Update on Implementation of the recommendations of the UK Shape of - PowerPoint PPT Presentation

Update on Implementation of the recommendations of the UK Shape of Training Steering Group Professor Ian G Finlay Chair UK Shape of Training Steering Group

Shape of Medical Education and Training Review (SoTR) Tasked to consider how medical education and training should adapt to meet the changing needs of patients over the next 30 years www.gmc- uk.org/Shape_of_training_FINAL_Report.pdf_53977887. pdf

What are these changing needs?

Percentage of patients with 2 chronic conditions needing care in the community according to age

Innovation, data and artificial intelligence • By 2030s it is anticipated that 50% of current jobs will not be required • In 2012 the top 10 technology based posts did not exist in 2004 • Data generated and stored last year equates to the previous 5000 years • 25% teaching in first year of science based degrees obsolete at graduation.

Workforce implications • Life long learning (governed) • Career changes • Current entrants to the workplace have different values and expectations • Portfolio careers • Career breaks • Potentially work longer

Focus on hospital care 25% in-patient could be treated in the community

Secondary Care Medical Workforce 7000 200% 190% 6000 180% 5000 170% 160% 4000 150% 3000 140% 130% 2000 120% 1000 110% 0 100% 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 6 8 0 2 4 9 9 0 0 0 0 0 1 1 1 9 9 0 0 0 0 0 1 1 1 9 9 0 0 0 0 0 0 0 0 9 9 0 0 0 0 0 0 0 0 1 1 2 2 2 2 2 2 2 2 1 1 2 2 2 2 2 2 2 2 Consultant Doctor In Training Consultant Doctor In Training Data from : ISD Scotland

Focus on specialist training Specialist Training General Skills

Future hospital commission report • “All too often our most vulnerable patients are failed by a system ill-equipped and seemingly unwilling to meet their needs” “ There is increasing evidence of substandard • care provided to many older patients with care poorly coordinated and reports of patients being moved between wards and within wards ‘like parcels’.” (Royal College of Physicians London, 2013)

Current Post-Graduate Medical Training § Many attributes but outdated § Organised in “silos” § Medical Royal Colleges and Faculties. § Rigid and inflexible § Time based – no allowance for ability § No capacity to “upskill” the trained workforce in a governed structure.

Shape of Training review was a framework for change § Proposed broad concepts, ideas and solutions § Open to interpretation § Did not consider the practical implications of implementation § Ministers convened the UKSTSG

UK Shape of Training Steering Group • Policy advice for Ministers in relation to implementation of the recommendations • 4 Nation consensus • Minimal service disruption • Facilitative of National strategic plans

Securing the Future of Excellent Patient Care March 2017 October 2013

UKSTSG Report and the Ministerial Statement www.gov.scot/publications/2017/08 /9303/downloads

Principles of Shape of Training 1. Medical education and training will first and foremost take account of patient need (service providers) 2. There needs to be an emphasis towards more Generic skills 3. Increased flexibility within and between training pathways 4. Training support the delivery of more care in community settings 5. Credentialing for better governance and flexibility purposes

Principle 1 Training will first and foremost take account of the needs of patients/service • Hitherto service providers have not been able to provide input as to the kind of doctor that they need to deliver an effective and efficient service. • A mismatch has developed between the needs of the service and training. • “General surgery”

Principle 2 Recommendation – to develop a more general emphasis to training What do we mean by a “generalist”? • To deliver the appropriate acute unselected take in hospitals • To provide continuity of care • To engender the expectation that most doctors in the future will contribute to the care of unscheduled patients

Principle 3 Curricula and training pathways are inflexible • Previous learning not easily recognised. • Little flexibility within and between pathways. • Concept of the “finished fully trained doctor” giving way to one of “career long learning”. • Competency not time based • Transferable

Principal 5 -Credentials What are credentials? • Discrete modules of learning delivered in a governed and educationally supervised environment. • Components of current curricula or entirely new areas of learning. • Determined by objective service /patient need • Recognised by GMC/others

Principal 5 -Credentials What will they achieve? • Provide the flexibility for doctors to change careers, develop portfolio careers and to train in new techniques and technologies. • Provide flexibility for service providers to rapidly respond to innovation • Provide governance in areas currently unregulated e.g. ad hoc Post CCT fellowships/cosmetic surgery. • Provide a better governance and delivery framework for specialist and sub sub specialist services.

What is happening now? 1. Credentialing Framework - Developed by GMC. - Stakeholder consultation.

What is happening now? 1. Credentialing Framework - Developed by GMC. - Stakeholder consultation. 2. Introduction of capability and competency based training

What is happening now? 1. Credentialing Framework - Developed by GMC. - Stakeholder consultation. 2. Capability rather than time based training 3. Curriculum Oversight Group - GMC. - Reviewing curricula submissions. - UKSTSG principles.