Western Sussex Hospitals NHS Foundation Trust Bebba Smithers

Western Sussex Hospitals NHS Foundation Trust • Bebba Smithers – Strategic Medical Education Manager • Cross-site responsibility

Western Sussex Hospitals NHS Foundation Trust • St Richard’s Hospital, Chichester, Worthing Hospital and Southlands Hospital, Shoreham • Merged in 2009 • Serving a population of 450, 000 • • 298 Deanery trainees 112 Trust doctors 270 consultants 400 medical students pa

Value for Money – The Added Extras • All Trust’s receive same tariff – how they use the tariff is crucial • Important for recruitment of trainees and allied health professional • Importance for retention of existing workforce • Offers development of existing workforce – ie. simulation champions, etc.

LEP Educational Integration Providing a high quality integrated learning environment HE prioritise achieving outcomes: • • Leadership Governance Culture Learner Engagement Resource Management Quality Standards Education Supervision Teaching and Learning

Reporting Structure L E A D E R S H I P Trust Board Executive Director with Educational Responsibility – Director of Workforce HEKSS Dean Director WORKFORCE & DEVELOPMENT MANAGEMENT GROUP Medical Director Chair: Denise Farmer INTEGRATED EDUCATION OPERATIONAL GROUP DME David Beattie Chair: Denise Farmer EE Doctors & Medical Students Bebba Smithers Vice chair Pharmacy Saffron Mawby Paediatrics Denise Matthams O&G/ Midwives Tracey Mudd Radiograph ers Caroline Davidson ODPs Cathy Brazier Nurses & Midwifery Tricia Rigby LAB Paediatrics LFG joint O&G LFG joint ACCS LFG joint Ophthalmology Surgery LFG Chi Surgery LFG Wor Anaesthetic LFG Chi Anaesthetic LFG Wor EM LFG Chi EM LFG Wor Foundation LFG Chi Foundation LFG Wor GP LFG Chi GP LFG Wor Medicine LFG Chi Medicine LFG Wor S Integrated Governance Sam Vaughan LFG joint I M Undergraduate joint L&D Val Fish Dental LFG Chi U L A T I O N Health-Care Scientists Stuart Burnett AHPs Nicky Sullivan

Integrated Education Operational Group Educational Quality Management Systems • QIT template

Western Sussex Hospitals NHS Foundation Trust WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST HEKSS Quality Improvement Tool / Action Plan Level of Concern Definitions: 0 = No concern. 1 = No concern as area is already being addressed, but improvement is advised. 2 = Slight concern, improvement required before next review. 3 = Concern to be addressed - mandatory. 4 = Serious concern, to be addressed immediately (concerns at this level are rare). Standard Indicator Criteria Examples of Evidence Provided Level of Conc ern Actions to be Taken STANDARD 1 - PATIENT SAFETY The responsibilities, related 1 a Learners provide safe Learners make the care of duties, working hours and high quality care patients their first concern. supervision/mentorship of to patients. The provider ensures that learners must be consistent the principles and values of with the delivery of highthe NHS Constitution are quality, safe patient care. endorsed and upheld. There must be clear procedures to address immediately any concerns from learners about patient safety. • Feedback from patients on ECQ P 4. 8(f), P 11. 6 - All areas have 3 quality of care. met these indicators. • Evidence that mandatory Contract Review Action Plan 2013 - induction training that evidence of departmental inductions focuses on patient safety is for all specialties was not available. An taking place. induction officer has been appointed. • CQC Inspection report. CQC Inspection 23 -01 -14 - care and • Robust policies are in place treatment was not consistently and are understood and used planned and delivered in a way that by learners, e. g. handover was intended policy, inter-hospital transfer to ensure people's safety and welfare. process, clinical protocols. This was because on some Wards care plans and risk assessments were not in place to provide staff with information on how to provide care for patients with dementia. Evidence that mandatory induction training that focuses on patient safety is taking place. Continue to support learners in improving the patient experience. Ensure care plans and risk assessments are in place. • A current whistle. ECQ P 5. 1, 5. 2 - All areas have met blowing/raising concerns these indicators. policy is in place and is The Board was advised that no accessible by all learners. definitive answer on whistle blowing • Evidence that learners are had yet been received from the Care made aware of how to use Quality Commission (CQC); this had the policy if necessary, e. g. been raised during one of the CQC’s included in induction. unannounced visits, although no • Examples of when the policy concerns had been raised by them. has been used by learners and has resulted in a positive outcome. Provide evidence of a clear process for learners to raise concerns regarding patient safety. Provide examples of when it has been used if applicable. Person Responsible PGME 1 b Learners are able to raise concerns regarding patient safety. There must be a clear process for learners to raise concerns regarding patient safety. Learners are encouraged and enabled to raise concerns with positive outcomes. 3 PGME

Western Sussex Hospitals NHS Foundation Trust 1 c Learners only Learners are never asked to • Examples of learner Contract Review Action Plan 2013 - undertake appropriate work beyond the limits of feedback on the quality of there was evidence of Foundation tasks in which they are their competence without supervision. trainees transcribing cytotoxics; competent or are appropriate support and • Visit Reports. however, action has been taken and learning to be supervision. • Results from National foundation trainees now sign to confirm competent, and with Those supervising the clinical Training Survey. they have been trained and understand adequate supervision. care provided by learners • Ratio of mentors/supervisors what they may and may not prescribe must be clearly identified; to students/trainees. or transcribe. competent to supervise; and be accessible and approachable at all times while the learner is on duty. 3 Provide evidence that this action is effective and that learners are not asked to work beyond the limits of their competence without appropriate support and supervision. PGME 1 d Shift and on-call rota patterns are designed so as to minimise the adverse effects of sleep deprivation. Work patterns and intensity • Evidence of shift patterns. of work must not result in • Copies of learners' rotas. sleep deprivation, which may • Results of National Training have adverse effects on Survey. patient safety. Learners must have adequate rest periods. 2 Ensure workload issues are addressed so trainees are able to attend teaching sessions. PGME 1 e Formal handover arrangements are in place, ensuring continuity of patient care. Learners must have well organised handover arrangements, ensuring continuity of patient care at the start and end of periods of day or night duties every day of the week. Provide evidence of robust handover arrangements in all areas. PGME 1 f (Trainee doctors only) Before seeking consent both • Visit Reports. Trainees must act in trainee and supervisor must • National Training Survey. accordance with the be satisfied that the trainee • Annual Foundation GMC's Guidance - understands the proposed Programme Questionnaire. Consent: patients and intervention and its risks, and doctors making is prepared to answer decisions together associated questions the (2008). patient may ask. If they are unable to do so they should have access to a supervisor with the required knowledge. Continue to ensure that trainees are acting in accordance with the GMC's guidance on consent. PGME GMC Survey 2013 - there were no red flags for workload, but there were 2 green flags (O&G and paediatrics). During the visit of 14 -02 -14, trainees reported that out of hours theatre work was appropriate and on call workload was sometimes challenging but appropriate. However, the junior doctors have enormous difficulties attending the teaching sessions, due to the high workload on the wards. • Handover policy. Visit Reports 2 • Examples of handover sheets. GMC Survey 2013 - there was a red flag • Evidence of well-organised for handover in respiratory medicine. handover processes to ensure The visit of 14 -02 -14 found that continuity of care. handover policies on sites are robust with time built in to shifts for face to face handover. There is a CEPOD board at Chichester which is useful in keeping track of patients on the emergency list. LEP Metrics 2013: Number of red flag 1 indicators for Consent, Site Marking, and Immunosuppressants found by the most recent Foundation visiting process or by the annual STFS survey was rated as Green.

Finance at IEO • Overview of ALL income streams for financial year • Spend and projected spend – linked to Trust priorities/development • Other opportunities/joint bids

Western Sussex Hospitals NHS Foundation Trust Eduction Funding 2014 - 2015 Department HEKSS/Medic Trust No. of Staff in Size of Staff group funding How is the funding allocated? al School/etc. Budget £ team funded by team funded relates to - Criteria for allocation Funding £ HEKSS/Med by. Trust - High level breakdown of School/other allocation for 2014/15 Learning and Development CPD (Cash) Apprentice Funding (HEKSS) Corporate Budget Medical Education (PGME) WITHIN MEDICAL PLACEMENT TARIFF Salary Support Transitional increment F 1 shadowing salary support Training Grade Doctor study leave PGME OUTSIDE MEDICAL PLACMEENT TARIFF Foundation Lead payments Foundation/GEAR Admin Dental trainee funding/study leave GP F 2 study leave GP placements Handover project funding SAS EDUCATION (outside LDA) Consultant/Trust Doctor study leave (outside LDA) Undergraduate - Brighton Medial School (outside LDA) Undergraduate - GKT (outside LDA) Undergraduate - Southampton (outside LDA) TOTALS £ Trust controls

Western Sussex Hospitals NHS Foundation Trust Library (Covers all NHS staff within coastal West Sussex CCG area) Libraries SECAMBS WSCC Library WSHT non-medical placements Library WSHT SIFT BSMS Sussex Community Trust Sussex Partnership Trust Coastal West Sussex CCG Research Practice Development - Corporate CPD funds - allocated to be used at Brighton Univeristy and Surrey University only Library Services Nursing Child Midwifery 18 Month Midwifery Mental Health Dietetics AHP Other ODP Occupational Therapy Physiotherapy Pharmacists Non-Medical Placement Trafiff Funds Nursing Adult

Monthly Update at IEO – Affects all Allied Health Professional • • Nurse revalidation GMC Survey – Operation Green Flag Simulation Opportunities Video conferencing Staff conference Training venues Apprenticeships/Pre-Employment Programme

Opportunities 2015/16 • 50/50 medical/simulation posts x 2 • Departmental induction videos – 40 • Departmental induction handbooks as downloadable apps. – 40+ • Expand sim and clinical skill provision for undergrads. • Use Facebook and Twitter to fill gaps/maximise opportunity

Western Sussex Hospitals NHS Foundation Trust

PGME STRUCTURE - LEADERSHIP • Monthly Education Executive – DME, SMEM, MEM and two CTs • The EE is the LABs operation groups • Discuss all Ti. Ds, LFG issues, finance, staffing, visits, inspections, workloads, innovation, etc. • Vital to have an experienced and robust PGME team – all correctly banded.

Western Sussex Hospitals NHS Foundation Trust DME Clinical Tutor MEM Strategic MEM Academic Registrar Foundation Manager GP STP Manager Clinical Skills Manager WHEC Integrated Simulation Manager Clinical Skills Manager CMEC Senior IT/AV Technician Dental & Induction Manager Strategic MEM & MEM Foundation/ Faculty Administrators CMEC WHEC GP CPD Course Administrator - CMEC Integrated Simulation Administrator - CMEC IT/AV Technician CMEC Undergraduate Administrator - CMEC Front of House Administration Apprentice - CMEC Simulation Apprentice CMEC WHEC Undergraduate Administrator/SIM WHEC