clinical attachment policy · will understand that the commencement of the observership is subject...

Clinical Attachment Policy

Unique Identifier: CORP/POL/559 Version Number: 2

Type of Update / Status: Ratified with Minor / No Technical Changes Divisional and

Department: Human Resources

Author / Originator and Job Title:

Julie Summers, Deputy Undergraduate Manager

Replaces: CORP/POL/559, Version 1, Clinical Attachment Policy Description of amendments:

Updated to new template

Approved by: Joint Negotiating Consultative Committee Approved Date: 05/10/2019

Issue Date: 05/10/2019 Review Date from Date of Approval:

1 Year

☐

2 Years

☐

3 Years

☒

05/10/2022

4 Years

☐

5 Years

☐

Version Control Sheet

This must be completed and form part of the document appendices each time the document is updated and approved

Date dd/mm/yy

Version Author Reason for changes

05/10/19 2 Julie Summers, Deputy Undergraduate Manager

General review

Consultation / Acknowledgements with Stakeholders

Name Designation Date Response

Received

Occupational Health 11/02/2019

Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy

Revision No: 2 Next Review Date: 05/10/2022

Do you have the up to date version? See the intranet for the latest version

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CONTENTS

Version Control Sheet ................................................................................................................ 1

Consultation / Acknowledgements with Stakeholders ............................................................. 1

1 Introduction / Purpose ....................................................................................................... 3

2 General Principles / Target Audience .............................................................................. 3

3 Definitions and Abbreviations ........................................................................................... 3

4 Responsibilities (Ownership and Accountability) ............................................................ 4

5 Policy .................................................................................................................................. 4

5.1 Conditions of Attachment ............................................................................................. 4

5.1.1 Supervision........................................................................................................... 4

5.1.2 Patient Access ..................................................................................................... 4

5.2 Compliance with Policies and Procedures .................................................................. 5

5.3 Period of Attachment .................................................................................................... 5

5.4 Application Process ...................................................................................................... 6

Appendix A: Clinical Attachment - Process .............................................................................. 7

Appendix 1: Clinical Attachment – Letter with application....................................................... 9

Appendix 2: Clinical attachment – Letter – unable to accept ................................................ 10

Appendix 3: Application Form ................................................................................................. 11

Appendix 4: Occupational Health Form .................................................................................. 13

Appendix 5: Confirmation letter ............................................................................................... 16

Appendix 6: Equality Impact Assessment Form .................................................................... 17




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1 Introduction / Purpose

The purpose of this policy is to detail the procedure for handling requests for Clinical Attachments. This Policy will ensure that the Trust:

Complies with relevant legislation on pre appointment checks.

Maintains patient safety, security and confidentiality.

Ensures that the individual concerned is aware of the limits of the observer / attachment status.

Complies with any statutory obligations to such observers / attachments.

2 General Principles / Target Audience

This policy applies to:

Doctors who have qualified overseas, who may or may not have General Medical

Council (GMC) /General Dental Council (GDC) Registration but without work experience in the UK, who wish to undertake a clinical attachment. During the attachment they will to learn how medicine is practiced in the United Kingdom (UK) prior or to obtain employment. The advice from the British Medical Association (BMA) is that it is best practice to undertake an attachment after passing the International English Language Testing System (IELTS).

This Policy does not include:

Overseas medical students seeking electives. Any such requests should be referred to the Director of Medical Education (DME).

Visiting medical staff. Doctors acting in a supernumerary capacity to treat identified patients, to carry out clinical research, or to be trained in medical procedures (such Doctors are required to be appropriately registered with the GMC / GDC) will require

pre-checks in line with NHS Standards before being issued with an Honorary Contract. Overseas Medical Practitioners requesting the opportunity to observe best practice should be dealt with under the Procedure for Honorary Contacts.

3 Definitions and Abbreviations

BMA British Medical Association CV Curriculum Vitae DBS Disclosure and Barring Service DME Director of Medical Education

GDC General Dental Council GMC General Medical Council ID Identification IELTS International English Language Testing System UK United Kingdom




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4 Responsibilities (Ownership and Accountability)

Responsibility of the Trust Board:

The responsibility for the provision of Clinical Attachments rests initially with the DME. It is their responsibility to ensure that the Trust complies with all relevant

legislation relating to Clinical Attachments.

Responsibility of Supervising Consultants:

Supervising Consultants will act as a ‘sponsor’ for each Clinical Observer / Attachment during their placement. They will be responsible for ensuring that the conditions for the attachment are adhered to and for determining the degree of supervision required.

At the end of the attachment, the Supervising Consultant will provide a reference which will be available to the Doctor to assist them in obtaining employment.

Responsibility of the Clinical Observer / Attachment:

The Clinical Observer / Attachment will need to provide an up to date Curriculum

Vitae (CV) and evidence of medical qualifications being registerable with the GMC.

The Clinical Observer / Attachment will be required to provide evidence that they hold the appropriate immigration status to visit the UK. They will also be required to undertake an enhanced Disclosure and Barring Service (DBS) check and Occupational Health clearance prior to commencement of the attachment.

5 Policy

5.1 Conditions of Attachment

5.1.1 Supervision

An Observer will be under the supervision of a named Consultant and will be

required to abide by any directions which he/she or anyone acting on his/her behalf may make.

5.1.2 Patient Access

Clinical Observers:

Must not take part in any procedure involving patients including ordering tests, taking

specimens, obtaining or witnessing signatures for consent.

Must not advise Trust staff on the treatment of patients, teach clinical procedures, carry out research or assist with laboratory work.




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Will not normally be permitted to visit other departments except for attachments where agreement has been made in advance with the supervising Consultant and Consultant staff in the department to be visited.

Must comply with the Trust’s policy on patient confidentiality and respect patients’

cultural needs. It is the responsibility of the Supervising Consultant to ensure that the Clinical Observer / Attachment is aware that patients must give free and informed consent to their observation of any treatment and that they have the right to decline their presence.

Must be readily identifiable at all times whilst on Trust premises and will be provided with an Identification (ID) Badge to facilitate this.

5.2 Compliance with Policies and Procedures

Clinical Observers:

Will be required to comply with all Trust Policies and Procedures as appropriate.

Will be included in the Trust’s responsibilities to those on its premises under health

and safety legislation. The Clinical Observer will be required to cooperate with Managers in discharging the Trusts responsibility and take reasonable care for the health and safety of him / herself and others.

In the event fail to comply with Trust policy, are subject to concerns of misconduct or concerns relating to performance and/or behaviour will have their attachment

terminated.

Will understand that the commencement of the Observership is subject to approval and approval of all required documentation.

5.3 Period of Attachment

The duration of an attachment per specialty is typically 4 weeks.

Only exceptional circumstances may an attachment be extended for more than the four week period. The Supervising Consultant must contact the DME for approval and reasons for this.

All attachments will cease upon the Clinical Observer securing a locum / fixed term or

substantive post within the NHS.

If a Clinical attachment is arranged through a recognised organisation, Royal College, REACH etc., length of attachment may vary according to recognised programme.




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5.4 Application Process

Clinical Observers / attachments will be required to formally write to the DME requesting an observership / attachment. The DME will determine if there is an opportunity to support an attachment, review the CV, and ensure it meets the criteria for eligibility.

Provide evidence of identity and evidence of medical qualifications and right to work in home country.

The Medical Education Department will write to the Clinical Observer (Appendix 1 or 2) and notify them of the outcome of their application.

Supervising Consultants will be required to formally confirm supervision of the

attachment for the given period before confirmation of the attachment.

If the attachment has been agreed, full checks and documentation will be required before confirmation of full acceptance and credential checks including ID check, DBS check and Occupational Health Clearance. Written confirmation of exact dates and

confirmation of the placement will be sent once all checks have been cleared.

The Supervising Consultant will ensure that the Clinical Observer receives an appropriate local Induction within the specialty the attachment will be undertaken.

The process is attached as Appendix A.




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Appendix A: Clinical Attachment - Process

CLINICAL ATTACHMENTS / OBSERVERSHIP PLACEMENTS PURPOSE

The purpose of a clinical attachment / observership is to familiarise the doctor familiar with the UK practice prior to working in the NHS. In the period of attachment the student may only observe practice and must not take part in management or decision making of any patient in any shape or form. They must be supervised by a Consultant in the area of attachment, or a delegated member of the team at all times. The doctor may take a history, examine or conduct key basic tests only under direct supervision of the consultant in charge or delegated practitioner. The doctor must not take part in any procedure / process forming part of the management of any patient, including

surgery and invasive procedures. The attachment / placement is usually, but not necessarily, requested by International medical graduates. The request is made directly by a doctor or a contact within the Trust. The period of attachment will be for four weeks, any extension to the attachment will only be by Director of Medical Education in exceptional circumstances. Any extension to the attachment must be requested by the supervising consultant in charge to the Director of Medical Education. PROCESS :- Request:-

Request for clinical attachment / observership

By doctor - Doctor to contact with full CV

If eligible(not previously worked in UK)

Find Placement/Supervisor

Identify specific learning objectives for placement

Confirm with Educational Lead for area and Head of Department




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Appendix A: Clinical Attachment - Process

Response:-

DME

Able to accommodate attachment (pending application) (Appendix 1)

Unable to accommodate (Appendix 2)

Process:-

Unable to accommodate – to inform the doctor (Appendix 2) Agreed for attachment - Pending approval of all documentation

Application (Appendix 3)

Occupational Health Clearance (Appendix 4 )

Agreement from supervising Consultant

Agreement from Division (Educational Lead and Head of Department)

Confirmation of placement to candidate (Appendix 5)

All formalities must be completed prior to confirmation of commencement for the

attachment.




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Appendix 1: Clinical Attachment – Letter with application

http://fcsp.xfyldecoast.nhs.uk/trustdocuments/Attachments/CORP-POL-559/Clinical%20Attachment%20(A1)%20-%20Updated%20Template.docx




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Appendix 2: Clinical attachment – Letter – unable to accept





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Appendix 3: Application Form

http://fcsp.xfyldecoast.nhs.uk/trustdocuments/Attachments/CORP-POL-559/Application%20Form%20November%20%20(2)%20(current)%20%20%20(A3)%20-%20Updated.doc




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Appendix 4: Occupational Health Form

http://fcsp.xfyldecoast.nhs.uk/trustdocuments/Attachments/CORP-POL-559/Appendix%204%20OH%20Health%20Form.docx




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Appendix 5: Confirmation letter





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Appendix 6: Equality Impact Assessment Form Department Medical Education Service or Policy Clinical

Attachment Date Completed: 15 December 2015

GROUPS TO BE CONSIDERED Deprived communities, homeless, substance misusers, people who have a disability, learning disability, older people, children and families, young people, Lesbian Gay Bi-sexual or Transgender, minority ethnic communities, Gypsy/Roma/Travellers, women/men, parents, carers, staff, wider community, offenders.

EQUALITY PROTECTED CHARACTERISTICS TO BE CONSIDERED Age, gender, disability, race, sexual orientation, gender identity (or reassignment), religion and belief, carers, Human Rights and social economic / deprivation.

QUESTION RESPONSE IMPACT

Issue Action Positive Negative What is the service, leaflet or policy development? What are its aims, who are the target audience?

The purpose of this policy is to detail the procedure for handling requests for Clinical Attachments. This Policy does not include: • Overseas medical students seeking electives. Any such requests should be referred to the Director of Medical Education (DME) • Visiting medical staff. Doctors acting in a supernumerary capacity to treat identified patients, to carry out clinical research, or to be trained in medical procedures (such Doctors are required to be appropriately registered with the GMC/GDC) will require pre-checks in line with NHS Standards before being issued with an Honorary Contract. Overseas Medical Practitioners requesting the opportunity to observe best practice should be dealt with under the Procedure for Honorary Contacts.

No action required. Positive – alternative arrangements for overseas and visiting medical staff can be made via a different procedure

Does the service, leaflet or policy/ development impact on community safety

Crime

Community cohesion

N/A

Is there any evidence that groups who should benefit do not? i.e. equal opportunity monitoring of service users and/or staff. If none/insufficient local or national data available consider what information you need.

N/A

Does the service, leaflet or development/ policy have a negative impact on any geographical or sub group of the population?

N/A

How does the service, leaflet or policy/ development promote equality and diversity?

It meets Trust standards around equality and diversity

Does the service, leaflet or policy/ development explicitly include a commitment to equality and diversity and meeting needs? How does it demonstrate its impact?

N/A

Does the Organisation or service workforce reflect the local population? Do we employ people from disadvantaged groups

N/A

Will the service, leaflet or policy/ development i. Improve economic social conditions

in deprived areas

ii. Use brown field sites iii. Improve public spaces including

creation of green spaces?

N/A




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Appendix 6: Equality Impact Assessment Form Does the service, leaflet or policy/ development promote equity of lifelong learning?

N/A

Does the service, leaflet or policy/ development encourage healthy lifestyles and reduce risks to health?

N/A

Does the service, leaflet or policy/ development impact on transport? What are the implications of this?

N/A

Does the service, leaflet or policy/development impact on housing, housing needs, homelessness, or a person’s ability to remain at home?

N/A

Are there any groups for whom this policy/ service/leaflet would have an impact? Is it an adverse/negative impact? Does it or could it (or is the perception that it could exclude disadvantaged or marginalised groups?

N/A

Does the policy/development promote access to services and facilities for any group in particular?

N/A

Does the service, leaflet or policy/development impact on the environment

During development

At implementation?

N/A

ACTION: Please identify if you are now required to carry out a Full Equality Analysis

Yes No (Please delete as appropriate)

Name of Author: Signature of Author:

Date Signed:

Name of Lead Person: Signature of Lead Person:

Date Signed:

Name of Manager: Signature of Manager

Date Signed:

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