dr John Colvin (JC) for items 6-8; Dr David Cowell (DC), Ms Helen McIntosh (HM).
Apologies: Dr Celia Aitken (CA), Dr Raj Bhat (RBh), Ms Vicky Binnie (VB), Dr John Bremner (JB), Mr
John Cummings (JC), Ms Frances Dorrian (FD), Dr Daniel Ho (DH), Dr Iain McGlinchey (IM), Professor
Stewart Fleming (SF), Professor Graeme Houston (GH), Dr Gavin Main (GM), Dr Hamish McRitchie
(HMcR), Dr Shona Olson (SO), Professor Rowan Parks (RP), Ms Karen Shearer (KS), Dr David Summers
(DS).
Action
1.
Welcome and apologies
The Chair welcomed all to the meeting and apologies were noted.
2.
Minutes of meeting held on 23 April 2015
The following amendments were noted:
Page 5, item 13.2, second sentence to read ‘...the issue of deliverability across
UK ...’
Page 5, item 13.3, first sentence to read ‘...one trainee exited training.’
Page 6, item 13.5, sentence to read ‘...Interventional Neuroradiology ...’ and
same amendment on actions arising from the meeting.
With these amendments the minutes were accepted as a correct record of the
meeting.
3.
Notification of AOB
No other business was notified.
4.
Medical Specialty Profiles
Dr David Cowell, Scottish Clinical Leadership Fellow, presented to the STB. He
noted the Fellowships were established by the Professional and Excellence
Group and he was in post from January 2014 – January 2015. This was an
immersive programme involving learning by doing and with a national
perspective. Trainees in Scotland were eligible to apply and this provided one
year OOP experience in a variety of host organisations eg Scottish Government,
Colleges. The programme had increased up from 2 original Fellows and 8 have
been through or were presently in the programme and the new cohort of 6
people will start in August. There were 3 broad strands of work within the
Fellowships – leadership and management via the National Leadership Unit;
wider healthcare context; project work within the host organisation. Much
networking was involved and he has attended STB and Chief Executive
meetings to observe and present and he considered the project he worked on
has been both relevant and valuable.
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The Fellows were seeking to form an alumni group and there was a move to
expand numbers. Personally he has very much enjoyed the year which he felt
has given him a good perspective and he would recommend the Fellowship to
any interested trainee.
He has been engaged on the Medical Specialty Profiles project. This was an
attempt to provide a concise and up-to-date medical workforce data resource
by building on various existing data and Reshaping work and the project sat
within the Shape of Training Transitions Group. The philosophy behind the
project was to work collaboratively and iteratively as numbers constantly
changed. Trainee data was provided by NES; consultant information by ISD and
the External Adviser Office (EAO) which gathered data on the number of
applications/shortlisting ratios.
He demonstrated the 2 main components of the data to the STB using a specific
specialty as an example. Projections – comparing data eg consultant
retrials/growth in demand – resulted in projected over/under supply and
cumulative projected vacancies (all WTE). They can identify areas where there
was difficulty eg HST with residual vacancies carrying forward from one year to
the next resulting in an increased number of posts being advertised each year.
Using this information they were able to provide support to the plan to reduce
HST numbers and create core posts instead. Such data was available for all
specialties and David Arnot, another Scottish Clinical Fellow, was now taking
this work forward. He noted that Dr John Colvin/Shirley Rogers will be
contacting each of the STBs soon for information for 2016 recruitment.
PJ noted his own previous contact with the EAO had not been helpful and
highlighted ISD past coding inaccuracies. DC said EAO was starting to collect
data on the template he/his colleague provided and data should be available on
request. Coding issues within ISD were well known however it was now
represented on the Shape of Training Transitions Group and involved in the
work so it should be possible to align its information with that held by NES.
PJ noted that specialty workload data continued to rise and Diagnostic services
should be factored into 24/7 discussion. DC suggested Diagnostics should
collate data on the growth in demand for the specialties; retirement age eg
retiring before 61; loss of trainees at CCT and post training and especially post
CCT although both were increasing. He will summarise feedback from the STB
to the discussion at today’s meeting and send this to John Colvin.
5.
5.1
DC
Matters arising/actions from previous meeting
Combined Infection Training: information
JH confirmed a meeting will be arranged. The College will put in place
transitional arrangements for trainees and he felt there should be no major
issues.
Three MM and ID jobs were advertised in West, 2 Virology posts in South East
and 1 in MM/ID in North – all 3 posts in West filled; none of the Virology posts
filled. The post in the North was offered and accepted however a website n
issue became apparent and subsequently resolved. A LAT will be appointed to
the North post and Virology will go into the next recruitment round.
5.2
Nuclear Medicine update
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NHS Education for Scotland
To note that Dr Sai Han has joined the STB to represent Nuclear Medicine.
5.3
Histopathology vacancies – Round 2
MM reported there were 2 new posts – one in South East and one in West and
2 posts in Dundee. The Edinburgh post filled – information on other posts was
awaited although it was expected the fill rate overall will be high.
5.4
Study Leave
WK confirmed a meeting has taken place to agree what will be funded. It was
for each TPD to decide what they will/will not fund and although they aimed for
consistency each area could never match perfectly. The study leave policy was
available on the NES website.
5.5
Paediatric Pathology
CE confirmed the College has approved the programme, paperwork was
proceeding to the GMC and its response was awaited. They have one current
post which PJ proposed could be filled meantime as a LAT. CE noted they have
created placements rather than rotations to enable trainees to move around
the country.
5.6
Forensic Pathology update
Following the previous STB meeting, PJ and RB met and discussed programme
aspirations. RB said they hoped to get an extra post and planned to approach
different bodies. Meantime they lost a consultant in Edinburgh so had a vacant
post and were discussing how to fill/at what level. PJ confirmed the STB was
supportive of Forensic Pathology’s efforts to increase numbers.
6.
6.1
Recruitment
Recruitment update
Chemical Pathology failed to recruit in Scotland – PJ has raised the issue with
MDET and the need to seek a solution to this continuing problem.
All posts in Radiology filled. There were 3 applicants for 2 Interventional
Radiology posts in the West, 2 of whom were interviewed and one appointed.
This was the first time applicant numbers for the posts have been as low and
they will be readvertised.
PJ asked MM, SO, CE, RB and will also ask SH to begin compiling data for 2016
recruitment – specifically the number of consultant posts in specialty by centre;
the number of posts which are filled/vacant/anticipated vacant over the next
12 months; the number of new posts and additionally the number of
consultants who will retire early or cut their hours/sessions. It would also be
helpful to have attrition rate information if available plus workload statistics. PJ
will circulate a template for completion with a return date.
MM, SO,
CE,RB,
SH
PJ
JC joined the meeting and confirmed the proposal was to replace vacancies and
the Transitions Group will consider all information provided.
7.
8.
Royal College of Radiology ARCP decision aid
It was agreed to discuss ARCPs at a future meeting.
Agenda
Professional Compliance Analysis Tool (PCAT)
JC said it became clear that compliance with EWTR etc has produced different
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working patterns across Scotland and hence the PCAT tool has been developed
to ensure consistency. Reem Al-Soufi and Myra McAdam, both Clinical Fellows,
have led on this work using evidence from published sources, undertaking
qualitative work with trainees and some iterative material via early pilots in
Emergency Medicine and Anaesthesia. The tool has been offered in areas
where there were problems with working patterns ie in Remote and Rural,
where there were red flags and significant sickness rates. Structured
conversations will take place with departments with a training lead, service lead
and trainee present in the room. They were also assisting some areas with
rotas and testing where there was good practice. The DME network has proved
very helpful as have the STBs. Further research and evaluation will be done
after which it was hoped it will become a formal assessment tool. He noted
support from SAMD, NES, GMC and the Chief Executives Group and from Daniel
MacDonald from Scottish Government Workforce. There were 900+ rotas in
Scotland and all will be assessed to ensure professional and contractual
compliance. They were also aiming to build a library of good practice however
work was still at early stage.
Feedback from the STB on this work and any information was welcomed to
ensure awareness of specialty variation. PJ felt the work played well into
research findings eg StART which demonstrated that trainees rated working
conditions most highly in their choice of location.
EW reported they have used the tool in 2 areas – one via face-to-face and one
using survey monkey. The face-to-face meeting produced good feedback on
granularity. The College has also used the tool in Lothian and found it very
helpful. JMW noted he has seen a demonstration of the PCAT tool and felt it
highlighted the importance of quality of life and training particularly relating to
day/night working.
PJ expressed interest in running a pilot in the Pathology Department at
Aberdeen Royal Infirmary and will ask Reem Al Soufi to arrange to meet FP to
discuss. Any other areas or departments with an interest in doing likewise
should let JC know. JC noted he welcomed feedback and was happy to share
more detailed information. He will send this to HM to circulate to the STB.
PJ/FP
JC, HM
JC asked the STB to make an effective case for any specialties with specific
issues eg a different model in its response to the annual letter from Scottish
Government.
9.
Scotland Deanery: QI - QM framework
There was nothing to report at present.
PJ noted that Dr Bernard Croall, Vice President of the College of Pathologists,
was keen to reinvigorate the Scottish Regional Committee.
10.
11.
Interventional Neuroradiology
WK reported they were not currently training anyone in Scotland. PJ will flag
this up in the response to the Scottish Government letter.
PJ
Nationalised Neuropathology numbers and academic training
PJ noted the changes due to take place in the Scotland Deanery in August this
year at which time Diagnostics will move to the East region and Lead Deans re4
NHS Education for Scotland
assigned to the STBs. He will delay progressing Neuropathology until then
however if a case could be made the STB should do this.
12.
Scottish Careers Fair: 12 September 2015 update
All were asked to note the date in their diaries. PJ has requested stands – one
for Pathology and smaller specialties, one for MM and Virology and CIT and
Chemical Pathology and a separate one for Radiology. He will also book a slot
at the event to speak about careers. He requested names of trainees willing to
become Trainee Ambassadors to be sent to Lisa Pearson. He asked specialty
leads to provide or suggest suitable literature and materials for stands on the
day. He noted that Medical students and school pupils were being invited to
attend the event.
13.
13.1
Update reports
Lead Dean/Director
No additional update was received.
13.2
Histopathology
MM noted improved communication links with the National Training Schools in
England which were now communicating with TPDs. There was also a plan in
place to run local courses. The curriculum was still in process of being
approved.
13.3
Paediatric Pathology
CE reported they have started work on a proposal for a weekly teaching
seminar within term-time.
13.4
Forensic Pathology
No additional update was received.
13.5
Radiology
Noted: TPDs planned to meet 6 monthly.
13.6
13.7
Medical Microbiology
Virology
No updates were received.
13.8
Chemical Pathology and Metabolic Medicine
PG reported they will be reviewed by the GMC as part of its smaller specialty
review. Recruitment to the specialty was down by 30% and this was a major
issue. They had dropped one training rotation in at the Royal Hospital for Sick
Children in Edinburgh.
13.9
Nuclear Medicine
No update was received
13.10
Trainees
JMW noted discussion around Advanced Medical Training Fellowships and
whether these had a role within Diagnostics. PJ confirmed the posts have been
discussed over the years and were originally to have been funded from
disestablished posts. However this funding did not materialise and posts were
funded now from gaps from consistently underfilled posts and there was
reluctance to do this. Theoretically there was continuing value in the
All
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Fellowships especially when credentialing was introduced.
EW confirmed there were several such posts approved by the Transitions Group
mainly in acute facing specialties and Diagnostics specialties considered as a
resource for such posts.
13.11
13.12
Academic issues
Service issues
No updates were received.
13.13
DME
EW reported the DME group were looking at the new GMC standards and to
demonstrate they were met. DMEs were also actively encouraging TPDs to
engage with Recognition of Trainers.
13.14
Lay representative
No update was received.
14.
Received for information
No additional information was received.
15.
15.1
AOB
Approval to shorten training
PG reported the GMC will allow highly competent people to shorten training
before their 4th year ARCP as long as this was planned. This would shorten
Chemical Pathology training by 6 months from five and a half to five years.
Trainees who failed to deliver in their final year would receive an outcome 3.
16.
Date and time of next meeting
The next meeting will take place at 10.30 am on Tuesday 1 September 2015 in
Forest Grove House, Aberdeen (with videoconference links).
Actions arising from the meeting
Item no
4.
Item name
Medical Specialty Profiles
6.
6.1
Recruitment
Recruitment update
7.
ARCPs
8.
Professional Compliance Analysis Tool
(PCAT)
Scotland Deanery: QI - QM framework
9.
11.
Scottish Careers Fair: 12 September
2015 update
Action
To summarise feedback from
today’s meeting and send to
John Colvin.
Who
DC
To begin compiling data for
2016 recruitment; to circulate
template.
Agenda item for future
meeting.
To ask Reem Al Soufi to meet
RP; to circulate information.
To highlight Interventional
Neuroradiology in response to
Scottish Government.
To send Trainee Ambassador
names to Lisa Pearson.
MM, SO,
CE,RB, SH
PJ
PJ
PJ
JC, HM
PJ
All
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