NHS Education for Scotland

Meeting of the Anaesthetics, Intensive Care and Emergency Medicine Specialty Training Board held at 10.45 am on Friday 12 December 2014 in Meeting Room 5, Westport, Edinburgh

Present: Eddie Wilson (EW) Chair, Russell Duncan (RD), John Keaney (JK), Stephen Lynch (SL), Alastair McDiarmaid (AMcD), Lynn Newman (LN), Neil O’Donnell (NO), Alan Orr (AO), Rowan Parks (RP), David Semple (DSe), Ellie Simm (ES), Elizabeth Wilson (EWi), Ian Young (IY).

VC: Luke Boyle (LB) deputising for Adam Collins, Mark Mitchelson (MM), Gillian Needham (GN).

Apologies: Adam Collins (AC), Paul Holder (PH), Carol McMillan (CM), David Stewart (DSt).

In attendance: Paola Solar (PS).

  1. Welcome and apologies

The group introduced themselves and were welcomed to the meeting. A particular welcome was given to Ellie Simm, trainee rep, and Luke Boyle, deputising for Adam Collins.

The apologies were read.

  1. Minutes of meeting held on 30 October 2014

The minutes of the previous meeting were approved as a correct record.

  1. Matters arising
  2. Anaesthetic Assistance in Scotland

William McClymont was not present so this item was deferred.

Action: Agenda

3.2RCoA Recruitment Committee - Question bank update

Ken Stewart (RCoA Scottish Board) has volunteered to lead the organisation of the question bank update.

3.3Interviewers for ICM UK recruitment

EWi reported that 6 interviewers had been confirmed from Scotland, with 2 from the South East, 3 from the West and 1 from the North with representation confirmed for each interview day.

  1. Workforce Planning
  2. Anaesthesia

ISD data confirms that expansion in consultant numbers is on-going. Transition group had agreed a maximum core intake of 64 for 2015. Currently 63 posts confirmed on vacancy manager.

4.2Emergency Medicine

ISD data confirms a 10% increase in WTE Consultant numbers for the year to June 2014. Recent discussion between College of EM and Scottish Government highlight continued required expansion to deliver current service model. 20.5 WTE are currently vacant with 8 WTE vacant for more than 6 months. Planned intake of ACCS EM with run-through option to similar number of posts as in 2014 (26). Currently 22 confirmed on vacancy manager.

4.3Intensive Care Medicine

4 additional funded posts have been approved and uploaded to the vacancy system. ICM still relies heavily on Anaesthesia for badged posts and this is not sustainable in the long term. This will require further input to workforce discussion.

  1. Recruitment update

5.1Specialty updates

  • Anaesthesia

Anaesthesia has filled 80% of the ST3 posts at recent interviews, with some regional variation. The CT1 Interviews will be held over 4 days in late January and early February. There are currently 120 applicants who have put Scotland as their first choice for the 63 posts in Anaesthesia. Last year there were 110 applicants and all posts were filled. ST3 interviews will take place in April, in Dundee.

  • Emergency Medicine

Further round of ST4 recruitment held in Yorkshire in November.

15 posts, 1 filled. Fill rate 1/9 West, 0/2 South East and 0/4 North. No posts on this occasion from East.

This fill rate is unsurprising given 159 posts UK wide in this round with only 17 applicants, 14 appointable and 14 posts filled.

For 2015 recruitment, currently 22 posts agreed. Interviews to be held 12-15th January in Edinburgh.

  • Intensive Care Medicine-UK Recruitment and through SMT.

UK interviews will take place mid-April in Birmingham EWi has sent information to all trainees, including LATs, about their eligibility to apply for dual training. Interviews for the badged posts to be held in Dundee in late April.

  1. GMC National Training Survey

Board members had been asked to bring their comments and concerns about the GMC’s NTS results.

Anaesthesia TPD from West of Scotland detailed a specific case where a single trainee had highlighted a personal concern re a culture of bullying with reference to the regional training committee. While acknowledging that this was only one comment they had taken the matter very seriously, contacted their PG Dean who had passed the issue on to the QM team of another region to investigate and take forward. It was agreed that this was the appropriate action. EW offered to assist in this investigation if the Dean/QM team felt this would be helpful.

It was noted that the GMC NTS was anonymous, so a trainee could only be identified through their GMC number in cases where patient safety issues were raised.

Other TPDs gave examples of cases within their programmes where the Survey had resulted in some negative comments. These were discussed.

  1. Shape of Training

RP reported that there has been a formal statement from the SoT Steering Group, which is a high level group with representation from the four nations. They had met after the six workshops held in September and October and had agreed a number of proposed policy statements to be passed to the four Health Ministers. Discussion of the proposal was pending but it was envisaged that the next stage will be the economic evaluation of the Shape of Training. Timing has not been clarified yet but discussions are still at a high level.

  1. Liaison Dean Report

GN had been introduced earlier as the new MEL allocated to this STB under the new single system. Philip Cachia will be liaison Dean until the end of the month, but since he was not available today, GN had offered to start the new arrangement early. From January onwards, each STB and the Foundation Board will have a MEL (Postgraduate Deans and GP Directors) aligned to it, together with a General Manager and a Training Manager.

EW stated the thanks of this Board to Philip Cachia for all his help and support to date. Philip had also asked EW to pass his thanks to the Board for their collaboration.

The structural changes brought by the implementation of the Medical Vision are ongoing. GN noted that MDET is working diligently with all relevant stakeholders to ensure that the transition is as smooth as possible.

The group were made aware of the correspondence from Shirley Rodgers, Scottish Government Health Department, to the Health Boards with a proposal to establish Overseas AMTF in Scotland. Boards had been asked if they would support this type of fellowship with overseas trainees, and whether they would be able to fund them. NES had been asked to look at the educational content of the posts once the bids were received from the HBs. RP stated that the STBs expertise would be called upon at a very short notice to assess the educational value of the posts required. It was not clear as yet whether this would be only a yes/no qualification of the posts or NES will also be asked to rank them. Once final bids and more guidance from the SG have been received, they will be passed on to the STBs for their input. The Scottish Government would like interviews to take place in January so the timeline for this work will be before the next meeting of this STB.

It was noted that the initiative above was separate from the MTI process.

  1. Academic Issues

There was no report. EW will contact John Kinsella to discuss future input.

EWi noted that FY2 academic trainees felt they get very limited time between wards to do academic projects work. GN clarified that NES offers Academic posts in collaboration with the Scottish universities, which usually offer 4 month blocks in academic teaching.

The Academic Foundation trainees get local support from John Kinsella. They get half a day a week for academic purposes. Duncan Henderson, Chair of the Foundation Board, would be the best point of contact if more information is needed.

  1. College reports
  • Anaesthesia

The College will launch the National Workforce Census next year. It will be a comprehensive survey which will require data input from service and training leads in the first instance. The survey will be piloted in 2 hospitals in England beforehand but it is expected to be out by April or May.

  • Emergency Medicine

The DREAM route is now part of the ST4 recruitment. Scotland had no applicants through this route last year. This route only applies to Surgical trainees, who in general do not have many competencies with Emergency Medicine so, although they are appointed to ST3, they are effectively at ST1 or ST2 level.

Trainees coming out of ACCS Core Training might be appointable to ACCS ST or to ST4. There is no way to find out the trainee’s competencies before appointment so only can move the trainee after they’ve been appointed and sometimes that leaves vacancies at other levels .

Last year the College approved recruiting LATs at ST3 level and then giving them NTNs.

EWi noted that the South of England has developed several ICM courses directed towards the FFICM examination but as yet none are approved by FICM.

  1. Trainee reports

The main issue reported is the excessive working hours’ shifts in EM in the South East of Scotland.

  1. Any other business

There were no other businesses.

  1. Dates of meetings 2015

PS will circulate the 2015 meeting dates.

Action: PS

Actions

Item Number / Item Name / Action / Owner
3.1 / Matters Arising: Anaesthetic Assistance in Scotland / To defer to next meeting / Agenda
13 / Dates of meetings 2015 / To circulate meeting dates / PS

Anaesthesia, ICM, EM 12.12.14 Minutes1