BOA Members may be aware of three statements issued in the last month on this issue:
- Health Education England, ‘Supporting winter pressures safely through managed education and training programmes’
- BOTA and ASiT, Wednesday 12th December 2018, ‘Winter Pressures affecting Surgeons in Training’
- RCSEngland, Wednesday 28th November, ‘Guidance to help manage winter pressures’.
The BOA view is that the HEE document will carry considerable weight with Directors of Medical Education, TPDs and Deaneries. We strongly advise that trainers and trainees should familiarise themselves with this. We also support the BOTA/ASiT statement.
The HEE document states that temporarily redeploying doctors in training “should never be the preferred method of managing acute pressures” but it provides guidance for doing so in “crisis situations” in a “pre-planned, safe manner with minimal disruption to education and training”. It stipulates that “movement of any trainee must not exceed a total of two weeks during the winter period.”
The HEE document explains that “The option of using other professional groups and trained doctors in the area requesting additional trainee doctor cover should be fully explored and exhausted before trainees are asked to work outside of their usual training programme.” We too believe that redeploying trainees should be the last resort. Where it does occur, we underline the importance of safeguards to ensure that the trainee remains within their competencies to practice and that appropriate supervision is provided.
In relation to loss of training time, we highlight to trainees the section of the document on this:
“HEE is aware that exceptionally the burden of service pressures in the winter may mean that surgical trainees have less exposure to planned elective surgery and this may impact on curriculum requirements in terms of numbers of procedures. These trainees should not be disadvantaged in terms of their career progression; there is provision in the Gold Guide for PG Dean discretion to be exercised to allow an extension to training in a “no fault manner” (Gold guide 4.72 clause IX). Surgical trainees must keep logs of cancelled sessions as evidence to produce at ARCP, and all efforts must be made for required numbers of procedures to be caught up at less pressured times of the year.”
From this section, HEE clearly sees that such a level of disruption should be ‘exceptional’. The BOA is aware of a very small number of trainees affected last year and will monitor this going forward. It is imperative that trainees are not routinely disadvantaged by winter pressures measures.
We and BOTA will continue to monitor this situation as the winter progresses. We are keen to be informed by members of deviations from the HEE advice and suitable safeguards. If you wish to contact us, please do so at: [email protected].