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
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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
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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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
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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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.
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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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.
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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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.
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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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
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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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.
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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Appendix 1: Clinical Attachment – Letter with application
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
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Appendix 2: Clinical attachment – Letter – unable to accept
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
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Appendix 3: Application Form
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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Appendix 3: Application Form
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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Appendix 4: Occupational Health Form
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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Appendix 4: Occupational Health Form
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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Appendix 4: Occupational Health Form
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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Appendix 5: Confirmation letter
Blackpool Teaching Hospitals NHS Foundation Trust ID No. CORP/POL/559 Title: Clinical Attachment Policy
Revision No: 2 Next Review Date: 05/10/2022
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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
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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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: