Postgraduate School of Paediatrics Quality Management Visit to Northern Devon Healthcare NHS Trust

 23rd April 2015

 

Primary author of report (name and job title): Dr Y Kumar

Provider visited: Northern Devon Healthcare NHS Trust

Date(s) of visit: 23rd April 2015

Visit team (names and educational job titles):

Chair

Dr Yadlapalli Kumar – Head of School

Panel member

Dr Giles Richardson – TPD ST4 – 8 Trainees

Panel member

Dr Jonny Graham – College Tutor - Torbay

Panel member

Dr Simon Bedwani – College Tutor - Truro

Panel member

Ms Jane Bunce – Quality Manager – HESW(P)

Programme

No. of trainees seen

No. of trainers seen

Paediatrics

4 with 2 vacancies

5

Evidence considered prior to review taking place: Feedback questionnaires from some of the trainees and trainers

2014 GMC national training survey

Date visit report ratified by HESW – Peninsula

Tuesday 9th June 2015

Date visit report made available to provider

Tuesday 9th June 2015

Date provider ratifies visit report

Wednesday 10th June 2015

Circulation of this report: Peninsula Postgraduate Medical Education Quality Team

Director of Medical Education

Website

 

Executive Summary

Today’s visit was a very positive one with a good level of attendance by both the trainees and trainers.  The trust has six training posts for ST3+ trainees and although there are only currently four trainees in post the two vacancies are filled by long-term locums which appears to enhance the trainee experience, in relation to their work and rota’s which are not affected. 

The trainees are rota’d to attend clinics on a 4 weekly basis where they are free from ward duties during the day and although supervised by consultants, they are permitted to book in patients.  The number of patient bookings and subsequent follow up appointments are dependent on the trainee’s level of training and consultant supervision is always available.  Trainees also have the opportunity to attend visiting consultant clinics.

Departmental simulation takes place twice a month, and every three months there is a multi-disciplinary simulation session normally run by the Emergency Department but incorporating different specialties and scenarios.  In addition the department has a dedicated Simulation Lead in Dr Jonathan Walsh.

It was pleasing to note that there have been improvements to the formal teaching sessions within the department.

 

 

Key recommendations

1

Formalise handovers and reduce the time taken to conduct these handovers by September 2015

2

Provide bleep free formal teaching sessions for all trainees

3

Facilitation of a Careers Day to be considered (see ‘additional comments’ section)

 

Dr Yadlapalli Kumar – Head of School


 

Areas of good practice

Department / Programme / Specialty

Area of good practice

 

Rostering of Trainees to Clinics

 

 

Summary of the visit

Patient safety inc. handover and induction

No patient safety issues reported, and the trainees were very impressed with both the trust and departmental handovers, which were reported as comprehensive and useful.

In relation to handover, there is a handover which takes place 3 times a day, (0830, 1600 and 2030 at weekends and 2100 during the weekdays).  This is not formalised nor multidisciplinary, and is therefore variable in the time taken to conduct the handover.

Induction was reported as good and thorough.

Department / Programme / Specialty

Area of development

 

Handover, This would benefit from the following;

  1. Follow the SBAR format
  2. Becoming an MDT handover
  3. Having a set location
  4. Having a standardized time frame in which to handover

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

All clinical and educational supervisors have completed the Deanery courses and have time allocated in their job plans for educational supervision.  They meet their trainees three times during their placement and provide both formal and informal feedback as well as career guidance.

Trainees reported being well supported by approachable Consultants.

 

Nursing staff were described as ‘brilliant’.

Training environment (inc. access to educational resources

The trainees have good access to their library and feel the environment in Barnstaple is conducive to them being able to get involved in audits and other areas of training.

 

 

Work load

The trainees feel the workload is adequate with a good variety of cases as well as a high rate of PICU transfers.

Adequate experience / achievement of curriculum competencies

The trainees feel that with the varied cases they see they are gaining adequate experience commensurate with their level of training, and manage to link to the curriculum with good support from consultants in getting WPBAs signed off.

 

Teaching – local, regional and study leave

Local teaching takes place every Friday in the form of a grand round in the mornings and a specialist or trainee led session in the afternoon for 1 hour per session.  The value of this teaching is assessed as good, however this is diminished slightly as the sessions are not bleep free and the trainees do get called out of their teaching sessions, for what are on occasions non-urgent matters.

The trainees offered the following suggestion to improve attendance at local teaching, which is to hold it on a different day as Friday is not particularly good for them, generally being the busiest day of the week.

 

The trainees have no problems getting study leave to attend regional teaching.

Department / Programme / Specialty

Area of development

 

Provide bleep free teaching sessions for the trainees.  This could be achieved by a consultant holding the bleep for the duration of the teaching session, or the PGMC administrator if the session is in the PGMC who could then contact the on-call trainee if the bleep was urgent

Bullying and harassment

Nothing to report

Additional comments / feedback

The trainees feel they are valued members of the team and are made to feel very welcome by all in the department, and would recommend NDHCT to a colleague for its quality of training and the training environment, the one downside is the geography.  None of the trainees had stated a preference to NDHCT but their perceptions of the trust changed once they got into post.

 

A careers day was requested to discuss issues such as OOPE and LTFT.  Suggestion to build in to the ST1-3 induction day and to hold for ST3-4s in September.

 

 

 

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:

Yadlapalli Kumar

Chair educational role:

Head of School, SW Peninsula Post-Graduate School of Paediatrics

Date of signature:

 

 

 

 

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

PPME educational role:

 

Associate Dean for Quality

Date of signature:

 

10th June 2015