Foundation ARCP and Revalidation update 2017 Alys Burns

Foundation ARCP and Revalidation update 2017 Alys Burns John Saetta Helen Johnson Mark Bullock

ARCP Essentials www. hee. nhs. uk www. eoe. hee. nhs. uk

Q. 1 What is the purpose of an ARCP? Give up to three principles www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 1 What is the purpose of an ARCP? Give up to three principles 1. reviewing and recording of progress 2. make a judgement of competences acquired by the trainee and suitability to progress to the next stage 3. provide a final statement of the trainee’s successful attainment of competences and thereby completion of the F 1/F 2 programme www. hee. nhs. uk www. eoe. hee. nhs. uk

Q. 2 Which trainees should the ARCP process apply to? www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 2 Which trainees should the ARCP process apply to? All F 1 & F 2 Foundation trainees, including: • • • LTFT (annual basis, not pro rata) Academic Foundation OOPE/research other leave eg. maternity LATs www. hee. nhs. uk www. eoe. hee. nhs. uk

Q. 3 What evidence is required to undertake an ARCP? www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 3 What evidence is required to undertake an ARCP? Everything must have been shared with trainee • structured end-of-year educational supervisor report (collation of requirements for SLEs, attendance to structured teaching, CS reports, sick leave, reflective log) • Items on the checklist – subject to change eg SCRIPT • academic supervisor’s report • can have an additional report from FTPD which may be helpful if concerns • Form R – now the enhanced Form R www. hee. nhs. uk www. eoe. hee. nhs. uk

Key Principles – ARCP Panels • ARCP panel processes for making decisions on trainee educational progression • The information reviewed by an ARCP panel is confined to the evidence presented • Information withheld by a trainee is a probity issue • Referral to fitness to practise procedures can occur at anytime, according to circumstances, not just at ARCP www. hee. nhs. uk www. eoe. hee. nhs. uk www. hee. nhs. uk

Q. 4 Is it a requirement for the trainee to attend an ARCP panel? www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 4 Is it a requirement for the trainee to attend an ARCP panel? • The ARCP process is an assessment of the documented and submitted evidence presented by the trainee and as such the trainee should not normally attend the panel. • However, deaneries may wish to invite the trainee to meet with the panel to discuss the outcome, as well as other issues that may relate to training. • If an outcome 3 or 4 is a possibility then the trainee should be invited to attend. If this is not possible a meeting must be arranged with the trainee, the FTPD and ES as soon as possible after the panel has met. www. hee. nhs. uk www. eoe. hee. nhs. uk

Q. 5 How long can training be extended if there is a recognised requirement for additional time? www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 5 How long can training be extended if there is a recognised requirement for additional time? • Training may be extended by up to one year, and at the same grade. • This does not apply to F 2 LATs www. hee. nhs. uk www. eoe. hee. nhs. uk

Q. 6 What is the role of the ARCP panel in relation to fitness to practice (FTP)? www. hee. nhs. uk www. eoe. hee. nhs. uk

A. 6 What is the role of the ARCP panel in relation to fitness to practice (FTP)? Any concerns about FTP raised during the ARCP process should be bought to the attention of the PG Dean or representative www. hee. nhs. uk www. eoe. hee. nhs. uk

Foundation ARCP: Timelines and checklists E-portfolio demo www. hee. nhs. uk www. eoe. hee. nhs. uk

Organising your panels • The panel should consist of at least three panel members • The panel typically comprises of the FTPD (Chair of the panel) and two other members. Additional /other members could include: • a postgraduate centre manager/other senior administrator • specialty training doctor (ST 4 or above) • clinical supervisor /educational supervisor • lay representative • external trainer • employer representative • external deanery/foundation school representative www. hee. nhs. uk www. eoe. hee. nhs. uk

Key facts for panels • Outcome 3 and 4 should include a lay panel member. • At least two panel members should consider the evidence. • If there is disagreement between the two panel members, the evidence should be scrutinised by a third member • It is not essential for panel members to review the e-portfolio at the same time. • All panel members must be trained in equality and diversity within the last 3 years www. hee. nhs. uk www. eoe. hee. nhs. uk

Reviewing the evidence and recording an ARCP outcome E-portfolio demo www. hee. nhs. uk www. eoe. hee. nhs. uk

Revalidation Doctors in training www. hee. nhs. uk www. eoe. hee. nhs. uk

Principles of revalidation The GMC states revalidation: • Confirms that a doctor with a licence to practise continues to be fit to practise. • Provides confirmation that a doctor with a licence to practise is working within a governed system. • Requires all doctors to engage with systems of periodic review. www. hee. nhs. uk www. eoe. hee. nhs. uk

Principles of revalidation: Doctors in Training • Responsible Officer for all doctors in training is the Postgraduate Dean • Doctors in training should collect the information required for their current curriculum and assessments • UK variation in evidence required www. hee. nhs. uk www. eoe. hee. nhs. uk

Who are Doctors in Training? • All Foundation Year 2 doctors holding a licence to practice with full GMC registration • All specialty trainees • Locums Appointed for Training (LAT) www. hee. nhs. uk www. eoe. hee. nhs. uk

Revalidation recommendations • Foundation year 1 trainees have a Licence to Practice with provisional GMC registration • The Certificate of Experience completed at the end of Foundation Year 1 enables trainees to gain full GMC registration with their Licence to Practice • All Trainees will receive a revalidation recommendation from the Deanery RO: • Five years after gaining their Licence to Practice with full registration • On applying for a CCT www. hee. nhs. uk www. eoe. hee. nhs. uk

What is the Process? • The new ARCP needs to be equivalent to NHS appraisal • Includes full scope of a doctor’s practice • Includes Fitness to Practice concerns from Employers/Performers List • Information from the ARCP process supports the RO’s recommendation to the GMC www. hee. nhs. uk www. eoe. hee. nhs. uk

The System • Trainee declares fitness to practice on enhanced Form R before each ARCP • Employers complete an exception report where there is a concern or investigation as it occurs sent to Deanery • Employers complete a six monthly collective exit report sent to the Deanery • Clinical and educational supervisor reports are amended to include questions with regard to fitness to practice • The enhanced Form R and reports are compared and correlated at ARCP • The ARCP form records the outcome www. hee. nhs. uk www. eoe. hee. nhs. uk

Information to support revalidation through ARCP • Enhanced Form R • Self declaration • Full scope of practice since last ARCP • Involvement in significant events arising from full scope of practice • Complaints and compliments arising across full scope of practice • Declarations of health and probity • Educational / clinical supervisor sign-off of no concerns • 6 monthly employer exception reports of concerns • Routine notification of SIs, complaints and concerns continues www. hee. nhs. uk www. eoe. hee. nhs. uk

The Role of the ARCP Panel Chair To meet trainee revalidation requirements the ARCP panel chair will need to confirm that: 1. A review has taken place that covers the scope of the doctor’s work since the last ARCP 2. Appropriate supporting information has been presented 3. A review of training progression since the last ARCP has been undertaken 4. Agreement has been reached about any necessary actions for the next year 5. There are no outstanding causes for concern about the trainee’s fitness to practise across their full scope of practice www. hee. nhs. uk www. eoe. hee. nhs. uk www. hee. nhs. uk

Scenarios www. hee. nhs. uk www. eoe. hee. nhs. uk

Foundation ARCP Outcomes Outcome 1 - satisfactory completion of Year 1 Outcome 3 - Inadequate progress - additional training time required Outcome 4 - Released from the training programme Outcome 5 - Incomplete evidence presented - additional training time may be required Outcome 6 - (F 2) Foundation Achievement of Competence Outcome 8 - time out of Programme www. hee. nhs. uk www. eoe. hee. nhs. uk

An F 1 has a record of sickness amounting to 29 working days. Her attendance to programmed teaching to date is 50%. She has been reported to be struggling even though her work has been reduced to day-time Mon-Fri with no on-call. ARCP Outcome? Concerns? Comment? 3 (what U Code would you give her? ) Yes May need additional support www. hee. nhs. uk www. eoe. hee. nhs. uk

There have been repeated concerns about an F 1 trainee's poor attitude towards colleagues. The ES has discussed these in detail with the doctor. A plan of action is agreed and documented in the e-portfolio. The trainee is performing well clinically and has satisfied all other requirements of e-portfolio to date, with no further complaints. ARCP Outcome? 1 Concerns? No Comment? Potential causes of concern have been properly identified, dealt with and resolved in year, but they are documented in the eportfolio www. hee. nhs. uk www. eoe. hee. nhs. uk

An F 2 trainee has continued to disengage completely with e-portfolio despite meetings with the educational supervisor and FTPD, followed by a formal meeting at the Foundation School. However feedback suggests that the trainee is clinically competent. ARCP Outcome? 5 Concerns? No Comment? Incomplete evidence is a choice, giving time for the trainee to provide the panel with a reason for an apparent lack of engagement with his/her training record www. hee. nhs. uk www. eoe. hee. nhs. uk

An F 2 has been referred to the GMC for allegedly having inappropriate sexual relations with two patients during Foundation Year 1. The Foundation School have no current concerns and the GMC interim orders panel has not suspended the doctor. ARCP Outcome? Concerns? Comment? 6 Yes GMC process regarding FTP will continue. The employing organisation will need to complete the investigation and inform the Foundation School / PGDean of the outcomes for the trainee www. hee. nhs. uk www. eoe. hee. nhs. uk

The last doctor is suspended from the medical register for one year by the GMC. ARCP Outcome? 4 (What U Code? ) Concerns? Yes Comment? Suspension from the GMC register leads to automatic removal from the training programme www. hee. nhs. uk www. eoe. hee. nhs. uk

An F 1 trainee has been progressing well throughout the year and for the first 8 months has completed all requirements for F 1 sign off. It becomes clear to the ARCP panel, on review, that the trainee has significant gaps in their third rotation. ARCP Outcome? 5 Concerns? No Comment? Incomplete evidence is a choice, giving time for the trainee to provide the panel with a reason for an apparent lack of evidence for his 3 rd rotation performance www. hee. nhs. uk www. eoe. hee. nhs. uk

Questions? Want to know more? • GMC website – Info and FAQs: http: //www. gmc-uk. org/doctors/revalidation. asp • HEEo. E website – Revalidation & Assessment section: https: //heeoe. hee. nhs. uk/revalidation_assessment_home www. hee. nhs. uk