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GMC visit to NHS Lothian What do I need to know & do?
ADME RIE Alastair Campbell ADME RHSC Sonia Joseph DDME Lothian Hannah Monaghan DME Lothian Simon Edgar
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Why visit? Quality Management
Scotland: Oct – Dec 2017
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The visit model South Team Lead: Tim Lancaster, Oxford
GP & Director of Studies Oxford Medical School 4
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What will the 2017 review focus on?
General internal medicine General surgery Geriatric medicine Paediatrics Undergraduate Foundation Core medical training, core surgical training, ACCS 5
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National Review of Scotland
October 5th & 6th ’17 Royal Infirmary of Edinburgh General Medicine Medicine of the Elderly RHSC Medical Paediatrics Postgraduate Training & Education all grades in these specialties Undergraduate Students with understanding of these specialties
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Why visit Lothian? Large Territorial Board Multi-specialty
Co-located Teaching Board and Medical School Data of interest in PG National Training Survey Data of interest in UG Teaching Survey Risk based review but also good practice review We host:
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Question item analysis
We selected a number of key questions from the trainee survey to undertake separate analysis. The aim is to check how all trainees in a site answer these particular questions, focussing on the selected issues, rather than relying on solely on the indicator system, which gives us an overall picture of the quality of training.
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10 standards centred around patient safety
Promoting excellence sets ten standards that medical schools, postgraduate deaneries and local education and training boards, and local education providers, as organisations responsible for educating and training medical students and doctors in the UK, are expected to meet. Requirements set out what an organisation must do to show they are meeting the standards; most apply to all stages of education and training but some apply to a specifically to undergraduate or postgraduate. Patient safety is the first priority and is supported by a statement at the beginning of Promoting excellence. Patient safety is inseparable from a good learning environment and culture that values and supports learners and educators. Patient safety runs through the standards and requirements; but it is no longer a stand alone domain. Patient safety was one of the domains in Tomorrow’s Doctors and The Trainee Doctor. It focused on protecting patients from risks posed by medical students and doctors in training.
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Who will the Visit team meet?
GMC team will ask to meet with: Learners - medical students, doctors in training Educators - trainers, clinical & educational supervisors Organisers & Managers Other Healthcare team members
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What will the Visit team ask?
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Theme 1 Patient Trainee & Trainer Student
Safety & Learning from Error Environment for working & learning Patient Trainee & Student Trainer Theme 1 Culture of learning & improving
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Theme 1: Learning environment & Culture
Could you demonstrate how your current system on raising concerns works? What arrangements are in place to identify and manage patient safety concerns involving students and trainees? How do you encourage learning after something went wrong such as incidents or near misses? How do you ensure there is appropriate supervision for students and doctors in training? How do you differentiate learners at different stages of training? How do you ensure that students/doctors in training do not work beyond their competence? What systems do you have in place to ensure that rotas are maximising learning opportunities, ensuring patient safety and minimising the adverse effects of fatigue and workload? How do you use handovers as a learning opportunity for doctors in training? What access do learners have to technology enhanced and simulation-based learning?
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Theme 2
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Theme 2: Educational governance and leadership
Could you describe how the quality of education and training is managed? Can you describe who or what is accountable for overseeing the quality of education and training in the organisation? How much are you involved in processes relating to changes in policies or systems? How do you monitor and evaluate progression of your doctors in training or medical students? How do your local quality processes ensure issues are identified, resolved and reported back to medical school and LETB/deanery? How much time do you have in your job plans to complete your educational activities? How safe is this environment for education and training? How do you mitigate safety risk caused by inadequate supervision? How do you ensure that medical students have a named doctor who coordinates clinical placements? What is your process to identify and address concerns of learners? How do you select/recruit educators?
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Theme 3
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Theme 3: Supporting learners
How do you support learners to meet professional standards in Good medical practice? What is your support for learners' health and wellbeing? If someone was being undermined or bullied, what would happen at this LEP? How are students, trainees and trainers supported in this process? What are the challenges in supporting doctors with disability? What support do you have for doctors starting a new programme? How do you ensure support is consistent for all, including those in less than full time training? How do you ensure learners receive timely feedback? What is your support for learners in difficulties?
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Theme 4
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Theme 4: Supporting educators
How do you select/recruit educators? What training is there specific to these roles? How are these roles appraised? How do you ensure teaching time is protected? Do you feel that the induction and development plans prepare educators aptly for your role? How do you support educators in addressing their concerns or difficulties? How do you escalate educational issues within the Board See GMC trainer survey 2016 RoT Lessons learned SOAR, TURAS Please use Recognition if you currently have a named role All new appointments to named roles have to be “recognition ready” Recognition is aligned with revalidation
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Theme 5
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Theme 5: curricula & assessments
How do you raise concerns about graduates' competence? How do you get involved in the medical school's curricular development? To what extent are you involved in the medical school's arrangement for student assistantship? How do you ensure that placements/posts offer learners adequate opportunities to meet the requirements of their training programmes? How do you promote a culture of learning and collaboration between specialties and professions? Could you describe an example of reasonable adjustment?
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More information & Help
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Website: http://www.med.scot.nhs.uk
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Standards System Performance Climate
MED Team: Site ADMEs Alastair RIE Karen SJH Sonia RHSC Lesley WGH Pauline REH Standards System Performance Climate
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GMC visit to NHS Lothian What do I need to know & do?
ADME RIE Alastair Campbell ADME RHSC Sonia Joseph DDME Lothian Hannah Monaghan DME Lothian Simon Edgar
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