Minutes of the Meeting of the General Practice, Public Health Medicine and Occupational

Minutes of the meeting of the General Practice, Public Health Medicine and Occupational Medicine Specialty Board Meeting held at 1.30 pm on Wednesday 20 February 2013 in Room 3, Westport, Edinburgh

Present: Ronald MacVicar (RM) Chair, David Bruce (DB), Philip Cachia (PC), Jim Chalmers (JC), Alastair Leckie (ALe), Ian Longair (IL), Sarah Mills (SM), Donald Smith (DS)

By videoconference: Iain Wallace (IW).

Apologies: John Gillies (JG), Moya Kelly (MK), Anthea Lints (ALi), Alan McDevitt (AM), Jean Robson (JR), Paul Ryan (PR), Frank Sullivan (FS), Carrie Young (CY).

In attendance: Helen McIntosh (HM).

1. / Welcome and apologies
The Chair welcomed all to the meeting and apologies were noted.
2. / Minutes of meeting held on 12 December 2012
The minutes were accepted as a correct record of the meeting and will be posted on the website.
3. / STB membership: Occupational Medicine representative
ALe has approached a couple of people so far without any success but will continue to seek a representative. He will be unable to attend the next 2 STB meetings and if a second representative has not been appointed by then he inform RM of any issues to be raised.
Action:
·  ALe to seek a second Occupational Medicine representative.
4. / STB report for MDET 4 February 2013
The STB report was noted for information. RM highlighted recruitment and the GMC review of Occupational Medicine. To note the report was also received by SRDB for information.
5. / Matters arising/Action points from previous meeting
5.1 / Enhanced GP Training update
ALi was attending a meeting in London today led by Simon Plint and with GP Director representation from all 4 countries to consider the economic impact of enhanced GP training. IW said that while he remained supportive he had concerns regarding costs. RM confirmed this would only progress with 4 nation approval however there was support for the educational case.
To note the NES board received an update paper at its January meeting. The item will be kept on the agenda.
IL requested clarification on the term ‘spiral curriculum’. It was confirmed this meant widening experience and breadth as individuals progressed through training and increasing complexity throughout an individual’s career.
5.2 / Shape of Training Review update – NES/ NHS Scotland response
Received for information. It was noted the call for evidence has received 300 formal responses to date.
5.3 / E & D training for assessors
DS confirmed HR colleagues have contacted all those requiring refresher training.
6. / GP returners and induction policy update
ALi held positive discussion with AMcD last week. A final paper will be produced for the STB meeting in April.
Action:
·  ALi to produce paper for STB meeting in April.
7. / Small specialties review: Occupational Medicine
The GMC was reviewing all small specialties n the UK including Occupational Medicine. The review was conducted by videoconference however this broke down repeatedly and as a result the flow of the discussion was interrupted
No major problems were identified in the review and no areas of non compliance. Some recommendations were made to which there were no ready solutions. One of the strengths identified was that due to the small size people were known individually. To date there has been no follow from the review noted from the WoS Deanery as lead Deanery.
It was felt the chief aim of the review was for the GMC to pilot the process. ALe said that while the GMC felt the process was satisfactory his view was that face-to-face was preferable.
RM noted the GMC report commended the work of the STB.
8. / NES Post CCT Fellowships
The item was deferred to the April meeting.
Action:
·  Agenda item for April meeting.
9. / Revalidation for Doctors in training
Individuals will have to revalidate 5 years post registration. Revalidation will be an annual process with a formal recommendation required every 5 years. Any Issues should be picked up at the annual ARCP and not identified at the last minute. Information on the process has been sent out to trainers and trainees.
In response to a query PC confirmed that an individual with a CCT in February would not be required to revalidate in January and then again in February as the Responsible Officer will have the option to defer. The Responsible Officer will have 3 options – to tell GMC there was no issue/non-engagement/ or to seek deferral for a number of reasons. As soon as individuals revalidated the clock will be re-set for the next 5 years whether they were in training or not.
10. / Recruitment update
10.1 / GP
The Stage 3 selection centre has taken place. There was an improvement in the standard of Stage 2 machine market testing and those involved in the recruitment process noted a higher quality of candidates at Stage 3. 289 candidates were interviewed for 298 posts with a Round 2 in May however the quality of applicants was generally higher. Preferences have been matched and offers will be made by 27 February – information on fills/gaps will be available soon.
Numbers were slightly up from last year although still below what they would wish. The recruitment ratio in Scotland was 1.5 – about average for the UK.
10.2 / Public Health
JC attended the 2 days of selection held in Loughborough. 77 places were advertised UK and 190 applications received and 9 were first choice Scotland. It had not been possible to tell from responses which candidates were Medical (6) and non Medical (3). Recruitment went well and results awaited at the end of February.
10.3 / Occupational Medicine
There were 4 vacancies of which they will recruit to 3 via SMT (2 posts in NoS; one in WoS) with one post lying fallow for a year. Shortlisting will be online and interviews be held on 20 April in Falkirk.
Previously national recruitment was not favoured however it was now felt it could be preferable.
11. / Updates
11.1 / Specialty updates
·  GP
DB highlighted:
·  Discussion of role of NES in GP Appraisal system following a complaint. Clarified Health Boards employed appraisers and the NES role was to quality assure training. A paper will be brought to the STB for its next meeting.
·  CPD: desire to establish a national strategic role for GP and a short life working group has been established to take this forward.
·  Remediation of trainees for whom CSA result will not be available by end of remedial contract. Individuals will be given an Outcome 4 delayed to the end of the remediation period.
Public Health and Occupational Medicine
No additional updates were received.
Action:
·  Paper on NES role in GP Appraisal to be discussed at April meeting.
11.2 / Liaison Dean update
PC highlighted:
·  HEE will go live in April; as yet no final budget was agreed. 13 Local Education and Training Boards (LETBs) will be established replacing PG Deaneries and staff will transfer via TUPE. There will be a PG Dean role in each accountable to Directors of Educational Quality who will not necessarily be Medical personnel. This could be an issue for GMC. The London Deanery will be divided into three. Overall this was a significant change in the way PGME was organised and delivery. HEE was already assuming a UK wide role eg MDRS system. Project Managers were appointed for this and attended the recent COPMeD conference. The PG Deans were assured MDRS would not be MTAS Mark 2 however HEE has already gone out to tender for the electronic UK recruitment and offers process for August 2014. There was devolved authority representation on the HEE Governance Board; the work of HEE will impact on NES. PG Deanery systems in Northern Ireland and Wales were also under review.
·  NES was working on the Medical Vision with the aim of moving to a single managed system.
·  Shape of Training review. Consistent themes were emerging ie generalism v specialism; flexibility for training especially in early years; flexibility of stepping in/out of training for service experience or other reasons; education pressures. Professor Greenaway attended and answered questions at the COPMeD conference. However there were increasing concerns as to who will action the report when it was published. Foundation training was a major issue and August 2013 will see the first impact of the increase in medical school numbers in England. Previously all UK graduates were placed however Foundation placements were open to EEA applicants and this year it was estimated there will be 160 excess UK graduates and up to 400 excess per year over the next few years. Extra places were being created in F1 this year but this was a short term measure so alternative solutions were being sought. It was proposed to abolish F1 for 2014 and to establish 6 years of UG training with the final year funded as a bursary and to incorporate F2 into early years’ core training. This was seen as an affordable solution and would solve the EEA problem however the curriculum would have to be amended and GMC approval would be required. There would also be a service impact as medical students were not able to undertake various procedures. Many unanswered questions remained eg whether this would apply to Medical Schools already doing 6 years training.
·  GMC standards for education and training 2014: to discuss as an agenda item at the April meeting.
·  National IDT process: this will change from April to a national process run by the London Deanery with 2 application windows per year. It was likely IDTs will become less flexible and there could be an increase in ad hoc decisions made at the Dean’s discretion for special/exceptional circumstances which could not wait until the next application window.
·  Recruitment to training posts in Scotland: some specialties were finding it difficult to fill posts. This year 4 NES representatives attended the BMJ Careers Fair in London and saw how much effort was put in by other Deaneries. Professor McLellan was leading on a more proactive Scottish approach in Scotland via the START Alliance which will be launched at the PGME Conference on 30 April.
Action:
·  To discuss GMC standards for education and training 2014 at the April meeting.
11.3 / Service update
The main issue was the GMS contract which was moving to a more Scottish version; it will be interesting to see if this impacted on Scottish recruitment. Anecdotally it was becoming increasingly difficult to fill consultant posts in Scotland.
11.4
11.5 / Academic update
DME update
No update reports were received.
11.6 / Trainee update
SM noted the email about revalidation was well received. The main issue for trainees was the GP trainee contract and its impact on pay. Trainees received a base salary plus banding dependent on the number of hours worked. DB said this has been discussed over a number of years and the GP supplement remained high while other bandings changed. The BMA will have a view on the issue.
11.7 / Lay representative update
IL reported his comments regarding the selection day for lay assessors were answered by the second session where there was time allocated to discuss individual cases. The second session had also included GP assessors and it had been beneficial to hear their comments; he felt it was good to have a mixed group. RM will feedback these comments to Dr McLeay.
Action:
·  RM to feedback IL’s comments to Dr McLeay.
12. / AOB
No other business was raised.
13. / Date of next meeting
The next meeting will take place at 1.30 pm on Wednesday 24 April 2013 in Room 5, Westport, Edinburgh (VC available).

Actions arising from the meeting

Item no / Item name / Action / Who
3. / STB membership:
Occupational Medicine representative / To seek a second Occupational Medicine representative. / ALe
6. / GP returners and induction policy update / To produce paper for STB meeting in April. / ALi
8. / NES Post CCT Fellowships / Agenda item for April meeting. / RM/HM
11.
11.1 / Updates
Specialty updates / Paper on NES role in GP Appraisal to be discussed at April meeting. / RM/HM
11.2 / Liaison Dean update / To discuss GMC standards for education and training 2014 at the April meeting. / RM/HM
11.7 / Lay representative update / To feedback IL’s comments to Dr McLeay. / RM

2