Scope and Research

Principles

Objectives

Responsibilities

Confidentiality

Ethics and Valuing Diversity

Monitoring and Review

Procedures and Operational Guidelines

 

Introduction 

  • The following policy has been developed by the Severn Postgraduate Medical Education (SPME) Trainee Support team and should be referred to in combination with the SPME Trainee Support Guide.
  • The SPME Trainee Support team believes that every trainee in a SPME Training Programme should have access to support should they encounter difficulties in their training for whatever reason. The development of a three-level model is designed to ensure that support is available for trainees at the employer and SPME level. Where an issue cannot be resolved by those at Level-1 or Level-2, referral to the SPME Trainee Support team for Level-3 support is required. 
  • For initial guidance on how to support trainees, please refer to the SPME Trainee Support Guide.

Scope and Research 

  • This policy applies to all trainees on a SPME training programme, in any grade or specialty.
  • This policy is designed to provide guidance and information for those who are involved in supporting trainees at various levels, including:
    • Educational and Clinical Supervisors
    • Training Programme Directors
    • Directors of Medical Education
    • Heads of School
    • Specialty (College) Tutor
    • GP Educators
  • Much of the research and evidence base relating to this area is covered in Cox, J., King, J., Hutchinson, A., and . McAvoy, P (2006). Understanding Doctors Performance. Oxford: Radcliffe Publishing (published in association with the National Clinical Assessment Service of the National Patient Safety Agency). Conclusions from the evidence include:
    • A trainee’s performance is affected by a complex array of issues
    • The influence of work context and environment should not be underestimated and needs to be fully explored alongside factors in the individual
    • Early signs of performance issues are possible to detect and, in most cases, potentially amenable to early intervention

Principles 

  • SPME has responsibility for all doctors in training and is responsible for problems that arise which prevent normal progression through the training process, for whatever reason.
  • The Trainee Support team aims to support and encourage the development of trainees within a SPME training programme who have been referred or self-referred to the service.
  • Patient safety and the safety of the trainee is considered at all times.
  • The Trainee Support team is advisory. This approach does not supersede the assessment role of the Annual Review of Competence Progression (ARCP) or Human Resource (HR) policies at the employer level.
  • The Trainee Support team relies on the engagement of the trainee in the process in order to be successful. If the trainee does not wish to engage with remedial or supportive plans, future support or training provision may not be provided.
  • The support process will be as transparent as possible to reduce ambiguity.
  • The Trainee Support team strives to operate with a clear evidence base.
  • The Trainee Support team takes a responsible approach to the use of funding and resources.
  • The Trainee Support team will refer to appropriate national guidelines when appropriate.
  • The Trainee Support team will apply the operational guidelines laid out in the SPME Trainee Support Guide.

Objectives 

  • To offer and provide support, advice and appropriate resources to trainee doctors who have been referred or who have self-referred to the Trainee Support team.
  • To manage concerns in line with the areas of the NCAS performance triangle (Behaviour, Health, Clinical Competence and Environment).
  • To identify and, if appropriate, fund or partially fund resources offered by external agencies in support of the trainee.
  • To offer and provide support and advice to trainers and educators involved in supporting trainees by directing to appropriate resources and documentation. This includes the SPME Trainee Support Guide and training courses.
  • To come up with a clear and jointly agreed action plan for the trainee moving forward (please see Appendix 1 in the SPME Trainee Support Guide).
  • To review progress through updates from both trainers and trainees and to log outcomes for the purpose of on-going evaluation.
  • To take regulator (GMC) advice should a concern call into question the doctor’s fitness to practice

Responsibilities 

  • The Severn Trainee Support team has developed a 3-level model of support for trainees. This is described in detail, along with the roles and responsibilities of those within each level, in the SPME Trainee Support Guide.
  • The Severn Trainee Support team document issues and areas of support in line with the NCAS Performance Triangle – Behaviour, Health, Clinical Competence and Environment (Home and Work).

Confidentiality 

  • Data regarding referrals and self-referrals to the Trainee Support team will be stored confidentially in line with the Data Protection Act and local Information Governance Policies.
  • Trainee Support team information will be stored separate to the trainee’s main Deanery training file and will only be accessed by members of the Trainee Support team via a secure access server.
  • Information will be shared with parties agreed with the trainee, including external specialist resources and agencies for support.
  • Data may be anonymised and used for research purposes to identify learning and development opportunities for the Trainee Support team.

Ethics and Valuing Diversity 

  • In undertaking our work the Trainee Support team and the deanery are committed to working within the framework described in the Equality Act 2010 and fully recognise the protected characteristics described within the legislation.
  • Where a situation arises where there is a conflict of interest – e.g. a member of the Trainee Support team knowing a trainee or trainer on a personal level – appropriate steps will be taken to address this so that this conflict of interest does not impact on the support provided.

Monitoring and Review 

  • Each new referral to the Trainee Support team for Level 3 support will be allocated a sequential case number and details of the referral logged in a confidential and secure database.
  • Cases are reviewed on a weekly basis to ensure action and follow up
  • For on-going evaluation, cases will be reviewed by an expert panel on a quarterly basis to provide feedback, advice and guidance, referred to as the Reference Group (see Appendix 1 for Reference Group Terms of Reference).
  • Any trainee within SPME who has been issued with an ARCP outcome 3 will be contacted by the Trainee Support team to advise on resources available which they may find helpful for their particular circumstances.
  • An annual Strategy Group will be held to ensure on-going informative service development for the Trainee Support team (see Appendix 2 for Strategy Group Terms of Reference).
  • Staff within the Trainee Support team will undergo appropriate training and development.
  • A rolling programme is in place to inform and develop knowledge and skills of Educational Supervisors who may be required to support a trainee in difficulty. This takes the form of a half day workshop ‘How to Support Trainees’.
  • It may be necessary for a Transfer of Information (ToI) to take place if a trainee receiving support is moving to a new location/department. This will be discussed with the trainee and is for the purpose of ensuring patients safety as well as the on-going support of the trainee.

Procedures and Operational Guidelines 

  • For full details on procedures, please see the SPME Trainee Support Guide and the SPME Trainee Support website 
  • National frameworks and guidelines that may be referred to by the Trainee Support team include, but is not limited to:
    • NACT Guidelines
    • NCAS Guidance documents
    • GMC Good Medical Practice
    • GMC The Trainee Doctor
    • GMC Gold Guide 2010
    • UKFPO Guidance documents
    • DoH Maintaining High Professional Standards 

 

Prof Selena Gray - Deputy Postgraduate Dean SPME

Dr Michael O'Connor - Assoicate Dean Support and Development SPME

Mr Alan Cook - Head of Medical Education SPME

Mr Tailte Breffni - Support and Development Manager SPME


 

 

Appendix 1 

Trainee Support Reference Group – Terms of Reference

For on-going evaluation, cases will be reviewed by a panel on a quarterly basis to provide feedback, advice and guidance, referred to as the Reference Group

Objectives and scope:

  • The Reference Group is a forum of panel members whose purpose is to review current complex cases being handled by the Trainee Support team.
  • The aim of such a review is to: 
    • Provide advice and guidance to the Trainee Support team with regards to whether it is felt adequate support is being provided to individuals accessing the service.
    • Adequate support is defined as support which aims to, within the limits of available resources, to promote the individuals own well-being and safety, whilst also ensuring patient safety or the safety of others is not compromised.
  • The scope of the Reference Group is therefore to:  
    • Review current complex cases in terms of their history, resources put in place and future actions
    • Provide feedback, advice and guidance as to whether it is felt these plans are appropriate
    • Provide feedback, advice and guidance on other options the Trainee Support team could consider for each complex case.
  • The Reference Group will not:
    • Formally evaluate the effectiveness of the Trainee Support service. This will be conducted through regular and Annual Reports to the Postgraduate Dean, as well as through qualitative evaluation of Trainee experiences in accessing the service.
    • Take over the management of any of the complex cases discussed.
    •  
      • Members will consist of individuals representing Members of the SPME/PPME executive teams in order to advise on wider SPME processes and guidance.
      • Members of the support teams across Severn and Peninsula
      • Members will be bound by confidentiality and must not discuss any of the details of the cases disclosed during the Reference Group with any other party outside of the Reference Group.
      • If a member of the Reference Group recognises a case and feels there is a potential conflict of interest, they must immediately declare this. The other panel members may deem it appropriate for this individual to remove themselves from the Reference Group whilst the case is discussed and to rejoin when discussions have concluded.
      • ‘Complex Cases’ for discussion at the Reference Group will be identified prior to the meeting.
      • The name of the trainee doctor will be removed from the case prior to the Reference Group meeting in order to increase anonymity.
      • Notes will be taken at each Reference Group meeting and these will be stored securely and electronically by the Trainee Support team. They will not be distributed to members of the Reference Group in order to ensure data protection and confidentiality.
      • Reference Groups will meet on a quarterly basis each year where possible.
      • The Strategy Group is a forum of key stakeholders of the Trainee Support team whose purpose is to inform and guide the strategic direction of the Trainee Support team within SPME.
      • The Strategy Group will review the principles and objectives of the Trainee Support service as outlined in the Trainee Support Policy.
      • The Strategy Group will consider what systems work well, what could be improved and what other processes or resources could be drawn upon.
      • The Strategy Group will provide valuable feedback, advice and guidance to help inform the strategic direction of Trainee Support.
      • The Strategy Group will consist of key stakeholders involved in Trainee Support, including:
        • Those detailed in the Three-Level Trainee Support Framework (e.g. Educational Supervisors, Programme Directors, Directors of Medical Education, HoS).
        • Individuals representing employers across the Severn footprint, including Human Resource/Medical Staffing personnel.
        • Occupational Health representatives.
        • Representation from SPME Careers Guidance service.
        • Trainee representation – ideally a representative from Foundation and a representative from Higher Specialty training.
        • Representation from SPME executive team.
        • Representation from SPME Trainee Support team.
      • Attendees will be bound by confidentiality and must not disclose any data discussed during this meeting with any other party without gaining written consent and confirmation from the Trainee Support team.
      • Update data on referral figures and patterns across the year will be discussed at this meeting but will be anonymised to prevent identification of individuals who have accessed the service.
      • No confidential case details will be discussed at this meeting without gaining the individuals prior consent.
      • Notes will be taken at this meeting to inform future strategy development for the Trainee Support team.
      • Strategy Group meetings will take place annually where possible.

      Policy Approved: 21/01/2014 Review by: January 2015

Roles and responsibilities:

Process and timeframes:

 


 

Appendix 2 

Trainee Support Strategy Group – Terms of Reference

An annual Strategy Group will be held to ensure on-going informative service development for the Trainee Support team.

Objectives and scope:

  • • The Strategy Group is a forum of key stakeholders of the Trainee Support team whose purpose is to inform and guide the strategic direction of the Trainee Support team within SPME.
  • • The Strategy Group will review the principles and objectives of the Trainee Support service as outlined in the Trainee Support Policy.
  • • The Strategy Group will consider what systems work well, what could be improved and what other processes or resources could be drawn upon.
  • • The Strategy Group will provide valuable feedback, advice and guidance to help inform the strategic direction of Trainee Support.

Roles and responsibilities:

• The Strategy Group will consist of key stakeholders involved in Trainee Support, including:

o Those detailed in the Three-Level Trainee Support Framework (e.g. Educational Supervisors, Programme Directors, Directors of Medical Education, HoS).

o Individuals representing employers across the Severn footprint, including Human Resource/Medical Staffing personnel.

o Occupational Health representatives.

o Representation from SPME Careers Guidance service.

o Trainee representation – ideally a representative from Foundation and a representative from Higher Specialty training.

o Representation from SPME executive team.

o Representation from SPME Trainee Support team.

• Attendees will be bound by confidentiality and must not disclose any data discussed during this meeting with any other party without gaining written consent and confirmation from the Trainee Support team.

Process and timeframes:

• Update data on referral figures and patterns across the year will be discussed at this meeting but will be anonymised to prevent identification of individuals who have accessed the service.

• No confidential case details will be discussed at this meeting without gaining the individuals prior consent.

• Notes will be taken at this meeting to inform future strategy development for the Trainee Support team.

• Strategy Group meetings will take place annually where possible.