Medical Education and the Future

Patricia HamiltonDirector of Medical Education

(England)

A High Quality Workforce

MEE

• Coherent professional voice on education and training

• Coordination of changes to postgraduate training pathway

• Integration of service and professional perspectives

MEE

• Professional high level scrutiny of and advice on the quality of workforce planning at national level;

• Professional scrutiny of and advice on the education and

training commissioning plans developed at SHA level

FoundationProgramme

Selection Overall review

Shadowing

Core training forUncoupledSpecialities

SpecialityTraining

General Practice

Speciality Training

CCT for entryto the

SpecialistRegister

ConsultantCPD life

long learning

CCT for entryTo the

GP register

GPCPD life

long learning

Selection Credentialing

Broad based entry

Extension of training

Credentialing48 hour Quality

Accreditation of supervisors

Use of simulationLeadership

New specialties

Workforce planningCommissioning quality

Workforce planning

Time for Training

A review of the impact of the European Working Time Directive on the quality of trainingProfessor Sir John Temple

Findings…..

“It is possible to train in 48 hours”

BUT

“This is precluded when trainees have a major role in out of hours service, are poorly supervised and access to learning is limited”

Positive impact where well implemented

• Good rota design

• Involvement of experienced doctors

• Enhanced supervision

• Increased training opportunities

• Improved patient safety and experience

• Better work/life balance

Problems

• Gaps in rotas

• Emergency/OOH workloads

• Traditional apprenticeship models

• Current pattern of service

Findings – Consultant Expansion

Implement a consultant delivered service

• Direct responsibility 24/7

• Work more flexibly

• Align with CCT holder output

• Consultant contract

• Reward consultant trainers

• How will we afford this?

Response from SoS

To bring the Directive back to the European Commission in order to limit its impact on UK health services

• Not to go back to the past with tired doctors working long hours

• To align the New Deal with the Directive

• The service and the profession to change working practices

• Implement the consultant contract and job planning more effectively

• Determine the appropriate service contribution of the trainee

Review of Foundation Programme

Centre for Workforce Intelligence

The Centre for Workforce Intelligence

• Mouchel and Manchester University

• Plus Workforce Review Team

• Commissioned to – Model numbers for 2011

– Model CCT output and consultant delivered service

– Model future numbers over next 5 years

Specialist Registration before subspecialty

Post CCT Fellowships

Transferable competences

Hybrid trainingprogrammes

Abandon CCT concept

Train

hospitalists

CESR/ CCTBecomes CSR

Exit examinations

Define role and

responsibility of

trainee

OUTSIDE THE BOX

Flexible duratio

n

of tra

ining

DefineE-learning/

simulationusage

More recruitment

entry points

3 Secretaries of State…

….and a new government

SoS Vision for health and care

• A patient-led NHS • Delivering better health outcomes • A more autonomous and accountable system• Improved public health• A focus on reforming long-term and social care

Training and Education

• Employers and staff agree plans and funding for workforce development

• This determines education commissioning plan

• Education commissioning led locally and nationally by the healthcare professions

Through similar mechanisms for nurses, midwives and AHPs

For doctors, healthcare scientists and pharmacists

Through

• The professions will play a leading role in deciding the structure and content of training, and quality standards

• All providers will pay to meet the costs of training

• The national commissioning board will provide oversight

• The CfWI will act as a constant source of information

Timescale

“Reforms will be managed so changes do not destabilise individual providers”

“the summer” Engagement process with stakeholders

“the autumn” Consultation paper

Thank you