Specialty Training Board

Minutes of meeting of the Mental Health Specialty Training Board held at 10:30 am on Monday 8 September 2014 in Meeting Room 1, Ground Floor, 2 Central Quay, 89 Hydepark Street, Glasgow

Present: Susan Miller (SM), Roger Blake (RB), Margaret Bremner (MB), David Brown (DB), Jane Naismith (JN), Euan Easton (EE), Helen Goode (HG), Jackie Pickett (JP), Rhiannon Pugh (RP), Karen Richard (KR), Chris Sheridan (CS), John Taylor (JT).

By videoconference: Inverness: John Channon (JC), Ronald MacVicar (RMV); Edinburgh: Niall MacIntosh (NM).

Apologies: Dik Athawes (DA), Geraldine Bienkowski (GB), Tom Brown (TB), John Crichton (JC), Robin McGilp (RM), Seamus McNulty (SMcN), Gillian Needham (GN), Norman Nuttall (NN), Rowan Parks (RP), John Russell (JR), Judy Thomson (JTh), Sally Winning (SW).

In attendance: Helen Minnis (HM), Helen McIntosh (HMc), John Sheppard (JS).

Action
1. / Welcome and Apologies
The Chair welcomed Dr Maggie Cairns, trainee shadowing EE, and Dr Rabia Ellahi, shadowing JT, to today’s meeting.
Apologies were noted.
2. / Academic Child Psychiatry presentation
The Chair welcomed Dr Helen Minnis, Senior Lecturer in Child Psychiatry at Glasgow University to the meeting.
Dr Minnis (HM) was invited to speak on Academic Child & Adolescent Mental Health. Over the last 5-10 years there has been a change in thinking regarding Child & Adolescent Mental Health however this has not translated into clinical practice to the extent they would have liked. There was an awareness of the need to focus more on early years however there were no NHS Infant Health Clinics in Scotland and very little Academic engagement. There were 3 Academics in post currently and as they were all of a similar age retirals could be an issue. Recent recruitment to Child & Adolescent Psychiatry has been very poor with a pull towards England away from Scotland and this will continue unless they continued to work on raising its profile. Some trainees have applied for CSO Fellowships but with little success as Scotland did not have a track record in this area. Previously people undertook MPhil however this was no longer an option and while there was one Psystar post this was time limited and unlikely to be happen again. There was no capacity within NES to fund higher degrees.
MB said funding was set aside for a Child & Adolescent SCREDS post in NoS however it did not fill and was not re-advertised by the University and it would have to be clear there was interest first before seeking funding again.
HM felt the creation of a SCREDS post would a good development and assist people in applying for Fellowships/CSO posts. SM recorded the STB’s support for promoting the profile of Academic Child & Adolescent Psychiatry and at her invitation HM agreed to produce a paper outlining arguments for funding of a SCREDs post. She will send the paper to SM to take the proposal forward.
JT noted that endowment funds were available via the service on which trainees could seek information/make an application. / HM
3. / Scottish training survey
The Chair welcomed Niall MacIntosh (NM) to the meeting. NM explained the survey has been running for over a year. This was an end of post survey which all trainees were invited to complete. Foundation trainees will be sent the survey to complete at the end of their training. The survey took around 10-15 minutes to complete and they were seeking to develop it further with the inclusion of specialty specific questions relating to specific training areas. He asked STB members to highlight specific areas for which he would then develop questions and potentially add an extra indicator to the survey.
Suggestions highlighted were: collecting information on whether trainees gain Psychotherapy competences in post; experience of Emergency Psychiatry; handover; trainees willingness to continue with a career in Psychiatry; access to Academic support; non clinical supervision. Any other suggestions for areas to explore in the survey should be sent by email to NM. He confirmed that areas in the questionnaire which were not relevant to trainees could be marked as such.
Work on the survey will be taken forward by a new Quality workstream appointee who should be in post towards the end of the year. He was hopeful the survey will be ready to issue in time for the next specialty trainee changeover in February 2015. A reporting dashboard for the survey was still under construction and the survey will eventually be available online.
In terms of dealing with issues raised via the survey, all data was anonymous however if a serious issue was raised the trainee could be asked if they wished to be identified and the issue could then be addressed. If the trainee was unwilling to do this the issue could not be taken further. Feedback on the survey was available via Quality Managers to Regions. / All
4. / Minutes of meeting held on 16 June 2014
The minutes were accepted as a correct record of the meeting and will be posted on the website.
5. / Matters arising
5.1 / Learning Disabilities Psychiatry
Noted: now renamed Intellectual Disabilities Psychiatry. JR has been appointed National TPD and GN will be lead Dean as the programme will be hosted in NoS. It was not clear when the programme will become operational as a national programme; a November start date was envisaged.
5.2 / Shape of Training – update
The summary note of the Scottish sub group’s discussion was circulated for information. The group has been asked to consider broad based training and credentialing and what training should fall into these categories. It will meet again at end September/beginning October; the College was also due to meet on 9 October.
A series of 6 UK wide stakeholder meetings have been arranged under Shape of Training with the aim of developing policy for recommendation to the 4 UK Ministers followed by implementation by August 2017 at the earliest. Some recommendations may be implemented before full implementation was agreed. RMV reported he will attend the meeting to be held in London to discuss primary/secondary care and the link between GP, Psychiatry and Paediatrics. It was not clear how this would be configured and timescales were also unclear. He also reported there was significant opposition to the proposal from some quarters. For information he noted the UK wide Implementation Group was chaired by Professor Ian Finlay and its membership included Stewart Irvine.
SM said feedback from Heads of Schools showed no specialty favoured shortened training. One area agreed was that all postgraduate trainees required an understanding of Mental Health.
5.3 / AMP Training
SM reported that NES were taking over provision of this and will eventually provide day training and update training for consultants. The College in Scotland has identified a lead person for this work and material has been circulated on which comments were being sought. It was felt it was essential to establish a sufficient number of training days and to ensure trainees know how and where to sign up for training. This was a role for TPDs.
JT said this was discussed at a recent Medical Managers meeting where there was some confusion who within NES was leading on this work. SM will contact the relevant NES person for an update. / SM
5.4 / CT3 trainees’ intentions survey
MB reported that response so far has been positive. SM asked speciality leads and anyone else interested to consider comments received and their implications. It was noted that dual training was favoured and Forensic and General Adult were particularly highlighted. / Leads
5.5 / SAS Doctors as Educational Supervisors
Noted: the College continued its opposition.
6. / Dual training
6.1 / Forensic Psychotherapy
This has been approved by MDET and by Scottish Government however it has to be cost neutral. SM will discuss how to take this forward with JC. It was still hoped to start the programme in August 2015. / SM/JC
6.2
6.3 / General Adult Psychotherapy
CBT posts have also been approved for dual training with General Adult and these were seen as more attractive. The Dynamic post will remain single specialty. JN reported there has never been a problem in filling single specialty training in the central belt and they will continue to offer these.
Other dual posts
SM will ask JR to consider other dual training programmes relating to Intellectual Disabilities Psychiatry. JT noted service concern regarding the potential for lengthening training especially give there were fewer people undertaking training. However it if were possible to recruit more people to Scotland by providing training combinations not available elsewhere this would be welcomed. / SM/JR
7. / National programmes
Professor Reid has asked the STB to consider other areas for national programmes. Following discussion SM asked JP to consider this for Child & Adolescent Psychiatry and provide feedback. She will also ask SMcN to consider and feedback the view from Old Age Psychiatry. / JP
SMcN
8. / Progress in training 2011 – 2014
A Scottish Government management trainee was undertaking this work with the current cohort. Information produced by this work fitted with previous work done by SM and provided consistent evidence that only 50% of trainees felt they were ready to progress to ST4 after 3 years. The management trainee was also looking at where CCT finishers went. SM will invite the management trainee to the next STB meeting to discuss this work and also to provide information on his post to the STB. / SM
9. / 2014 Recruitment
Scotland’s CT1 fill rates compared well with other areas. However ST4 recruitment has been very disappointing, other than in Old Age Psychiatry. Overall in the UK dual posts filled well.
CT1 recruitment will be run in February 2015 in Dundee for August 2015 start.
ST4 recruitment in November 2014 will be held in Manchester and run by North West. There was a shortage of interviewers as the email requesting volunteers was not circulated to correct addresses. SM has now circulated this information and Michele Laverty was happy to collate information on their behalf.
CT1 recruitment will be held in Dundee. As yet there was no information available on ST4 August recruitment.
9.1 / Psychiatry ARCP outcomes
Information was circulated – 80-90% had a satisfactory outcome. It was agreed Outcome 5s should be strictly and consistently applied via the eportfolio.
10. / Workforce planning meeting with Scottish Government on 11 August 2014
The summary of the meeting between SM, Alastair Cook, John Colvin and Stewart Irvine, plus Scottish Government representatives was circulated for information. SM said the need for more core was understood and there was a discussion over whether unfilled residual HST posts could be used as core posts as a temporary measure – there was support for this although numbers would have to be built up over time. There was also support for the development of more Foundation posts to provide Psychiatry experience as a way of attracting more people into the specialty. An FY1 post in South Glasgow in Liaison Psychiatry with attachments was noted. JT noted the Liaison model where FY1s also undertook on call Medicine/Surgical as 4 month posts. CS reported Lanarkshire had 2 posts working on a similar model ie 9-5 within Psychiatry and out of hours in General Medicine. During the day they shadowed consultants and nurse practitioners. Such opportunities were not always easy to provide due to the lack of senior staff to supervise. SM requested feedback on what was being provided for FY1 and FY2 throughout Scotland.
RMV noted there was a long term challenge in GP and Psychiatry to change undergraduate attitudes towards entering the specialties. In response to JC’s query whether there was any scope for the employment of Physicians Assistants it was confirmed there has been on discussion within Psychiatry on their role and senior nurse practitioners tended to be used. JT said that while there was no reason Physicians Assistants could not be used he did not see any scope for this role. His understanding was that Foundation numbers will increase and there will be an increased focus on GP and Psychiatry however the perception was that this would be at the expense of other specialties and it should be made clear these would be new posts with separate funding streams. / All
11. / Heads of School: report from meeting on 5 September 2014
KR and SM both attended the meeting at which there was a presentation by Maura Kerrin from Workforce Psychology on the pilot evaluating CT1 recruitment and its methodology. 181 of 513 applicants for CT1 Psychiatry also applied to GP and the study considered the GP Situational Judgement Test (SJT) and how it correlated and evidence showed correlation was good. The College’s Recruitment Group was encouraged by this pilot and was considering the use of SJTs as part of Psychiatry recruitment. The second station in recruitment will be dropped.
The portfolio was now online and seemed to be working well and has received positive feedback; all feedback was welcomed. The College was setting up a group with Foundation leads and Duncan Henderson will be invited to join.
The GMC has issued two papers for consultation – one on dual training and one on subspecialties. SM will circulate both documents to the STB. / SM
12. / Scottish Careers Fair – 20 September 2014
The STB will have stands at the event and the College and some Health Boards will also have stands on the day. There were sufficient consultants involved and SM will work out a suitable rota for their involvement. It was planned to have Academic materials supplied by Glasgow on one stand, TB will give a talk on Careers in Psychiatry and there will also be ‘speed dating’. STB members were invited to bring along their own material on laptops and posters will be devised; they will also include quality data on the stands. SM, RP and KR will finalise arrangements.
RMV said the involvement of trainees on the day was key as evidence showed the biggest influence on career decision was that of peers/near peers. Data was provided on the effectiveness of Trainee Ambassadors in General Adult Psychiatry recruitment for an article in BMJ Careers Online and this will also be available in print next week. Around a dozen trainees will be present on the day.
SM confirmed the planned summer school for Medical students in Glasgow did not take place; RP confirmed one was run in Edinburgh this year. KR reported there were a large number of undergraduates in Tayside who were Associates of the College and it would be useful to survey where they went in terms of their career; this could be done via STARG. / SM/RP/
KR
13.
13.1 / Updates
Liaison Dean/MDET
RMV reported the work on Recognition of Trainers with the Faculty Development Alliance to support the educational requirements for named supervisors was progressing well It was agreed the STB will discuss Recognition of Trainers as an item at a future meeting. He also noted the move to a single Scotland Deanery in April 2014 and there will be a significant and increasing role for STBs within the new structure. / Agenda
item
13.2 / Region and Specialty
RP noted the proposal to rebadge Outcome 3 as extending core to 12 months rather than remedial training. SM confirmed this was for discussion with the PG Deans.
HG highlighted the issue of the timing of CASC exam; as these were held in September and January there was no point in extending training by 6 months. SM will discuss the issue with GN and the need for a national agreement. / SM
13.3 / College update
DB reported there will be no exit exam due to Shape of Training developments.
13.4 / Service update
JT welcomed efforts to focus on recruitment issues and in particular the meeting with Scottish Government as already noted. He also raised some uncertainty about revalidation and SOAR. It was confirmed this was linked to CCT date.
13.5
13.6 / Academic update
Regional Planning update
No updates were received.
13.7 / Trainee/Specialty Doctor update
RB reported industrial action in the rest of UK regarding the failure to implement DDRB uplift.
The Junior Doctor contract was currently being negotiated for implementation next year. CS confirmed Scottish junior doctors received a slightly higher pay rate than the rest of UK.
13.8 / STARG
No update report was received.
14. / Received for information
14.1 / Fifth NES Medical Education Conference - 27/28 April 2015
The flyer for next year’s conference was received for information.
15. / AOB
No other business was raised.
16. / Date of next meeting
The next meeting will take place at 10.30 am on Friday 14 November in Room 6, Ground Floor, 2 Central Quay, 89 Hydepark Street, Glasgow (videoconference available).

Summary of actions arising from meeting