Minutes of Less Than Full-Time (Flexible) Training

MINUTES OF LESS THAN FULL-TIME (FLEXIBLE) TRAINING

JOINT SPECIALTY ADVISORS’

AND LEAD TRAINEES’ MEETING

Thursday 30th June 2011 at 10:00am

MINUTES

ITEM / ACTION
Present:
Helen Goodyear – Associate Postgraduate Dean LTFT Training (Chair)
Laura Higginbotham – Administrator, PMDE Team (Minutes)
Specialty Advisors / Lead Trainees
Sarah Barrett / GUM / Louise Baxendale / Anaesthetics
Jill Dixon / O&G / Laura Coleman / Radiology
David Ford / T &O / Heather Jarvis / Paediatrics
Elizabeth Justice / Rheumatology / Sharmila Madhogaria / Dermatology
Lavanya Kamesh / Renal Medicine / Elizabeth McEvoy / GP Training
Pecklin Lip / Opthamology / Martina Mockova / Neurology
Sally Natynczuk / Psychiatry / Katie Wright / Emergency Medicine
Nicky Osborn / Anaesthetics
Shewli Rahman / Emergency Medicine
Elizabeth Smith / Geriatric Medicine
Lucy Strens / Neurology
Konstance Tzifa / ENT
Bridget Wilson / Paediatrics
1 / Apologies & Introductions:
Specialty Advisors / Lead Trainees
Rachael Boddy / Emergency Medicine / Eleanor Dryhurst / Psychiatry
Karen Ellery / Dentistry / Emma Parry / Psychiatry
Savita Gossain / Immunology / Ingrid Du Rand / Respiratory Medicine
Claire Hookey / Palliative Care
Helen Lewis / Dermatology
Jo McHugo / Radiology
Ruth Lester / Plastic Surgery
Rachael Sam / Surgery
Brief, round the table introductions were given.
HG welcomed Shewli Rahman to the meeting, who has jointly with Rachel Boddy replaced Ellen Jones as Specialty Advisor in Emergency Medicine. HG extended thanks to Ellen Jones in her absence for her contribution to this committee over many years.
2 / Minutes of the meeting held on Tuesday 18th January 2011
In relation to agenda item 9, Dr Barrett stated that Sexual Health and GUM are the same thing.
With this amendment, the minutes were agreed as a true and accurate record of proceedings.
3 / Matters arising
-LTFTT Programme Forms
The programme forms have been subtly changed. Dr McEvoy advised there are queries in GP training around who trainees should be obtaining signatures from. Since the forms have changed, this has become less clear. HG explained it is very difficult to devise a form which is completely suitable for all specialties and will ask Maddie Meades to continue to provide support.
To be discussed further under any other business.
There is also some confusion around the flowcharts; Heather Jarvis will help to review these. HG advised trainees to contact their advisors with queries and will request that this is also added to the flowchart.
HG clarified that GP forms should be sent to Rob Grinsted who is the LTFTT Advisor for general practice and not to the LTFT advisor of the hospital specialty which was being undertaken. / HG / HJ / M. Meades
4 / Bi-annual LTFT Survey
HG tabled the paper titled ‘Analysis of the Bi-annual survey of Less Than Full-Time Training,
1st November 2010 – 30th April 2011’
There was debate at the LTFT Forum on Tuesday 28th June as to whether the survey should continue to be carried out bi-annually or revert back to annually because the data is very similar.Due to the MMC changes in 2007, the survey became bi-annual. The following points were noted from the results of the survey:
-Numbers have increased steadily
-6.6% of trainees are LTFT
-The largest number of LTFT Trainees is STR3+/SpR grade. GP Registrar numbers continue to increase. The number of SpRs has reduced slightly since 2010.
-There are a high number of supernumerary posts in other deaneries. The committee questioned the accuracy of these figures.
-Gender split. The committee again questioned the accuracy of this data. Some deaneries stated they were unable to provide accurate data. The majority of LTFT trainees are female but there are a significant number of male LTFT trainees.
-Data regarding enquiries is meaningless. NHS Employers and BMA request this data but only calls to the LTFT administrator are counted rather than the other many ways in which trainees find out about LTFT training.
-Very small number of academic trainees are LTFT
-Eligibility – the most common reason is because of childcare. Other reasons include
ill-health and caring for relatives.
-Category 2 is not split into reasons.
-Data surrounding trainees with a delayed start is again meaningless. The majority of reasons are categorised as unknown. The next survey will be changed, using 2 categories, to clarify if it is a trainee or other issue.
-Rejected applications are often because the trainee does not meet the eligibility criteria and because trainees wish to carry out research.
-GP is the most popular specialty group with 674 trainees, and paediatrics isthe second most popular.
-The West Midlands remains stable, trainees are not rejected if they meet the eligibility criteria. Raw numbers show the West Midlands have a large number of LTFT trainees with 320 trainees.
-HG advised the committee that she did not put comments in the box at the end on this survey because there were no significant changes. For the next survey, the forum agreed that success and achievements will be the theme rather than the same repetitive comments.
Further discussion ensued around the accuracy of data. It was thought that if the survey was reverted back to an annual event the accuracy of the data would improve. It was also pointed out that the most inaccurate data within the West Midlands will be around maternity leave. HG reminded the committee of the importance of informing the deanery of when a trainee is on maternity / sick leave etc.
5 / Report from LTFT Forum, Sheffield – 28th June 2011
HG advise the committee of the following business which was discussed at the LTFT Forum:
Visas and LTFT Training
Discussion took place around visas and LTFT training. If someone is working on a tier 2 visa, they are not allowed to drop their salary by more than 15%. The committee were asked to advise HG of any trainee who are working on visas.
Pregnancy and LTFT Training
Pregnancy and LTFT training and on-call rota issues were discussed. Guidelines have been produced by West Midlands Deanery around pregnancy. These will be finally signed off shortly. Certain circumstances require referral to Occupational Health and alternatives researched. If there are no alternatives, trainees should go on maternity leave at 29 weeks.
Trainees were widely unhappy with the first paragraph of the document. HG advised that this has been changed and will re-circulate to the group.HG requested that the document is reviewed by all and that comments are forwarded to her as soon as possible. Informal swaps betweencolleagues are acceptable for on call but trainees cannot demand a higher banding for this arrangement.
HG reminded the committee that there may be some competencies that cannot be signed off at ARCP if a trainee has not been on the on-call rota. In this case an ARCP outcome 2 would be given.
JEST & GMC Surveys
ARCP outcome 2s are considered as a fail by trainees. The Medical Post Graduate Dean has said that if the JEST and GMC surveys are not completed, an ARCP outcome 2 will be given. The deadline for return of this survey this is 18th July 2011. Consultants are required to complete the trainer’s survey. Trust will also be looked at in terms of returns. Some new questions, as discussed at the LTFT forum may be added to the survey in 2012.
Minimum Amount Of Work Time in LTFT Training
There was some discussion around the minimum amount that you can work LTFT. The colleges were keen to enforce 50%; however the GMC support European legislation which states trainees can work at any percentage. Debate centred on a document, put forward by the GMC, on proposals for resolving this issue. Following much discussion, the forum agreed a minimum of 20%, in very exceptional circumstances and time bound for a year. However, the exceptional circumstances were not agreed. During this time, trainees will be required to demonstrate 8 week’s worth of competencies at their ARCP. The GMC will run a consultation exercise in early 2012 in which every doctor will be able to take part. HG advised the committee that if any trainee wishes to work at less than 50%, they would have meet face-to-face with her and if there is a disagreement, the trainee would need to appeal to the Medical Post Graduate Dean.
Another suggestion put to the forum was to request that trainees reapply for LTFT Training every year. HG disagreed with this and this has been deferred for now. In terms of Mini CEXs, these are pro-rata but this varies in specialties and are dealt with on a case-by-case basis.
HG will clarify with HR Managers if trainees who have been out of work for any reason are entitled to 10 paid days per year on the Keeping in touch scheme.
Eligibility Certificates
Eligibility Certificates have been stopped because they are not widely used. A section will be added to offer letters instead. As soon as trainees receive their offer letter they will be required to inform the Deanery of their intention to work LTFT.
Royal College of Anaesthetics LTFT Survey
The Royal College of Anaesthetists have carried out a LTFT survey. The results show the following:
-The mean age of people training LTFT in anaesthetics is 35 years old.
-Most have done at least 3 years at full time.
-Only 8% were working at less than 60%.
-If the LTFT option was not available, trainees would take a career break, take a staff grade post or drop out of medicine.
-80% were happy with the work-life balance they had achieved.
-Compared to 1998, it was felt there is less discrimination about working less than
full-time
-Trainees found no difference to full-time in accessing training and teaching.
-There were concerns around the number of hours worked. In some deaneries trainees can only work at 50% or 60%.
-Trainees felt they have more limited access to specialised fellow posts than full-time trainees.
-There is inconsistency between deaneries when trainees return to work, in how much training they receive before going back on the on-call rota.
-Some trainees felt it was difficult to achieve all that they wanted to achieve when working at 50% / 60%.
Questions will be circulated should other specialties wish to use them.
Social Networking Sites
A discussion was held around social networking sites for LTFT Trainees.
Dr McEvoy spoke of an established group in the Coventry & Warwickshire for LTFT GP trainees. This has worked very well. Feedback has been positive. In relation to confidentiality, potential members have to be approved by the group administrators and are asked to agree that they will not discuss anything that takes place on the website outside of the group.
Discussion took place amongst the committee about the best way to set up the group(s). It was agreed that HG will set up a pilot group for the surgical specialties and then report back at the next meeting.
Deanery Website
The BMA have a league table of deanery websites. In 2008, West Midlands was number 1. In the latest table, following many website changes, West Midlands is number 3. Scores are based on the number of ‘clicks’ to reach a piece of information, this should not be more than 2.
HG advised the committee that trainee input would be very valuable. The deanery could give permission for trainees to make minor changes.
Dr McEvoy suggested adding links to the appropriate paperwork on to the LTFT flowcharts, as trainees feel that document titles are confusing. The committee widely agreed this would be useful.
HG agreed to start work on this and requested that all trainees and advisors review and provide feedback before permanent changes are made. / HG
ALL
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HG
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6 / Work & Pregnancy
Discussed under agenda item number 5, no further issues raised.
7 / Maternity Leave & Grace Period
HG confirmed that if a trainee is on maternity leave during their 6 month grace period, they can return for the remainder of their grace period. For example, if a trainee went on maternity leave after completing 4 months of her grace period, on her return she could complete a further 2 months.
8 / GP Google Groups
Discussed under agenda item number 5, no further issues raised.
9 / Careers Fairs
HG extended thanks to Dr Wright who took part in the Warwick careers fair and received a lot of interest and difficult questions. There had been extremely positive feedback.
The Birmingham careers fair took place on Saturday 26th June 2011. HG extended thanks to Isobel Brooks who deputised on the stand when HG took part in other talks. Again, there was a lot of interest, difficult questions but positive feedback.
The Deanery careers fair will take place on Saturday 8th October 2011 between 10:00am and 4:00pm at City Hospital and will be free entry. This will be similar to the careers fair that the deanery held with the BMJ last year. The following committee members agreed to assist by writing a 200 word case study with their photograph to appear on a poster and help out with the stand at the fair:
Heather Jarvis
Louise Baxendale
Laura Coleman
Elizabeth McEvoy
Sharmila Madhogaria
Martina will ask if a Neurology trainee could attend. / HJ/LB/
LC/EMcE/SM
MM
10 / Reports from LTFT Specialty Advisors
GUM
A trainee has returned to work following 3 years on OOP. There have been a few issues but these are now being resolved.
Paediatrics
In 1 subspecialty, rotas are now being released 6 weeks in advance instead of every 6 months. HG advised this should be at least 3 months in advance.
O&G
There are now 33 LTFT trainees. Not all trusts deliver advanced training modules resulting in 6 LTFT trainees currently being in full-time posts and difficulty allocating them to trusts.
Geriatric Medicine
There is a trainee who needs to attend their ALS course on what would be their day off. HG advised they would be entitled to claim this day back when appropriate over a period of 6 months.
In terms of study leave, funding for LTFT is pro-rata of a full-time trainee. Courses will be fully funded because study leave can be borrowed from the following study year.
ENT
There are 6 female trainees, none of whom are LTFT at the moment. One trainee has returned from maternity leave and another has come from full-time training. HG confirmed that trusts are given full-time funding if trainees work part time in a fulltime slot.
In terms of numbers of workplace based assessments, HG suggested that advisors contact the college or Janet Walls, who is the national lead for surgery, as each college has their own stance on this.
Anaesthetics
The Royal College of Anaesthetics has updated the LTFT training section on their website which is very useful.
Neurology
There are 4 LTFT trainees in full-time slots.
Renal
Have a maximum of 4 trainees who slotshare. This is working well.
Psychiatry
No issues.
Rheumatology
There are 5 trainees. A trainee came into her penultimate year on maternity leave and failed at her annual ARCP despite having gained her competencies for the period she worked. This appears to be a misunderstanding by the person leading the ARCP.
HG asked Dr. Justice to speak to the ARCP committee to get this corrected.
T&O
This is working well. There are currently more males in LTFT training than females. One male has achieved as much training as a full-time trainee would. HG asked if it would be possible for a trainee to attend the Deanery careers fair.
Emergency Medicine
There are 4 trainees at registrar level. / EJ
11 / Reports from LTFT Lead Trainees
Dermatology
No issues.
Urology
Trainees are finding it takes a long time to get forms signed off at Queen Elizabeth Hospital, particularly by the Chief Executive. Some HRs will not sign forms until all other signatures have been obtained. HG asked that trainees contact the deanery if they continue to experience problems.
Paediatrics
No issues
Anaesthetics
No Issues
General Practice
HG clarified that if a trainee is staying in the same post where they have trained from February to the end of July, they do not need to start a new training programme in August. It is vital however that the trainee is in communication with Maddie Meades to explain his/her situation.
12 / Any Other Business
In relation to acting-up as a consultant and working LTFT, there was debate at the LTFT Forum as to whether this should be for 3 months only but each college does it differently. This will be discussed again at COPMED to clarify. HG advised that in the meantime the policy is to follow the relevant colleges’ rules.
13 / Date & Time of Next Two Meetings
Date: Tuesday 17th January 2012
Time: 10:00am
Venue: Main Conference Room
Date: Thursday 5th July 2012
Time: 10:00am
Venue: TBC

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