RCP: Patients need guarantee of national standards for doctors training

Tuesday, 1 November 2011 10:05 AM

In its evidence on education and training to the Future Forum, the Royal College of Physicians (RCP) stresses the need for all postgraduate medical education to be nationally planned and led by Health Education England (HEE) working with the royal colleges, and for the number of trainee placements for medical specialties to be set at a national level.

Professor David Black, RCP vice president for education, said:

‘Patients everywhere deserve doctors, who are trained to the same high standard, so that in whichever hospital they are treated, they can be guaranteed that the same knowledge and skills will be available to them, whatever their medical condition. With national planning of trainee placements we shall also be in a better position to prevent future shortages in medical specialties, shortages that can lead to long waiting lists.’

To deliver nationally planned education, the RCP advocates the retention of postgraduate deaneries to organise the training of doctors locally, suggests they be made accountable to HEE, and that they maintain sufficient independence, control and autonomy to undertake effective quality management. Funding should flow directly to deaneries from the national commissioner, HEE. Hosting arrangements for deaneries could be determined locally, but routes of accountability and funding should be common across the system.

Further points from the RCP’s evidence:

Structures
· For postgraduate medical education, the proposed Local Education and Training Boards (LETBs) should provide information and advice to the postgraduate deans and HEE.

· The Centre for Workforce Intelligence (CfWI) should undertake the long term modelling of the workforce under the direction of HEE, in close liaison with the RCP and the medical specialties.

· HEE could play an important role in overseeing workforce planning throughout a doctors career, creating a smooth continuum of medical education from undergraduates to postgraduates.

Incentives
· The RCP supports the concept of an NHS training levy paid by all providers.

· Measuring, publishing and incentivising quality of education and training is vital, but new proposals must be piloted and subject to proper prospective academic study.

Health reforms
· The Health and Social Care Bill 2011 should: give the Secretary of State a duty for the education and training of the healthcare workforce (clause 1); give the NHS Commissioning Board and Clinical Commissioning Groups a duty to promote education and training and write this into contracts (clauses 20 and 22), and; ensure that the provision of education and training in all NHS and private providers is a mandatory condition of being licensed by Monitor to provide healthcare to NHS patients (clause 93).

Provision of training
· Different professions have different requirements and multi-professional education at the undergraduate level has not been demonstrated to have any impact or saving (except where there are strong shared needs and knowledge).

· In the service field there are opportunities for the multidisciplinary training (eg for stroke services) of consultants, physiotherapists, nursing and pharmacy staff. Inter-professional learning for areas of the curriculum such as leadership and management, and for team building, is important.

· There needs to be stronger leadership of, and responsibility for, training the whole acute team.

Medical careers

· Acute hospitals need a workforce appropriately trained to deal with current demographics. We need to assess whether the current balance between physicians trained in a speciality and those trained in general internal medicine and/or geriatric medicine is right. The options for specialisation later in training should be fully considered, with greater flexibility for joint/modular training and a broader base of generalist skills gathered across a broader range of settings.

· There needs to be greater flexibility in medical career paths.

· There is now an urgent need to review rotas and the structure of the entire medical team to ensure that medical in-patients receive direct input from consultant physicians seven days a week.

Time for work that contributes to the wider NHS
This includes time for work that contributes to the wider NHS, including college work. Doctors must have time for Continuing Professional Development (CPD) and Supporting Professional Activities (SPA), which ultimately benefits patients by helping doctors develop their skills, train the next generation of doctors, improve clinical standards, and foster innovation and advances in knowledge and treatment.


Notes to editors

A full copy of the evidence can be downloaded from the RCP website:

http://www.rcplondon.ac.uk/sites/default/files/rcp_response_to_future_forum_education_workstream_-_october_2011.pdf

For further information and to arrange an interview with Professor Black, please contact RCP Communications Officer Andrew McCracken on 020 3075 1354, 07990 745608 or andrew.mccracken@rcplondon.ac.uk.


Andrew McCracken | Communications Officer
External Affairs | Royal College of Physicians
11 St Andrews Place | Regent’s Park | London NW1 4LE

Direct line +44 (0)20 3075 1354 | Mobile +44 (0)7990 745 608 | Fax +44 (0)20 7486 5425

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