Postgraduate School of Ophthalmology Quality Management Visit to Royal Devon & Exeter NHS Foundation Trust

Friday 7th of March 2014

  

Postgraduate School undertaking visit: Ophthalmology

Primary author of report: Professor Nabil Habib, Head of School

Provider visited: Royal Devon & Exeter

Date(s) of visit: 7 March 2014

Visit team (names and educational job titles)

Chair

Professor Nabil Habib, Head of School

Panel member 1

Miss Siobhan Rattigan,  College Tutor, Taunton

Medical externality

Mr Dipak Parmar, Consultant, Whipps Cross University Hospital

Lay representative

Jennifer Yallop

School Manager

Heather Rowley

Administrator

Sophie Chambers

Programme

No. of trainees seen

No. of trainers seen

Ophthalmology

3

4

Evidence considered prior to review taking place: 2013 GMC NTS data. ARCP data. Trainers mandatory training record

Date visit report ratified by HESW – Peninsula

23 April 2014

Date visit report made available to provider

24 April 2014

Date provider ratifies visit report

9 May 2014

Circulation of this report: PPME Quality Team, RDE Director of Medical Education, RDE Medical Education Manager

 

Executive Summary

The West of England Eye Unit in the Royal Devon and Exeter Hospital is a very well equipped department and provides a friendly environment within which very high quality of training is delivered. Trainer engagement is excellent and trainees experience is extremely positive.

The department also provides an excellent range of subspecialist trainee selected component training opportunities that are well sought after by trainees on the rotation.

Key recommendations

1

Establish a structured induction process into the department for new trainees.

2

Establish a formal handover protocol for on call trainees.

 

Professor Nabil Habib

Peninsula Head of School of Ophthalmology

 

Areas of good practice

Department / Programme / Specialty

Area of good practice

Ophthalmology

Excellent digital recording facilities in theatre to record and edit surgical videos.

 

Departmental ethos promotes excellent trainer engagement & training opportunities

 

Trainers facilitate ample educational feedback opportunities, guidance and work place based assessment.

 

Outstanding range of subspecialist trainee selected opportunities for senior trainees.

 

 

Summary of the visit

Patient safety inc. handover and induction

Good hospital and departmental induction. Informal handover protocol between trainees when on call. Some areas for improvement are listed below.

Department / Programme / Specialty

Area of development

Ophthalmology

  1. Currently there is a slow on line hospital induction programme which needs to be reviewed.
  2. A designated permanent member of staff (instead of different members) in the Ophthalmology team to lead the departmental induction.
  3. Review the availability of departmental guidelines to Junior Doctors. These can be available on line for ease of access.
  4. The current handover protocol should be made formal and written into the departmental protocols

Supervision – clinical and educational (inc. career guidance, feedback)

Excellent balance between plentiful clinical and surgical training opportunities and adequate supervision with appropriate encouragement and feedback. Agreed Educational Supervisors are accessible and all appraisals and one to ones are diarised.

Department / Programme / Specialty

Area of development

Ophthalmology

  1. Department to ensure enough time is allocated in trainers job plan to deliver educational obligations.
  2. College tutor in liaison with the School of Ophthalmology to ensure continuous compliance of all trainers with mandatory educational training.

Training environment (inc. access to educational resources)

Friendly and supportive training environment. In this department they have not been pulled off of shift to cover casualty. They have received a good balance between supervised and independent training.

Department / Programme / Specialty

Area of development

Ophthalmology

Review & establish a departmental policy on the number of patients in a training operating list to be agreed by college tutor and lead clinician.

Work load

Appropriate work load. There is a good volume of patients, it is a comfortable working environment and all clinics are managed well.

Department / Programme / Specialty

Area of development

 

N/A

Adequate experience / achievement of curriculum competencies

Excellent range of clinical training opportunities and appropriate surgical case work load to achieve required competencies as per Royal College curriculum.

Department / Programme / Specialty

Area of development

 

N/A

Teaching – local, regional and study leave

Outstanding local and regional teaching programme. All trainees are allowed to attend and encouraged to participate.

Department / Programme / Specialty

Area of development

 

N/A

Bullying and harassment

No issues reported.

Department / Programme / Specialty

Area of development

 

N/A

Additional comments / feedback

Good trainee experience has been reported and all of them would recommend the post to a colleague. Excellent range of subspecialist training opportunities including medical retina, surgical retina, paediatrics, plastics and glaucoma.

Department / Programme / Specialty

Area of development

Ophthalmology

Department to review the trainees preference of a 12 months Trainee Selected Component subspecialist attachment rather than 6 months if possible.

 

 

 

Visit Panel Chair Declaration

This completed report is a true and accurate account of the discussion that I participated in or that were reported to me from this visit.

The key recommendations identified within this report have been identified with good faith.

I can confirm that any areas of significant concern that have a direct impact upon patient safety have been brought to the attention of the relevant Director of Medical Education (or equivalent), responsible Medical Director and Executive Lead for Quality at Health Education South West Peninsula Postgraduate Medical Education.

Chair name:

Professor Nabil Habib

Chair educational role:

Peninsula Head of School of Ophthalmology

Date of signature:

19 April 2014

 

 

 

 

 

 

 

Health Education South West Peninsula Postgraduate Medical Education Declaration

I as signatory on behalf of Health Education South West, Peninsula Postgraduate Medical Education can confirm that the information and associated recommendations provided via this report have been reviewed and deemed appropriate for the purpose as stated.

The recommendations contained within this report have been documented as part of the quality management processes of Health Education South West, Peninsula Postgraduate Medical Education and where appropriate, will be reported to the General Medical Council (GMC) as required.

Name:

Dr Martin Davis

HESWPPME educational role:

Peninsula Associate Postgraduate Dean for Quality

Date of signature:

23 April 2014