NHS Education for Scotland
Minutes of the Anaesthetics, Intensive Care Medicine and Emergency Medicine STB, held on 22 August 2014, at 10.45am, in Room 6, Westport, Edinburgh
Present: Eddie Wilson (EW) Chair, David Semple (DS), Philip Cachia (PC), Carol MacMillan (CMcM), Alan Orr (AO), Alastair McDiarmid (AMcD), Russell Duncan (RD), Stephen Lynch (SL), Ian Young (IY), Louie Plenderleith (LP), William McClymont (WMcC), Neil O’Donnell (NO), Elizabeth Wilson (EWi)
Apologies: Rowan Parks (RP), John Kinsella (JK), Christine Rea (CR), Lynn Newman (LN), David Stewart (DSt), Mark Mitchelson (MM)
In attendance: Niall MacIntosh (NMacI) left meeting after Item 5, John Sheppard (JS), Paola Solar (PS)
1. Welcome and apologies
The group was welcomed to the meeting and the apologies were read.
NMacI was welcomed to the meeting. He had been invited to reply to issues and queries around the new Scottish Trainee Survey the Quality team are working on.
It was announced that this would be the last meeting for Louie Plenderleith. EW thanked him for his significant contribution and help in STB matters.
2. Minutes of the meeting held on 20 May 2014
Pg 3, Item 4.1: EW was asked to clarify whether the 10 extra Anaesthesia CT1 posts would mean 20 new salaries. EW will find out and get back to the group.
Action: EW
Pg 5, Item 5.2, first paragraph: the West filled 19 out of 20.
Pg 5, Item 5.2, third paragraph: The 2 unbadged posts had been filled and went to the West.
With the above amendments the minutes were approved as a correct record.
3. Matters Arising
3.1. Scottish Training Survey
NMacI distributed the survey questions in a new format to allow comment, and went on to reply to a number of queries that had come up at his last presentation to the Board. NMacI assured the group that this time the survey would include sub-placements, to include trainees in placements such as ICM. He further noted that a new version of Pinnacle was being developed, which would allow his team to capture more relevant data.
NMacI encouraged the Board to think about what information the trainees could provide that might be useful for QM.
It was clarified that this is an end of placement survey, so trainees might get more than one request per year. It was noted that for some specialties it might be better to do it only once a year.
The Colleges have had some input on the questions, and NMacI is also going to check the surveys sent by the Colleges to avoid overlaps.
The Board was asked to submit any suggestions, issues and feedback to NMacI and copy EW.
Action: All
3.2. CT2 Anaesthesia/ST3 Recruitment
EW reported that he had again brought up the subject to the College Recruitment Committee but it remained the case that full primary by time of interview was required for ST3 recruitment.
It was noted that at the recent RCoA College Tutors’ meeting a proposal to re-introduce an additional sitting of the primary exam in order to improve the chances of trainees was discussed. EW will take this up to the UK Recruitment Committee in October as a potential solution for the issue.
Action: EW
3.3. LTFT – Survey to EM trainees
Jayne McKinlay, who had been the EM trainee representative, has now moved to London. A replacement will be sought, possibly Dr Ellie Simm, and will be asked to carry out the survey on behalf of the STB. SL to approach trainee re taking on this role.
Action: SL
3.4. Anaesthetic Assistance in Scotland
WMcC reported that he had volunteered to take over the initiative on behalf of the RCoA Scottish Board but he was not yet up to speed. This item will be kept in the agenda and WMcC will report at the next meeting.
Action: Agenda/ WMcC
4. Workforce Planning
EW wanted to record his thanks to all those who had provided input into the reports sent to the Scottish Government, particularly as they had been requested at very short notice during peak holiday time.
The 3 reports have gone to John Colvin as part of a combined NES response. John is keen to meet up with representatives from the three specialties. EW will facilitate this.
Action: EW
4.1. Anaesthesia
The paper prepared by EW on behalf of the STB reflected past discussions with the main focus around maintaining the recent increases in CT1 year on year thereby increasing the pool for ST recruitment. The paper also highlights risks around future CCT supply and in particular the need for strategy to decrease the current significant levels of post-CCT attrition.
The group noted that Anaesthesia benefitted greatly of being able to appoint LATs regionally to flexibly fill gaps, noting that any HEE move to avoid future LAT recruitment should not be supported in Scotland.
4.2. Emergency Medicine
It was noted that the Scottish National Recruitment round requested by the Scottish Government had only attracted 3 applicants of which the only appointable one had been appointed to the West. The group agreed that it had been a big effort for a very small outcome, even more so when there will be a second round of recruitment in November.
Regarding the numbers paper, RD noted that attrition rates of 30-40% persisted. Recruitment rates to ACCS EM remain high and it is hoped that with the run-through training a significant cohort of current trainees will remain in EM training thereby stabilising future rotas and improving attractability of the specialty
4.3. Intensive Care Medicine
LP was thanked for a very detailed and helpful paper on funding for ICM. EW and EWi had used this paper in the ICM recommendations paper sent to the SG. The paper was a starting point for discussion, with the understanding that many assumptions had been made in order to obtain those numbers.
EWi noted that she had enquired about the process used in Wales to obtain independent ICM funding. She noted that this had been achieved thanks to the involvement of senior colleagues such as the Postgraduate Dean.
PC noted that all three papers had been very useful and will probably get further comment by Rowan Parks before they are officially submitted to the Scottish Government. PC further noted that although NES is aware of the issue in ICM, Scottish Government have already indicated to NES that there will be no new money to go into training grades in the next couple of years. Any new posts created in that period will have to be funded by NES, which is already being asked to make efficiency savings every year. The other issue will come from the Shape of Training review which while it has no agreed timescale may generate a wait and see approach around funding issues.
PC also indicated that all other specialties are going to go through the UK Recruitment process, Oriel, so as things stand ICM will be the only one using the SMT recruitment website in 2015.
EWi will send a paper to PC detailing exactly at what point during ICM training is the money being used. This information will be very helpful to back the push for more funding. It was highlighted that, of 50 trainees, only about ¼ receive ICM salary at any one time – there are only 12 posts per year for ICM training.
5. Recruitment update
5.1. CCT date flexibility for February intake
There is ongoing regional discussion to decide what vacancies there are for the February intake. Anaesthesia and Emergency Medicine will have a recruitment round 2 in November.
5.2. Specialty Updates
· Anaesthesia
For round 2 recruitment ST3: Agreed vacancy of 7 in the West, 5 in the North, 3 in the South East and 0 in the East.
It was noted that for round 1 recruitment in 2014 the fill rate at ST3 level was 75%, higher than last year’s 63%. LAT appointments again done regionally. No additional ST3 appointments through UK clearing.
· Emergency Medicine
For Round 2 recruitment at ST4: The most recent figures were agreed vacancy of 9 in the West, 4 in the North, 0 in the South East and 0 in the East.
Round 2 of recruitment will be hosted by Yorkshire & Humber.
· Intensive Care Medicine.
Recruitment numbers as confirmed at previous STB.
5.3. RCoA UK Recruitment Committee
EW reported on the last Committee meeting:
· As stated above, no change to the current regulations re eligibility and having full primary FRCA.
· Changes to the self-scoring system for ST3 this year. Self scoring had of late rewarded candidates who had passed full primary FRCA in 1st year of core training and/or had passed at first attempt. This has led to the unintended consequence of candidates either sitting too early when poorly prepared or delaying their first attempt to increase the chances of 1st time pass. The RCoA felt both of these positions were undesirable and for 2015 the self score matrix will change to remove these concerns.
· It was noted that Anaesthesia at ST3 level was the only specialty which has a separate interview for clearing. It is thus likely that there will be no separate interview for clearing purposes from 2015.
· There was a call for TPDs and College Tutors to review the interview questions for UK recruitment in order to refresh the bank.
· ST3 Interviews (Round 2) will take place on 9 October and Core Training interviews for August 2015 intake in January 2015. All interviews in Dundee.
6. 10 Priorities of Emergency Departments in Scotland
This paper from the College of Emergency Medicine was distributed only for information.
7. Advanced Medical Training Fellowship in ICM
The East of Scotland was seeking STB educational approval for this AMTF, which will allow a post-CCT opportunity for those interested in ICM. Supported by STB.
8. Shape of Training
PC reported that there will be six national workshops in September, 4 in London, 1 in Cardiff and 1 in Edinburgh. These workshops will be by invitation only and the themes will be: General and CST; Interaction with Employers, Interface between Primary and Secondary Care; SAS Doctors; Academic Pathways; Credentialing.
All STBs will receive feedback after the workshops take place.
9. Recognition of Trainers
There was no update related to Recognition of Trainers. It was noted that there were local differences about how to get accreditation. PC confirmed that NES will provide non-compulsory education modules that will be accounted for recognition. NES is still in discussion with the DMEs to obtain an agreement on standards. In addition, there is an initiative to build a website dedicated to RoT. PC will liaise with Gillian Needham, who is leading the work on RoT, to find out the current situation and to get information about the website.
Action: PC
10. Liaison Dean report
PC informed the STB that the GMC has programmed a visit to Scotland in 2017. This will be the first integrated visit to all of Scotland. It is likely that there will be four teams visiting the Medical Schools and the Education Providers, and 2-3 smaller teams to visit smaller Education Providers. This will be the last UK visit of the current GMC round of visits.
PC highlighted that, working back from the timeline for the GMC visit, Scotland will have to start preparing for it as soon as possible. The GMC requires a very large amount of data at least 6 months before the visit, which means that we must be ready to submit it in 2016, and we will have to work with the QM data obtained in 2015. This means that there will only be one Training Survey between now and then. It was noted that the GMC will often focus on issues and concerns raised in the annual trainee survey.
11. First Scottish Medical Careers Fair
The plans for the first Scottish Medical Careers Fair are well advanced. RD is working on the Emergency Medicine representation, while EW is working with Liz McGrady for Anaesthesia. The Training Ambassadors will be heavily involved, but please email EW with the names of volunteers from any specialty.
Action: All
12. Fifth National Scottish Medical Education Conference
The paper on the Awards was distributed for information only.
The date of the next Conference was noted.
13. Academic Issues
There was no Academic report. It was noted that there was very poor attendance and sporadic input around academic issues. EW will follow this up.
Action: EW
14. College reports
There was no update from the College.
15. Trainee reports
There was no trainee update.
PS and EW will look into trainee representation. It was noted that a previous approach to BMA had been proposed to seek a replacement for Dr Chris Hoy.
Action: EW and PS
16. Any other business
There was no other business.
17. Date of next meeting
10.45am on Thursday 30 October 2014, meeting room 6, Westport, Edinburgh (videoconference available)
Action Points
Item / Subject / Action / Who2 / Minutes of previous meeting / To check whether the 10 Anaesthesia CT1 new posts will mean 20 salaries / EW
3.1 / Scottish Training Survey / To send feedback and suggestions to NMacI and EW / All
3.2 / CT2 Anaesthesia/ST1 Recruitment / To bring additional exam sitting to the next UKRC as possible solution / EW
3.3 / EM Trainee Representative / To identify EM trainee rep. / SL
3.4 / Anaesthetic Assistance in Scotland / To add to next agenda and report / Agenda
WMcC
4 / Workforce Planning / To set up meetings between John Colvin and the three specialties to discuss workforce plans / EW
9 / Recognition of Trainers / To seek information about state of affairs and new website from Gillian Needham / PC
11 / First Scottish Medical Careers Fairs / To email suggestions and volunteers names to EW / All
13 / Academic Issues / To seek academic input to future STBs / EW
15 / Trainee representative / To seek result of previous approach to BMA re trainee rep (to replace Dr Hoy.) / PS
EW
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