Paper 1
NHS Education for Scotland
Minutes of the Mental Health Specialty Training Board meeting
held on 16 June 2014, at 10.30am, in Room 5, Westport, Edinburgh
Present: Susan Miller (SM) Chair, Roger Blake (RB), David Brown (DB), John Crichton (JCr), Alex Keith (AK), Seamus McNulty (SMcN), Jane Naismith (JN), Norman Nuttall (NN), Rowan Parks (RP), Rhiannon Pugh (RPu), John Russell (JR), Chris Sheridan (CS), John Taylor (JT), Carol Wilson (CW).
Videoconference: Richard Athawes (RA), Margaret Bremner (MB), Sally Winning (SW)
Apologies:Euan Easton (EE), Helen Goode (HG), Stephen Lawrie (SL), Robin McGilp (RMcG), Jackie Picket (JP) and Judy Thomson (JTh).
In attendance: Arturo Langa, Stephen Robertson – SPSP presentation only. Paola Solar (PS)
- Apologies and welcome
The apologies were read and Professor Arturo Langa and Mr Stephen Robertson, Healthcare Improvement Scotland, were welcomed.
- Notification of AOB
There was no notification of AOB.
- SPSP – Mental Health, training opportunities
Prof Langa gave a short presentation on the work of HIS on Scottish Patient Safety Programme for Mental Health.
This four year programme is hosted by HIS and supported by NES. It started in 2012 and almost all Health Boards agreed to participate.
After the first testing it was clear that the most influential factors for implementation were applicability, complexity and resources in the ward.
The work is divided in workstreams, which are managed by national development teams.
Prof Langa pointed out that Scotland is ahead of the rest of the UK in this work.
Trainees are offered an opportunity to engage either full or part time in placements of 3-6 months.
After some discussion the group agreed that this is an excellent opportunity for trainees. It could be used for the special clinical interest session. Or the trainee could request a 12 month OOP, with PG Dean’s approval.
There are SPSP Fellows in other specialties and Prof Langa was asked to obtain more information about them. The group will then alert Psychiatry trainees to this training opportunity.
- Minutes of the meeting held on 28 April 2014
The minutes of the previous meeting were approved as a correct record.
- Matters arising
- Learning Disabilities Psychiatry – update
The group noted that the new name of the specialty was Intellectual Disabilities.
The closing date for applications for the new TPD was today.
5.2.Shape of Training – update
MB had attended a meeting in London on 5 June which had felt very positive although it was a small group. They had all assumed that the Shape of Training recommendations would go ahead although there is no official confirmation yet.
At that meeting it had been agreed that Psychiatry training would be no less than 6 years, and that Core Training would expand to include GP, General Medicine and Paediatrics. It is also envisaged that higher training might be divided into an adult stream and a child stream. There were no formal proposals yet and if there were any they would have to go to the Faculty Executive first for approval.
RP confirmed that although there is no ministerial statement yet, there is a lot of background work alreadytaking place. It was also confirmed that higher specialist components would very likely be taken out of the curriculum and put into credentialing. SW noted that at a recent meeting she attended with a GMC representative it was clear that Shape of Training would hinge on credentialing, but there is no provision of funding for it from the Service. The costs of credentialing would fall to the individual doctors. SW was asked to circulate the notes of this meeting to the group.
Action: SW
It will all depend on what is put into the curriculum and what is added to credentialing. MB will send out the minutes of the 5 June meeting as well, so that the group have a basis for discussion.
Action: MB
RP further noted that a Scottish Government level Working Group will be created to take SoT forward, so a small Mental Health working group to inform it would be supported by NES and MDET. SM will seek expressions of interest to be part of the small working group.
Action: SM
5.3.Handover and consultant presence at weekends
This issue had come up after visits to the West of Scotland where it was clear that there was no consultant presence at weekends. The East and the South East do not have this issue. The West and North have a consultant available over the phone in the first instance, but things are changing slowly. The Service is happy that this is safe and trainers have not expressed any concerns.
5.4.AMP Training
Item deferred to next meeting.
5.5.New Consultants College group
The College was taking this forward. There had been a nomination for a lead on the First Five Years.
- 2014 Recruitment – fill rate
JR thanked all those involved in the ST4 interviews in April and May. They had received lots of feedback both from trainees and interviewers and the UK Recruitment Board had taken them on board. Some of the changes agreed for the October recruitment were: longer breaks, regular wash-ups, more interviewers, interviews onlyin Manchester and trainees will have only 2 options to choose from.
The fill rates in Scotland were very disappointing but in line with the rest of the UK: Forensic Psychiatry 2 out of 4, General Adult Psychiatry 6 out of 34, Old Age 7 out of 10, CAP 5 out of 13, Intellectual Disabilities 1 out of 9, and Psychotherapy 2 out of 4. In total Scotland had recruited 23 out of 74 vacancies. There will be no clearing and no Round 2, so the rest will be advertised as LATs.
The specialties and regions with more issues are Intellectual Disabilities and General Adult Psychiatry, and the North and East of Scotland.
It was noted that there had been many candidates deemed unappointable, possibly due to not having shortlisting this year.
RP confirmed that the Scottish Government is now very aware of this serious issue thanks to Stewart Irvine’s table of fill rates. Core Psychiatry has recruited well but the specialties will have to wait 2-3 years to see the benefits.
MB reported that she had partially drafted a survey aimed to ST4 trainees to see why they had chosen their specialties. The group agreed that it would be extremely useful to send a similar survey before the end of July, from the STB, to find out CT3 trainees’ intentions.
Action: MB
A number of expansion Foundation posts in the last couple of years had been placed in Psychiatry and Community Care. The overall exposure in Scottish Foundation to Psychiatry is currently 27%, whilst in England is 44%. Foundation has accepted that it is not high enough and they are working to increase it.
About 60-65% of students in the Scottish Medical Schools are from Scottish origin and there is a Government plan to increase that number, but this will be a longer term solution.
There is also some ongoing work to increase exposure to CAP and Intellectual Disabilities during Core Training.
There is evidence that dual training is a popular choice in England, so Scotland will also do some work to provide this option to trainees. This will be taken to MDET for approval.
Action: SM
It was suggested that a College-run course to help trainees get through the interviews process might also be helpful. CW will take it up with the RCPsy.
Action: CW
A few more feedback points from the interviewers were given to JR:
- The middle question about careers aspirations gives very little difference between trainees so it could be changed to a question more specialty specific.
- To give a presentation rather than a portfolio.
- More input from the Forensic Psychiatry Executive at the communication skills station.
A CT1 ranking issue was reported: if a trainee is ranked high they get their choice of region, but once they are appointed to the programme the TPD decides their placement. Due to national recruitment, the TPD has less information about the trainee’s preferences so it is an issue difficult to address.
- Proposal for forensic Psychotherapy Specialty Training
The group supported the proposal distributed by JCr. SM will send it to MDET for approval at their July meeting. JCr will start working with the GMC for their approval.
Action: SM / JCr
- Dual training
The paper was for information as this has been taken to Heads of School.
It was noted that although it is possible to drop one of the specialties in dual training, if done in 2+3 years for example, this is not encouraged and it would need PG Dean’s approval.
- Workforce
This item was covered above.
- Recognition of trainers – time tariff
The papers had been distributed for information, noting that paper 5c only applies to England.
The list of Educational and Clinical Supervisors needs to be completed by 31 July 2014, and all those in the list fully approved by the GMC by 31 July 2016. It is crucial that these roles are recognised in job plans.
The agreed time tariff was 0.25 per trainee per week both for ES and CS.
SW noted that the GMC recognises SAS doctors as Educational Supervisors but the RCPsy is the only College who does not. This has been raised at the Heads of Schools before and SM will take it up again, with a suggestion to pilot it in Scotland.
Action: SW
- Quality – CASC results
SM had distributed these for information, to compare results by deanery and with the average in the UK.
Good results here could be a good selling point for the Scottish Careers Fair, as well as the good feedback received by Scottish Psychiatry training from the NTS.
- ARCP
The team is in the middle of ARCPs. EPortfolio has been dropped as it is too slow on the day, and instead the ES is presenting the trainee. This is working very well although it means more preparation work for the ES.
Trainees have been emailed regarding what to do about Outcome 5.
- Scottish Careers Fair – 20 September 2014
The date is not ideal for Psychiatry as it is right after the College Postgraduate Education and Training in London. AK has a list of Trainee Ambassadors interested in participating on this. He will forward it to PS.
Action: AK
It was agreed that apart from trainees, it would be good to have enthusiastic trainers and TPDs. RPu will take to the Local Training Committees to find appropriate people.
Action: RPu
The Colleges will have their own stalls so College reps will have to make sure that they are not double-booked.
SM and RPu will write something about quality for a leaflet/poster, highlighting the good results in tests and NTS feedback.
Action: SM / RPu
If anyone else has ideas, please send them to SM.
Action: All
- Heads of School
The notes of the HoS meeting had been circulated. HEE had been asked to provide evidence of future supply and demand in Psychiatry.
There were a few points discussed at the ETSC:
- Lots of discussion about Shape of Training.
- Academic training requesting endorsement in liaison. It has been agreed by the College that academic trainees may be able to gain competencies for liaison endorsement in less than 12 months wte.This is not the case for other trainees,eg flexible trainees,where rigid time criteria apply as well as competencies. There was a lot of discussion and concern at this apparentinconsistency.
- Detailed guidance for OOP applicants will be provided.
- The GMC has confirmed that there will not be an exit exam.
- OOH Survey presentation. Too focused on going to A&E but Psychiatry has other ways for trainees to obtain Emergency exposure.
- Updates
- Liaison Dean / MDET update
RP noted that next year’s Scottish Medical Education Conference will be held over 2 days, on 27 and 28 April 2015, at the EICC.
15.2.Region and Specialty updates
This was covered above.
15.3.College update
This was covered above.
15.4.Service update
This was covered above.
15.5.Academic update
SM read the Academic report sent by SL. PsySTAR trainees are doing well, there will only be one place to fill which will be advertised in the autumn.
15.6.Regional Planning update
This was covered above.
15.7.Trainee/specialty Doctor update
SW noted that they were about to recruit 6 new people.
15.8.STARG
There was no representative for STARG.
- Received for information
No other papers had been received for information.
- AOB
There were no other businesses.
- Date of next meeting
Monday 8 September – Rooms 1&2, 2 Central Quay, Glasgow
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