Minutes of Trainees Advisory Committee

Minutes of Meeting

Trainee Advisory Committee, Oxford Deanery Rosemary Rue Building, Oxford PGDME 3rd September 2010, 14.30 – 17.00

Attendance: Alexander Finlayson (Academic), Carl Morris (Chair, Anaesthetics), Anwar Rashid (Anaesthetics), Peyton Davis (Emergency Medicine), Amar Latif (Foundation), Charlotte Frise (Medicine), Emily Fletcher (Ophthalmology), Robert Purbrick (Ophthalmology), Caroline Scott-Lang (Paediatrics), Andrew Ho (Paediatrics), Anna Eccles (Pathology), Rosamund Southgate (Public Health), Anna Sharman (Radiology), Jonathan Stedman (Radiology), Gael MacLean (Surgery), David Bailey (Oxford Deanery)

Apologies: Sylvia Tan (Dental), Lola Martos (Psychiatry), Michael Bannon (Oxford Deanery), Peter Burbridge (Medicine), Tahreema Matin (Academic), Bettina Lieske (Surgery), Sucharita Yarlgadda (Public Health), Peter Lees (NHS South Central)

Chaired by Dr Carl Morris (CM, Anaesthetics)

1. Last meeting

Minutes from last meeting agreed by those present

2. Terms of Reference and Membership

It has become apparent the Foundation reps are only in post for one year and so they are unable to complete their two year terms on the TAC as per our ToR. Tessa Candy has said specialties need to demonstrate fair methods for selection of TAC representatives. This is especially difficult to achieve for medicine and surgery, as outside of core training there is no centralised way of contacting all trainees within subspecialties. (Action for all: please pair up with your other trainee rep and document a mechanism for selection of reps for your specialty)

It was suggested by several people that the Heads of School should be able to help with selections, but this may also introduce more complexity. It was decided that the TAC would be unable to enforce selection criteria other than a requirement for the individual specialties to be fair and transparent in their selection.

Anwar Rashid (AR) suggested we need to be keeping records of when people will be leaving the committee if that date is going to be before the end of their 2 year terms (Action for Andrew Ho (AH)

AH noted that we are now missing one representative for each of Emergency Medicine and General Practice. Peyton Davis (PD) has an alternate for Emergency Medicine, and AH has a contact in GP to find a GP replacement. (Action for PD to contact AH with EMed alternate and AH to chase second GP member)

3. Website

Emily Fletcher (EF) and Jonathon Stedman (JS) have been working on the new trainee section of the Deanery website in conjunction with Ruth Crawley and following a review of other national deanery websites. JS gave a tour of the website to the committee (Now online at http://www.oxforddeanery.nhs.uk/ ) which was well received.

1 EF and JS then opened discussion up to the committee, asked what we would like to see on the website. CM has asked for a search facility, but there may be technical limitations currently. CM then suggested the listing of the TAC members on the site and also the competition ratios for subspecialty application. JS offered a noticeboard for us to post notices to the trainees, a suggestion which was well received.

4. Last HoS Meeting

CM attended the last HoS meeting in June. There has since been a change of process and the minutes are not available till approved at the next HoS meeting. CM therefore gave a provisional report of the discussions. This included:

 Counter Fraud presentation: John Micklewright, Deloittes. Definitions, costs, what to do when suspicions arise.

 “NESC” courses including the leadership programme: Don Strange, courses and conferences manager. Funding available for trainees in the deanery, encouraged to promote these courses, or any ideas for new courses. AH reported that Paediatrics have had offers of support for the arrangement of courses from “NESC”.

 Workforce planning: reduction in number of hospital speciality trainees is inevitable. Details being urgently sought by HoS.

 New gold guide and curricula implementation.

 Payment for training of educational supervisors / training programme directors.

 Late withdrawals from interdeanery transfers: possibility of sanctions.

 Website: extranet versus intranet content.

 BMJ careers fair: trainee representation sought on Oxford Deanery stand.

Potential reductions in hospital trainee numbers, and issues around IDTs were emotive topics for discussion. In the absence of firm information, these will need to be revisited at our next meeting, when the full minutes from the HOS meeting are available

Re workforce planning: Anna Sharman (AS), Amar Latif (AL) and Gael McLean (GL) stressed the importance of the link between service provision, out of hours commitments and training time. The TAC must be vocal where concerns are raised about the effect of workforce reductions on training. PD reported that Emergency Medicine has minimum target numbers for recruitment to run rotas - other TAC members were not aware of similar assessments within their schools.

Re curricula implementation: not all TAC members were aware of this process. Not all specialities are undergoing major curriculum revision.

Re payment for consultant activities related to training: TAC members reported that provision of SPAs for educational supervision appears to be variable across trusts. (This is mandatory in Radiology following advice from their Royal College (AS)).

Re late withdrawals from IDTs: we await the HoS minutes for clarification.

Re trainee representation at BMJ careers fair: CM pointed out that this would be a good opportunity to learn from other deaneries what can be achieve with Trainee Advisory Committees

2 5. Q&A with Dr David Bailey

This started with a discussion of the implications of the white paper on medical education, the publication of which is imminent. DB feels that our role practically as a Deanery will be unchanged, but that it may affect our relationships with other agencies. DB also noted the Deanery are keen for website redevelopment.

AH asked about the implications of imminent funding cuts; DB replied that both staffing and sessions will be cut with implications for training. Trainee salaries should be unchanged.

AL asked about workforce planning (see earlier). This is to be arranged nationally through the CFWI, who have prepared a report. A document from the SHA regarding the effects on our deanery is in its final stages. Training numbers for hospital specialties are to be cut by 1-8% and those numbers to be diverted into GP training. Alexander Finlayson (AF) asked why this was taking place. DB explained that this is part of the movement towards providing more health services in the community. GM and AS asked how hospital service provision was to continue given cuts in hospital doctor numbers. DB suggested that staff/trust grades will be needed to fill rota gaps at a Trust level. Performance managers are working at a Deanery level to maintain training standards as these changes come into force.

As a group we asked about the Deanery’s ability to contact all the trainees in the region. DB explained that the Deanery has a computer system “Intrepid” that holds contact details for trainees. However, the Deanery is reliant on trusts / trainees to update those details. Furthermore, the database is not complete as the Deanery is not involved in recruitment to all specialities. Nevertheless, the TAC may be able to access information from Intrepid in order to improve our communication with fellow trainees. (Action: CM or AH to contact Tessa Candy Re: access to Intrepid)

AL then asked about inspections and quality control within the Deanery. DM explained that as well as regular reviews of training quality, specific assessments have been instituted following the results of the PMETB surveys. (The annual survey is now carried out by the GMC). The reports from these assessments should be available on the Deanery website. CM suggested there could be a link to these from the trainee area of the website.

AS then raised the issues of prospective cover for gaps in rotas and asked if we were obliged to cover these gaps. DB reminded us that these answers should be within our terms and conditions of service in our contracts, but that the onus should not be on trainees to find cover. If there are issues, they should be raised with the Trainee Programme Directors or the Heads of Schools. CM suggested the BMA as a source of advice. AF pointed out that there seemed very little consistency between different hospitals or clarity. CM asked AS to report back to the TAC if she was able to find consistent advice that could be applied across specialities.

6. Summary of Activities

The annual Deanery report to the GMC includes a section from the TAC (as per the Terms of Reference). CM and AH will put this together before the deadline of 22nd October.

7. AoB

Charlotte Frise (CF) then brought up the loss of on call rooms across the region. AH has had some recent discussions with management at Milton Keynes about this issue and has a letter from them which may interest the group. (Action: AH to see if document suitable for dissemination)

EF informs us that some trainees working non-resident on calls are being forced to pay for their own rooms for these shifts if they live outside of 30mins from the hospital. AH has colleagues who have been able to claim back costs from the Deanery for hospital

3 accommodation when they live far from their place of work. (Action: AH to disseminate guidance document in his possession to the group)

AL requested a regular slot in future meetings for rota and similar issues.

Peter Lees, Medical Director and Director of Leadership at NHS South Central has kindly accepted our invitation to speak at a TAC meeting about trainee leadership opportunities.

8. Date of Next Meeting

26/11/2010 at 1430.

Venue – Rosemary Rue Building (To be confirmed)