Designing Dental Core Training. COPDEUK May 2013

Transcription

1 Designing Dental Core Training Paul Cook Elizabeth Jones Nigel Fisher Nicholas Taylor COPDEUK May 2013

2 SWOT analysis of Dental Core Training STRENGTHS Great demand for posts. 376 applicants for 70 posts (compared to three years ago difficult to fill the posts) Funding MADEL funding of 50% of 600 posts available to use by HEE Blank piece of paper to design posts fit for purpose and to align with local service needs

3 WEAKNESSES Different experience in each LETB No consistent approach No agreed structure, syllabus, timetable, QM, QA, outcomes

4 OPPORTUNITIES To develop a career structure for young dentists between Foundation and Specialty To guarantee the viability of the training grades through robust QM/QA. To have a consistent approach across the UK To ensure the funding available is used most wisely To incorporate the opportunities of DES

5 THREATS Without a structured and agreed approach the funding might be vulnerable Without an agreed consistent approach it may be considered that the posts are service posts The public, providers, commissioners and trainees all expect QM/QA of training

6 Size of the Workforce Proportion of DF2 to CDP (England, Wales and Northern Ireland) Based upon data supplied by individual Deaneries, May 2013

7 Proportion of DF2 / CDP currently occupying OMFS, non-omfs and Salaried Service Posts (with indicative costs) ,985K

8 Scotland Distribution of DF2 trainees (No CDPs)

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10 Data returns: Number of Posts: 643 (England, Wales and Northern Ireland) DF2: 426. CDP: 217 Recruitment / Management: Mixed; some have Deanery recruitment. At least one delegates to a named Trust. Another has local Trust recruitment

11 Why are we here? Before Modernising Dental Careers we had Dental SHOs 2010, Dental Foundation Training launched two years of post-graduation foundation training relying on VT and SHO posts. Never-resolved issues: Increased number of VT places required Insufficient number of SHO places (to match) No mandatory requirement to do. A curriculum difficult to deliver in the secondary care setting.

12 Aims and Objectives of DCT Career development. Exploring opportunities within dentistry. Precursor to training to become an Enhanced Skills Practitioner Precursor to Specialty Training and/or working in the secondary care environment (Trust Dentist) Experiencing rare/more complex cases. Gaining confidence. Learning in an environment that promotes completing membership exams Working alongside experts in their particular field of dentistry.

13 Aims and Objectives of DCT Career development. Exploring opportunities within dentistry. Precursor to training to become an Enhanced Skills Practitioner Precursor to Specialty Training and/or working in the secondary care environment (Trust Dentist) Experiencing rare/more complex cases. Gaining confidence. Learning in an environment that promotes completing membership exams Working alongside experts in their particular field of dentistry.

14 Aims and Objectives of CDT Career development. Exploring opportunities within dentistry. Precursor to training to become an Enhanced Skills Practitioner Precursor to Specialty Training and/or working in the secondary care environment (Trust Dentist) Experiencing rare/more complex cases. Gaining confidence. Learning in an environment that promotes completing membership exams Working alongside experts in their particular field of dentistry.

15 How can the A s & O s be met? Employment in relevant environment primary or secondary care Appropriate timetable commensurate with the aims & objectives. It is a training post, time with trainers is essential (WTR) Supervised clinical activity Didactic teaching and induction Input into multidisciplinary clinics (MDTs) to promote an understanding of joint learning and optimum patient care Promotes understanding of the pressures of primary care and understanding of working in different environments

16 Person Specifications DCT 1 Completed DF (VT) by the time of appointment (satisfactorily?) 1st part of a Membership completed by the time of appointment. No more than 18 months working as a dentist Enthusiasm for further training in a secondary care or enhanced skills practice environment. DCT 2 Completed DCT 1 by the time of appointment. Final part of a Membership completed by the time of appointment. No more than 30 months working as a dentist. Enthusiasm to enter Dental Speciality training or to become an Enhanced Skills Practitioner DCT 3?

17 Job Descriptions DCT 1 Broad-based training engaging several specialities Enhanced supervision No un-supervised out of hours working No overnight on call (unavailable for training the following day) DCT 2 Focused training engaging the trainees chosen speciality or an allied speciality Reduced supervision Out of hours work Overnight on-call (as appropriate) DCT 3?

18 Essential entry qualifications: BDS Membership (1 st Part) Membership (Final) Competitive Entry: Dental School 5 years DF 1 year DCT 1 1 year DCT 2 1 year Specialty Training 3 5 years With enhanced Skills and Qualifications Mapped to: Dental Contract Reform Pilots: Tier One (GDP) Tier Two (Enhanced Skills Practitioner) Primary Care Dental Services Tier Three (Specialist) Secondary Care Dental Services

19 Current Arrangements Full Funding Specialty Training Other routes 50/50 Funding Full Funding In Primary Care FOUNDATION TRAINING Curriculum (one year)

20 DENTAL CORE TRAINING (DCT) Full Funding Specialty Training Other routes 50/50 Funding Full Funding In Primary Care FOUNDATION TRAINING Curriculum (one year)

21 The Primary Care Element: Possible DCT primary care placements Large GDS/PDS practice, several educators, skill mix, general involvement in education - Financed by UDAs/pilot contract + Deanery training grant Practice as part of commissioned clinic network + GDS. E.g. Oral Surgery, orthodontics - Financed by Service funding + Deanery training grant Salaried service - Paediatric, Special Care, GDS, CDS - Financed by salaried service. Secondments to DWSi/DES/specialist services from DGH - sessional - Salary paid by DGH/Deanery (50/50), service + grant to practice.

22 DCT in primary care: Innovative ideas Keen dental practices & practitioners Suitable clinical & educational environment NHS England Area Team involvement Trust involvement Deanery support staff

23 Considerations Is there a need for a DCT year 3, prior to entry into speciality training? What are the relative proportions required for each year? How did we arrive at the current distributions: Examples: London Number of trainees at: DF (DF1) = 138 CDT 1 (DF2) = 70 CDT 2 (CDP) = 30 CDT 3 (potentially) = 2 West Midlands Number of trainees at: DF (DF1) = 87 CDT 1 (DF2) = 20 CDT 2 (CDP) = 36 CDT 3 (potentially) = (IS)

24 Considerations: Equivalent entry routes essential if time-served barriers are to be imposed Demand for posts Examples: North West DF2 / CDP recruitment applications for 43 posts London DF2 recruitment applications for 73 posts London CDP recruitment applications for 31 posts

25 Considerations: Curriculum or Syllabus? If the A &O s are accepted, then it is the stakeholders who accept the responsibility of teaching the young learners. The time Trust personnel have available is increasingly constrained. This impacts upon their time and willingness to train at this level (no HEFCE, no Trainers grant, limited service delivery, only 50% MADEL funded, at most) Therefore those commissioning the training (Deaneries) must be mindful that good will is preserved. We believe therefore a syllabus is more appropriate at this stage of training in the current climate.

26 Considerations: Assessment Framework: Portfolio (epdp or ISCP?) PDP Logbook WBAs 6 monthly review of competency progression Outcomes?

27 Move towards National Recruitment - Raise the profile - Level playing field - Promote understanding of the aims and objectives - Economies of scale - Dental training establishment will be joined in the purpose and benefits - Agreed JDs/ timetable - Cope with the increasing demand

28 Selling this to Trusts and other Providers: Benefits: 1. A young learner who wants to train 2. A fixed term of training 3. 50% salary 4. Kudos of being a training establishment 5. Encourages succession planing 6. Allows our trainers their own personal development 7. A more stable and predictable workforce

29 WORKSHOPS!