The RCPE is frequently consulted by Government and other health-related
organisations at a Scottish and UK level on a wide range of policy
areas. Our responses to such consultations are informed by the
views of our Fellows and Members (elected Council, Committees,
RCPE surveys, the views of individual Fellows and Members identified
from our database by specialty and interest, and occasional open
meetings).
Preliminary RCPE Response
to Temple Report (Impact of EWTR on Training)
Preliminary Response to “Time for Training” – a
review of the impact of the European Working Time Directive
on postgraduate training in England.
The College has provided detailed written evidence to the
Temple Inquiry and I added verbal evidence, supported
by trainee representatives from the College. We welcome Sir
John Temple’s report and endorse the key comments
and recommendations; in particular:
- the recognition of lost opportunities for high quality
training within normal service provision;
- the difficulties caused by gaps in the trainee rotas;
- the absence of necessary senior support during out of hours
for supervision and training due to increasing patient numbers
and complexity;
- the need for adequate allocation of time in job plans for
consultants with significant training responsibilities.
However, the College has some reservations, in the main the
apparent contradictions between certain recommendations or
with other recent policy decisions: namely
- the faith placed in models of Hospital at Night which
are as yet unproven in many hospitals;
- the recommendation that all trainee-consultant interactions
provide a valuable training opportunity and yet training
may be restricted to consultants (or units) that excel at
it;
- the recent Department of Health decisions to remove funding
from innovative projects, e.g. e-learning for health just
as Sir John calls for new and different ways of providing
medical training.
The College recognises that Sir John’s report focuses
on training challenges in England but from recent research
with Fellows and Members we know that these are replicated
across the UK. I will ensure that changes in training and workforce
planning in England as a result of the Temple Report are also
considered in Scotland. In particular the College supports
the recommendation for more flexible consultant working to
enhance patient care and training opportunities across the
full working week. This will be a challenging time to call
for an expansion in the consultant workforce but without increased
consultant capacity the required improvements will be undeliverable
and the EWTD will indeed impact adversely on the abilities
of the consultants of the future to deliver a safe and effective
service. I will ensure the College has an opportunity to contribute
to the next round of discussions regarding Sir John’s
recommendations.
Neil Dewhurst, President, 30 June 2010
Recent RCPE Responses to Major Policy Consultations and Announcements
REVALIDATION: THE WAY AHEAD
In the main, the College is supportive of the GMC proposals,
but has made a number of detailed recommendations, including:
Proportionality: at a time of financial constraints in the public
sector the College calls for a simple, workable system that will
earn the confidence of the public and the profession.
Standards: standards should be viewed as a benchmark against
which individual doctors measure their own practice. Appraisal
(as part of revalidation) should aspire to support all doctors
to improve their practice continuously – revalidation must not become
a proxy for minimum standards.
Simplification of frameworks to support information gathering: the Colleges have developed standards for supporting information
as a necessary first step, and as clinical information systems
become better established it will be feasible to be more specialty-specific.
Fellows and Members have stressed the need to simplify the frameworks
and further work is necessary to re-package the specialist standards
and frameworks to reassure doctors that the task they face is manageable
and will evolve as clinical information systems mature.
Implementation: we are concerned that enforcing a strict start
date before employing organisations are fully prepared to support
revalidation and in advance of lessons from pilot studies would
be risky, damage the confidence of doctors and deter engagement.
It is also essential that quality assurance procedures are developed,
tested and in place and that the approach to remediation is agreed
before individual cases are considered.
