Medical Education and the Future

1. Medical Education and the Future Patricia Hamilton Director of Medical Education (England)

4. A High Quality Workforce

5. MEE • Coherent professional voice on education and training • Coordination of changes to postgraduate training pathway • Integration of service and professional perspectives

6. MEE • Professional high level scrutiny of and advice on the quality of workforce planning at national level; • Professional scrutiny of and advice on the education and trainingcommissioning plans developed at SHA level

7. Selection Credentialing New specialties Foundation Programme Selection Overall review Shadowing Core training for Uncoupled Specialities Speciality Training CCT for entry to the Specialist Register Consultant CPD life long learning Accreditation of supervisors Speciality Training Broad basedentry 48 hour Quality Leadership Credentialing Use of simulation Workforce planning Commissioning quality General Practice CCT for entry To the GP register GP CPD life long learning Workforce planning Extension of training

8. Time for Training A review of the impact of the European Working Time Directive on the quality of training Professor Sir John Temple

9. Findings….. “It is possible to train in 48 hours”

10. BUT “This is precluded when trainees have a major role in out of hours service, are poorly supervised and access to learning is limited”

11. Positive impact where well implemented • Good rota design • Involvement of experienced doctors • Enhanced supervision • Increased training opportunities • Improved patient safety and experience • Better work/life balance

12. Problems • Gaps in rotas • Emergency/OOH workloads • Traditional apprenticeship models • Current pattern of service

13. Findings – Consultant Expansion

14. Implement a consultant delivered service • Direct responsibility 24/7 • Work more flexibly • Align with CCT holder output • Consultant contract • Reward consultant trainers • How will we afford this?

15. Response from SoS To bring the Directive back to the European Commission in order to limit its impact on UK health services

16. Not to go back to the past with tired doctors working long hours • To align the New Deal with the Directive • The service and the profession to change working practices

17. Implement the consultant contract and job planning more effectively • Determine the appropriate service contribution of the trainee

18. Review of Foundation Programme

19. Centre for Workforce Intelligence

20. The Centre for Workforce Intelligence • Mouchel and Manchester University • Plus Workforce Review Team • Commissioned to • Model numbers for 2011 • Model CCT output and consultant delivered service • Model future numbers over next 5 years

22. OUTSIDE THE BOX Specialist Registration before subspecialty Post CCT Fellowships Define role and responsibility of trainee More recruitment entry points Abandon CCT concept CESR/ CCT Becomes CSR Transferable competences Hybrid training programmes Train hospitalists Flexible duration of training Define E-learning/ simulation usage Exit examinations

23. 3 Secretaries of State…

24. ….and a new government

26. A patient-led NHS Delivering better health outcomes A more autonomous and accountable system Improved public health A focus on reforming long-term and social care SoS Vision for health and care

27. Training and Education • Employers and staff agree plans and funding for workforce development • This determines education commissioning plan

28. Education commissioning led locally and nationally by the healthcare professions

29. Through For doctors, healthcare scientists and pharmacists Through similar mechanisms for nurses, midwives and AHPs

30. The professions will play a leading role in deciding the structure and content of training, and quality standards

31. All providers will pay to meet the costs of training • The national commissioning board will provide oversight • The CfWI will act as a constant source of information

32. Timescale “Reforms will be managed so changes do not destabilise individual providers”

33. Thank you