Minutes of the Anaesthetics, Intensive Care and Emergency Medicine Specialty Training Board held at 10.45 am on Thursday 26 September 2013 in Meeting Room 6, Floor 1, Westport,Edinburgh
Present: Eddie Wilson (EW) Chair, Philip Cachia (PC), Stephen Lynch (SL), William McClymont (WMcL), Alastair McDiarmid (AM), Kirsty Mitchell (KM), Neil O’Donnell (NOD), Christine Rea (CR), David Semple (DS) part meeting, Iain Young (IY).
By videoconference: Dundee(Deanery) – Carol McMillan (CMcM), Fiona Small (FS) part meeting; Dundee (Emergency Department, Ninewells) – Russell Duncan (RD).
Apologies: Valerie Beattie (VB), David Caesar (DC), John Colvin (JCo), Roelf Dijzhuizen (RD), Paul Holder (PHo), Chris Hoy (CH),John Keaney (JK), John Kinsella (JKin), Michele Laverty (ML), Anthea Lints (AL), Cieran McKiernan (CMcK), Mark Mitchelson (MM), Carol Murdoch (CM), Hugh Neill (HN), Lynn Newman (LN), Alan Orr (AO), Rowan Parks (RP),Louie Plenderleith (LP), David Stewart (DS),Liz Wilson (LW).
In attendance: Helen McIntosh (HM).
1. / Welcome and apologiesEW welcomed all to the meeting and apologies were noted.
2. / Minutes of meeting held on 28 August 2013
The minutes were accepted as a correct record of the meeting and will be posted on the website.
3.
3.1 / Matters arising
CT2 Anaesthesia/ST3 recruitment: discussion with Recruitment Committee and Council
There was no progress to report. EW will take the issue to the UK Recruitment Committee in October and JC to the next UK College Council meeting and specifically whether those who gained the exam by the date of clearing could be entered into the clearing process.
Action:
- EW and JC to take issue to next UK Recruitment Committee and UK College Council meetings and report back to STB.
3.2 / Emergency Medicine Run Through Pilot: update
IY noted Scotland previously stated it did not wish to engage with the pilot as it did not address the real issues around recruitment and retention in the specialty. However RD attended a recent Training Standards Committee where the suggestion was made that all core trainees including those in post already would be offered run through posts.
PC reported he deputised for Professor Irvine at a recent HEE meeting where it was made clear HEE favoured the pilot for which the College was the main driver. He had emphasised the view that it would not address issues and highlighted that current run through programmes in other specialties have problems with attrition however felt these points were not completely accepted. EW will update JC on the issue for the next Reshaping Group meeting.
Action:
- EW to update JC on the issue for the next Reshaping Group meeting.
4. / Workforce Planning
The Reshaping Group was due to meet on 27 September. EW will brief JC on today’s discussion to take to the Group. He has already seen some provisional numbers information and while the process looked similar it suggested a smaller number of core numbers than highlighted at the 9 July stakeholder meeting (10 – 6).
4.1 / Anaesthesia
The College newsletter of August 2013 reported all 4 nations filled CT1 posts; this also showed ratios from core to ST3 were much lower in Scotland than in the other 3 countries which could explain the specialty’s difficulty. EW will take this information to JC and Dr Finlay for the Reshaping Group meeting. They will continue to make the case for increasing core and at least maintaining ST3 numbers.
WM highlighted the Anaesthesia training programme was on average longer than 5 years and as they also ‘badged’ some posts for ICM recruitment this created a shortfall from the outset. He felt expanding ST3 numbers would align with what was happening in England and if not addressed soon Scotland would become less and less attractive to trainees.
The draft numbers paper showed – ST3 intake comprising CCT number and vacancies minus 10 ‘badged’ posts. It was agreed that anaesthesia would for now continue to support the provision of posts to be specifically badged with ICM to provide a route to recruitment and dual training opportunity. It was noted that the reshaping paper currently states the Anaesthesia ST establishment as 301. CR and EW will clarify establishment numbers outwith today’s meeting involving TPDs as required.
Actions:
- EW to take College newsletter information to JC and Dr Finlay for discussion at Reshaping Group meeting.
- CR and EW to clarify establishment numbers involving TPDs as required.
4.2 / Intensive Care Medicine
As noted, it is likely that reshaping will again recommend recruitment to 10 ‘badged’ posts. The specialty leads are keen to enter some posts in UK recruitment. It was hoped Spring recruitment would be more successful with more trainees applying and advertised posts filled. As last year’s timescale was short it was hoped the process would be improved this year with better publicity and a generally better understanding of the process.
4.3 / Emergency Medicine
Noted: any planning will have to take account of the run through pilot. IY reported WoS appointed 14 CT1s in 2013 using 11 salaries and 3 transferred ST salaries so transfer of funding for HST will be required if they wished to maintain 14 training numbers even before any increase in core numbers could be considered. This matter will need discussion with the Regional Workforce Group. IY will produce a paragraph outlining the issue. EW will ask JC to take to the Reshaping Board.
Professor Parks circulated an email to STB Chairs with information on indicative Core numbers for 2014 based on 2013 intake and not as yet including increases that may be proposed in the reshaping process.He has asked Chairs to confirm if they were broadly happy with the figures shown or whether there was likely to be any major changes. CR noted the deadline for indicative vacancies for CT1s was 7 October and she had this work in hand. EW will respond to Professor Parks.
PC noted HEE was seeking an Emergency Medicine representative to participate in a teleconference to discuss the challenges in the specialty. IY will either do this or nominate a colleague and PC will forward information received to IY.
Action:
- IY to produce paragraph for EW for JC.
- EW to respond to Professor Parks re indicative recruitment numbers.
- PC to forward information from HEE to IY; IY to decide representation for teleconference.
5. / Recruitment update
5.1 / Update on possible CCT date flexibility for February intake
EW will continue to take the issue forward: there was no urgency at present.
Action:
- EW to continue to take the issue forward.
5.2 / Pilot situational judgement test – timetable/arrangements
RCoA has responded to HEE stating that due to the timescale and its commitment to the Oriel pilot it will not participate in the pilot.
Trainees will still be invited to participate. All trainees applying for CT1 will be sent an email inviting them to participate on a voluntary basis. There were 2 parts to the test – a situational judgement test and a clinical scenario component based on Foundation competencies. PC expressed concern that if the pilot proved successful HEE planned to introduce it for CT1 recruitment for all posts for 2015 however it was difficult to envisage how the test would be assessed. HEE’s view was that if there were 1,000 applicants this would be statistically valid.However it was agreed by STB members that those who will voluntarily sit the test will likely be a self-selecting group and there would be no way of assessing,in the narrow timeframe proposed, whether a good result in the test predicted good progress in training programmes.
5.3 / Specialty updates
- Anaesthesia
Interviews were held this week for ST3 recruitment for February 2014 intake. Eight candidates were ranked for 13 vacancies and offers will be issued at the end of next week with 8 October the deadline for acceptance. FS will update the STB once she has more information. EW said that while the process has worked well the outcome,in terms of likely fill rates, was disappointing.
Work on CT1 recruitment has begun – the advert will be placed on 7 November and applications open between 12 November and 5 December. The process was run by West Midlands however interviews will be held in Scotland and panellists were being sought.
EW noted that FS will no longer be involved in recruitment and thanked her on behalf of the STB for her input and dedicated support.
- Emergency Medicine
- Intensive Care Medicine
5.4 / RCoA UK recruitment committee
Item deferred to November meeting.
Action:
- Agenda item for November meeting.
6. / Quality Assurance of Training: GMC trainee survey 2013
WMcL noted Anaesthesia was rated very highly - 2nd to GP in overall satisfaction in the UK and 3rd in Scotland. It was felt it could be difficult to tease out the meaning of individual flags. One issue highlighted this year for the first time was red flags for educational supervision – perhaps as a result of 9+1 contracts. IY said a WoS Deanery QM meeting will be held soon when they will discuss red/green flags in detail. ICM did not feature in the survey as it was too small although they may pick up any issues via Anaesthesia.
Deaneries will have been informed of any issues from the survey so if specialty leads/TPDs have heard nothing this implied there were no issues. Colleges will be informed by the end of the month and will start to feed information back.
7. / Remote and Rural Anaesthesia Fellowship
AM highlighted an issue relating to experience gained in post in Adult Transfer. Previously trainees received this via EMRS however the organisation now has a different workload emphasis and although it could continue to take people they would not be able to fully participate. Dr Read was investigating other options eg simulator training with helicopter/retrieval with fixed wing aircraft to fulfil training requirements. JC will also take the issue to the Scottish Government. AM and JC will keep the STB updated on developments. It was felt the issue should be resolved for next August’s intake. NO’D noted the WoS Shock team was unlikely to continue in its previous form. IY noted the plan for all inter-hospital transfers to come under one umbrella organisation (ScotSTAR) from the beginning of next year and this may provide training opportunities.
Action:
- AM and JC to keep STB updated on developments in provision of Adult Transfer experience.
8. / START
The first meeting of the group was held on 3 September. EW was unable to attend but will aim to attend future meetings and feedback to the STB. Noted: ScotMT website has been revised and launched.
9. / Scottish Anaesthesia Trainees Survey
CR will follow this up with CH.
Action:
- CR to follow up on the results with CH.
10. / Liaison Dean Report
PC noted the Shape of Training report will be issued in October. This will be discussed as an agenda item at the next STB meeting.
He noted there was nothing further to report on Foundation or dual training.
Action:
- Shape of Training report – agenda item for next STB meeting.
11. / Academic Issues
No report was received.
12. / College reports
EW noted the recent Scottish College Board meeting with Tutors and Regional Advisers. This was well attended and received and covered a wide range of topics. There will be some upcoming vacancies on the Scottish College Board – volunteers were welcomed.
13. / Trainee reports
No reports were received.
14. / Dates of 2014 STB Meetings
The STB approved the following meeting dates:
- Friday 7 February
- Thursday 20 March
- Tuesday 20 May
- Friday 22 August
- Thursday 30 October
- Friday 12 December.
15. / Any other business
15.1 / National Planning Forum on Managing Trauma
A draft report was due to be produced by a sub group of the Forum. This will propose the creation of 4 designated trauma centres in Scotland with the aim of getting people to hospital/trauma centre within 45 minutes. Matter highlighted to STB for information.
16. / Date of next meeting
The next meeting will be held at 10.45 am on Thursday 28 November 2013 in Meeting Room 6, Floor 1, Westport, Edinburgh (videoconference available).
Actions arising from the meeting
Item no / Item name / Action / Who3.
3.1 / Matters arising
CT2 Anaesthesia/ST3 recruitment: discussion with Recruitment Committee and Council / To take issue to next UK Recruitment Committee and UK College Council meetings and report back to STB. / EW, JC
3.2 / Emergency Medicine Run Through Pilot: update / To update JC on the issue for the next Reshaping Group meeting. / EW
4.
4.1 / Workforce planning
Anaesthesia / To take College newsletter information to JC and Dr Finlay for discussion at Reshaping Group meeting.
To clarify establishment numbers involving TPDs as required. / EW
CR/EW
4.3 / Emergency Medicine / To produce paragraph for EW for JC.
To respond to Professor Parks re indicative recruitment numbers.
To forward information from HEE to IY; IY to decide representation for teleconference. / IY
EW
PC, IY
5.
5.1 / Recruitment update
Update on possible CCT date flexibility for February intake / To continue to take the issue forward. / EW
5.4 / RCoA UK recruitment committee / Agenda item for November meeting. / EW/HM
7. / Remote and Rural Anaesthesia Fellowship / To keep STB updated on developments in provision of Adult Transfer experience. / AM/JC
9. / Scottish Anaesthesia Trainees Survey / To follow up on the results with CH. / CR
10. / Liaison Dean report / Shape of Training report – agenda item for next STB meeting. / EW/HM
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