Postgraduate Medical Education Meeting
Held on 11th June 2014
at 5.30 p.m. in the CSB
Present
Ed Simmonds
Chris Harmston
Maggie Allen
Asad Ali
Dorothy Apakama
Hemali Kanji
Marius Holmes
Dawn Adamson
Pijush Ray
Shirish Dubey
Matt Rogers
Sailesh Sankar
Melvin Xavier
Chris Bassford
Marie Midgley
Chair/Clinical Tutor
Lead Surgery
Associate Director Education, Research and Professional Development
Lead Respiratory Medicine
Lead A&E
Lead Acute Medicine Registrars/Renal
Clinical Tutor
Lead Cardiology
Deputy Clinical Tutor Foundation Year 1/GIM Training Committee
Deputy Clinical Tutor Foundation Year 2/Rheumatology
Lead Pathology
Lead Endocrinology/CMT
Lead GP TPD
Lead Intensive Care
Secretary/Manager Medical Education
Apologies
Krish Ramachandran
Waqar Ayub
Alaani Ausama
Andrea Lindahl
Atul Bansal
Ilam Khan
Kavita Goswami
Hemali Kanji
Lead Anaesthetics
Lead Nephrology
Lead ENT
Lead Neurology – also has stepped down handed role to Eleanor Pye
Lead Opthalmology
Lead Gerontology
Lead Obs & Gynae
Lead Acute Medicine
Minutes of previous meeting
Minutes of the previous meeting were approved with the amendment that Alaani Ansama was
present. Apologies were given for the error.
Matters arising
Change in Lead for Neurology
It was noted that Andrea Lindahl has stood down from her role as Educational Lead for Neurology. d
Eleanor Pye has kindly agreed to take on the position. Andrea was thanked sincerely by the
committee for all her hard work and for the improvements in educational provision she had been
able to introduce.
Action ES
Anaesthetics visit May 2014
The visiting team were pleased with the education and training of the trainees in Anaesthetics. They
noted a few areas where improvements were needed but no formal action plan is needed although
a progress report will be required in a few months’ time. Therefore, an informal internal action plan
will be developed to assist in action planning.
One area where action is needed is the continued practice by a few Consultants to use paper based
versions of the portfolio rather than using E-portfolio. This will be investigated and the relevant
Consultants will be given training and support to help them change practice.
Action KR
Neurosurgery Level 3 revisit due 20th June
ES reported that the progress report summarising actions that have been taken since the previous
visit in January has been submitted to HEWM and improvements have been achieved in all areas. ES
went to the JDF 2 weeks ago and 3 (out of the 5 trainees) were there. Generally they seemed
positive about their current training experience.
The previous visit had highlighted three patient safety issues – trainees managing the Halo Clinic,
bullying and harassment and handover.
The Halo clinics are no longer managed by trainees but rather the work is being undertaken by an
Associate Specialist. It was noted that originally these ‘clinics’ had been set up by trainees and had
been cited as good practice at a regional meeting, so it is wise to keep innovations under review to
ensure that they continue to meet training needs.
Seven out of the departments eight Consultants have attended a Team Resource management
course (TEREMA) designed to look at communication style. The eighth consultant was on leave and
plans to attend the follow up session booked for October 2014. The current trainees have reported
that they do not have concerns about bullying and intimidation currently and felt that there had
been an improvement in communication.
Action has been taken to improve the quality of the handover between neurosurgery and Hospital at
Night however in order to avoid difficulties the rota has been changed and from August the
Neurosciences will move to a 24 hour rota and will no longer use H@N.
Acute Medicine Level 4 visit with GMC representation due 30th June
MR reported that he had been tasked by Meghana Pandit CMO to set up a task and finish working
party to address all the issues identified by the visiting team on 21st February 2014 (a number of the
issues had been unresolved from previous visits). The group had been working hard on all the
issues. In a prior visit the Trust had lost two acute registrar training places and there is a significant
risk that further training posts could be removed. The best that the Trust can hope for from the
upcoming visit is that the status will be downgraded to a further Level 3 visit to check on the
progress and outcome of the changes that have been made as a number of them have only just been
implemented.
The areas where there has been significant progress include –
Appointment of Consultant staff – one substantive Acute Medicine Consultant appointment has
been made, the other Acute Medicine consultant posts have been advertised and there are 3
individuals with relevant experience who have shown an interest in the 2 posts (appointments due
26th June). Two Renal/Acute consultant medicine posts have been advertised with interviews set for
17th July 2014. Two Endocrine/Acute posts have been identified and these are with RCP for
approval. Two Respiratory/Acute posts have budget and two Gastro/Acute posts are under
consideration.
Appointment of ANPs – Six ANP posts were interviewed for on 21st May. Four offers have been
made and one person is already in post.
Appointment of Clinical Fellow posts – Five Clinical Fellow posts have been advertised and they have
received 40 applications.
The new rota from August will identify two extra Foundation trainees on ward cover.
Rotas- Two new rotas have been agreed. The SHO rota will start in August and the Registrar rota will
start in September. The AMU rota is reviewed by a trainee doctor every week so that shortfalls can
be identified early and filled. The two new rotas are better aligned and will allow blocks of working
together.
Induction/Teaching – Nihal is organising the induction and training for the Acute medicine trainees
and Hemali is organising the induction and training for the registrars covering Acute medicine take
(which includes preparing a presentation with voiceover for e-induction).
Action NA and HK
Handover – A handover sheet for the morning handover has been adopted. At 7.30 the Consultants
do a post take ward round. However, problems with the evening handover were discussed and SS
and PR agreed to discuss these with Simon Fletcher. MR agreed to add to the Acute Medicine Action
groups list of things to address.
Action SS, PR & MR
Rota monitoring - It was recognised that when the new rotas are introduced they need to be
monitored to ensure EWTD compliance. MR agreed to ensure that Human Resources undertake this
task.
Action MR
Meetings between ED and Acute medicine – It was noted that the planned regular meetings between
ED and Acute medicine staff to ensure good working relations and smooth patient pathways were
not yet happening. MH agreed to help facilitate these.
Action MH & MR
It was noted that the Acute Medicine action group had been working really hard to address the
issues and significant progress had been made in a number of areas but there was still a lot to do.
MR was thanked for chairing the group.
HEWM clustered scheduled visit to Histopathology School – hosted at UHCW
It was noted that the Trust had just received notice of a Level 2 visit to Histopathology on 7th July.
(Post meeting note – this visit has now been deferred to later in the year – date to be confirmed).
HEWM scheduled visit to CMT/GIM on 13th November 2014
This is a level 2 visit. The group acknowledged that they have concerns about the quality of training
available to the two CMT posts at Rugby. This problem has been flagged to senior management i.e.
that because of the changes in consultant staffing at Rugby there are concerns about the levels of
supervision and the loss of training opportunities at Rugby. It was felt that in some cases the
opportunities for learning were available but trainees were not taking advantage of these because of
failures in supervision i.e. pointing out that trainees should attend certain clinics or providing
feedback on trainees work. ES, MH and MA had agreed with the CMO that they should visit Rugby
to review the training situation. MA was following up the possibility of asking Suresh Gureijala to
take on the role of Educational Lead at Rugby.
Action MA, MH & ES
HEWM scheduled visit to ACE, Emergency Medicine on 26th November 2014
MH agreed to contact HEWM to clarify which trainees the visiting team wish to see at this visit.
Action MH
GMC trainee survey
It was noted that results of the survey should be published this month. MA reported that she had
asked HEWM if the Trust could be advised of any patient safety issues that may have been raised
asap and ideally before the Acute medicine visit particularly if they relate to this specialty. It was
noted that UHCW trainees had achieved a 100% compliance rate for completing the survey and
nationally West Midlands had achieved a high compliance rate.
GMC trainer survey
This survey will be out soon and ES asked that the Educational leads encourage their colleagues to
complete it. The previous survey was 3 years ago and the compliance rate for UHCW at that time
was approximately 40% so we need to improve on this.
Action All
When the notification comes through ES & MH will also send a message to all consultants.
Action MM for ES & MH
Induction
It was noted that there needs to be a central register of attendance at all inductions – the
attendance lists should be sent to Ruth Cottrell. MA agreed to ask Richard Harding to send the new
medicine rotas to all Educational leads
Action All
Action MA
It was suggested that in order to ensure patient safety the Trust should consider cancelling all
elective work on the main changeover day in August so that Consultants are available to cover the
wards.
Trainee revalidation
It was noted that for revalidation trainees to know if they have been named in a complaint, have
been involved in a SIG or are under investigation for conduct issues. They should identify
themselves by completing a Form R and this forms part of their e-portfolio. The Educational leads
were asked to remind supervisors of this process.
Action All
ES reported that he had formed a working group to help streamline the process in the Trust. The
Complaints manager and Revalidation manager are members of this group which is meeting monthly
and it is being used to develop a proactive system for recording these events and ensuring that
HEWM have timely and accurate reports in addition to sending the reports to the trainees and their
educational supervisors.
It was noted that currently HEWM requires full disclosure e.g. if the trainee is mentioned in a
complaint then a report is required regardless of the outcome of the investigation so trainees that
have behaved appropriately are currently being reported. This approach is the subject of review as
it is recognised that it is causing potential distress to trainees who have not behaved inappropriately.
However, the GMC believe the current system allows them to pick up potential patterns of low level
adverse behaviour which otherwise could be missed.
MR agreed to raise the issue at the next PMG Board meeting and will talk to Sandra Hall about the
weaknesses of the current approach.
Action MR
Foundation Schools merging
It was noted that the five schools in the West Midlands are merging into three. This will allow
economies of scale. Dan Higman is stepping down from his post as Head of the Coventry and
Warwickshire Foundation school which is merging with Hereford and Worcester schools. The
changes shouldn’t affect the August rotations. It will be the task of the new Head of school to decide
on how to manage the rotations and it is predicted that the GP rotations are more likely to be
affected. It was noted that the Coventry and Warwickshire school had been more successful in
setting up community placements and this is something other parts of the new school may learn
from/utilise.
GMC named clinical and named educational supervisor recognition project 31st July 2014
milestone
It was noted that the Trust needs to load information about its named clinical and educational
supervisors onto HEWM’s information system (INTREPID) by the end of July. Other Trusts in the
region have already undertaken this work and therefore in a recent report UHCW appeared to be
lagging behind, however, a great deal of work to collect accurate information about the current
training status (in terms of TTT and equality and diversity training) has already been undertaken by
MA and ES which now needs loading. ES currently has the names of clinical supervisors for
Foundation, CMT and GP trainees but needs the Educational leads to help him confirm the names
for all trainee grades
Action All
On the undergraduate side the Medical school have taken responsibility for updating the database
for undergraduate supervisors.
The Educational leads were asked to take a very active role in ensuring that all their educational
supervisors and clinical supervisors are up to date with their training i.e. Training the trainers (initial
2 day course and 1 day refresher every 3 years) and Equality and diversity training and ensure that
assessment of this is included in the PDRs. Also to ensure that ES has an up to date list for their
specialty.
Action All
Any other business
GP trainees in Obs & Gynae - MX raised concerns about the GP trainee posts in Obstetrics and
Gynaecology, trainees have raised concerns that they are being denied some relevant educational
opportunities and there was a lack of registrar support to help them complete their DoPs. MH and
ES agreed to take these concerns forward.
Action MH & ES
Visit to CMT – SS agreed to take the lead for the November visit by HEWM and PR agreed to work
with him
Action SS & PR
Dates for future HEWM visits
20th June 2014
Neurosurgery
Level 3 revisit
Acute medicine
Level 4 with GMC rep revisit
30th June 2014
Histopathology
Level 2 whole school visit
deferred (to be hosted at UHCW)
CMT/GIM
Level 2
13th November 2014
Emergency Medicine
Level 2
26th November 2014
Dates for PMEC meetings in 2014
Thursday August 14th
12.30 p.m. in CSB – LUNCH PROVIDED
Tuesday October 14th
17.30 p.m. in CSB
Wednesday December 10th
12.30 p.m. in CSB - LUNCH PROVIDED