Enhancing Patient Care Through Training Training Programmes Models of Medical Career Development Keith Gardiner BMA SAS NI Conference Friday 15 September 2017 Enhancing Patient Care Through Training

Enhancing Patient Care Through Training Workforce Policy Director Department of Health NIMDTA Act NIMDTA Directions Management Statement NIMDTA Board Senior Management Committee Enhancing Patient Care Through Training

Management Statement The Duties And Powers of NIMDTA 1.4.1 NIMDTA commissions, promotes and oversees postgraduate medical and dental education and training throughout Northern Ireland. Its role is to attract and appoint individuals of the highest calibre to recognised training posts and programmes to ensure the provision of a highly competent medical and dental workforce with the essential skills to meet the changing needs of the population and health and social care in Northern Ireland. 1.4.2 NIMDTA organises and delivers the recruitment, selection and allocation of doctors and dentists to foundation, core and specialty training programmes and rigorously assesses their performance through annual review and appraisal. NIMDTA manages the quality of postgraduate medical and dental education in HSC Trusts and in general medical and dental practices through learning and development agreements, the receipt of reports, regular meetings, trainee surveys and inspection visits. It works in close partnership with local education providers to ensure that the training and supervision of trainees support the delivery of high quality safe patient care.

NIMDTA and its Training Enhancing Patient Care Through Training Continuing Professional Development Training of Trainee Doctors & Dentists Appraisal Career Development GPs GPs GDPs DCPs Assoc Director Assoc Director Dental Advisor DCP Tutor HSCB SLA HSCB DoH Objectives Enhancing Patient Care Through Training

Training Doctors & Dentists Leading & Delivering Services Improving services Research & Development Future Trainers Trained workforce Teaching Skills Appraisal Supporting Role Models Engaged employees Professionalism Communicator Team worker Leadership Skills Generalist Skills Expert in specialty Evidence- Based Practice Quality Improvement Skills Innovation Research Skills Enhancing Patient Care Through Training

Enhancing Patient Care Through Training Medical Training GP Histopathology Neurosurgery Ophthalmology Paediatrics Emergency Med Chemical Pathology O&G Radiology Medical Micro PHM Foundation Training 252 (267)/year Total 504 Run through training ST 1-8 Under Graduate Medical training F1 F2 Total 1200 Core CT1-3 Higher Specialty Training Anaesthetics Medicine Psychiatry Surgery CCT Enhancing Patient Care Through Training

Delivery of Training Trainee Components Training Unit Formal Education Practical Experience Assess ARCP Trainee Support R&S Allocate Induct Revalidate Academic LTFT Career Advice Study Leave OOPT OOPE OOPR IDT Enhancing Patient Care Through Training

Enhancing Patient Care Through Training Colleges & Faculties Specialties Sub- specialties Royal College of Anaesthetists 2 1 College of Emergency Medicine 1 2 Royal College of GPs 1 Joint Royal Colleges of Physicians Training Board 29 4 Joint Committee on Surgical Training 10 1 Royal College of Obstetricians & Gynaecologists 1 5 Faculty of Sexual & Reproductive Health 1 Faculty of Occupational Medicine 1 Royal College of Ophthalmologists 1 Royal College of Paediatrics & Child Health 1 17 Royal College of Pathologists 8 5 Royal College of Psychiatry 6 3 Faculty of Public Health 1 Royal College of Radiologists 2 1 14 different ways of doing everything 65 Specialties 39 Sub-Specialties Enhancing Patient Care Through Training

Enhancing Patient Care Through Training Specialty-Specific National person specification Curriculum Work place based assessments Log books Portfolio Supervisor’s Reports Assessment/Appraisal criteria Examinations Delivery of Training Enhancing Patient Care Through Training

Delivery within Education System Appoint Educational Leaders Organise programmes Attract and appoint HiQ doctors and dentists Place in approved posts in the HSC Oversee delivery of training Manage progress of trainees Support and remediate Ensure regulatory standards are met Revalidate

NIMDTA MDRS GDC GP QUB GMC HEE GDP Royal College NES PHA GP GDP Wales COPDEND COGPED MDRS GDC GP QUB GMC HEE NIMDTA Northern Belfast South Eastern Southern Western GDP Royal College Academy NES PHA GP GDP Wales COPMED UKFPO

What does VALUED look like? Our strategic vision centres around six key aims:

Enhancing Patient Care Through Training Research Opportunities Evidence Based Medicine training for all Research Opportunities Symposium Trainee Research Day (with UMS & QUB) Increased funded Academic Fellows/Lecturers ICAT Wellcome Institutional Strategic Fund Open opportunities to dentists Enhancing Patient Care Through Training

Leadership Opportunities iQuest Workshops ENGAGE Committees Deanery Visits RQIA Reviews or Visits ADEPT Clinical Leadership Fellows Chief Registrars (RCP England)

Enhancing Patient Care Through Training HSC LC Leadership Development HOST Project & Supervision NIMDTA Oversight & Support BLG & Trusts On Call Maintaining Skills Enhancing Patient Care Through Training

Enhancing Patient Care Through Training

Enhancing Patient Care Through Training Simulation Simulation Lead Simulation ADEPT Fellow Scoping of simulation facilities and faculty Network Conference Strategy Enhancing Patient Care Through Training

Professional Support

iQuest Generic Skills

GMC NTS Indicators NI vs other countries 1st 2nd 3rd 4th Overall Satisfaction Reporting Systems Workload Local Teaching Clin Supervision Supportive environment Regional Teaching Clin Supervision OOH Feedback Teamwork Study Leave Handover Induction Adequate experience Curriculum coverage Educ Governance Educ Supervision

2016 Trainee Examination Success GP Results – 1st in UK Clinical Radiology Results – 2nd in UK

Educational Excellence Day 2017 Enhancing Patient Care Through Training

Trainee Foundation GP & Specialty Excellence Awards EQUIP Celebration Welcome Evenings Regional Inductions Newsletters Generic Skills iQuest Presentation QI & Leadership Excellence Events Excellence Awards EQUIP Celebration ADEPT Presentations Foundation GP Specialty ADEPT ENGAGE EQUIP Reach Out Foundation GP Specialty Research Professionalism QI Resilience Leadership Trainee Research Day FMLM Conference Simulation Conference

Routes of Entry onto Specialist Register Foundation Non training role Core Specialty Core Specialty Higher Specialty Higher Specialty CCT CESR CESR (CP) GMC Specialist Register

Entry to Training Programmes

Recognition of Previous Experience CESR Combined Programme (CP) Apply for Specialty Training Appointed to Programme Awarded NTN Enrol with College Notify College of desire for recognition of previous experience in non-approved posts LAS Clinical Fellow Staff Grade/Specialty doctor Enhancing Patient Care Through Training

Recognition of Previous Experience CESR Combined Programme (CP) Apply for recognition of months -> years Evidence submitted and experience assessed Entry level confirmed (no later than 1st ARCP) NTN (CESR CP) awarded Deanery applies to GMC for enrolment approval Must be able to complete at least 2 ARCPs No subsequent request for recognition of prior training possible Enhancing Patient Care Through Training

Recognition of Previous Experience CESR Combined Programme (CP) Complete rest of programme Apply for CESR (CP) within 12 months CESR (CP) awarded Eligible for entry to Specialist Register Eligible to apply for UK consultant post Not automatically recognised in Europe Enhancing Patient Care Through Training

Training Opportunities in NI Enhancing Patient Care Through Training

Specialty Vacancies 2017 Anaesthetics 4 Emergency Medicine 7 Obstetrics & Gynaecology 22 Paediatrics 17 Core Medicine 18 Acute Medicine 2 Cardiology Haematology Neurology 3 Palliative Medicine 5 Rehab Medicine Renal Medicine Child & Adolescent Psychiatry

Advantages of Training Programmes Regulated environment Structure Formal training Study leave Careers advice Professional Support (Mentoring; Coaching) Additional opportunities (Academic/Leadership) Out of Programme opportunities Enhancing Patient Care Through Training

Enhancing Patient Care Through Training