Policy responses and statements
Background: The Scottish Medical Training Board(SMTB), formerly the Specialty Training Programme Board, is calling for evidence on the Scottish Foundation Programmes review. The review will encompass the strengths and challenges of the Foundation Programmes, the current management arrangements, and take account of wider workforce planning developments. The SMTB is particularly keen to hear from those with a knowledge of the Programmes, their impact on quality and delivery of training, on employment, and the delivery of local and national health services. This paper provides information on the context for the review, and invites responses on a range of questions. CONTEXT FOR REVIEW OF FOUNDATION IN SCOTLAND: 1. The introduction of a 2 year Foundation programme for all graduates from UK medical schools was one of the main changes introduced by Modernising Medical Careers. The programmes started in August 2005 with the first cohort completing Foundation training in 2007. In 2008, following the problems surrounding recruitment to specialty training, the MMC enquiry, led by Sir John Tooke, published Aspiring to Excellence. That report made a large number of recommendations, including one that the employment linkage between the two years of the Foundation programme should be broken and the competences currently covered in the FY2 year should be included in the first year of themed core programmes. 2. In his response to Tooke the Secretary of State in England deferred decision on this recommendation and has since asked Medical Education England to commission a review of the Foundation programme. This review commenced in late 2009 and is due to report to the Department of Health in May 2010 with a final report to ministers in June 2010. 3. In Scotland during 2009 some concerns were brought to the Specialty Training Programme Board (STPB) around the frequency of placement changes for Foundation doctors. The concerns centred on lack of continuity of both patient care and training support, with worries that frequent changes of placement were leading to increased stress on trainees and risks to patient safety. There were different views on the extent to which this was caused by 4 month placements or changes in working patterns necessitated by Working Time Regulation compliance. It was agreed by STPB that changes to placement length would probably be desirable but that any such changes should be introduced following a review. STPB agreed that a Scottish review should be initiated to run in parallel but link closely to the review in England. 4. At an initial stakeholder day in November 2009 a number of key issues were identified for wider consideration. This paper summarises those issues and invites interested parties to provide evidence, views, comments or to raise any other areas of concern that need to be addressed as part of the review. 5. On 5th November 2009, the groups attending the stakeholder event were asked to consider the purpose, structure and content of foundation programmes and this paper follows the same framework. 6. For purposes of this call for evidence the terms “Foundation” or “Foundation element of training” are used to describe an initial period of postgraduate training that is completed by all UK graduates before entering specialist training. The length, nature and content of such a period are open for debate as part of this review. Download this consultation response as a .pdf Copies of this response are available from:
Lesley Lockhart, Tel: 0131 225 7324 ext 608 [31 March 2010]
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