Postgraduate Medical Education Committee

Minutes for the meeting held on Tuesday 12th June 2013

in the Clinical Sciences Building at 5.30 p.m.

Present

Eddie Simmonds Chair – Clinical Tutor Marie Midgley Secretary – Manager Med Ed Shirish Dubey F1 – Deputy Clin Tutor M. Christie-Large Radiology Tutor Asad Ali Respiratory medicine I. Khan Gerontology Chaitanya Bhatt ENT Dawn Adamson Cardiology Chris Harmston Surgery Matt Rogers Pathology Shabin Joshi Neurosurgery

Apologies Sailesh Sankar Malvin Xavier Maggie Allen Andreas Ruhnke David Bennett Jones Andrea Lindahl Peter Dekker Kim Neuling Resignations Roger Townsend Peter Dekker

Minutes were approved with amendments

Dawn Adamson and Ilam Khan had sent their apologies for the last meeting

Objectives for PMEC

It was agreed that meetings will be held every two months and that there will be a mixture of lunchtime and evening meetings to accommodate the needs of the members.

The objectives were agreed.

Consent update

Simon Darlow has given three talks on consent for F1s

Sailesh has set up a course – a one day session followed by assessment.

For Radiology James Harding has said that all the information on consent is on the E-library. Trainees are asked to download the relevant pamphlets and give them to the patients. The patients are then formally consented when they go to radiology by a radiologist. It was agreed that Shirish would be there for the consent lecture and will pick up on the issues. Shirish will work with Amanda Gould to develop a pink form and procedure to be filled in. There was a debate about the viability of the current approach. Concern was raised about trainees being expected to print out leaflets in triage – why can’t clerks hand them out – there was concern that there is insufficient staffing and then Consultants have to sort it out. It was suggested that this could be a topic for the Grandround where the procedures could be explained to the Consultants and then they can educate their trainees. This was agreed.

Action SD & M C-L

Bronchoscopy consent – it was noted there is a full day of training with associated certificate.

Visit updates

Cardiology on 23rd April 3013 – this was a good visit with very positive feedback. They liked what the Trust was doing. They were asked to stop from 1st July any clinics off site where there was no consultant present – this includes Rugby so if the Consultant is on annual leave the clinic needs to be cancelled. This change is coming down from the Colleges and will affect all specialties.

Gerontology and Neurosurgery noted that they don’t do clinics outside the Trust and don’t run them before 9.30 a.m. i.e. before handover.

Registrars on their own doing peripheral clinics is potentially difficult. Inspectors are increasingly critical of registrars managing clinics without an identified Consultant in the vicinity. This problem also came up in the Obs & Gynae visit.

Neurosurgery

It was noted there was only a red flag for consent – generally the report was just whites and some pinks. The report hasn’t been this positive for 5 years.

Obs & Gynae

It was noted that the JEST results for this year are much better than prior to previous visits. Most trainees would recommend the post to a friend. The team are optimistic that the forthcoming visit will go well. The group congratulated Kavi Goswami for moving the service forward.

GMC Survey

There is a new tool to use to interrogate the data. Bogdan Tanea is looking to download the information and develop a summary for all departments which Ed with then circulate when ready Action ES

E handover Tool

On the Foundation School visit the handover was picked up as needing some attention. This applies to both medical and surgical departments. The Handover in the evening is seen to be working well. The H@N provide handover to the respective wards for the patients they have been taking care of in the operations room. This happens at weekends and in acute medicine it happens on Ward 12. But the consensus of the group was that the hand over process is not very good. It was noted that conscientious staff contact the doctor on the wards to tell them otherwise there is not a formal system. The e-handover tool has been invested in patchily across the Trust (by the clinical teams) if at all. It was felt that the system needs to be invested in at senior level and embedded with this group first and then they will encourage trainees to engage with it. The different specialties described their systems. One restriction noted was the lack of access to computers in some areas – however the group were advised that Robin Arnold the Director of ICT has stated that he is happy to supply additional computers to any area requiring them as long as desk space is identified. However, there is sometimes local resistance to the use of desk areas for computers – in this case mobile units can be supplied but these come with their own security risk (i.e. could be more easily stolen).

It was noted that Collette Marshall is planning a relaunch - the e-handover learning module will be part of the obligatory induction for the August rotation.

Foundation trainees

It was noted that there are some gaps e.g. 3 gaps in FY1. Ruth Cottrell will contact the Clinical Supervisors to advise them of where the gaps are.

However with the Foundation trainees and the GPVTS trainees there are always some last minute changes.

Ali Asad noted that there are some good people in the Trust that want to stay and asked if these could not be recruited to fill the gaps. Shirish agreed to check the position with Maggie Allen

Action SD

It was agreed that ES would raise concerns about gaps in training and lack of timely notification with TERC Action ES

Acute medicine

Due to a number of recent resignations and imminent retirements there is one substantive consultant in Acute medicine at the moment. The trainees feel more pressurised and there are significant concerns both within the Trust and at the ‘Deanery’ about patient safety. Nick Balcombe and Mike Iredale have been tasked with addressing the problem. Various medical departments CDs have been approached and asked to volunteer Consultants to take on an Acute medicine role to fill the gaps until new appointments are in post. There is no clarity about whether individuals have agreed to take on this task at the moment. The Trust have written to the ‘Deanery’ with a plan of how it intends to address the problem. There is a meeting with Nick and Mike tomorrow lunchtime to review progress against the plan. On the 1st July the ‘Deanery’ are coming an hour early (before the Obs & Gynae revisit) to discuss the plan. Members of the group expressed deep concern about the issue and ES was asked to put the problem onto the risk register. ES was also asked to write to Meghana on behalf of the committee. It was noted that Maggie is meeting with Nick and Mike on Friday Action ES Dates of next meetings

Thursday 22nd August lunchtime 12.30 – 1.30 (lunch provided) Tuesday 15th October evening 5.30 Wednesday 11th December lunchtime 12.30 – 1.30 (lunch provided)