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Annual Report | 2019 THE SCOTLAND DEANERY Click anywhere to continue... ANNUAL QUALITY REPORT | 2019 2 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 CONTENTS C3 36 C4 46 THE TRAINING YEAR 2018 / 2019 53 59 C5 67 12 71 22 30 74 © NHS Education for Scotland 2019. You can copy or reproduce the information in this document for use within NHSScotland and for non‑commercial educational purposes. Use of this document for commercial purposes is permitted only with the written permission of NES. NESD0977 | Designed and typset by the NES Design Service 3 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 FOREWORD Welcome to the 2019 Scotland Deanery Importantly, we reflect our work around Annual Quality Report in which we give a sites included within the GMC's Enhanced round‑up of our Quality Management and Monitoring process and report on an Improvement activities over the course of the overall reduction in Enhanced Monitoring 2018‑19 training year. sites from 9 to 7. Clear evidence that partners are working collaboratively to The report yet again reveals the extent our bring about sustained improvement. Deanery staff and colleagues in Health Boards go to, to continually monitor and Improving what we do within the Deanery improve the standard of medical education is also important and working with doctors and training in Scotland. The level of joint in training to make our process better is working is quite striking and I am pleased key to making sure doctors in training in to see many more good practice recognition Scotland have real influence over how letters across all specialties. A reminder training is delivered. The report highlights that Scotland continues to provide excellent our commitment to working with our medical education and training. Trainee Associates and Clinical Leadership Fellows to make this happen. PROFESSOR STEWART IRVINE Our pan Scotland Quality Management Medical Director & Deputy Chief Executive approach is now well established and the I trust you will gain great insight from in‑depth knowledge we have built‑up around the 2019 report and like myself be each specialty is reflected in the reports reassured that the Deanery is working, provided by each specialty grouping. In collaboratively and productively with each case we provide a summary of what Health Board partners to make sure has happened and been actioned, where we Scotland’s doctors in training continue found good practice and what are the main to receive excellent training. issues for consideration in the coming year. 4 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 THE TRAINING YEAR IN NUMBERS 212 HOSPITAL 81 VISITS AUG JULY 5679 34 GP PRACTICE 2018 2019 TRAINEES WITHIN LETTERS OF RECOGNITION 86 VISITS REMIT OF THE SQMG SQMGS HELD (AUG 2018 – JUL 2019) ISSUED FOLLOWING QRP JOINT UG / PG VISITS 2 FACT FINDING 4 MEETINGS ENHANCED MONITORING NUMBER OF GP RQMGS HELD EAST HOSPITAL VISITS 7 (AUG 2018 – JUL 2019) 4 PROGRAMME VISITS NORTH 11 ??? ?? ?? ?? 5 ENQUIRIES SCHEDULED HOSPITAL VISITS 28 94 FOLLOWING QRP SOUTH EAST WEST TRIGGERED HOSPITAL 227 HOSPITAL 20 REVISITS 13 6 TRAINING VISITS 6 PROGRAMMES WITHIN REMIT OF THE SQMG 5 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 THE TRAINING YEAR 2018 / 2019 FOUNDATION MEMBERSHIP OF THE FOUNDATION QUALITY MANAGEMENT GROUP (FQMG) Lead Dean Director – Professor Clare McKenzie Associate Deans (Quality) – Dr Geraldine Brennan and Dr Fiona Drimmie Associate Deans (Regional) – Dr Fiona Cameron, Dr Duncan Henderson, Dr Joy Miller and Dr Caroline Whitton Consortium Leads – Dr Edgar Brincat, Dr Alastair Milne, Dr Brian Neilly, Mr Yatin Patel and Dr Joe Sarvesvaran Trainee Associates – Dr Patrick Hughes and Dr Christopher McDermott PROFESSOR CLARE MCKENZIE Lead Dean / Director for Foundation Quality Improvement Manager – Ms Jill Murray Lay Rep – Mr David Ramsay Quality Improvement Administrator – Mrs Gaynor MacFarlane 6 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 HIGHLIGHTS 79 TOTAL AUG JULY 13 VISITS 2018 2019 1632 5 TRAINEES WITHIN LETTERS OF RECOGNITION REMIT OF THE SQMG SQMGS HELD (AUG 2018 – JUL 2019) ISSUED FOLLOWING QRP JOINT UG / PG VISITS 0 ENHANCED MONITORING FACT FINDING HOSPITAL VISITS 1 1 MEETING TRAINING PROGRAMMES PROGRAMME VISITS 0 54 WITHIN REMIT OF THE SQMG SCHEDULED HOSPITAL VISITS 5 ? ? ? ? ? ? ? 7 QIM ENQUIRIES FOLLOWING QRP TRIGGERED HOSPITAL DME ENQUIRIES FOLLOWING QRP HOSPITAL 5 REVISITS 2 0 VISITS ? ? ? ? ? ? ? 7 APGD ENQUIRIES FOLLOWING QRP 7 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 OVERVIEW VISITS UNDERTAKEN IN 2018 – 2019 SITE SPECIALTY VISIT TYPE DATE OF VISIT OUTCOME OF VISIT CAITHNESS HOSPITAL Whole Site Enhanced Monitoring (EM) 29/10/2018 De-escalated from EM Improvements had been UNIVERSITY HOSPITAL AYR General Surgery Triggered 06/11/2018 made. Continue to monitor. Very positive visit. UNIVERSITY HOSPITAL AYR Emergency Medicine Triggered 06/11/2018 No further action. NETHERGATE MEDICAL Very positive visit. General Practice Scheduled 26/11/2018 PRACTICE No further action. A number of changes had ROYAL INFIRMARY been made within the Trauma & Orthopaedics Revisit 30/11/2018 EDINBURGH department. A revisit is required. Positive visit. ROYAL VICTORIA HOSPITAL Medicine for the Elderly Scheduled 11/02/2019 No further action. Very positive visit. PERTH ROYAL INFIRMARY General Surgery Scheduled 19/02/2019 No further action. Improvements had been NINEWELLS HOSPITAL Trauma and Orthopaedics Revisit 15/03/2019 made. No further action. Serious concerns. VICTORIA HOSPITAL (FIFE) General Medicine Triggered 22/03/2019 Revisit required. 8 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 SITE SPECIALTY VISIT TYPE DATE OF VISIT OUTCOME OF VISIT UNIVERSITY HOSPITAL Obstetrics and Fact Finding Meeting (FFM) 26/03/2019 No visit required. CROSSHOUSE Gynaecology GLASGOW ROYAL General Medicine Triggered 14/05/2019 Revisit recommended INFIRMARY ST JOHN’S HOSPITAL, Positive Visit. ENT Scheduled 30/05/2019 LIVINGSTON No further action GLASGOW ROYAL Serious concerns. General Surgery Triggered 21/06/2019 INFIRMARY Revisit required. DRS CHEUNG, AL-AGILLY & Report not available General Practice Scheduled 23/07/2019 MORGAN at time of review. VISITS IDENTIFIED BUT LED BY ANOTHER SQMG: SITE SPECIALTY VISIT TYPE DATE OF VISIT OUTCOME OF VISIT NINEWELLS HOSPITAL & Report not available at time Emergency Medicine Scheduled 22/05/2019 PERTH ROYAL INFIRMARY of review. THE FOLLOWING ENQUIRIES WERE RAISED AT THE 2018 QUALITY REVIEW PANEL: NO OF TPD NO OF APD NO OF DME NO OF QIM QRP ENQUIRY STATUS ENQUIRIES ENQUIRIES ENQUIRIES ENQUIRIES FOUNDATION 0 7 0 7 Complete 9 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 SITES ON ENHANCED MONITORING WITH RELEVANT TRAINEES LDD COMMENT ON OVERALL SATISFACTION 01/08/2018 – 31/07/2019 The Scottish Foundation School and Foundation Quality Management Obstetrics and Gynaecology, Princess Royal Maternity Hospital / team work hard to improve the training our Foundation doctors receive. Glasgow Royal Infirmary All the Foundation programme directors and educational supervisors General Adult Psychiatry, NHS Tayside are to be commended for their ongoing efforts which have resulted in General Medicine, University Hospital Ayr the School improving in the rankings. Many departments proactively General Medicine, Queen Elizabeth University Hospital support the training and development of these young doctors. We Trauma and Orthopaedics, University Hospital Wishaw recognise there is more to be done and our focus will be to increase General Medicine, Vale of Leven awareness of good practice as well as continuing to promote the Foundation programme in Scotland. OVERALL SATISFACTION RESULTS PROGRAMME 2017 UK 2018 UK 2019 UK LDD OVERVIEW TYPE RANKING RANKING RANKING The Foundation Quality Management Team (FQMG) have worked well FOUNDATION 9th of 16 13th of 16 9th of 17 this year and should be commended for their dedication to the agenda YEAR ONE of improving the quality of training for Foundation doctors. There FOUNDATION continues to be good attendance at Foundation Quality Management 15th of 16 10th of 16 9th of 17 YEAR TWO Group meetings from the regional Foundation Associate Postgraduate Deans (APGDs) who provide soft intelligence regarding the training issues on the ground. Together the team reviews and interprets a significant amounts of survey data as well as reviewing all visit reports and DME action plans for sites where Foundation doctors are training. 10 NHS EDUCATION FOR SCOTLAND | THE SCOTLAND DEANERY ANNUAL QUALITY REPORT 2019 Over the last year we have amended the emphasis during the FQMG The FQMG is keen to identify and promote good practice to aid trainers meetings towards increasing the amount of time spent discussing improve the training environments. Dr Fiona Drimmie, Associate the DME action plans received by FQMG and other SQMGs in relation Postgraduate Dean-Quality (APGD-Q), has worked with other APGD- to Foundation specific actions. Through the Quality Improvement Qs and DME representatives reviewing the data in relation to Trauma Manager (QIM) network, we have raised our concerns if the actions and Orthopaedics. The output of this work was highlighted through are not considered adequate from a Foundation training perspective, a workshop at the 2019 Scottish Medical Education Conference. recognising that Foundation has specific and unique issues. Working together,
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