Bett The Leeds Pilot Sharon Nightingale Associate Medical Director for Doctors in Training January 2015

Leeds and York Partnership NHS Foundation Trust Pilot Aims: 1.Maximise training opportunities by increasing daytime working for junior doctors in psychiatry. 2.Improving communication skills 3.Protected time for teaching experience to undergraduates

Maximizing training opportunities (1) 12 /52 survey of Core Trainee (CT) activity CT approx 30% of 48 hours in placements with clinical supervisor. 70% was: Alone in less supervised out of hours work (13 CT on call each 24 hours) – Often not in contact with patients – Contact with patients is of no benefit to training Time off post on call Important areas to be protected such as educational meetings, exam course and psychotherapy training

Maximizing training opportunities (2) New out of hours (OOH) care pathway designed, piloted and now fully implemented placing CT’s together with MDT OOH 5 CTs returned to daytime hours each 24 hours when patient preference for care, training opportunities and clinical supervision greatest. Increased gold standard joint emergency assessments OOH. Minimum of at least 7 joint assessments and a work place based assessment before CT works autonomously should work load OOH prevent joint assessment.

Improved Communication Skills(1) Situation-Background- Assessment- Recommendation SBAR(and decision ) tool on mental health inpatient wards rolled out. Since end of pilot now rolled out to Crisis team and Intensive community support team with own SBAR champions to promote culture. Formative Assessment of Communication Skills (FACS) – modified pilot May 13. Now part of MRCPsych Course HEYH and feedback used to inform CT1 ARCP.

Improved Communication Skills(2) Recognising and Assessing Medical Problems in a Psychiatric setting (RAMPPS) (created by Paul Rowlands) – piloted 11/12 and HEYH clinical SIM fellow implementing through HEYH ‘Who’s Who guide to the Medical Workforce’ MDT guide on expected competencies in doctors in training in psychiatry created and used on all Trust new employees in induction. Free to use in all Trusts via RCPsych and HEYH websites.

Who’s Who in Medical Workforce? Reproduced under licence from bbc.co.uk- 2013

Yorkshire School of Psychiatry Clinical Simulation Training Strategy From the BTBC pilot following agreed and monitored via School Committee: CT1 – clinical interview skills on MRCPsych course (process of interviewing) – FACS end of year 1 CT2 – RAMPPS and CASC training MRCPsych course – Repeat of FACS if required CT3 – CASC training MRCPsych course ST mentors (supervised by CT Educational Supervisor) working with CT to improve communication skills SIM fellow further developing RAMPPS to provide training into CT 3 and ST years and beyond

Improving Teaching Competencies Protected time for CT to deliver the Campus to Clinic teachings for 2 nd medical students. Tailored teaching resources available on Trust intranet CT1/GP trainee: 4 hours protected teaching time in a 6 month period CT2: 6 hours protected teaching time in 6 month period CT3: 8 hours protected teaching time in a 6 month period WPBA recommended and considered in ARCP 100% take up by CT’s and medical student and CT experience feedback questionnaires showed high satisfaction and led to ‘Teaching Skills’ module being added to the HEYH MRCPsych course as of October 2013

Questions?