Minutes of the General Practice, Public Health and Occupational Medicine STB Meeting Held

Minutes of the General Practice, Public Health and Occupational Medicine STB meeting held at 1.30 pm on Wednesday 18 June 2014 in Room 6, Westport, Edinburgh

Present: Ronald MacVicar (RMV) Chair, David Bruce (DB), John Kyle (JK), Anthea Lints (AL), Rowan Parks (RP), Paul Ryan (PR), Carrie Young (CY).

By videoconference: Jean Robson (JR).

Inattendance: Helen McIntosh (HM).

Apologies: Philip Cachia (PC), Jim Chalmers (JM),John Gillies (JG), John Henderson (JH), Moya Kelly (MK),Alastair Leckie (ALe), Ian Longair (IL), Alan McDevitt (AM), Stewart Mercer (SM), Iain Wallace (IW).

1 / Welcome and apologies
The Chair welcomed all to the meeting and apologies were noted.
2. / Minutes of meeting held on 16 April2014
The minutes were accepted as a correct record of the meeting and will be posted on the website.
3. / Matters arising/action points from previous meeting
3.1 / Occupational Medicine recruitment: meeting update
The item was deferred to the next meeting.
Action:

Agenda item for next meeting.

4. / STB report to MDET – meeting held on 7 April 2014
The report was received for information.
5. / Role of STB in Quality Management/Quality Improvement
5.1
5.2 / 2014 GMC NTS
Scottish Training Survey (STS)
The Annual NTS Survey information will be released on 23 June. The STS was run 3 times per year gathering data at the end of each post and providing very useable information. RMVsought the STB’s view on what survey information should come to the STB and the STB’s role in dealing with the data received. DB said the STB was unique in bringing stakeholders together and should receive survey information for discussion and interpretation. It was agreed RMV will provide a paper using information from both surveys for each of the STB’s specialties for the next meeting.
Action:

RMV to produce paper using information from both surveys for the next meeting.

6. / Recruitment update
6.1 / GP
6.1.1 / GPST – proposals for underfill
MK reported there were 33 unfilled programmes in Scotland, the majority (23) in WoS 4 year programmes. She noted that fill of rural track programmes has improved.
England has proposed a number of suggestions/initiatives to deal with unfilled programmes. One proposal was to introduce a pre GP programme using unfilled hospital based posts to create a one year programme with some educational content to prepare people for next year’s recruitment. The GP Directors group has discussed the proposal and was not supportive and MDET took the same view.
DB felt the proposal was put together very quickly and all aspects were not considered adequately in advance. Those who would be offered posts would already have been unsuccessful in both recruitment rounds and he did not consider that what was on offer properly constituted training programmes. JK agreed that while it was important to fill posts this was not a good proposal; this was the view of the STB. It was also proposed that Scotland could run a 3rd recruitment round in the Autumn but as it was likely there would be few candidates this proposal was not supported by the GP Directors group. Local recruitment was undertaken for locums but not for GPSTs. JR asked whether there could be an option of offering 3 year posts to people with experience eg with 2 years experience in Medicine, however RMV felt this would be a challenge where only 4 year programmes were available. However local design of programmes could be discussed with MK although there would be service implications if a year were to be dropped. JR will discuss this with MK.
RP reported there was a slight reduction in recruitment to GP over the last 2 years but the picture was better than 3 years ago.
Action:

JR to discuss local design of programmes with MK.

6.2 / Public Health
6.3 / Occupational Medicine
RP reported a 100% fill rate in both specialties in Scotland – in the rest of the UK the fill rate was 36.4% in Occupational Medicine and100% in Public Health.
7. / GP trainee workload data collection
JK reported feedback from trainees who have expressed some unhappiness around recording information and some difficulty with data collection. The closing date for submissions was 25 June and information received will be used in Contract negotiations. Contract negotiations were due to complete in October.
8. / StART Alliance
8.1 / Scottish Medical Careers Fair – 20 September 2014
8.2 / Trainee ambassador recruitment
The Careers Fair will take place on 20 September 2014 in Glasgow and will be co-hosted by BMJ Careers which was advertising the event at no cost. Regular planning meetings were taking place and it was planned to give each STB space in the Strathclyde Suite alongside Foundation and Core. A series of talks will be run on a variety of topics and Health Boards/Colleges/BMA will also have stands. Free buses will run from Edinburgh, Dundee, Aberdeen and Inverness and there will be a small charge for registration to ensure attendance on the day. Trainee Ambassadors will be engaged and fully involved in the event. RMV will discuss with JC and ALe and the GP regional team as to how STB input will work on the day and what to highlight/promote and how. He confirmed he was working with the RCGP to avoid duplication. In terms of the potential impact of the Referendum vote on the event, CY said the BMA has produced a paper outlining key questions on issues concerning doctors, training and GMC registration which it has sent to Scottish Government. It was not clear whether further work will be done before the Referendum takes place. CY agreed to send the BMA paper to RMV as background information. She felt the different ethos in Scotland around the NHS and positive working together could be used as selling points as the current situation in England was deterring some people; they should also highlight that competition was not permitted in Scotland. JK added that the general trainee feeling was that training and working in Scotland was better in Scotland than in England in terms of exposure to training and experience. He felt Scotland should promote the variety of opportunities available and not solely those in remote and rural but also in central inner cities as there were as a danger some applicants could be deterred by an over emphasis on the rural lifestyle and the rural nature of Scotland. RMV noted a core planning group meeting will be held on 19 June at which he will discuss STB input to the Careers Fair on its behalf.
Action:

CY to send BMA paper to RMV as background information.

9. / GP Fellowship/ scholarship
9.1 / Recruitment
Rural and Paediatric recruitment was now completed –9 of 12 rural posts have filled; all Academic, medical education and health Inequality posts have been filled; one of four Occupational medicine posts has been filled; and the 5thannual cohort of Paediatric Scholarships appointed to.
9.2 / Output
A survey on Rural Fellowship output and where people went has taken place and the results circulated for information. RP noted the survey results provided very good and useful evidence. CY noted that a policy paper Being Rural: exploring sustainable solutions for remote and rural healthcare produced by the RCGP Scotland Rural Strategy Group Scotland and presented at a recent RCGP Scottish Council meeting had recommended expansion of Rural Fellowships, however terms and conditions would have to be discussed before any expansion was considered; this was the existing agreement with the STB.
10. / Recognition of Trainers/Faculty Development Alliance
DB reported that the second meeting of the Faculty Development Alliance had taken place. The meeting clarified the structure, a small executive group has been formed and the SCOTS and GP National Training Development Group brought together with the administrative group. DMEs within each Health Board area will be approached to propose members of Faculty to co-deliver workshops and products. This will be administered from the Integration Group and those nominated will be offered training.
A half day orientation to regulation workshop has been signed off and was now available – this will be a short life course.
Work was taking place to confirm one day workshops for new trainers or those updating skills and these would be rolled out in the Autumn. A series of Building on Your Skills workshops will also be rolled out by the end of the year. This training will be offered to trainers who will each be required to demonstrate they were maintaining training up-to-date by whatever appropriate means. DB said he hoped to attend a DME group meeting to provide details of the training on offer and to see gauge how many DMEs will wish to use NES products. All training materials will be piloted and courses will be iterative and modified as appropriate.
11. / Judicial review – Implications
The review did not find in favour of BAPIO however paragraphs 20, 21 and 24 of the judgement highlighted the College’s need to encourage Deaneries to address the fact of underperformance by South Asian and BME candidates in the Clinical Skills Assessment. The paragraphs made it clear GP would have to consider how to support this group of candidates. The GP Directors discussed this at their meeting earlier in the day and RMV has undertaken to gather data on what was currently done across regions to provide standardised support. Various good initiatives were already in place providing targeted training and support and it was essential that as well as providing the training and support this was recorded. He will provide collated information for the next meeting. JK noted the College was undertaking similar work and was already looking at scores from assessment centres and seeking trainee involvement. It was also considering establishing a website for those requiring early support.
Action:

RMV to collate information what initiatives were already in place for the next meeting.

12. / Updates
12.1 / Specialty updates

DB highlighted:

Ongoing work on QA of GP OOHs.
The Judicial Review.
Encouraging different ways of recording Enhanced SEA – it was felt this would be a better learning tool rather than simply a recording mechanism.

12.2 / Liaison Dean update
In PC’s absence, RP highlighted:

Recognition of Trainers was a major task – definitions and time tariffs were agreed with DMEs and work undertaken with DMEs and Medical Schools on list of trainers with provisional recognition. Much credit was due to DMEs and others for their contributions.
Feedback on the Conference on 6 May at EICC has mostly been positive. He noted there was much anxiety/interest in Shape of Training implementation and the event was a good focus for that and other discussion. Next year the conference will run over a day and a half on 27/28 April. Planning for the event was already taking place by the core group with an early decision to repeat some sessions on the day.

12.3 / Service update
PR highlighted

Pressures in Accident and Emergency and the consequent knock on effect.
Health and Social Care Integration – this was now out for consultation however he felt this should not impact on training; its aim was to avoid delayed discharge. The proposal that GP OOHs should be included in integrated partnerships was currently out for review. CY noted this would not just impact on community facing hospital services asthe Scottish Government currently planned to allow integrated boards to direct the spending of a secondary care ‘set aside’ budget which will be calculated by using Integrated Resource Framework data on all adult unscheduled admissions to hospital. DB noted there was concern that training and its complexities could get lost in the Health and Social Care Integration initiative. NES has built up an understanding of the need for the quality of educational and learning environments and there was concern that will be lost or not taken into consideration. The provisional date for the Health and Social Integration implementation remained 1 April 2015.

12.4 / Academic update
12.5 / DME update
No additional information was received.
12.6 / Trainee update
The Chair congratulated JK on his appointment to a Clinical Leadership Fellowship. JK noted he hoped to continue as BMA trainee representative on the STB and will go forward for re-election in September.
12.7 / Lay representative update
No update report was received.
13. / Received for information

BMA response to Shape of Training paper

This had provided an opportunity for the BMA to feed in some of its concerns on Shape of Training review and to ensure that NES and the STB were aware.
DB reported a 4 Nation Implementation Group has been established and has been divided into 6 strands of work. The community based strand will be led by the Department of Health England and a series of workshops held in September will provide an opportunity to debate and discuss implementation. Information on where they will be held was awaited and invitations to attend will be issued; he stressed the importance of involvement in the workshops. He further noted that Scotland was well represented on the Implementation Group – Professor Finlay and Professor Stewart Irvine were 2 of the 6 person membership.

Lachlan Grant publication

Circulated for interest and information.
14. / AOB
No other business was received.
15. / Date of next meeting
The next meeting will take place at 1.30 pm on Wednesday 20 August 2014 in Room 6, Westport, Edinburgh (VC available).
Item no / Item name / Action / Who
3.
3.1 / Matters arising/action points from previous meeting
Occupational Medicine recruitment: meeting update / Item deferred to next meeting. / ALe
5.
5.1
5.2 / Role of STB in Quality Management/Quality Improvement
2014 GMC NTS
Scottish Training Survey (STS) / To produce paper using information from both surveys for the next meeting. / RMV
6.
6.1
6.2 / Recruitment update
GP
GPST – proposals for underfill / To discuss local design of programmes. / JR/MK
8. / StART Alliance / To send BMA paper to RMV as background information. / CY
11. / Judicial review – Implications / To collate information what initiatives were already in place for the next meeting. / RMV