Educational Quality Management the Trust Perspective

1
Educational Quality Management the Trust
Perspective

• Dr Andrew Long
• Consultant Paediatrician
• South London Healthcare NHS Trust
• Associate Dean
• London Deanery

2
(No Transcript)
3
Context

• 11 years as Clinical Tutor
• 3 acute sites ? 1 new PFI hospital
• 5 CEOs and 5 MDs
• countless internal reorganisations
• approximately 120 trainees
• 4/12 posts to 2 year programmes
• responsibility to c1500 trainees
• unique learning opportunities

4
Historical perspective

• role of Clinical Tutor
• manage the educational contract
• central role in co-ordinating PRHO training but
  should liaise with college tutors, educational
  supervisors...
• Clinical Tutor survey 2004
• contractual arrangements
• areas of responsibility
• accountability
• continuity

A Guide to the Management and Quality Assurance
of Medical and Dental Education AOMRC/COPMeD,
August 2000
5
Trusts as Learning Environments

• Pilot process 2004 within BHT
• Joint visit by Deanery/RCP/RCOG/RCS
• engagement
• information
• co-operation
• senior commitment
• benefit realisation

6
Modernising Medical Careers

• Foundation training
• resistance
• threats
• crisis management
• incentives
• Speciality training
• opportunities
• challenges
• reformation

7
Trust responsibilities

• CEO
• Medical Director
• Director of Medical Education

• organisational lead
• strategic development
• implement governance
• manage performance
• maintain standards
• clinical governance
• patient safety
• medical leadership
• educational governance
• educational leadership

8
Trust educational commitment

• cons

• pros

• Service demands
• inexperienced doctors
• Consultant time
• EWTD
• Trainee expectations
• training
• facilities
• Trainer expectations
• time
• Patient expectations

• Wider benefit of the NHS
• Salary contributions
• Quality of service provision
• Staff retention
• Risk reduction
• Organisational success
• Patient experiences

Developing postgraduate medical education for
trusts a secret to long-term success. Hackett M,
Gee H. Health Manpower Management, 1998.
9
(No Transcript)
10
Quality Control (PMETB)

• LEPs are responsible for ensuring that
  postgraduate medical trainees receive education
  and training that meet local, national and
  professional standards. Organisations
  responsible for QC include ...all NHS Trusts...
  Day-to-day delivery is at this level. The
  director of medical education or an equivalent
  role provides local leadership by working with
  and across all specialties.

Operational Guide for the PMETB Quality Framework
Version 4.3 March 2009
11
(No Transcript)
12
The Red Guide

• consultation with COPMeD and AoMRC
• proposed principles and simple single model
• clarification of the relative roles of Colleges,
  Deaneries and service involvement
• facilitates Quality Assurance by PMETB
• should ease current confusion over roles and
  function of medical educators
• make it easier to argue for additional resources
  (time and money) for those undertaking roles

Proposals for the Organisation of Medical
Education. NACT UK, August 2007
13
Medical Royal Colleges
Illustrative Organisational Model
Deanery Dean Director
Trust Chief Executive
Educational Faculty
Director of Medical Education/ CT
Director (s) Foundation Schools
Director (s) Specialty Schools
Director of Postgraduate GP Education
Undergraduate Sub Dean
Specialty Training Programme Director (s)
Medical Education Managers Postgraduate Centre
GP Specialty Training Programmes
Foundation Programme Director (s)
Training Practices
Educational Infrastructure
14
Developing the LEP

• educational governance
• Deanery QM process
• consistency within Foundation and Specialty
  Schools
• local assessment process
• credibility of medical educators
• educational roles within the Trust
• succession planning

15
Educational faculty

• role of the enthusiastic amateur
• select those that have the necessary skills and
  appropriate attitudes
• offer training according to need
• provide local support
• ensure adequate time provision
• reward equitably
• parity with clinical management

16
What makes a teaching hospital?
A working environment that is conducive to
learning is critically important to successful
training SCOPME 1991

• Trust commitment
• trained teachers
• commitment to supportive development
• attention to educational principles
• investment in educational infrastructure
• educational planning and feedback

17
Conclusion

• LEPs must be encouraged to develop their own QC
  infrastructure
• engagement with senior staff is critical to
  success
• commitment to training should be recognised
  within healthcare targets
• clinicians taking on educational roles should be
  appropriately trained and rewarded