1. West Hertfordshire Hospitals NHS Trust MMC Why? CMO “Unfinished Business” –Lost tribe of SHOs – Followed Calman – Perceived lack of skills > For the NHS > Management of acutely ill patient > Shortened, focussed, run through training

2. West Hertfordshire Hospitals NHS Trust MMC – What? Modernising Medical Careers www.mmc.nhs.uk www.mmc.nhs.uk Phase 1 – Foundation Training - August 2005 Phase 2 – Specialist Training - August 2007

3. West Hertfordshire Hospitals NHS Trust MMC – What? Foundation Training Year 1 – F1 =PRHO - GMC registration and Medical School Year 2 – F2 = SHO posts

4. West Hertfordshire Hospitals NHS Trust Foundation Training – What? Curriculum - Acutely ill - NHS Skills - Team working - Clinical Governance - Risk Management - Occupational Health Ready for Specialty training

5. West Hertfordshire Hospitals NHS Trust Foundation Schools – How? Mapped to Medical Schools and Deaneries Head of School - 3 PA’s - Reports to Deans Trust Programme Directors - 1 per 20-40 FTs - 1 PA

6. West Hertfordshire Hospitals NHS Trust MMC Phase 1 “Fears” of Service Costs - Direct - Indirect (eg Consultant time) Disappearing SHOs Inexperienced F2 Trainees Time out to train ? Benefits

7. West Hertfordshire Hospitals NHS Trust Foundation - Assessments 6 per year Minicex 6 point scale 4-6 per yearDOPS 2 per yearMultisource feedback 6 – 8 per yearCase Discussion

8. West Hertfordshire Hospitals NHS Trust Impact on Service – MMC 1 Costs –Funded Foundation Schools Trust Programme Directors 1PA/30 FTs GP Placements/ Academic Placements –Indirect costs Consultant time

9. West Hertfordshire Hospitals NHS Trust Impact on Service Disappearing SHO – No! –Straight trade SHOs for F2 (=F1) –Mainly medicine/surgery –Enhances supply to A&E, psychiatry

10. West Hertfordshire Hospitals NHS Trust Impact on Service Are F2 trainees as good as SHOs? –Different Species – but always had 1 st year SHOs Less experienced Not doing what they wanted –Informal feedback Able and competent Enthusiastic

11. West Hertfordshire Hospitals NHS Trust Impact on Service Time out to train –In works training –Tasters 5 days focussed experience and participation –Multi-professional training (1 day once a month) –Assessments –Use of Study Leave 15/30 days

12. West Hertfordshire Hospitals NHS Trust MMC Speciality Training Starts August 2007 SHOs to GO Enrolled into training Adopts RITA Process Selection from F2

13. West Hertfordshire Hospitals NHS Trust Service Impact Questionnaire 52% - no additional clinical supervision Cause assessment supervision/appraisal 4 month placements work well 17/25 too early to tell “no difference at all” “observing trainees- have picked up bad habits early and corrected them”

14. West Hertfordshire Hospitals NHS Trust Medical Model (and neurosciences)

15. West Hertfordshire Hospitals NHS Trust Selection From F2 National, e-based, deanery, speciality Selection centres, multiple stations (PACES) From MST2 ? Person Specification ? Role of MRCP

16. West Hertfordshire Hospitals NHS Trust Assessments Basic and Higher Medical Training Minicex DOPS MSF Knowledge based assessments –Pilots underway (Neurology, Cardiology, Dermatology, Gastroenterology, Geriatrics)

17. West Hertfordshire Hospitals NHS Trust Basic Neuroscience Training 2 year training post foundation Neurology, neurosurgery, neurophysiology, neuroradiology, neuropaediatrics Also stroke, rehab, psych, geriatrics, ? GPs ? Content

18. West Hertfordshire Hospitals NHS Trust