Minutes of the Meeting of the Mental Health Specialty Training Board Held at 10.30 Am

Minutes of the meeting of the Mental Health Specialty Training Board held at 10.30 am on Monday 2 December 2013 in Room 4, Westport, Edinburgh

Present: Susan Miller (SM) Chair, David Brown (DB), Alastair Cook (AC), John Crichton (JC), Euan Easton (EE), Anita Ganai (AG), Helen Goode (HG), Alex Keith (AK), Stephen Lawrie (SL) part meeting, Robin McGilp (RMcG), Seamus McNulty (SMcN), Siobhan Murphy (SMu), Norman Nuttall (NN), John Russell (JR), Chris Sheridan (CS), Carol Wilson (CW).

By videoconference: Aberdeen (Forest Grove House) – Margaret Bremner (MB), Sally Winning (SW) part meeting. Due to network problems John Channon (JCh) was unable to join the meeting from Inverness.

Apologies: Dik Athawes (RA), Geraldine Bienkowski (GB), Roger Blake (RB), Tom Brown (TB), Ashley Catto (AC), Stella Clark (SC), Sandra Duke (SD), Linda Findlay (LF), Tracey Hicks (TH), Kathy Leighton (KL), Johan Leuvennink (JL), Ronald MacVicar (RMacV), Michelle McGlen (MMcG), Gillian Needham (GN), Rowan Parks (RP), Rhiannon Pugh (RP), Karen Shearer (KS), John Taylor (JT), Judy Thomson (JT).

In attendance: Helen McIntosh (HM).

1. Apologies and welcome

SM welcomed all to the meeting and in particular: Chris Sheridan as new BMA trainee rep, Alex Keith and Anita Ganai as RPsych trainee reps and Carol Wilson, Vice-Chair of PTC.

Apologies were noted.

2. Minutes of the meeting held on 23 August 2013

One amendment to the minutes was noted:

, Item 4, first paragraph, final sentence to read ‘…in particular on the actor stations …’

With this amendment the minutes were accepted as correct record of the meeting and will be posted on the website.

3. Matters arising 3.1 Workforce: Destination of CCT holders

AC reported the Regional Advisers Workforce Group discussed provision of experience for school students. Destination of CCT holders was discussed by the Regional Advisers workforce group and how to collect destination data. It was agreed to collect information starting from August 2013 and STB members were asked to add any information they held.

3.2 Foundation: discussion with BMA/Academy and CMO

AC reported no meeting has been scheduled with CMO.

3.3 Trainee/Specialty doctor update: College rules re supervisor definition

Noted: College has confirmed Educational and Clinical Supervisors must be consultants.

1 3.4 Deferral for research: update SL reported an additional 3 months had been sought for submission of a PhD application; this has been resolved. A CT applicant has been encouraged to apply for an NTN; this required approval from the PG Dean.

3.5 Forensic Psychiatry post conversion

JC confirmed they will convert an SES HST post to core for this Autumn. NN will inform the Deanery the post was to be included in recruitment numbers.

Action: NN to inform Deanery the post was to be included in recruitment numbers.

4. Recruitment 4.1 EoS post: update on adding to recruitment 4.2 Recruitment Board meeting: information available 4.3 Future role of recruitment group 4.4. Update on ST4 recruitment round November 2013 4.5 Recruitment update

The outcome of the November ST4 recruitment round in Scotland for General Adult, Child & Adolescent and Learning Disability was awaited. Nine people were interviewed one of whom was interviewed for both specialties. MB noted that .North Child and Adolescent vacancies were not advertised in the recruitment round as the posts had not been signed off by Finance.

CT1 interviews will be held in Scotland at the end of January in Dundee and follow the same process as before. It was likely the same process will be followed for 2015 CT1 interviews although this was not yet confirmed. ST4 interviews will be held in London and Manchester.

In terms of process, the 3 stations will continue with some slight alteration to focus. The actor station will focus mainly on communication skills as this was a useful discriminator for CT1 applicants. Actor stations will also be used for ST4 interviews to explore communication skills but with a specialty focus. Stations 1 will consider portfolios with a greater specialty specific focus for ST4. It was possible some generic changes will be made to Station 2. Allocation of candidates to London and Manchester was not yet finalised but was likely to be based on applicant choice. SM noted discussion at Heads of School where it was agreed the STB in conjunction with TH would recruit interviewers. A pilot day for recruitment will be held later in the week. DBr has attended this previously and found it helpful as a way of checking that stations worked: JR will attend this year.

DBr noted an issue regarding a question in Station 3 in Forensic Psychiatry. The question was used and agreed last year and agreed again for this year however without consulting Scotland. JC should have been consulted as national lead via the FECC, and this has been acknowledged. The intention was not to disadvantage anyone unaware of legislation in the UK or the differences between the devolved countries and so candidates would not be tested on this. Although JC felt candidates required an awareness of the differences this was not part of the UK national recruitment process however the first station will explore candidate commitment to specialty. All questions in the process were published in advance and the College will also provide a communications update for trainees. Scotland is committed to participation in the national recruitment process & cannot run recruitment differently.

2 SMur confirmed the EoS post previously discussed has been advertised on the website as dual Psychotherapy/General Adult for recruitment in the next round.

DBr confirmed he was standing down as recruitment lead and JR will replace him. SM thanked DBr for his outstanding contribution to recruitment and welcomed JR to the role. It was agreed JR will convene a meeting of the recruitment sub group to discuss its future direction.

Action:  JR to convene a meeting of the recruitment sub group.

5. Proposed national training programme for Learning Disability Psychiatry

JR confirmed TPDs have discussed and agreed the proposal for a national training programme. The STB endorsed the decision and SM will take it to the MDET meeting on 6 December for its approval for introduction in August 2015. GN confirmed she was happy to be the Lead Dean for the programme; meantime TPDs will discuss TPD arrangements.

Action:  SM to take proposal to MDET on 6 December for its approval.

6. Annual specialty report for RPsych

SM reported the College requested an annual report and this was done by the Deanery.

7. Workforce

RP produced trainee establishment information for 2013 however it was felt some of the information collated was incorrect. SM will check and confirm information from each Deanery before sending to RP.

AC reported ST4 recruitment was the major concern raised by the Workforce Committee and its message for Scottish Government was to defer any changes until Shape of Training was implemented.

Action:  SM to check establishment information by Deanery and send corrections to RP.

8. ARCP sub group update 8.1 Psychiatry ARCP outcomes

JR collated and circulated information and will repeat the exercise next year. Compared to last year outcomes in SES this year were worse largely due to the lack of assessments undertaken. SM noted RP was keen to get comparative data from RPsych to benchmark and JR agreed to seek this information.

It was noted WoS was moving to electronic ARCPs. JR also noted a small number of ARCPs will be undertaken soon and hoped there would be no problems with the College server. The ARCP forms required to be reviewed so they mapped to the curriculum and this work will be done for core trainees.

Action:

3  JR to seek comparative data from RPsych for RP.

9. Foundation

AC reported the Foundation Programme Director in WoS was bidding for additional posts; NN believed SES will receive 2; MB said the current F1 NoS post was continuing and she was not aware of any additional. All other Deaneries reported either no change or no current information.

10. START Alliance

SM reported her attendance at a recent meeting and noted much work was underway. Feedback was available on the NES stand at the BMJ Careers Fair and from the survey on ‘push-pull’ factors and she will circulate it to the group on request. The START Alliance also planned a stand at the Scottish Medical Education Conference in May in Edinburgh. The next meeting of the group was arranged for 10 December.

AC highlighted 2 issues being addressed by the START Alliance – doctors leaving Scotland across all specialties and retention of those training and working in Scotland. A series of webinars were being arranged and he and SM will seek via the START Alliance to organise one for Psychiatry. In general people were much less mobile than previously however Edinburgh University has a high percentage of non domiciled medical students – other Scottish universities less so – and so numbers tended to remain steady. Work was being done with Medical Schools to increase the numbers of Scottish domiciled applicants with a particular initiative in the Highlands.

Action:  AC/SM to seek Psychiatry webinar via the START Alliance.

11. Heads of School meetings

SM and SD both attended the meeting on 29 November. Topics included Shape of Training Review, recruitment; standards for ARCPs and Psychotherapy curriculum. CW noted concern concerning trainees entering non dual Psychotherapy training however SMur reassured her dual was not the only training track available. Scotland was considering dual CBT but this was not envisaged for Dynamic training. The climate in England was very different with much anxiety and this was not the case in Scotland. CW also noted discussion on eportfolio at the meeting; SM confirmed this was not an issue in Scotland where named administrators have access to information. It was noted panel members’ access to ARCP information was only available on the day of the review.

12. Updates 12.1 Liaison Dean/MDET update

SM reported on behalf of GN in her absence and stressed the need to maintain a Scottish link to recruitment; she highlighted START engagement and marketing material. SM will circulate START papers to the STB for information.

She also noted applications received for funding via the SAS project.

The next MDET meeting will be held on 6 December.

Action:

4  SM to circulate START papers to the STB for information.

12.2 Deanery and Specialty updates  Psychotherapy SMur reported Psychotherapy was part of the GMC small specialties review following which it was asked to specify the number of sessions for short and long cases in the curriculum. This work has been completed however much disquiet remained and ongoing discussion was taking place with the GMC so there may be further changes.

An ILO 19 for Core Psychiatry for reflective practice has been introduced; in November ILO 19 for General Adult went to GMC and was likely to be rolled out.

Finally, SMur reported she will retire in March and as she was unable to attend in February this was her final STB meeting. She was seeking to identify a successor for the STB. SM thanked SMur for her contribution to the STB and in particular her work in establishing a national programme.

 Learning Disability Noted: due to consultant retirals there were insufficient trainees to fill vacated posts.

12.3 College update

No update was received.

12.4 Service update

AC noted arrangements differed in Health Boards in the provision of experience for school students. Medical Schools were tending to move away from this but the situation was not entirely clear or consistent.

12.5 Academic update

SL reported:

 2 Lecturer posts were still available.  3 Psystar trainees have now embarked on their PhDs.  4 Psystar trainees were moving through Scotland at present.  Final slots have been advertised and 7 applications received.

12.6 Regional planning update

No update was received.

12.7 Trainee/Specialty doctor update

 Trainee update CW reported recruitment issues were the main concern for trainees and she will propose further discussion in the recruitment group.

 Specialty doctor update SW reported the SAS project was going well. In terms of the definition of Educational/ Clinical Supervisor she noted the situation where SAS doctors ‘acted up’. AC confirmed day-to-day supervision by the person ‘acting up’ was accepted but they were not

5 technically Clinical or Educational Supervisors. SM will check the situation regarding locum consultants and report back to the STB.

Action:  SM to check the situation regarding status of locum consultants as trainers and report back to the STB.

12.8 STARG

No update report was received.

13. Shape of Training

The report has now been received and work on implementing its recommendations will begin. Medical School training will be followed by Foundation then 4-6 years of broad based specialty training and then credentialing. A UK Implementation Board was to be formed plus a Scottish group. The report was sent to the Ministers of each of the 4 countries and Scottish CMO highlighted to the Academy that Scotland was prepared to take a pragmatic view and he would recommend where necessary when Scotland was unable to implement recommendations as in the rest of the UK. Any flexibility in implementation would however pose problems from a College perspective and cause curriculum to be rewritten. AC was attending a College Council meeting later in the week and will gauge views there.

CW reported that trainees welcomed the flexible approach outlined in the report and felt this could attract more people into Psychiatry; the recommendation to increase Psychiatry trainees’ involvement in physical health training was also welcomed. Concerns were expressed about the potential for creating a sub consultant post, although this was an issue more directly linked to discussion on the consultant contract, and the need to ensure no loss of status for General Adult Psychiatry.

In general the STB felt generalism was attractive and would assist service delivery within the context of population changes. Some concern was expressed on moving the point of registration to graduation as this could impact on retention. Also credentialing would only be possible if the service identified a local need and could result in less mobility. AC in particular felt this should be considered on a Scottish wide basis to prevent too narrow a focus. Many of the recommendations were based on English needs and whatever the outcome of the independence referendum it was agreed Scotland will continue to provide a different service. It was the timescale for full implementation of the report within 7 years was ambitious.

CW said the PTC has sent a response to the report which she will circulate to the STB when available. SM will report MDET discussion after the meeting on 6 December.

Action:  CW to circulate PTC response to the report to the STB when available.  SM to report MDET discussion after the meeting on 6 December.

14. Received for information

No additional information was received.

15. AOB 15.1 NES Deanery re-structuring

6 SM reported NES was moving to a single Scottish Deanery next year while retaining the 5 local offices. Much of the detail was still being worked on and she will report further after the MDET meeting on 6 December.

Action:  SM to report further after MDET meeting on 6 December.

16. Date of next meeting

The next meeting will take place at 10.30 am on Friday 14 February 2013 in the Mackay Room, 2 Central Quay, 89 Hydepark Street, Glasgow (VC available).

17. Dates of future meetings

 Monday 28 April – Room 5, Westport, Edinburgh  Monday 16 June – Room 5, Westport, Edinburgh  Monday 8 September – Mackay Room, 2 Central Quay, Glasgow  Friday 14 November – Calman Room, 2 Central Quay, Glasgow.

Actions arising from the meeting

Item no Item name Action Who 3. Matters arising 3.5 Forensic Psychiatry post To inform Deanery the post was NN conversion to be included in recruitment numbers. 4. Recruitment 4.3 Future role of recruitment group To convene a meeting of the JR recruitment sub group. 5. Proposed national training To take proposal to MDET on 6 SM programme for Learning Disability December for its approval. Psychiatry 7. Workforce To check establishment SM information by Deanery and send corrections to RP. 8. ARCP sub group update 8.1 Psychiatry ARCP outcomes To seek comparative data from JR RPsych for RP. 10. START Alliance To seek Psychiatry webinar via AC/SM the START Alliance. 12. Updates 12.1 Liaison Dean/MDET update To circulate START papers to the SM STB for information. 12.7 Trainee/Specialty doctor update To check the situation regarding SM status of locum consultants as trainers and report back to the STB. 13. Shape of Training To circulate PTC response to the CW report to the STB when available. To report MDET discussion after SM the meeting on 6 December. 15. AOB 15.1 NES Deanery re-structuring To report further after MDET SM meeting on 6 December.