Minutes of the Anaesthetics, Intensive Care and Emergency Medicine Specialty Training Board held at 10.45 am on Thursday 28 November 2013 in Meeting Room 6, Floor 1, Westport, Edinburgh
Present: Eddie Wilson (EW) Chair, Philip Cachia (PC), John Keaney (JK) part meeting, Stephen Lynch (SL), William McClymont (WMcL), Alastair McDiarmid (AM), Kirsty Mitchell (KM), Mark Mitchelson (MM) part meeting, Lynn Newman (LN), Neil O’Donnell (NOD), Rowan Parks (RP), Louie Plenderleith (LP), David Semple (DS), Iain Young (IY).
By videoconference: Dundee: Carol McMillan (CMcM) – due to technical difficulties it was not possible to connect the link.
Apologies: David Caesar (DC), John Colvin (JCo), Roelf Dijzhuizen (RD), Russell Duncan (RD), Paul Holder (PHo), Chris Hoy (CH), John Kinsella (JKin), Michele Laverty (ML), Anthea Lints (AL), Cieran McKiernan (CMcK), Carol Murdoch (CM), Hugh Neill (HN), Alan Orr (AO), Fiona Pullar (FP), Christine Rea (CR), David Stewart (DS), Elizabeth Wilson (EWi).
In attendance: Helen McIntosh (HM).
1. / Welcome and apologiesEW welcomed all to the meeting and apologies were noted.
2. / Minutes of meeting held on 26 September 2013
The following amendment was noted:
Page 4, item 5, first sentence to read ‘WMcL noted Anaesthesia was rated very highly - 2nd to GP in overall satisfaction in the UK …’
With this amendment the minutes were accepted as a correct record of the meeting and will be posted on the website.
3.
3.1 / Matters arising
CT2 Anaesthesia/ST3 recruitment: discussion with Recruitment Committee and Council
EW reported the College and UK recruitment had no plan to change or to revisit provisional offers. He had asked if those who passed in May could be appointed via clearing but was told this was not possible. He believed no trainees were disadvantaged in the longer term but this seemed unsatisfactory given the difficulty the specialty has in filling posts and noted the difference in quality between those applying via clearing and those applying for LAT posts. JC planned to raise the issue at the Council and EW will check what response he received although no change will be possible for this year.
Action:
· EW to check with JC on response received from Council.
3.2 / Emergency Medicine Run Through Pilot: update
It has been agreed to pilot this for 5 years followed by evaluation for all UK and those already in Core and not currently in remediation will be offered run through posts. Scotland agreed to join the pilot as it did not want its trainees to be disadvantaged but it was not clear this will solve the specialty’s issues. The STB agreed information on the pilot must be communicated consistently to all eligible trainees and to document they were given the opportunity and their decision recorded. EW/Leads will meet immediately following today’s meeting to agree the wording of the NES email to be sent to core trainees.
The STB noted the survey of Emergency Medicine consultants. MM reported an approach by the University of Aberdeen regarding a survey on why trainees were leaving/moving to other specialties. AM also noted a separate survey which will ask TPDs to provide trainee email address and they would then be asked to participate; if they agreed they would fill in a short questionnaire followed by a longer telephone questionnaire. PC stressed any contact with trainees would be made via TPDs. Many survey requests were received and in order to prioritise and limit the number all requests were made via MDET. MM and AM were asked to send survey requests to MDET for consideration.
Action:
· EW and EM Leads to agree wording for NES email to core trainees.
· MM/AM to send survey requests to MDET.
3.3 / Remote and Rural Anaesthesia Fellowship: update on provision of Adult Transfer experience
AM confirmed that following further discussion arrangements had been agreed which would provide appropriate training and experience in transfer and thus maintain access to this crucial part of the fellowship.
4. / Dual CCT Programmes: clarification on CCT or CESR route should trainee leave one programme
It was confirmed that where trainees undertaking Dual CCT left one programme it is likely that they will be able to CCT in the remaining specialty. PC confirmed trainees had no right to this however PG Deans were able to exercise discretion on a case by case basis.
5. / Workforce Planning
5.1 / Anaesthesia
· Reshaping Group update
EW noted the recommendation to increase numbers in core Anaesthesia however RP confirmed that while the principle and desire for this was widely supported no funding has been identified. Additionally until the Cabinet Secretary signed off recruitment numbers there was nothing further to report at present.
· Establishment numbers
EW reported establishment numbers in Professor Padfield’s paper were higher than anticipated by the specialty. CR was checking this information and he and she will report back to the STB.
Action:
· EW/CR to report back on establishment numbers once clarified.
5.2 / Emergency Medicine
· Indicative recruitment numbers
Noted: 21 posts in Scotland for ACCS (11/4/3/3) – all posted on the website. These were indicative numbers only and could increase over time.
· HEE teleconference update
IY reported no contact as yet from HEE.
5.3 / Intensive Care Medicine
In total there were 10 posts badged with Anaesthesia although as previously noted numbers remained to be signed off. EWi was keen to put posts on the website but this was not possible until funding was agreed. RP said pressure was being put on Scottish Government for sign off as the deadline for information for any posts to be entered in UK recruitment was 29 November.
Methods of calculating recruitment numbers varied between specialties although they were largely based on retirals. This method worked for Anaesthesia however there was a less coherent picture for Emergency Medicine. RP noted Dr Ian Finlay has now replaced Professor Padfield at Scottish Government and in recent discussions has acknowledged reductions were not always appropriate and was supportive of the increases suggested by the STBs. If approved for 2014 expansion beyond then was likely to be paused while the Shape of Training report was implemented
6. / Recruitment update
6.1 / Update on possible CCT date flexibility for February intake
EW highlighted that ST3 Anaesthesia recruitment for February intake continued to be to replace previous vacancy but took no account of CCT numbers between August and February. This is at odds with the strategy in the rest of the UK. He confirmed that there had been no detrimental effect on recruitment on this occasion but wished to explore this matter to establish a principle for future years. It was agreed that EW/RP and Anne Dickson would discuss this outwith today’s meeting.
Action:
· EW/RP and Anne Dickson to discuss outwith the meeting.
6.2 / Specialty updates
· Anaesthesia
Applications will close next week and all arrangements were in place.
Indicative numbers were: 16 ACCS Anaesthesia; 36 in Core Anaesthesia. There was some discussion on whether numbers on the website were correct; RP said there were often reasons for a seeming disparity e.g. returners and the need for financial sign off. He and EW will check accuracy. It was agreed to post one indicative post for ACCS Anaesthesia in NoS on the website.
It was noted the Anaesthesia person specification was the same as last year with the exception of the requirement for ALS certification by start date for CT1. It was also noted assessor on-line training was available on the College website.
EW has asked FP to provisionally book Westpark Centre, Dundee in April in for Anaesthesia recruitment (ST3); he will check arrangements.
· Emergency Medicine
Noted: ACCS recruitment will be held in Scotland in Edinburgh.
· Intensive Care Medicine
Ten badged posts were anticipated and debate continued whether to add one unfilled post from last year’s recruitment. Funding for the posts was still awaited and if not confirmed in time for UK recruitment may have to be done via SMT.
Action:
· RP/EW to check on accuracy of Anaesthesia numbers on website.
· EW to check Anaesthesia recruitment dates and arrangements with FP.
6.3 / RCoA UK recruitment committee
EW noted the College/UK Recruitment was always keen to involve more people to write questions: he will provide contact information on request.
7. / Scottish Anaesthesia Trainees Survey update
The item was deferred to the next meeting.
8. / Shape of Training Report
PC reported the report has been broadly welcomed. It contained around 20 high level recommendations and their implementation will form a large piece of work with some to be implemented more quickly than others and some requiring further discussion. A UK group will be established to work on the detail and a separate Scottish group will also be established reporting to the UK group.
Main proposals were for registration at the point of graduation followed by 2 years Foundation; 4-6 years of specialty training with the emphasis on generalism, cross specialty skills and competencies, flexibility of training and more team based training. There would be more integration and community based focus for some specialties. CST will replace CCT and some subspecialty training will be undertaken post CST as credentialing providing consultants with the opportunity for further training as dictated by service need.
RP said the Scottish group will take advice from a wide range and STBs will have a major role to play and provide a forum for discussion. He also felt there was a role for STB members in providing intelligence on College discussions and views. He felt it likely credentialing will be the first element to be defined and as the number of specialties may well reduce Scotland had to be part of shaping how this would look.
9. / Liaison Dean Report
PC highlighted:
· Shape of Training was a key issue and he will keep the STB fully informed on the development of a Scottish implementation group.
· NES Medical Directorate – the move to a single Deanery from 2014 has been formally approved by the NES Board.
· Foundation – over subscription remained and additional funded posts have been created to ensure all UK graduates will get posts.
10. / Academic Issues
DS reported that English trainees were allocated 50% academic time; he will send this information to EW.
Action:
· DS to send information regarding English Academic training to EW.
11. / College reports
No reports were received.
12. / Trainee reports
Noted: SJDC will confirm a new trainee representative in due course.
13. / AOB
13.1 / Quality Assurance - ICM
LP reported specialty leads met to consider red flags identified by the GMC survey and to cross reference with PAQ. However this discussion did not support the red flag findings and it has been agreed Educational Supervisors will look at this in the context of this year’s PAQ. Some trainees also remained confused regarding their nominated Educational Supervisor and WMcL said they stressed to ST2 trainees who spent time in Dundee and Perth their Educational Supervisor was for the whole year with other supervisors feeding into assessments.
RP confirmed survey data analysis was done regionally. They were keen for STBs to assume a bigger role in this work and to allocate QIMs to support the STBs however resourcing this was an issue.
14. / Date of next meeting
The next meeting will take place at10.45 am on Friday 7 February 2014 in Meeting Room 6, Floor 1, Westport, Edinburgh (videoconference available).
Actions arising from the meeting
Item no / Item name / Action / Who3.
3.1 / Matters arising
CT2 Anaesthesia/ST3 recruitment: discussion with Recruitment Committee and Council / To check with JC on response received from Council. / EW
3.2 / Emergency Medicine Run Through Pilot: update / To agree wording for NES email to core trainees.
To send survey requests to MDET. / EW/EM Leads
MM/AM
5.
5.1 / Workforce Planning
Anaesthesia / To report back on establishment numbers once clarified. / EW/CR
6.
6.1 / Recruitment update
Update on possible CCT date flexibility for February intake / To discuss outwith the meeting. / EW/RP, Anne Dickson
6.2 / Specialty updates: Anaesthesia / To check on accuracy of Anaesthesia numbers on website.
EW to check Anaesthesia recruitment dates and arrangements with FP. / RP/EW
EW
10. / Academic Issues / To send information regarding English Academic training to EW. / DS
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