1. Foundation Programme Curriculum:
Key Changes for 2016
David Kessel
Chair
AoMRC Foundation Programme Committee
Clare van Hamel
Special Advisor
UKFPO
New Improved?
Approved by GMC March 2016
Improved following feedback from FS stakeholders alongside input from Royal Colleges, NICE, Resus Council, Patient groups and many others

2. Regulator’s requirements
Generic Professional Capabilities Framework
The Curriculum needed to be aligned to a few GMC publications Tomorrow's doctors, The Trainee Doctor, Good Medical practice
In addition we had to meet the new Promoting excellence and also the Generic Professional Capabilities Framework which has only very recently been approved by the GMC

3. Purpose of Foundation
No Change

4. Terminology Level of performance
Minimum standard of practice to be ‘met or exceeded’
Foundation Professional Capability
= Outcomes of foundation training
Descriptor
Expectation / Indicative example of practice
Sign off will be at the Foundation Professional Capability level (FPC)
Foundation Doctors do not have to provide evidence of meeting all descriptors; these are possible examples of how the FPC might be evidenced

5. High level descriptors for F1 and F2
Level of Performance
High level descriptors for F1 and F2
Minimum level which must be met or exceeded for progression at the end of each year of training
Sign off dependent on evidence of achievement in each of the 20 foundation professional capabilities
New!

6. Level of Performance F1
Has worked effectively to establish him or herself in clinical practice in his or her role as a doctor in training
Has established him or herself as a member of the healthcare team
Has been able to adapt practice to suit the clinical setting in each placement
Has demonstrated the ability to learn in the workplace
Has demonstrated the knowledge, skills and behaviours necessary to apply the professional duties, principles and responsibilities set out in Good Medical Practice, Generic Professional Capabilities Framework, other professional guidance and statutory legal requirements.
Is competent to perform the core procedures mandated by the GMC
These are phrases that describe at high level how an F1 should be performing

7. Successful Completion F1
Foundation Year 1 Certificate of Completion (F1CC)
Recommendation to the GMC that the foundation doctor be granted full registration
Eligible for progression into F2 training.
New!
Certificate renamed but impact of F1 completion unchanged

8. Level of Performance F2 F1 plus
Has taken additional responsibility for decision making in clinical practice
Has started to develop a leadership role within the healthcare team
Has been able to adapt practice to new clinical settings with new challenges e.g. outpatient clinics
Has demonstrated the ability to teach as well as learn in the workplace
Has demonstrated progressive increase in knowledge, skills and behaviours applied across the professional duties, principles and responsibilities set in accordance with Good Medical Practice, Generic Professional Capabilities Framework, other professional guidance and statutory legal requirements.
Has increased their ability to perform the core procedures mandated by the GMC e.g. can perform them in more challenging circumstances and has increased the scope of procedures they are able to perform.
In addition to the F1 high level performance the f2 is expected to demonstrate …..

9. Successful Completion F2
Foundation Programme Certificate of Completion (FPCC)
Eligible to enter a core, specialty or general practice training programme.
New!
New name of certificate impact of completion of programme unchanged

10. Organisation of Curriculum
Contents Introduction Purpose of the Foundation Programme Progression through foundation training How to use the curriculum in the workplace Resources: foundation doctors Resources: trainers, supervisors and placement supervision group The educational framework and recognising learning styles Curriculum design Educational framework Educational culture and practice How to use the syllabus Learning and teaching Supervised learning events (SLEs) Assessment Syllabus Bibliography Appendices A Changes since 2012 and future development B Ensuring quality in foundation programmes C Mapping the foundation programme curriculum 2016 to GMC standards D Curriculum development and list of contributors

11. Remove to Improve! The Syllabus 2012-2015 2 sections 12 subsections
40 subheadings
> 100 outcomes
Competences
Remove to Improve!

12. Key Structural Changes
2 sections
12 subsections
40 subheadings
> 100 outcomes
Competences
2016
4 sections
Ooops!
Within the curriculum there were 2 sections and within the 2016 curriculum there are 4 sections which has increased however as highlighted within the following slides, outcomes (now named foundation professional capabilities) have reduced from 100 to just 20!

13. Sections
1) Professional Behaviour and Trust 2) Communication, Team-working and Leadership 3) Clinical Care 4) Safety and Quality

14. Key Structural Changes
2 sections
12 subsections
40 subheadings
> 100 outcomes
Competences
2016
4 sections
20 foundation professional capabilities (outcomes)
Section 1
Foundation Professional Capability 1
Foundation Professional Capability 2…

15. Professional Behaviour and Trust
Foundation Professional Capabilities:
Acts professionally
Delivers patient centred care and maintains trust
Behaves in accordance with ethical and legal requirements
Keeps practice up to date through learning and teaching
Demonstrates engagement in career planning

16. Communication, Team-working and Leadership
Foundation Professional Capabilities:
Communicates clearly in a variety of settings
Works effectively as a team member
Demonstrates leadership skills

17. Clinical Care Foundation Professional Capabilities:
Recognises, assesses and initiates management of the acutely ill patient
Recognises, Assesses and manages patients with long term conditions
Obtains history, performs clinical examination, formulates differential diagnosis and management plan
Requests relevant investigations and acts upon results
Prescribes safely
Performs procedures safely
Is trained and manages cardiac and respiratory arrest
Demonstrates understanding of the principles of health promotion and illness prevention
Manages palliative and end of life care

18. Safety and Quality Foundation Professional Capabilities:
Recognises and works within limits of personal competence
Makes patient safety a priority in clinical practice
Contributes to quality improvement

19. Syllabus Changes 2016
Emphasis on physical and mental health management in all clinical descriptors
Emphasis on chronic as well as acute health conditions
Emphasis on illness prevention
Inclusion of NHS organisational understanding
Descriptors help to identify this change in emphasis

20. Syllabus Changes 2016 Specific symptom management has been removed
Evidence provided by F1/2s to be signed off at the end of the year should include acute and chronic health; mental and physical health
The programmes encompass a wide range of specialities which will to an extent determine the opportunities available to F1/2s

21. Key Structural Changes
2 sections
12 subsections
40 subheadings
> 100 outcomes
Competences
2016
4 sections
20 professional capabilities
Descriptors
Section 1
Foundation Professional Capability 1
Descriptors F1 / F2
Foundation Professional Capability 2

22. Indicative examples and general expectations
Descriptors
Indicative examples and general expectations
Web Based

23. Indicative examples and general expectations
Descriptors
Indicative examples and general expectations
Foundation doctors do not have to provide evidence for every descriptor. The supervisor's are assessing the overall performance of the foundation doctor and the descriptors may help supervisor's to articulate/identify when a foundation doctor's performance is falling short of expectations

24. No Change Assessment Clinical Supervisor’s Reports
Educational Supervisor’s Reports
TAB
Informed by:
Observation of practice
Feedback from PSG
Evidence of achievement of 20 outcomes
No Change
The assessments remain as CS and ES reports and TAB and these are informed

25. Supervisors’ reports 2012-15 Sign off outcome level
Based on achievement of >100 outcomes

26. Supervisors’ reports 2016 Supervisors Comment at section level
Is the foundation doctor on course to meet or exceed the minimum level of performance in each of the 20 foundation professional capabilities required for sign off by the end of the year of training?

27. On Track! Supervisors’ reports
No Concern Indicates that this doctor is performing at the expected level for this stage of foundation training, that there are/have been no issues which still need to be addressed and is on course to meet/exceed minimum expected level of performance required for sign off across all 20 foundation professional capabilities (Foundation Programme training outcomes) by the end of the year of training Issues which have been satisfactorily resolved should be recorded in the e-portfolio
On Track!

28. Needs Support Supervisors’ reports
Some Concern Indicates that there are or have been aspects of performance which are ongoing and considered to need extra support in order to meet/exceed minimum expected level of performance required for sign off across all 20 foundation professional capabilities (Foundation Programme training outcomes) by the end of the year of training
Needs Support

29. Risks not being signed off
Supervisors’ reports
Major Concern Indicates that there are or have been aspects of performance which if not corrected may not meet the minimum expected level of performance required for sign off across all 20 foundation professional capabilities (Foundation Programme training outcomes) by the end of the year of training and may impact on this doctor’s ability to satisfactorily complete the current year of Foundation training
Risks not being signed off

30. Concerns regarding performance?
Supervisors’ reports
Comments in support of rating for each section
Concerns regarding performance?
Drop down menu
Select outcome/s +/- descriptor/s where concerns exist
Narrative to justify
Discuss with trainee and document
Note: Screenshot available on the following slide for CS section sign off on ePortfolio.

31. CS section sign-off screenshot

32. End of Year ES end of year report ARCP
Review of evidence whether the foundation doctor has met or exceeded the minimum level of performance in each of the 20 foundation professional capabilities to allow them to progress to the next stage of training?

33. TAB changes
TAB will include foundation doctors but will still require sufficient senior input to be valid
E-portfolio will now identify to foundation doctors what ‘rater’ feedback is required to make it a valid round
TAB will no longer show as incomplete if ES overides mix and deems TAB round valid
Column colours will change to be red for major concern and green for no concern

34. New Reference Guide