The Royal College of Anaesthetists Educating, Training and Setting Standards for Anaesthesia, Critical Care and Pain Medicine

Transcription

1 The Royal College of Anaesthetists Educating, Training and Setting Standards for Anaesthesia, Critical Care and Pain Medicine ADVISORY BOARD FOR NORTHERN IRELAND MINUTES Chairman: Dr JR Darling Ulster Hospital Belfast BT16 1RH N. Ireland, UK Meeting held on Tuesday 4 th October 2011at 3 pm in the Boardroom, NIMDTA, Beechill House, 42 Beechill Road, Belfast BT8 7RL Present: Dr JR Darling (Chairman) Dr Pete Nightingale Ms Sharon Drake Dr Darrell Lowry Dr Clive Stanley Mr Sidney Ewing Dr C Hawe Dr M Bill Dr Conn Russell Dr K Kelly In attendance: Miss Deborah Rowlanes 1. Apologies Apologies were received from Dr Kieran Fitzpatrick and Dr Ken Lowry. 2. Minutes of last meeting The minutes from the meeting held on 8 th April 2011 were agreed as an accurate record with the following amendments being noted: Northern Irish Trainees should remain in Training wording needs to be amended. Ms Drake provided an update to the board on item 5.1 of the minutes and confirmed that the CPD approval charge of 50 + VAT has been abolished. It was confirmed that all regional and local courses can still be approved by a Regional Advisor. Dr Stanley noted that the system was working well. Dr Darling updated the board on item 4.2 of the minutes and confirmed that since the last Board meeting the 2011 round of Clinical Excellence Awards for Northern Ireland had been cancelled. 3. President s Business The President stated that the list for England and Wales had been published with an overall number of higher awards set at just under 200 compared to 300 in Anaesthetists had fared poorly with just 6% of the total awards. He confirmed that he was waiting for an update on what is going to happen with the current process. He noted that although there is a need for clarity from Nicola Sturgent, and the date of publication is still to be confirmed, there is likely to be around 300 gold and silver awards which will result in the bar being set very high for

2 He confirmed that Scotland have stopped the higher and lower awards, England have suspended the current round of ACCS and Northern Ireland have already closed for 2011 and is now waiting for a report for a suggested way forward. Dr Darling pointed out that if Clinical Excellence Awards were removed entirely that this would cause major problems motivating Consultants to take part in Education. Dr Nightingale noted that in England and Wales, education and training which is delivered locally receives 5billion. It is essential for the Regional Health Authorities to access these funds in order to fund education providers. The current framework is under review during the autumn we should know more by Christmas. He informed the board that he will shortly be attending a meeting at the Academy of Medical Royal Colleges and will check that this has been placed on the agenda so they can discuss how College Officials can be released for national curriculum exam and professional standards setting duties. The President informed the Board that this is his last year as President and that Dr J-P van Besouw and Professor Robert Sneyd are the Vice-Presidents of the College. 4. Chairman s Business i. Training Standards for those who assist anaesthetists Following the recent visit to the Multi-professional Anaesthetic Assistants Development Group (SMAAD) in May 2011 and the recent concerns raised by Professor Fee at the last Board meeting, Dr Darling noted that there is a definite need to ensure Northern Ireland prepare an effective strategy for training standards for anaesthetic assistants and produce a suitable model which will work best for Northern Ireland s assistants. It was noted that Northern Ireland face several disadvantages compared to Scottish colleagues as it is: 1) Smaller in size 2) Does not have a regional educational support structure in place compared to the NHS Education for Scotland 3) Only now addressing this when there are significant financial constraints on healthcare and education. However, it was noted that there are definite advantages to proceed with this initiative as Northern Ireland is: 1) Small enough so assessments could be more tightly controlled 2) Using a platform which is already working for Scotland could prove useful. Several means of accessing training were discussed and a number of problems were highlighted, such as the difference in pay scales between ODPs and nurses, the length of time spent in training and difference in routes taken to get to the same position Dr Nightingale stated that he would support this initiative and suggested that support may also be found in the Regional Quality Improvement Agency and the Patient Safety Forum. Dr Darling agreed to meet with these Groups to try and move this situation on. Dr Nightingale stated the need for a phased approach and a grandfathering/equivalence route for anaesthetic assistants, the approval process could be led by Consultants or the anaesthetic assistants could be assessed by nurse trainers to a national level. There could be the award of an in-house certificate to say the assistant had achieved appropriate competencies. He also suggested that the Board look to see whether the Association of Peri-operative Physicians had a position statement on this subject. 2

3 ii. Core Topics Day, October 2012, Belfast Dr Darling confirmed that the 2011 programme was put together to provide a variation of topics that are not necessarily covered within Trusts. He confirmed that for 2011 delegates numbers are down due to delegates wanting to register on the day, and he would use the day as a gauge as to whether a Core Topics day should be run again in The re-design of the College website and an online booking system in place for 2012 would also help delegate registrations. Dr Darling noted that there would be 7 trade exhibitors on the day representing various companies. He confirmed that from informal feedback for a regional meeting the trade fee of 900 inclusive of VAT is set too high. He suggested that the College should look into this matter for future meetings as trade stands are a real draw for delegates to attend. Ms Drake suggested that for 2012 there should be trainee poster presentations as this is another pull in getting consultants and trainees to attend the meeting. This was supported by the Board and Dr Darling confirmed that he would speak to Dr Martin Shields on this matter. It was suggested that Wednesday 3 rd October 2012 would be a suitable date for the next Core Topics Day and room availability and clashes with other meetings and events should be checked to ensure that this a suitable date for the meeting to take place. Dr Stanley thanked Dr Darling on behalf of the Board for organising the 2011 meeting. iii. Clinical Excellence Awards 2011 Round Dr Darling confirmed that he has provided written feedback to the Department of Health, and he briefed the board as to what he had included. He stated that the current system has several flaws and noted that many anaesthetists are being penalised for giving their time for supporting training, education and exams. It was noted that due to recent pension changes, doctors gaining higher awards may be penalised and the awards may result in a financial liability. It was also noted that the suspension of lower awards in Northern Ireland meant that fewer doctors would have enough points to apply for higher awards. Dr Nightingale asked Dr Darling to forward a copy of his feedback to the DH on Clinical Excellence Awards for his records. iv. Irish Fellowship examinations and UK CCT Dr Darling confirmed that the GMC are not going to recognise the Irish Fellowship and confirmed that there had been a conscious effort to pull together a working group to continue reciprocation with the Irish College. Dr Darling stated that a lot of work had gone into this proposal and it had been given a good hearing by Mr Nial Dickson, Chief Executive of the GMC who was aware that both CCTs were sound He confirmed that there had been general support from Dublin and Kevin Carson had notified the RCoA that deadlines for mapping to the CCT would be missed. The consensus was that both Colleges had developing curricula and that it may be possible to map one onto the other at a particular time-point, but it would be impossible for changes to both Colleges to satisfy the changing stipulations of the UK and Irish Regulators. It was also noted that the Irish regulators would have to accept UK exam changes. Dr Stanley agreed that new stipulations from the Irish Medical Council would make it impossible to run both CCTs together. All agreed that the failure to maintain the linkage between the Colleges would be a loss to both institutions but was unavoidable. 3

4 v. Out of hours operating Dr Darling in his capacity as Clinical Director and Council Member fed back to the board that there had been a lot of internet traffic about out of hours operating and noted that that there are concerns at the College that there is little supervision and trainees should not be left alone and consultants should definitely oversee trainees working outside normal hours. Dr Carolyn Evans is currently addressing this and has sent a draft to Dr Nightingale reporting on this matter, highlighting that elective lists at night should have a full 24 hour service with a consultant available at all times. There is also pressure to move this forward and use theatres for longer. vi. Constitution of NIAB Dr Darling asked if all present were happy with the present constitution of the Committee. It was decided that, if input from others was required, it would be possible to co-opt on a temporary basis. Advisers Business (i) RA: Manpower On behalf of the trainees, Dr Stanley reported to the Board that a gap in manpower continues to be a problem for Trusts. The reason for these gaps is due to maternity/ paternity leave and research posts. Since August 2011, his Trust has had a full composition of trainees with one exception; although he is unclear as to how many will depart in future months which will be a problem as the Trust will not recruit any more staff. He noted that there is a higher proportion of female applicants so planning for gaps throughout the year is essential. He asked the Board if consideration of re-banding rotas would be an option as Trusts experience these issues in cycles every few years, especially as not everyone will get a consultant post. Dr Nightingale confirmed that he is disappointed with the Centre for Workforce and suggested there was a need for clarity as developments on career structure are still being addressed. Dr Nightingale confirmed his attendance at the BMA/ DH meeting on the 10 th October where this matter will be discussed further. National recruitment was discussed and the Dr Stanley noted that this year there has been a recruitment of 8 CT1s, which have all been outstanding. He confirmed that the interview process worked well and will be used again with some minor changes. He noted the downside to the process was Scottish applicants had been interviewed here in Northern Ireland and had obtained interview practice but resulted in fewer places for locals from Northern Ireland. Dr Nightingale confirmed that there is worry on the horizon as two or three other Colleges (Obstetrics and Gynaecology and Physicians) are both unhappy with the rolling out of the programme. Dr Lowry updated the Board and confirmed that e-portfolio had been rolled out as a pilot scheme in Northern Ireland and at the moment there was still a mix of paper and electronic systems in place. It was confirmed that the 2007 trainees can finish in paper format. On behalf of Mr Bryant, Ms Drake thanked Dr Lowry and the Northern Ireland Board for piloting the e- portfolio system. (ii) RA Intensive Care Medicine Dr Conn Russell was welcomed to the board as RA representative for ICM following the departure of Dr Paul Glover. Dr Russell confirmed that the new curriculum will commence in August 2012 and the deadline for registering interest is January Trainees from Core/ACCS will be appointed to ST3 4

5 level single CCT programme but questioned how trainees will be appointed to enter at ST3 and be able to progress.. Dr Russell confirmed that Northern Ireland would not participate in the next round of National recruitment in August 2012 and confirmed that the future is unclear amongst the current RAs who feel that it will be impossible to police due to different entry backgrounds. Dr Russell noted that within core medicine and ACCS they are still another year away. Dr Stanley raised concern that they would still not be able to deliver a programme by August Dr Nightingale confirmed that although time was tight this is a UK wide issue and confirmed that there had been a teleconference between the Deans to discuss this matter. 3. College of Anaesthetists of Ireland Due to Dr K Lowry not being able to attend this item was not discussed. 4. SAS Representative Business Dr Kelly insisted that there were still some outstanding issues with the new contract and that some doctors who had changed post could lose out due to altered terms and conditions. Dr Darling stated that there was little that the Board could do about this and it was up to the individual to contact the BMA. He went on to say that one of the problems from a CD perspective was that Specialist Doctors were very expensive when used to cover on-call as a 16 hour night worked out at more than 5 sessions. Dr Kelly went on to state that she had not held a training day in 2011 due to logistical issues. She planned a Training Day in Dr Darling offered assistance in organising this.. 5. Trainee Representative Business Dr Hawe reported that the system which was put in place last year for the University Tutors had been a success. The Tutors now had better supervision than before and their teaching had a better structure. Dr Stanley agreed that things were much better this year and thanked Caroline for her personal efforts in achieving this improvement. Dr Hawe reported that trainees found that the e-portfolio was a useful resource and had encouraged trainees to use it where possible. Ms Drake confirmed that e-learning system is a good resource tool and there should be links to ensure that people can use it. 6. Lay member s business Mr Ewing reported that there are now 11 lay members on various College Boards and Committees to allow for much more lay representation. He noted that he now sits on the Equivalence and Training Committees. He noted EWTR implications for training and wider staffing needs. He confirmed that with the new College website there is now a section on patient safety issues and we will now be able to get patient information on anaesthetics out there more easily. He noted that there will be a forthcoming London exhibition taking place which would be a good opportunity for publicity on anaesthetics. Dr Ewing confirmed on behalf of the Welsh Advisory Board that implied consent for organ donation is still on the cards and looks like proceeding towards enabling legislation. 7. Any other Business: Dr Bill updated the Board and confirmed that several hospitals have cover by trainees with consultants who live in and noted that there are implications with this. She confirmed that consultants are not being provided with study leave and expenses to attend meetings. However, with this in mind the AAGBI provide very good online video links to lecture slides so material is now available to those that are unable to attend. Ms Drake also confirmed that the College is preparing a lecture capture system which will be tested over the next few months which will also provide learning material. 5

6 Dr Bill stated that applications for Founding Fellowship of the Faculty of Intensive Care Medicine are for UK Fellows only. It was felt that Irish Fellows would be able to join through assessment after the 1 st January Dr Nightingale informed the Board that the Welsh Specialty Advisory Committee have merged with the Welsh Advisory Board from the 1 st December Dr Darling stated that he felt it would beneficial if a similar arrangement took place in Northern Ireland. 8. Date of the next Meeting Tuesday 24 th April 2012 from 3pm 6