
962e21a3fb4a6b4943583b263d85a177.ppt
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Longitudinal Integrated Foundation Training LIFT Professor Paul Baker and the North West of England Foundation School
North West of England School § Trainees >1700 (F 1/F 2) § Third most populated region in the UK § Intake: 879 into 293 two-year programmes § 100% community placements in GP § 22. 5% mental health placements § 59% placement with offsite community element § Aug 16: Longitudinal Integrated Foundation Training (LIFT)
North West of England School LIFT Pilot § Dedicated to Prof Paul Baker Kate Burnett § FPD at Salford Royal § Trainee experience § Leading system change
UK Foundation training Ø 10 years old Ø Well established Ø Tooke/Collins/SHOT reports Ø Broadening the Foundation Programme
UK Foundation training Clinical Placements Education faculty Teaching
UK Foundation training Feedback/Monitoring visits Foundation trainees … • • • Busy – mostly, trainees can feel devalued Patchy/poor induction - many Little attention to curriculum – some Service displaces training – nearly all Clinic/theatre/121 time - few
Some pre-existing phenomena …. § General Practitioners (GPs) as educational supervisors § FY 1 s in general practice § Integrated hospital/community placements § ‘First placement’ anxiety § ‘Unbanded’ tracks
Case for change: 1. Flexner 2. Ethical erosion 3. Population and workforce needs
To sample a school on its clinical side, one [seeks]… § continuity of service on the part of the teachers… § the closeness that the student may follow the individual patients…” Abraham Flexner, 1910
UK Foundation training Longitudinal literature David Hirsh explains the benefits of a Longitudinal Integrated Clerkship https: //www. youtube. com/watch? v=c. KGe. WSws 1 So
Longitudinal Integrated Foundation Training (LIFT) • Summer 2015 – HENW Foundation team in place • Autumn 2105 – discussions with executive • November 2015 – expressions of interest LEP • December 2015 – funding granted 2 year pilot • August 2016 – cohort begins work
Programme Design …. § Longitudinal connection with trainer § Longitudinal connection with patients § No loss of medical input to hospital (1 to 2 WTE - 0. 9 to 1. 2 on wards) § Attention to neglected areas
UK Foundation training Clinical Placements Postgraduate teams Teaching
More attention to neglected areas…… § § 121 time with trainer Theatre time OPD time Educationally unproductive tasks
Evaluation Delivery of high quality, effective, compassionate care; Holistic Person Centered Care Measureable outcomes • Moral Development Rate • Empathy • Tolerance of Ambiguity • Patient Centeredness
Evaluation Develop the right people with the right skills and the right values; Workforce transformation for future NHS needs. Measureable outcomes • Impact on career choice • Enhancement of collaboration and networking • Work satisfaction • Trainee experience
What have we learnt so far … § Trusts must produce accurate information about placements, particularly out of hours duties § Primary care and hospital administrators, managers and trainers should be consulted for buy-in, planning and timetabling § Choose hospital placements carefully for trainer buy-in to avoid negative briefing of trainees § Every effort needs to be made to make LIFT trainees integral to the hospital part of the placement
What have we learnt so far … § Many trainees value out of hours duties and feedback will be improved if they are included § Trusts must provide clear, written weekly timetables § Smaller units have less flexibility and timetabling may have to be scheduled around them § Multidisciplinary activities and following the patient journey are to be encouraged. § If hospital on call duties mean missing GP time, this can be ‘paid back’ at another time
What have we learnt so far … § If a 3: 7 GP: hospital weekly sessional split problematic an alternating 4: 6 and 2: 8 split is ok § Practices as close to the acute hospital site as possible, to minimise travelling § HEE provides travel expenses for the use of Foundation trainees in primary care § A pseudo ‘job-share’ between two LIFT trainees in parallel tracks has many advantages
Thank you
962e21a3fb4a6b4943583b263d85a177.ppt