Better Training Better Care
Better Training Better Care aims to improve the quality of
training and learning for the benefit of patient care by enabling
the delivery of the key recommendations from Time for Training and
Foundation for
Excellence. DH Ministers commissioned both reports and
Medical Education England (MEE) is taking forward the work.
Sir John Temple’s Time for Training
called for better use of the expanded consultant workforce, not
only to ensure improved training for junior doctors but also in
terms both of efficiency savings for the service, as well as
enhanced safety and higher quality care for patients.
Findings from Sir John’s review were echoed
and built on in Professor John Collins’ Foundation for
Excellence which evaluated the Foundation Programme in the
context of the needs of patients, the needs of trainees and the
changing healthcare environment. Professor Collins’ review
identified Trusts that were doing well, having changed practices to
cope with reduced working hours. However, it also highlighted
concerns that in some cases some of the most junior trainees are
asked to practice beyond their level of competence and without
appropriate or adequate supervision.
Similar findings were also found in the 2009
Wilson report to the MMC Programme Board, the 2009 PMETB survey of
Foundation doctors, in evidence collected by Lord Patel, and in
recent PMETB / GMC training surveys. In part, similar concerns led
to the development and implementation of the Calman reforms and
Modernising Medical Careers (MMC).
In order to implement recommendations from
both the Collins and Temple reviews the work programme for Better
Training Better Care contains two overlapping components:
- the
identification, piloting, evaluation and dissemination of good
education and training practice; and
-
improvements to curricula and the underpinning education and
training frameworks to ensure training is fit for the purpose of
providing safe, effective and improving patient care
A series of workstreams and activities has
been developed with an emphasis both on the need for local and
national activity. Outputs from BTBC will inform the developing of
HEE commissioning decisions and work around the development of
reliable and valid quality metrics.
BTBC seeks to deliver improved patient
outcomes, safety and experience through better training and better
systems of care. This will be achieved by:
- Building on
service redesign which will draw upon greater consultant
involvement in the delivery of care
- Improved
and more immediate supervision of trainees
- Enhanced
multidisciplinary working which supports training
- Trainees
undertaking training on procedures and skills in simulation
environments
Benefits to trainees will be sought
through:
- Improved
mentoring and support
- Improved
and more accessible supervision
-
Opportunities to draw upon simulation, e-learning and other
innovative techniques to develop their skills
Benefits to consultants will include:
- Mentoring
and support for newly appointed consultants
- Recognition
of education and training in job-plans
- A framework
for the training and accreditation of trainers
The Secretary of State for Health has asked
that MEE take forward this programme as a priority. MEE agreed to
remit responsibility to its Medical Programme Board (MPB) and a
dedicated Taskforce reporting to the MPB has been established,
chaired by Sir Jonathan Michael, Chief Executive, Oxford Radcliffe
Hospitals NHS Trust.
Primary responsibility for delivering the
recommendations will rest with local education providers (LEPs)
supported by deaneries, Higher Education Institutions and medical
Royal Colleges and Faculties. In addition to proposing changes to
curricula, BTBC will provide evidence-based examples of good
practice and refine the quality metrics that will be used for
commissioning medical education and training by Health Education
England. The recommendations also require action at national level.
This will entail working with groups such as the GMC, Academy of
Medical Royal Colleges, NHS Employers and BMA among others.
All of the leading partners have agreed to
join the BTBC Taskforce to lead and co-ordinate the comprehensive
plan of action required for implementation. There is already a
great deal of interest from the service in this work and a number
of NHS Trusts have expressed an interest in taking part.
Better Training Better Care provides the
opportunity to embed within the NHS the changed practices and high
quality medical training required to provide the necessary levels
of patient care, including incremental improvements and safety
while ensuring a more efficient and productive service.
Local Implementation and
Pilots
Applications are now
being accepted for a group of around 10 pilot NHS
Trusts that will play a critical role in the delivery of the
three key objectives of the BTBC Programme:
- Appropriate
supervision, and/or implementing a consultant present
service
- Service
delivery that explicitly supports training
- Making
every moment count; ensuring training is planned and
focused
Effective and energetic implementation of
pilots will help achieve the desired changes outlined in both the
Temple and Collins reports resulting in benefits to patients,
trainees, consultants and providers.
NHS Trusts interested in being a pilot
site are asked to read the guidance document and
award criteria. Trusts must complete the intention to
apply form and send it to the BTBC team by 10 January
2012. Completed applications are due by 8 February 2012 and will
not be accepted after this date. For further information on the
programme and the role of the national Taskforce please see
the BTBC Taskforce terms of reference.
The presentation given at the expressions of interest
day for NHS Trusts held on 6 December can also be downloaded
below:
BTBC NHS trust
pilot Guidance
ANNEX A
BTBC pilots award criteria
ANNEX
B BTBC pilot trust application form
ANNEX C Professional services terms & conditions
BTBC pilots intention to apply form
BTBC EOI event
presentation
BTBC Taskforce terms of reference
BTBC Thematic Analysis