Health Education East Midlands. Fellowship Prospectus

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1 Health Education East Midlands Fellowship Prospectus

2 Contents Introduction FAQs about Fellowships Fellowships in Quality Improvement Frailty Service Development Fellowships in Medical Education Fellowships in Medical Leadership and Management Health Education East Midlands Fellowship Prospectus Health Education East Midlands aspires to excellence in medical training and provides flexible and innovative placements to help our trainees develop the competencies and confidence they need for the future

3 Introduction Our purpose is to develop a high quality workforce to meet the healthcare needs of the people of the East Midlands. We do this through commissioning and delivering high quality education and training. Health Education East Midlands (HEEM) aspires to excellence in medical training and provides flexible and innovative placements to help our trainees develop the competencies and confidence they need for the future. The Shape of Training Review published in 2014 recommends that, during their postgraduate training, doctors should be given opportunities to spend up to a year working in a related specialty or undertaking education or medical leadership and management work. The HEEM Fellowship Programme is designed to afford doctors in training in the East Midlands a range of development opportunities that are fully integrated with their clinical training. HEEM fellows can also obtain a Post Graduate Qualification and additional competencies beyond their specialty curriculum. HEEM has supported the provision of diverse fellowship opportunities as have many of the Trusts in the East Midlands. From 2015 HEEM will expand the range of Fellowships offered across training programmes in the East Midlands focussing on different areas of development. These include: Medical Education and Medical Leadership and Management Programme: Development of HEEM academic pathways for both 1 and 2 year fellowship opportunities intercalated with clinical training and opportunity to gain a higher qualification in the course of the fellowship. Quality Improvement Fellowship Programme: The introduction of a network of 1 year Quality Improvement Fellowships for medical trainees working across the East Midlands. Local Education Providers will host the Fellows, identifying a sponsor (Medical /Clinical Director or Chief Executive level) who will provide an initial shadowing period, ongoing support and mentoring throughout the course of the Fellowship including identification of a suitable trust quality improvement project. The projects should focus on high quality care for older people including those with dementia, reducing avoidable admissions and preventing unnecessary hospital stays and embedding the NHS values. Trainees will work towards a higher qualification in the course of the Fellowship. Quality Improvement Fellows will be working at CT/ST2 or above and progressing satisfactorily through specialty training. Quality Improvement Fellows will continue in specialty training for 50% of their time during the 12 month period and work as a QI Fellow for the remaining 50% of the time. Frailty for specialties aligned specifically to improve the quality of training in health care of the elderly for a wide range of specialty programmes. Better training for doctors in the care of older patients with multiple co morbidities will improve patient outcomes. These 1 year clinical fellowships will be created for trainees who have completed core training and wish to develop enhanced competencies in the care of older people before entering higher specialty training or 1 year Out of Programme (OOP) opportunities for NTN holders to equip these doctors to care more effectively for an ageing population. Specific development opportunities in Psychiatry and Emergency Medicine: HEEM will work with the Specialty Schools and Local Education Providers to identify and develop innovative opportunities to attract, retain and develop trainees working in these hard to recruit programmes. There are a range of possible fellowships to be supported to strengthen these programmes to include a regional network of Undergraduate and Postgraduate Teaching fellowships in Psychiatry, specific innovative fellowships for post CCT GP training in mental health, opportunities for specialty trainees in psychiatry for OOP in region to include Emergency and Liaison Psychiatry, Neurodevelopmental Psychiatry, Primary Mental healthcare and Eating Disorders. For Emergency Medicine a programme of Intercalated Fellowships for Emergency Medicine will be developed as well as a pre ACCS training programme for those doctors who may wish to explore working in Emergency Medicine after Foundation Training to inform their future career intentions. Post CCT training: Training may be required post CCT to develop doctors with specific capabilities to meet a future medical workforce need in the East Midlands. Some of the post CCT opportunities in development include a post CCT Fellow in Heart Failure and Palliative Medicine for a CCT holder in cardiology; this post will improve both training in the community for both GP and secondary care trainees in cardiology. HEEM are working to develop a post CCT Fellowship for a GP CCT holder in Pre Hospital Emergency Medicine in Lincolnshire. Out of Programme opportunities (OOP): to develop competencies in a sub specialty outside an individual specialty training programme; for example additional clinical experience in Intensive Care Medicine and Anaesthesia for the Elderly in Anaesthetics. Such opportunities have the potential strengthen training programmes and to attract trainees to the East Midlands. 1 year Post CCT GP opportunities: to develop the future GP workforce to acquire additional clinical, leadership and academic competencies to support delivery of the aspirations articulated by NHS England in its 5 Year Forward view. HEEM are in the process of developing an investment plan to ensure these innovative fellowship opportunities will become widely available for trainees from 2015/16. I have included details of the achievements of a cadre of trainees working across the region currently supported by HEEM in a range of Fellowship learning opportunities. These doctors have been given the opportunity to maintain their clinical skills whilst working towards a further qualification. This work is designed to develop a future medical workforce that is responsive to a rapidly changing clinical environment in the East Midlands. Introduction For forthcoming opportunities visit the Health Education East Midlands website, If you have any questions please HEEM.SpecialtyLiaison@nhs.net Dr Ann Boyle Associate Postgraduate Dean, Health Education East Midlands 04 05

4 What trainees will be eligible for Fellowship opportunities? Fellowships will be developed for trainees at all stages of the continuum of postgraduate medical training. Eligible trainees will be working and training in the East Midlands after successful completion of a 2 year Foundation Programme from 2015/16. There will be a range of opportunities - post Foundation, after completion of Core Specialty Training in uncoupled specialties and for those trainees working at ST3/4 and above. Post CCT Fellowships will be developed where there is an identified future workforce requirement for the region. Trainees will need to be making satisfactory educational progression at ARCP to be considered for a Fellowship opportunity. What benefits do Fellowship opportunities provide for trainees? All doctors in the course of completing specialty training will develop generic competencies in teaching others and management and leadership. Some trainees may wish to acquire additional experience and achievements at different points in their postgraduate training to help inform their future career intentions and to support their professional development. A range of HEEM Fellowship opportunities will be introduced as a phased development throughout the postgraduate medical training pathway from 2015/16. FAQs about Fellowships FAQs about Fellowships Some of these opportunities will prepare doctors in training for future leadership roles in clinical services and medical education as well as the opportunity to spend time working in a related clinical specialty outside of your CCT programme. Many of the Fellowships will be intercalated with existing clinical training programmes. HEEM hopes that these opportunities will help to attract and retain the most talented doctors to live and work in the region up to and beyond CCT. What benefits do Fellowship opportunities provide for NHS Trusts? Doctors have a direct and far reaching impact on patient experience and outcomes and an intrinsic leadership role within healthcare services. The contribution to doctors in training to improvement in the quality of healthcare services has been articulated in the Francis and Berwick reports. Hosting HEEM Fellowships will ensure that the NHS Trusts in the region are able to contribute to the development of a future high quality workforce with the capability to lead service transformation. The development of our future medical leaders requires a strategic and proactive approach beyond the award of a CCT. Fellowship pathways which will promote the retention and development of talented young doctors. This will attract high quality trainees to live and work in the region. Such investment will improve patient care in the immediate and longer term in all NHS organisations in the East Midlands. Doctors have a direct and far reaching impact on patient experience and outcomes and an intrinsic leadership role within healthcare services

5 Fellowships in Quality Improvement These 1 year fellowships have afforded trainees in both core and higher specialty training an opportunity to gain more experience of NHS leadership and management whilst completing a Quality Improvement project and a Post Graduate Certificate working either 50:50 or 75:25 split between clinical and academic work. Such Fellowships allow trainees an opportunity to have an enhanced experience of NHS leadership and quality improvement beyond the generic training as outlined in their specialty curricula. A 1 year HEEM Leadership and Quality Improvement Fellowship is a building block for those doctors who may wish to continue to develop these capabilities with an additional 1 year fellowship and further qualification in Medical Leadership and Management or Quality Improvement and Patient Safety. Frailty Charlotte Messer Old Age Psychiatry 1 year Quality Improvement Fellowship Postgraduate Certificate in Leadership and Quality Improvement Host NHS Trust: Leicestershire Partnership My project consisted of my role in the implementation of Electronic Patient Records (RiO) into Leicestershire Partnership NHS Trust. I was initially on the Project Board that introduced RiO and I then became (and remain) the Chair of the Rio Operational Management Group (ROMG). I also explored concepts such as emotional intelligence - which is composed of five components and people who possess these characteristics are more likely to be successful in senior management: I was able to reflect on my own leadership style and work towards becoming an effective collaborative leader. The NHS is constantly evolving we have signed up for a career that entails life-long learning. An awareness of the processes involved in successfully bringing about change and how to lead a team through it are essential. I have learnt a great deal over the last year and have benefitted enormously from doing this course. It has been a fantastic opportunity to learn more about my personal qualities and how this impacts on my leadership style. Fellowships in Quality Improvement Dr Rebecca Hall General Practice 1 year Quality Improvement Fellowship Postgraduate Certificate in Leadership and Quality Improvement Host NHS Trust: United Lincolnshire Hospitals This fellowship is a 12 month post, but I am already hoping that I will find ways to continue due to how much I have gained from the post in four short months. I am now involved with the team who are looking at re-designing services locally both in the acute care setting and working with the CCGs in Lincolnshire to improve services across primary care as well. The goal is to achieve a pathway for comprehensive geriatric assessment, which is seamless between primary and secondary care. I have managed to get the team in Lincoln linked in to a wider East Midlands Academic Health Science Network team looking at benchmarking quality standards for frailty across the East Midlands. The role has opened up the opportunity to undertake a Postgraduate Certificate in Leadership and Management delivered in Leicester. As part of the QI work in ophthalmology I have been involved in improving the quality standards for cataract surgery, used by CCGs for commissioning purposes, which is looking like it will be adapted for the national standards for the Royal College of Ophthalmologists. The benefits of the role has been a two way process. The consultants have actively enjoyed having a GP perspective in the team. Dr Manda Lam Geriatric Medicine 1 year Quality Improvement Fellowship in Interface Geriatrics Post Graduate Certificate in Leadership and Quality Improvement Host NHS Trust: University Hospitals of Leicester I was involved in service evaluation of a new community hospital service model and also developed a template for discharge correspondence from the Acute Frailty Unit and an Inpatient Nutrition project. I have been able to continue my clinical training for 75 % whilst involved in quality improvement work for 25% of my time. The skills and knowledge I have developed during this post have not only supported my professional development also the trust and patients. The programme afforded me a high degree of 1:1 supervision with opportunities to network with regional and national experts which far exceeded my expectations at the start of the fellowship. I have considered the possibility of building on this fellowship and moving onto a postgraduate diploma or even a Masters level qualification in Medical Leadership and Management

6 Service Development Dr Helen Colver Genitourinary Medicine 1 year Quality Improvement Fellowship Postgraduate Certificate in Leadership and Quality Improvement Host NHS Trust: Staffordshire and Stoke on Trent Partnership and University Hospitals of Leicester The focus of my fellowship is an exploration of the consequences of structural changes to the service as a whole, and the development of a unified pathway for the management of people with genital dermatological problems. I hope to develop a patient pathway which provides high-quality and holistic care to all patients referred with genital skin problems. The Fellowship has provided an opportunity to experience first-hand how the commissioning process works, as well as giving me a greater insight into the logistics of Dr Matthew Critchfield General Adult and Old Age Psychiatry 1 year Quality Improvement Fellowship Postgraduate Certificate in Leadership and Quality Improvement Host NHS Trust: Leicestershire Partnership Part of this qualification is based on my involvement in a quality improvement project over the year of the course. At present my project is in the developmental stage but my focus is the improvement and development of the service provided by Leicestershire Partnership Trust for adults of working age with organic memory problems. The overall long term aim of the project is to identify, develop and refine the care pathway for this group of patients which could potentially mean the development of a new commissioned service. The classroom based teaching that I receive as part of the Post Graduate Certificate and the self-directed learning that goes with this, together with the experience that I will gain embarking on and developing my quality improvement project creating a cohesive and robust pathway for patients with a particular health need. Increasing knowledge and experience of doctors in training in the field of quality improvement is a very positive step for HEEM and the wider NHS. In the present era of a rapidly-evolving health service with significant financial challenges it is essential that front-line staff are involved in quality improvement projects, and that they have the skills both to lead in their area of expertise, and to manage their teams effectively. will help me develop many aspects of leadership and management skills. I will learn about service mapping and report generating using technology and develop my analytical abilities, build on communication and negotiation skills and gain a deeper understanding of how services are developed and commissioned in the NHS. The NHS clearly needs strong clinical leaders who are able to inspire and strive to ensure that the service it provides is as good as it can be for patients. Investing in trainees who are passionate about these goals through leadership fellowships will help ensure that the clinical leaders of the future have the abilities, skills and attributes that will be essential in the modern NHS. Dr Ahmad Navid General Surgery 1 year Quality Improvement Fellowship Host NHS Trust: United Lincolnshire Hospitals I am leading a project on reducing length of stay in acute general surgical patients in Lincolnshire. The Postgraduate certificate complements the quality improvement project well. During the course of the Fellowship I hope to gain additional clinical experience and have already made a smooth transition from SHO to the registrar level working. Academically I am hoping to disseminate my work and gain presentations and publications, The NHS clearly needs strong clinical leaders who are able to inspire and strive to ensure that the service it provides is as good as it can be for patients. learn about management and effective leadership in health care and personally I am becoming a more responsible adult with a clear focus in life. As I have alluded earlier to a wider recognition in the NHS about the need for higher and better quality of care with limited resources, therefore these types of fellowships are good investments not just for the individual but both for HEEM and the wider NHS. In the present era of a rapidly-evolving health service with significant financial challenges it is essential that front-line staff are involved in quality improvement projects, and that they have the skills both to lead in their area of expertise, and to manage their teams effectively. Fellowships in Quality Improvement 10 11

7 Fellowships in Medical Education Fellowships in Medical Education Dr Richard Kitchen Palliative Medicine These fellowships have allowed trainees to build on an interest in Medical Education to provide time to develop advanced competencies in teaching and assessing others, achievements in Academic Medical Education including experience in research and the award of a higher qualification whilst continuing their clinical training. The time spent in medical education work means that the trainee s CCT date has been adjusted. Such a development pathway ensures doctors have the right experience and capabilities to become the future leaders in Medical Education in the East Midlands. 2 year Medical Education Fellowship Host organisation: LOROS Leicester Hospice Charity During this post I have completed a Masters in Medical Education at De Montfort University working 50:50 split between clinical and educational work. During early medical training there is often a focus on quantitative research. It is necessary to have a good knowledge of quantitative processes including randomised control trials as evidence-based medicine plays a big part in clinical decision-making. This post, however, has provided me with complementary skills to this. Through completing a qualitative research project, I have learnt how to carry out such research and about the attributes needed to do this. Dr Nicholas Woodier Medicine and Patient Safety Using the experience gained during the Fellowship I am currently developing PROACTive (Palliative care and clinical Reasoning Online learning intervention for Anaesthetic and surgical Core Trainees). This is an e-learning resource that is based around a series of cases of patients with palliative care needs or who are frail, who have a surgical problem. If the resource proves effective, it could be used to educate core trainees in surgery and anaesthetic throughout the region, and beyond. 2 year Medical Education Fellowship Host organisation: Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust For two days a week I teach undergraduate medical students in Nottingham. This post has allowed me to be innovative with teaching methods that has resulted in achievements which I have been able to present at various national education conferences. I have been involved as an undergraduate examiner and contributed to undergraduate medical curriculum redesign. I have completed my Post Graduate Certificate in Medical Education and am also a member of the Academy of Medical Educators. I am based at the Trent Simulation Centre which has allowed me to be involved with a wealth of simulation research and supervision of students undertaking simulation projects. I have been involved with organising a national simulation conference and have been devising a safety curriculum based on international curricula and input from various experts. EMPSIS - the East Midlands Patient Safety and Improvement Science course is now in the development phase and will be created as an e-resource, face to face and simulation based module. If someone is interested in patient safety as a science and its place in incident analysis and education (particularly simulation) then a post like this is ideal. If someone is interested in patient safety as a science and its place in incident analysis and education (particularly simulation) then a post like this is ideal

8 Fellowships in Medical Education The East Midlands is already a centre with opportunities for trainees and the wider workforce to develop themselves as medical educators. Dr Hayley Andrews General Adult and Old Age Psychiatry 2 year Medical Education Fellowship Host NHS trust: Leicestershire Partnership I have worked 50:50 split between clinical and educational work for the duration of the Fellowship allowing me to work towards a Masters level qualification in Medical Education. In addition to this I have developed an online educational package and to carry out some medical education research specifically relating to mentoring. To date, I have coordinated the development of an online package situated within the HEEM Virtual Learning Environment, which provides the equivalent of what was previously 2 days of face-to-face teaching. I am now working on my thesis project which specifically examines the impact mentoring can have on medical student well-being. In coordination with both HEEM and the University of Leicester, we have now run a study exploring the impact of mentoring on final year medical students well-being in terms of their levels of burnout and resilience. This post has funded my Masters and allowed me the time to study for it, developed my research skills, enabled me to deliver teaching in mentoring and clinical psychiatry and opened some doors which will allow me to continue to develop into a consultant medical educator in the future. Dr Rakesh Patel Renal Medicine NIHR Academic Clinical Lecturer in Medical Education 2 year MD Fellowship Host NHS Trust: University Hospitals of Leicester I received support from HEEM to complete an MD in Medical Education to enable me to progress and develop as a future clinical academic leader as an NIHR ACL trainee. I have developed various learning technologies which mimic real life clinical situations; enabling students and trainees practice clinical diagnostic decisionmaking in a safe environment without the fear of making a mistake. During this lectureship, I would personally like to shape the infrastructure here in the East Midlands for nurturing a cadre of new generation clinical academics from all health and social care backgrounds interested in medical education research. 14 The East Midlands is already a centre with opportunities for trainees and the wider workforce to develop themselves as medical educators. I supervise a number of FY2 academic clinical demonstrators, academic clinical fellows and specialty doctors on out of programme experiences. The aim is to develop the capacity of the workforce to become better educators but also become a centre of excellence for teaching and learning in health professions education. I would like to look back in 10 years time and feel that I was a part of this development. 15

9 Fellowships in Medical Leadership and Management HEEM has supported the development of a 2 year Clinical Leadership and Management Fellowship working 50:50 split between clinical and academic work. This model has allowed trainees to also gain a higher qualification whilst remaining in the region to work and train. To accommodate this, a trainees CCT date is extended by a further year. A 2 year Fellowship programme in Clinical Leadership and Management will be extended to other higher specialty trainees working in a range of specialities and NHS Trusts throughout the East Midlands from These fellowships provide an excellent basis for those wishing to acquire capabilities beyond the generic competencies in leadership and management that all doctors must develop in specialty training. HEEM are committed to developing an Academic Leadership and Medical Management pathway affording those trainees who are keen to develop into future national leaders in NHS Management to gain a Masters level qualification. Dr Sonia Panchal Rheumatology Leadership Clinical Fellow & Programme Lead Health Education East Midlands National Medical Director s Clinical Fellow Academy of Medical Royal Colleges & Health Education England The National Medical Director s Clinical Fellow Scheme provides doctors in training with the unique opportunity to spend one year in a national healthcare-affiliated organisation to develop their skills in leadership, management, strategy, project management and health policy. Being a leadership clinical fellow has given me the opportunity not only to develop my individual leadership style and skills but also shadow and learn from some of the most experienced and influential senior leaders within the NHS. My experiences have enabled me to lead on various national projects which have had direct impact on the clinical environment; develop strong networks and even explore healthcare politics by visiting No. 10 Downing Street to discuss how to empower doctors in training to drive changes for the benefit of patients. I will use the lessons learnt to drive forward the exciting opportunities emerging for medical leadership both through changes in culture and the relevance of leadership to good clinical practice. Dr Marlene Kelbrick General Adult Psychiatry 2 year Clinical Leadership and Management Fellowship During this post I completed a Master s Degree in Translational Research and Management with the University of Leicester. In my clinical role, it has changed my thinking to expand beyond the microenvironment, to be more strategic and visionary within the wider organisational context. I also completed a Post Graduate Certificate in Diabetes with the University of Leicester. Knowledge gained from this course and conducting the translational project, significantly improved the physical health care provided to patients in my clinical setting, a national and local mental health quality target. It is important that HEEM is demonstrating commitment to developing research and leadership skills. Research is essential for the development of new knowledge and doctors are increasingly expected to act as leaders within both their teams and wider organisations. Offering clinical fellowships Dr Tim Millward General Adult Psychiatry 2 year Clinical Leadership and Management Fellowship Host organisations: Northamptonshire Healthcare Foundation NHS Trust and St Andrews Healthcare The post within the mental health trust in Northamptonshire Healthcare Foundation NHS Trust was in provided excellent clinical training with a wide range of psychiatric presentations as well as St Andrews Healthcare an Independent Sector Unit with links to the Maudsley and Kings College in London. I was supervised in the post by the Medical Director in the NHS trust allowing me to gain great insight the real life challenges facing senior medical leaders. I worked 50:50 split between clinical training and academic/leadership for the 2 years of the Fellowship. helps to promote these areas and equips trainees with skills they may not develop otherwise. I would also hope to publish aspects of my research and present the findings in different fora. Simultaneously I would continue to work towards my Specialty competencies and therefore satisfactory Annual Reviews of Practice would also be an essential outcome. This scheme helps to bridge a gap in higher specialty training as it gives explicit importance to such issues which are currently not as explicitly represented in the curriculum. The fellowship also adds prestige to the Specialty training programme in psychiatry. It would help incorporate such qualities in future consultants and consolidate the safeguarding of quality of patient care and prevent future failures and improve public confidence in the specialty training of doctors. My training portfolio was boosted by a number of achievements. I acquired clinical skills in field of Forensic Psychiatry which strengthened my clinical training beyond the specialty curriculum. I was awarded a Masters in Translational Research and Management. I had the opportunity to develop specific training events spanning the NHS/Independent sector divide e.g. the East Midlands Psychiatry summer school and a day course in Leadership and Management. And finally I successfully interviewed for the post of Consultant Psychiatrist in Northamptonshire Healthcare NHS trust. Fellowships in Medical Leadership and Management 16 17

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11 About HEEM Health Education East Midlands (HEEM), part of Health Education England (HEE), was established in April Our goal is to develop a high quality, safe and sustainable workforce to meet the healthcare needs of the people of the East Midlands. By working closely with stakeholders, we act as a regional convenor, bringing people together across NHS, social care and the third sector to deliver the best possible services and outcomes for patients. HEEM covers the counties of Derbyshire, Leicestershire and Rutland, Lincolnshire, Northamptonshire and Nottinghamshire. Visit Published March 2015