Postgraduate Medical and Dental Education for WalesAddysg Feddygol a Deintyddol Ôl-raddedig Cymru

DEANERYVIEW

Updates on:• The BEST Trainee

Awards 2017• Doctors are Human Too• BSSU Developments

the magazine of the Wales Deanery | July 2018 @WalesDeanery

A Message from the Interim DeanSince the last Deanery View, much has happened both in regard to the implementation of Health Education and Improvement Wales (HEIW), and also within the wider education and training arena across Wales and the UK.

HEIW’s final location has been confirmed as Ty Dysgu in Nantgarw. Through staff engagement events, we have had an opportunity to input on the building’s internal design and its feel as a working environment. In the last few weeks, the selection process for the remaining Executive Director roles have been completed. It gives me great pleasure to welcome Professor Pushpinder Mangat as our new Medical Director. Many of you will know Push in his role as Deputy Medical Director of Abertawe Bro Morgannwg University Health Board. Stephen Griffiths, Director of the Workforce, Education and Development Services (WEDS) has been appointed Director of Nursing. Again, many of us have worked closely with Stephen and his team in WEDS in regard to workforce planning. I welcome Stephen to his role, and look forward to working with him. Danielle Neale has been appointed as the Director of Finance and Corporate Services. Danielle has a varied experience in the NHS, Ministry of Justice, and in consultancy work, including previous Director of Finance roles, as well as a breadth of experience in corporate services, planning, and performance.Dafydd Bebb has been appointed as Board Secretary. Dafydd is relatively new to the NHS, working currently as a senior solicitor in NHS Shared Services. He has previous experience as a company secretary in the private sector.You will be aware that we have commenced the transfer of undertakings (TUPE), and one-to-one consultation meetings continue, but this process will soon be completed, and hopefully, there will be more certainty for staff and their individual roles within HEIW.In addition to all the work going on to facilitate the implementation of HEIW, we continue business as usual. I would like to thank all staff in the Wales Deanery for their commitment to ensuring we continue to support trainees, trainers, and other health care learners in the NHS.Friday, 22 June saw the 14th annual Wales GP National Appraiser Conference in Llandrindod Wells. Enthusiasm remains high among delegates as we move into the second cycle of revalidation, with MARS (Medical Appraisal & Revalidation System) firmly embedded into day-to-day activity. There is considerable excitement about new possibilities within HEIW.We continue to support the Staff and Associate Specialist (SAS) grade doctors in the NHS. The 17th SAS Doctors' and Dentists' Conference took place in Llandudno on Thursday, 14 June. The title of the Conference was 'Support and Solidarity', and delegates received updates on HEIW, the progress of the SAS Charter, and the role of SAS doctors/dentists in the medical workforce.Over 120 people attended the recent Dental Care Professionals (DCP) Symposium in Cardiff on Friday, 18 May. This year’s theme was ‘Time for Change’, and was a great opportunity for DCPs across Wales to network while learning about the challenges of an ever-changing healthcare profession. Over the last nine years, this event has gone from strength to strength, and remains as popular as ever. Members of the dental team were able to appreciate the need to embrace change, and it was extremely pleasing to receive such positive feedback.Excellent results have been achieved by the recent cohort of 17 dental nurses who sat the National Examination Board for Dental

Nurses (NEBDN) Post-Qualification Certificate Courses in special care, sedation, and radiography. These courses are provided by the Wales Deanery’s Dental section, in line with developing the dental workforce. This is a key part of the Chief Dental Officer’s strategy to up-skill dental professionals, thereby ensuring patients receive the best and most appropriate care in Wales.The 2017 Commissioning Process provided a comprehensive review of LEP management, delivery, and support of postgraduate medical training as a key determinant for future allocations of trainees to health boards. It was also a mechanism to consider the changing medical education landscape, and to acknowledge best practice that could be shared across NHS Wales. The process remains important to align educational and clinical governance, and as an opportunity for focused and collaborative discussion and action planning with LEPs around exception reporting, educational governance, and financial accountability. As we move into HEIW, the potential for harmonisation of the Commissioning Process with the Undergraduate Teaching Review Meetings is being explored to ensure consistency of approach for those responsible for learning environments for both undergraduate medical students and postgraduate trainees.Local Faculty Team appraisals were introduced in 2013 to support continuous improvement in Faculty Team structures, functions, and support partnership working with the Wales Deanery to collaboratively support postgraduate medical training management. In this time, they have facilitated a seamless transition from considering organisational environments to demonstrating team effectiveness and generating excellence in training provision. Observations from this year’s round of Team appraisals included: increased cohesiveness amongst team members; environments in which team members are proactive and innovation is encouraged; increased team engagement with the Wales Deanery and local training structures; and teams proactively seeking opportunities for members’ professional development. Outcomes increasingly include direct improvements in postgraduate medical training quality pursuant to achievement of Faculty Team objectives set via appraisal.We are currently working through two major initiatives driven by the ‘Shape of Training’ review. The first is a UK-wide pilot; Improving Surgical Training, which aims to up-skill surgical trainees in emergency general surgery.The second is a fundamental reform of the medicine curriculum, which will be live in August 2019. A workshop, held on Thursday, 28 June, highlighted to all the complexities of the initiative. We will continue to work with colleagues across the NHS, Welsh Government, and the UK to ensure as seamless a transition as possible.As we approach the summer, I thank you all for your continuing hard work and commitment, and wish you a good break. Please do not hesitate to get in touch with me if you have any queries.

Professor Peter Donnelly (Interim Postgraduate Dean)

t: 029 2068 7412 e: pgdean@cardiff.ac.uk

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Health Education and Improvement Wales (HEIW): Update

The past six months have seen significant developments in the programme to establish Health Education and Improvement Wales (HEIW).

This special health authority, and eleventh member of the NHS Wales family, will formally unite the Wales Deanery, the Wales Centre for Pharmacy Professional Education (WCPPE), and NHS Wales’s Workforce, Education and Development Services (WEDS).

The Welsh Government’s 2015 review into health professional education and workforce development (the Evans Report) had originally recommended creation of a new single body to support development and transformation of the NHS workforce in Wales.

But in terms of workforce development, the new organisation’s ambition will extend beyond previous obligations – particularly in supporting immediate pressures on services and staff, and in implementing the Welsh Government’s recommendations from the recent Parliamentary Review of Health and Social Care in Wales.

HEIW will be working in shadow form between 1 April and 1 October 2018, when it becomes fully-operational, giving more time to finalise the new organisation, and to ensure that staff are transferred with minimum disruption.

As such, it will be “business as usual” for the Wales Deanery, which will continue to operate under existing organisational and governance arrangements until 1 October 2018, but with business priorities and plans slowly aligning with HEIW’s to ensure a smooth transitional process.

Following an option appraisal of a number of sites, February saw an announcement that Ty Dysgu in Nantgarw would become HEIW’s headquarters, with staff starting to move into the property from October 2018.

Ty Dysgu was chosen as it is a large, self-contained building, which has the space to offer dedicated training, teaching, and meeting room facilities.

The headquarters is located in the Pontypridd/Treforest strategic hub, an area that has been prioritised for investment and development by the Welsh Government; the decision for the lease to be between public bodies also represents good value for money.

Nonetheless, whilst HEIW’s main physical base will be in south-east Wales, it is important to acknowledge the new organisation’s all-Wales remit, as well as its commitment to build effective links with all regions, and to understand their local challenges.

Vaughan Gething AM, Cabinet Secretary for Health and Social Services, recently approved the new organisation’s functions, which will form the basis of HEIW’s remit letter from the Welsh Government.

These functions will include workforce intelligence; workforce planning; education commissioning; quality improvement; supporting regulation; leadership development; careers and widening access; workforce improvement; and professional support for workforce and organisation design in NHS Wales.

The process to implement HEIW’s organisational structures has also started, through recruitment of the Board’s executive and non-executive members.

Dr Chris Jones, HEIW’s Interim Chair, was recently involved in appointing the Board’s non-executive positions, which were approved by the Cabinet Secretary earlier in the year.

Members, who have already begun to meet in a shadow capacity, include:

• Tina Donnelly CBE DL FRCN;

• Dr Ruth Hall CB;• John Hill-Tout;

• Gill Lewis;• Prof Ceri Phillips;• Dr Heidi Phillips.

HEIW has recently been in the process of recruiting a robust executive structure, with mechanisms set up to embed an effective, multi-professional style of working within the new organisation from the outset.

The following individuals were recently announced as executive members of the HEIW Board:

• Julie Rogers, Director of Workforce and Organisation Design/Interim Deputy Chief Executive;

• Prof Pushpinder Mangat, Medical Director; • Stephen Griffiths, Nursing Director; • Danielle Neale, Director of Finance and Corporate Services; • Dafydd Bebb, Board Secretary.

It is clear that in order to operate successfully, HEIW must have meaningful connections with its key stakeholders. These include trainees; the NHS; professional and staff organisations; academic and education providers; regulators; key partners, such as Social Care Wales; and Welsh Government’s policy and professional leads.

Alex Howells (Chief Executive of HEIW) and Dr Chris Jones have met, and will continue to meet, with their counterparts from these organisations over the coming months.

The Welsh Government has also been hosting events that showcase the new organisation’s potential, whilst also gathering stakeholder feedback to further enhance it. For more information on up-and-coming events, please email heiw@gov.wales.

More updates can be found on HEIW’s two bilingual social media platforms: Facebook (found under ‘Health Education and Improvement Wales – HEIW’, and ‘Addysg a Gwella Iechyd Cymru – AAGIC’), and on Twitter (English: @HEIW_NHS / Welsh: @AaGIC_GIG).

Alex Howells is temporarily based in River House at Ynys Bridge Court, just north of Cardiff, and can be reached via email (alex.howells@wales.nhs.uk), should you wish to contact her directly.

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Doctors are Human TooAs I sit in Amsterdam airport awaiting my homeward journey, my head hurts from all the mental processing I’ve done at the Institute for Healthcare Improvement conference. One particular aspect struck a cord with me – I am human too.

What?! Yep… I am human too. Caitlyn Jenner gave an enlightening talk about her life experiences from being a champion winning decathlete with significant inner turmoil to the point of revelation of changing gender. She describes the personal challenges of overcoming societal and media opinions, the conflict of disclosing her inner difficulties to her family and finally evolving herself to be what she needs to be. She is an inspiration not just to transgenders but to all.

Her story also reminded me of Gareth Thomas. In his biography ‘Proud’ he describes the hardships and challenges he faced informing the international rugby stage, and those close and dear to him, he was homosexual. Coming out in this (at the time) macho, heterosexual and at times homophobic environment took Gareth immense courage. He too is an inspiration for all.

Both Caitlyn and Gareth went through significant mental hardship and both describe a point where they disclose their thoughts to their nearest and dearest. In both cases their concerns were met with pride, love and encouragement. Both Caitlyn and Gareth, in response to this reaction, state “this might be ok” - the relief. Both went against societal expectations despite huge risk, huge concern and worry and yet both won and more.

Medicine is a society just like any other and has its “unwritten rules”. Early in the conference a speaker eludes to the unwritten rule that “doctors are infallible”. Obviously this is ridiculous but its concept silently lingers in the bloodstream of the medical society. However ridiculous it sounds, I feel there are few who stand to

make any significant change. It’s well know that doctors suffer mental, physical, social and emotional hardships. How many doctors have gone through such personal hardships only to result in them taking their own lives? A life lost due to dedicating themselves selflessly for others - sad, unthinkable and simply not acceptable.

We don’t have our Caitlyn or Gareth (yet?), but it's time to take a stand against social expectations that doctors “can do it all and more” – I’ve heard of so many doctors (and friends) suffering silently through personal hardships - its unacceptable. I am a doctor, and I am human too. Say it to yourself, say it to your colleagues and friends but most of all say it to those you hold most dear. That is where the support and love thrives; they want to hear your mind and they want to help and support however they can.

Whilst saying it for yourself say it for others; ‘you are human too’. Look out for your colleagues and friends, I mean really watch them! Tell them they are human too. Tell them they can talk openly. Tell them you are always available to chat; leave that door open. Look after yourself and others, after all it’s only human.

Doctors are human too.

By Dr Rick Ellis, Clinical Leadership Fellow and Anaesthetic Registrar

Dr Neil V Shah, Dental Trainee

Welsh Dental Trainee Wins First PrizeDental trainee Dr Neil V Shah has recently won first prize for his oral presentation at the Welsh Hospitals Dental Specialties Annual Scientific Meeting, organised by the British Dental Association. Dr Shah won the prize for his project ‘Head and Neck Skin Cancers and where to find them’.

The dedicated trainee is currently in his final year of the Port Talbot Longitudinal Scheme. This scheme allows trainees to complete both Dental Foundation and Dental Core Training Year 1 concurrently.

As part of his training Dr Shah undertook a Quality Improvement Project and was able to identify a gap with regard to the awareness and identification of head and neck skin cancer and the subsequent path of referral if suspected by a Dentist.

The project has now progressed into an e-learning module which is in its final stages of development and will be available on the Wales Deanery CPD webpages in due course.

It aims to provide a simple screening protocol, which can be implemented in primary care to educate clinicians on the sinister features of skin cancers so they know when and how to refer patients. The module acts as 1 hour verifiable CPD and those who participate will receive e-certificates upon completion.

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BEST and BSAS Trainer Awards 2017

Welsh doctors have been honoured by the Wales Deanery at an event hosted by the British Medical Association (BMA) at the National Museum in Cardiff. The successful nominees were rewarded with accolades for their excellence in training the next generation of medical and dental professionals across Wales.

All Welsh doctors in training were asked to nominate a consultant, GP, dentist or staff and associate specialty grade doctor, who they believed performed outstandingly. The following healthcare professionals were named BEST trainers of the year 2017:

Dr Andrew Campbell, Consultant in Intensive Care Medicine and Anaesthesia at Wrexham Maelor Hospital; Dr Louise Cook, Associate Specialist in Sexual and Reproductive Health at St Cadoc’s Hospital, Caerleon; Ms Sujatha Udayasankar, Associate Specialist in General/Breast Surgery at Prince Phillip Hospital, Llanelli; Dr Amer Jafar, Associate Specialist in Medicine at St Woolos Hospital, Newport; and Dr Rhian Farquharson, Consultant in Emergency Medicine at Royal Gwent Hospital, Newport.

Professor Peter Donnelly, Interim Postgraduate Dean at the Wales Deanery, said: “The Wales Deanery is extremely proud to have developed the BEST awards in recognition of the high standards of medical and dental education in Wales. Once again, the standards have been exceptional, and reflect the time and commitment from those doctors and dentists at the forefront of training and education. The BEST awards are a fitting celebration for all those nominated by their trainees for the time, care and effort they put into the role on a daily basis.”

Dr Louise Cook, winner of the Wales Deanery’s ‘Staff and Associate Specialist Award for Innovation in Education’ said, “What an experience - from discovering that someone had taken the time and consideration to nominate me through to becoming the recipient of an award. The process was insightful making me reflect on my role as an Associate Specialist and educator as well as making me realise the work I do and the fantastic support I have from my colleagues. Receiving recognition for my role as an educator has been an unexpected but incredible experience and one I will be sharing with the rest of my team as they have all contributed towards my success.”

Meanwhile, Dr Andrew Campbell, winner of the Wales Deanery’s ‘Secondary Care Award’, said “I was absolutely thrilled to be nominated by our trainees for this award. It is an ongoing privilege to hold a position where I get to feed the enthusiasm and interests of our junior doctors as they come through Intensive

Care Medicine. I am obviously delighted to receive the award on a personal level, but also very proud to be part of the excellent team of educators in North Wales.”

Ms Sujatha Udayasankar, winner of the Wales Deanery’s ‘Staff and Associate Specialist Award for Clinical Service Innovation’, stated that, “I am greatly honoured to receive the BEST Award for Clinical Innovation 2017. I take this opportunity to thank the Breast Care team, Prince Philip Hospital, Surgical Directorate and Hywel Dda UHB for inspiration, support and guidance. I thank the Wales Deanery for organising the event; an excellent opportunity to meet the dignitaries and network with other outstanding achievers in Wales. I aspire to take this forward for my future endeavours and inspire my colleagues.”

Dr Helen Baker, the Deanery’s Associate Director for Secondary Care and recipient of this year’s Dean’s Recognition Award, said, “I am extremely proud and honoured to have received this award, which came as a complete surprise. I have a great job which I thoroughly enjoy, opportunities to develop and innovate, and a fantastic, dedicated and supportive team, all of which has led to the many successes recognised through this award.”

The awards form part of the Wales Deanery’s extensive programme of work to recognise and reward trainers, and its view that the quality of medical and dental practice and safety of patients are crucially dependent on the quality of training provided. They also contribute to the Deanery’s implementation of regulatory (GMC) requirements for the formal recognition of trainers in secondary care through the development and support of high quality trainers including Educational and Clinical Supervisors.

The annual BEST awards are part of the BMA/BMJ Clinical Teacher of the Year Awards, which is a collaboration between Cardiff Medical School, Swansea Medical School and the Wales Deanery.

The four winners of the award also received a Medical Education Bursary worth £3,000. The strategic aim of the Wales Deanery is to commission, quality manage and support the education and training of trainees, hospital doctors, GPs, dentists and DCPs in Wales.

Winners of the BEST and BSAS Awards 2017 at the National Museum Cardiff on 13 March 2018

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Welsh trainee doctors and dentists were honoured by the Wales Deanery at an event on Thursday, 22 February 2018 in Cardiff City Hall.

The Wales Deanery’s BEST Trainee Awards 2017 was an initiative developed in order for NHS staff to say ‘Thank you’ to those trainees who ‘go the extra mile.’

The Awards support and reinforce the Wales Deanery’s strategy to provide an exceptional Welsh offer to recruit and retain doctors training in Wales.

The successful nominees were rewarded with accolades in recognition of their exceptional contribution to clinical services through original and innovative work undertaken during their training.

There was a robust selection process in place for selecting the finalists, and subsequently, the winners; all specialty training chairs and heads of specialty schools within the Wales Deanery were asked to nominate doctors or dentists for each of the Awards categories.

Nominations were narrowed down to two per category, and the nominees were then invited to present to a judging panel made up of Professor Malcolm Lewis, Director of General Practice; Dr Helen Baker, Associate Director of Secondary Care; Professor David Thomas, Director of Postgraduate Dental Education; Dr Thomas Yapp, Associate Dean for Foundation; and Dr Shabeena Webster, runner-up at the 2016 Awards.

The ceremony commenced with an opening speech from Dr Chris Jones, the Chair of Health Education and Improvement Wales (HEIW), who was thrilled to be in attendance, with the following eight trainees being named as winners and awarded on the night:

w Outstanding Contribution to the Training Programme Dr Holly Morgan

w Outstanding Contribution Outside of the Training Programme (i.e. Charity) Dr Laura McClelland

w Outstanding Contribution to Raising the Profile of their Specialty in Wales Dr Swe Lynn

w Outstanding Contribution to Leadership Dr Syed Junaid

w Research Project Dr Kieran Foley

w Medical Education Dr Catrin Maidment

w Quality Improvement Project Dr Craig Planello

w Best Foundation Trainee Dr Jessica Oliver

Prof Peter Donnelly, Interim Postgraduate Dean, speaking at the BEST Trainee Awards at Cardff City Hall on 22 February 2018

The BEST Trainee Awards 2017

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Dr Holly Morgan was also presented with the 'Best Trainee of 2017' Award.

Interim Dean, Professor Peter Donnelly said, “This was an evening of great celebration, focusing on the immense contribution that doctors and dentists in training make, not just to patient care, but to the wider community.”

The ceremony this year was again a perfect opportunity to reward a highly-talented group of doctors and dentists in training for their achievements, as well as their contributions across all specialties.

We recently got in touch with two BEST Trainee Award 2017 winners to hear more about their work:

Dr Holly MorganDr Holly Morgan, a core medical trainee and winner of the Wales Deanery’s Overall BEST Trainee Award 2017 as well as the BEST Trainee Award in the category of Outstanding Contribution to the Training Programme, describes her experience of participating in the awards.

“In 2015 the Wales Deanery awarded myself and a colleague with a grant to develop and launch a website for core medical trainees in Wales. Since then, and with the Deanery’s support, the project has gone from strength to strength.

“Throughout my four years working in Wales, I have been continually impressed by how enthusiastic the Wales Deanery is to work with, and support, their trainees.

“I was delighted to find out I had been nominated for a BEST Trainee Award in December last year. The nomination was in the category of 'Outstanding Contribution to the Training Programme', and centred around my work developing the website, as well as representing the Wales Deanery at the national BMJ Careers Fair for two years running, and my involvement in the ‘Train.Work.Live’ campaign.

“In the grandeur of the Assembly Room at the BEST Trainee Awards ceremony in Cardiff City Hall, I was surrounded by my esteemed colleagues and felt honoured as I watched others receive recognition for their hard-earned achievements. I was absolutely delighted when I won my category, and was then completely shocked when I also won 'Overall BEST Trainee of the Year.”

“Events like the BEST Awards provide much-needed recognition for the extra-curricular work undertaken by doctors and dentists across the country. I have always believed in trainees taking a pro-active role in improving their training, but the motivation to continue to do this is sustained thanks to the approachability, kindness and support of my colleagues within the Wales Deanery.

“It is the privilege of whomever wins the Overall BEST Trainee Award to present the following years’ winners with their awards, and I’m very much looking forward to seeing what fantastic achievements my colleagues in Wales will showcase next year. See you there!”

Dr Laura McClellandDr Laura McClelland, who was awarded the Wales Deanery’s BEST Trainee Award in the category of ‘Outstanding Contribution Outside of the Training Programme i.e. Charity’, discusses the experience of winning the award in recognition of her outreach work:

“It was a lovely surprise to discover that I had been nominated for a BEST Award. In fact, whilst winning was clearly a hugely positive experience, I would go as far as to say that the nomination in itself was just as important.

“It made me feel as though people were appreciative of trainee efforts that are above and beyond what is officially required of them. This made me reflect on the contributions of all those who make up our training and working environments, as well as the greater community. It was a generally humbling process.

“The nomination that I received was in recognition of the work that I do as an outreach worker for a project called ‘Street Life’. The aim of Street Life is to provide support to street sex workers in Cardiff.

“Services we provide range from having simple conversations about general wellbeing, housing and benefits, to giving out food, driving someone to a place of safety or reporting crimes committed against sex workers.

“This intermediate step that outreach provides is an essential bridge of communication, which serves to improve the safety of all those providing and purchasing sexual services.

“The Street Life project has been a big part of my life for the past few years and will no doubt continue to be so in the future.”

Dr Holly Morgan [centre] Dr Laura McClelland

July 2018 | 7

Last autumn, I remember reading the flyer promoting the Wales Deanery BEST Awards and can recall wondering what a trainer would need to have accomplished to be considered for such an award.

I made the assumption that GPs and doctors working in a hospital setting would be those considered, rather than someone like myself working in a community based setting. It was therefore a complete surprise to open an email from the Wales Deanery and read the above statement. When I checked out the website I saw photographs of past award recipients and saw faces I recognised.

From being asked to write a personal statement, and then to presenting a summary of my teaching highlights to the award panel, proved an enlightening experience. To take time out to stop and reflect on the range of teaching and training activities and events I have undertaken, together with the different subject matter and variety of audiences I have had the privilege to teach over many years, proved to be a challenging but insightful exercise.

It wasn’t until the awards ceremony; a fabulous event held at the National Museum Cardiff, that I learnt that I was the winner of the ‘Innovation in Education’ award.

A common theme throughout my years as a trainer has been the ongoing work I have undertaken to raise awareness and recognition of children and young people at risk of child sexual exploitation, both through research and teaching/training. To receive an award in recognition of this work felt a great achievement.

Whereas NHS consultants are recognised for their contributions to service delivery and patient care through Clinical Excellence Awards

and merit awards, as an associate specialist, this was the first time this work had been formally recognised outside of my directorate.

While I may have won this award, I have an amazing team behind me who have helped and supported me throughout, learnt through my training, and adapted to the new changes I have implemented. They were as excited as I when I shared the award with them. I am especially grateful for the support and encouragement I have received from my clinical director.

Receipt of this award has opened new doors for me both in terms of teaching and also recognition of the CSE work I have undertaken. It has also given me the incentive I needed to get this work published. I am now looking at innovative ways to use the educational bursary.

I would like to thank the Wales Deanery for my award.

‘Reflecting on receiving the Wales Deanery BEST Award 2017, Innovation in Education’by Dr Louise Cook

From left to right: Dr Ian Collings, Interim Deputy Postgraduate Dean, Wales Deanery, Professor Peter Donnelly, Interim Postgraduate Dean, Wales Deanery, Dr Louise Cook, Associate Specialist in Sexual Health, Aneurin Bevan University Health Board, Dr Raj Nirula, Associate Dean, Wales Deanery at the BEST Awards 2017

Dr Louise Cook is an Associate Specialist in Sexual Health at Aneurin Bevan University Health Board and recipient of the Wales Deanery BEST Award 2017 in the category of ‘Innovation in Education’.

We are delighted to let you know that you have been nominated for the Wales Deanery BEST/BSAS Award 2017.

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The Revalidation Support UnitCommitted to ensuring ongoing improvement to the revalidation process throughout Wales. A key role of the Revalidation Support Unit is our commitment to ensuring the ongoing improvement to the revalidation process throughout Wales. The unit has been instrumental in organising annual Quality Assurance Events throughout Wales, the last of which took place in late 2017. The attendees were required to review 246 appraisal summaries across both primary and secondary care against agreed quality criteria. The results of which were scored and used for analysis with the intention to improve future training and support opportunities, and to encourage continuous quality reviews at a local level throughout the Health Boards. The national events were able to provide the unit with a snapshot of quality across Wales.The unit was able to identify that the all Wales average scoring for both primary and secondary care summaries was above 60%. In secondary care more than half of the overall summaries scored above 50% and in primary care this reached as much as 80%. From both the quality scores, feedback and suggestions for improvement provided by the attendees, the unit was able to establish key objectives to be achieved in 2018. The scoring criteria used in the quality events is currently being reviewed to ensure that the appraisers can continue to deliver a fair and consistent scoring for appraiser summaries as part of the revalidation process. The unit also aims to facilitate discussions on consistency within Designated Bodies in relation to summarising and inclusion of certain elements for appraisal and revalidation.

The Medical Appraisal and Revalidation System (MARS) plays an important part of the revalidation process and the unit is committed to ensuring that this can be used as a tool for Health Boards to provide regular appraisal feedback and up to date support for both medical practitioners and their appraisers. The unit will be aiming to develop a fit for purpose model of training for secondary care appraisers through providing additional appraiser training events. The unit also aims to facilitate discussions on consistency within Designated Bodies in relation to summarising and inclusion of certain elements for appraisal and revalidation.The unit have also been proactive in identifying improvements to the quality events themselves through promoting the benefits to appraisers attending. One improvement is the restructuring of the event to ensure additional time is devoted to those aspects which the previous attendees found beneficial to their role as an appraiser. Another improvement is to introduce additional technological tools to help facilitate communication and enable appraisers from across primary and secondary care to share experience and knowledge with their peers. The Revalidation Support Unit would like to invite both secondary and primary care appraisers to attend one of this year’s Regional Quality Assurance (RQA) events. The events will be taking place on the 18th October in North Wales and the 8th November in South Wales. If you are interested in attending any of our events or finding out more information, please contact Sian Parker-Hornsey or Gareth Lloyd-Richards at Revalidationofficer@cardiff.ac.uk

July 2018 | 9

Two Core Medical Trainees redevelop thecore.wales The Business Systems Support Unit at the Wales Deanery recently announced the launch of an enhanced website for Core Medical Trainees – thecore.wales.

Gareth Peters, Web Programmer, developed the core medical training website in collaboration with Dr Holly Morgan and Dr Melanie Nana, two trainees who are passionate about improving the CMT experience. The website is used by approximately 300 trainees in Wales and is supported by the Wales Deanery and the Royal College of Physicians.

The website contains learning materials for trainees, a forum, a messaging system, a clinic booking system and a section highlighting training events.

Melanie said, “Holly and I started developing thecore.wales in 2015 after receiving a grant from the Wales Deanery’s ‘Trainees Transforming Training’ initiative. We are grateful for the support of a huge number of consultants who have provided educational opportunities for the site. At the last count we had 600 clinics available for trainees to attend throughout Wales, all offered by local consultants. We would also like to thank Dr Tom Lawson for his boundless enthusiasm and optimism, and Gareth Peters for his excellent website design skills and patience.

“Our next challenge is to expand the resource to medical registrars’ dual training in general medicine and expand the current resource throughout the UK. We also look forward to attending the RCP Excellence in Patient Care Awards having been shortlisted for the Contribution to Training category.”

Digital Scoring Function Used at Specialty Training InterviewsIn 2018, national recruitment for specialty and GP training moved to using a digital scoring system to replace previous paper-based interview score sheets, using a cloud based scoring system. Panel members were issued with tablets to record trainees’ scores, and everything was monitored centrally.

As this was the first time interviews had been scored using this method, the Deanery’s Business Systems Support Unit (BSSU) provided technical support before and during the sessions to ensure the process was smooth and problem-free.

Katie McDermott, Specialty Training Manager, and Natasha Elwell, GP Specialty Training Officer said “The interviews proved to be a busy and challenging few days, but the new digital scoring system simplified the process. BSSU provided great support in terms of making sure the equipment worked on the day. Gareth and Chris set everything up beforehand and were on hand throughout to ensure everything went smoothly.”

Dr Holly Morgan [left] and Dr Melanie Nana [right]

BSSU Developments

Gareth Peters, Web Programmer, Wales Deanery, testing the digital scoring system

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BSSU Developments

UK Medical Careers Conference a success in Wales on St David’s DayOn St David’s Day, the UK Medical Careers Conference made its way to the iconic City Hall in Cardiff. Despite adverse weather conditions on Thursday 1 March 2018, the conference went ahead as planned and was well attended by those with an interest in leading and developing medical careers from across the UK.

The Wales Deanery Careers Team, steered by Sally Blake, hosted the conference helping to put Wales on the map as a first-class location to develop medical careers. Leadership for this event is governed by the Medical and Dental Recruitment and Selection (MDRS) Careers Strategy Group; a four nation group who lead and scope medical careers across the UK. There was a high level of interest in the conference with delegates coming from a range of professions including Health Management, Academia and Doctors across all grades.Vaughan Gething AM, Cabinet Secretary for Health and Social Services addressed the conference speaking of a vision for the future of the NHS. His speech highlighted key developments to increase the number of medical student placements and the agenda for widening access to Medicine.

One highlight the Cabinet Secretary focused on was the increase in GP recruitment in Wales since the commencement of the ‘Train.Work.Live’ recruitment campaign.Dr Graham Rutt, Director of the Postgraduate School of Primary Care – Health Education North East, spoke with regards to the MDRS Careers Strategy in the absence of the strategy group’s Chair, Dr Namita Kumar.Clare Owen, of the UK Medical Schools Council, then addressed the hot topic of widening participation into medicine, while Trevor Lambert from the UK Medical Careers Research Group presented the findings of a research study into the career journeys of junior doctors spanning a ten year period. Dr Tom Yapp, Associate Dean from the Wales Foundation School, updated delegates on the challenges facing Foundation Training in Wales, the implications of Brexit, and the imminent review of Foundation Training. The last keynote speaker was Ken Leach from the General Medical Council who presented the findings of a research study regarding training pathways. Although medical careers has been in place for some time and is continually evolving, there is still a huge amount of interest in this field and judging from the feedback, the conference proved to be a very interactive and stimulating event.

Foundation Programme benefits from enhanced online Matching SchemeAbrar Ullah and Marijn Kampf, Web Programmers in the Business Systems Support Unit, recently worked in close collaboration with the Deanery's Foundation Programme to launch an enhanced Matching Scheme.

The F2 Matching Scheme is an online programme which matches F1 doctors to F2 programmes in Wales. The process is carried out approximately five months after the start of the F1 year, allowing the F1 doctor to make an informed decision regarding their choice of F2 job.

Recent improvements to the Foundation Matching Scheme include enhanced functionality and usability using a 'Responsive Theme'. Responsive themes follow the responsive web design approach which aims to create websites that offer optimal user experience across various devices and screen resolutions including desktop computers, tablets such as iPad, smartphones and other mobile devices.

The enhanced Matching Scheme also offers an increased level of security, a feature constantly reviewed and prioritised by BSSU in all new developments and system enhancements.

Sioned Edwards, Executive Officer of the Foundation Scheme, commented, "The Scheme has been running very successfully for some years but required modernisation. The Wales Foundation School has worked closely with BSSU over the last few months to make these improvements ready for its opening on 5th January 2018.

We are extremely happy with the new enhanced version which not only looks good, but is more user-friendly for all concerned. The support provided by BSSU has been exceptional."

Updates have since been made to the Dental Scheme and BSSU Web Developers have also been collaborating with NWSSP to develop a Matching Scheme for nurses.

Wales Foundation School F2 Matching Scheme website

Vaughan Gething, Cabinet Secretary for Health and Social Services [right] is greeted by Dr Ian Collings, Interim Deputy Postgraduate Dean, Wales Deanery [left] at the UK Medical Careers Conference in Cardiff City Hall on 1 March 2018

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Main Image from left to right: Dr Ian Collings, Interim Deputy Postgraduate Dean, Wales Deanery, Professor Peter Donnelly, Interim Postgraduate Dean, Wales Deanery, Dr Amer Jafar, Associate Specialist in Medicine, Aneurin Bevan University Health Board, Dr Raj Nirula, Associate Dean, Wales Deanery at the BEST Awards 2017

An Interview with Dr Amer JafarDr Amer Jafar is Associate Specialist in Care of the Elderly at Aneurin Bevan University Health Board.We recently spoke with Dr Jafar about “opening doors” for Staff and Associate Specialist (SAS) doctors in Wales, the benefits of healthy competition, and passing the baton on to the next generation of doctors.Following a PhD in brain ischemia, Dr Jafar has worked as a SAS doctor in medicine at Aneurin Bevan University Health Board for over twenty years. He is one of 1,000 SAS doctors in Wales, who form a significant and vital hospital workforce.“Being Associate Specialist – or this grade of SAS doctor – enables you to do the day-to-day routine part of healthcare, and at the same time, you have the opportunity to make your own decisions regarding patient care,” Dr Jafar notes.“You can also engage in medical education, medical politics, do managerial work if you’re interested, and give feedback to the British Medical Association, the General Medical Council, the Wales Deanery, and the Academy of Medical Royal Colleges. “So you have freedom as Associate Specialist – freedom in your work.” With his exposure to a wide range of clinical scenarios, Dr Jafar was keen to transfer his experiences on to a new generation of doctors. His passion for teaching and education is fulfilled through his role as Clinical Supervisor for the core medical trainees and Foundation Programme doctors in his department, and his supervision of clinical teaching for fourth year medical students. Dr Jafar stresses the need to further emphasise medical education within the job planning of doctors in Wales.“It’s important to recognise doctors’ experience in medical education and allow more time, if possible, in the job plan to pursue it further, as there is a need – currently, and for the future.”Earlier this year, Dr Jafar was honoured for his work in medical education at the Wales Deanery’s BEST Awards in the category of ‘Innovation in Education’.He said, “In Wales, there are opportunities to advance your interests, and what is good is the recognition of the practice. “For example, the BEST Awards and also the NHS Wales Awards. I feel we should “open more doors” to doctors regarding competitions and awards.”

Dr Jafar believes there is always an opportunity to compete to enhance and improve your experience as a doctor and, therefore, the quality of patient care.“Psychologically speaking, by having competitions, you will ask yourself, ‘Well, this colleague is doing the same job as me; they have no better qualifications than mine, and they were able to do that within the same job plan as me – so why not me?’”In a field that is continually developing, it is clear that Dr Jafar is an advocate for doctors pursuing leadership roles to push the boundaries, and to improve the quality and standards of healthcare services.He believes, “It is always good to participate in bringing an improved service to your community. It is always great to have the feeling that your legacy is, for example, establishing a thrombectomy service for stroke patients in Wales, which we currently don’t have.“And this feeling of success is part of feeling happy. But you cannot achieve this success if the door is closed. So, if you open the door and give people the opportunity, they might succeed.”Reflecting on the recognition he has received throughout his career, from organisations such as the Wales Deanery and the Royal College of Physicians, Dr Jafar reminds us how leadership and competition can lead to shared achievements and improvements for all: “If I am successful, it’s not just about me – it’s because of the organisation behind me, the wider team. This is how I think about it.”Dr Amer Jafar has most recently been shortlisted for the Royal College of Physicians’ Excellence in Patient Care Awards in the category of ‘Outstanding Contribution to the Medical Profession’.

Dr Amer Jafar, Associate Specialist in Medicine, Aneurin Bevan University Health Board

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NHS Wales attract international attention at the International Forum on Quality and Safety in Healthcare Following last year’s success, the Wales Deanery, in joint collaboration with 1000 Lives Improvement Service, attended the International Forum on Quality and Safety in Healthcare, in Amsterdam on 2 - 4 May 2018. Representing NHS Wales, together, the team showcased how NHS Wales and partner organisations are working closely to improve outcomes for people accessing our services. This is through dedicated local and national quality improvement programmes aimed at building capacity and capability across our professional workforce, and improving patient safety and experiences for our patients.

The Forum is one of the world’s largest conferences for healthcare professionals committed to improving patient care and safety, and has been held annually since 1996. This year the forum took place at the Amsterdam RAI Exhibition and Convention Centre, and was attended by over 3,000 health professional from across 80 countries.

The theme of the conference was ‘Reclaiming the Quality in Healthcare’. Our hosts, the Netherlands, compared their country’s shared communal spirit and will to overcome the combined forces of the North Sea and the Alpine melt water, with their communal spirit and will to develop themes and systems for Quality and Safety in their Healthcare System.

Over the course of the two days, NHS Wales provided several speakers for the forum and the NHS Wales stand, well positioned at the entrance to the main auditorium, was a hive of activity. The stand drew worldwide attention and discussion with positive regard for our commitment and partnership with our patients.

Ewart Johnstone, QIST Lead, Dental, commented, “One highlight of the forum was the commitment and passion of the Wales Team, including The Wales Deanery, 1000 lives improvement and Public Health Wales.”

Hundreds of posters were displayed at the Forum, with NHS Wales having a number accepted and presented. It was inspirational to see the vast amount of quality improvement projects on show, and it was great to hear from and to meet some of the presenters.

Tanya Hellard, QIST Officer, would highly recommend the conference to others, “I had an absolutely fantastic experience. The conference provided practical ideas on how best to spread and sustain improvements. It also enabled us to identify potential links for future collaboration with other organisations.”

It was an excellent two days in Amsterdam with much interest in what we are doing here in Wales. The event showcased the collaborative working between the Wales Deanery and 1000 Lives Improvement Service, which is of real benefit to NHS Wales. We hope to have an even bigger presence at the IHI/BMJ International Forum of Quality and Safety in Healthcare in Glasgow 2019.

The NHS Wales representatives at the International Forum on Quality and Safety in Healthcare in Amsterdam in May 2018

The NHS Wales representatives at the International Forum on Quality and Safety in Healthcare in Amsterdam in May 2018

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Development of a Medical Trainer Agreement (Secondary Care and Undergraduate Education) for WalesFollowing the successful implementation of the Educational Supervision Agreement (ESA) in 2013 and the Named Clinical Supervision Agreement (NCSA) pilot in 2016, the Wales Deanery, Cardiff University School of Medicine and Swansea University Medical School are working collaboratively to develop a Medical Trainer Agreement (Secondary Care and Undergraduate Education) due to be rolled-out across Wales in Autumn 2018.

The new Agreement will incorporate the following four trainer roles subject to recognition by the General Medical Council (GMC):

• Postgraduate Educational Supervisors of Junior Doctors• Postgraduate Named Clinical Supervisors of Junior Doctors• Lead Co-ordinators of undergraduate medical education at

Local Education Providers (LEPs)• Doctors responsible for overseeing undergraduate medical

students’ educational progress at medical school

As with the ESA and NCSA the new Medical Trainer Agreement (Secondary Care and Undergraduate Education) will set out the mechanisms for, and support of, the provision of medical education and training. It will do this by defining the roles, responsibilities and rights of secondary care trainers as well as their employing LEP, medical school and the Wales Deanery.

Wales will be the first in the UK to adopt a single harmonised approach to Trainer Recognition, demonstrating the Deanery and medical schools’ commitment to collaboratively supporting individuals across the continuum of medical education and training in Wales.

Incorporating all four roles into one Agreement will provide a more streamlined and consistent approach to managing Trainer

Recognition and supporting secondary care and undergraduate trainers in Wales, and will enable individuals to move ‘fluidly’ between the roles.

The Agreement will be administered via ‘TAG’ (Trainer Agreement Gateway) – an e-agreement system developed by the Deanery’s Business Systems Support Unit - which will also hold records of all recognised trainers. This will ensure the process for managing agreements is more efficient for all parties.

The development of the Agreement is fully supported by the Deanery’s Management Executive, Quality Committee and Trainer Recognition Group, as well as BMA Cymru Wales, the GMC and Local Education Provider Medical Directors.

It is hoped that this important programme of work will raise the profile of medical education and training in Wales; ensure safe, high quality patient care; and increase Wales’ attractiveness as a destination to train and work, thereby improving recruitment and retention.

There is also potential for future iterations of the Agreement to be extended to other roles (e.g. College Tutors, Faculty Leads, Deans of Medical Education, Dentists, Optometrists, Pharmacists, etc).

The Deanery will keep all stakeholders appraised of progress in relation to the development and roll-out of the Agreement. In the meantime, if you have any queries or require any further information relating to this high profile piece of work please contact us at walesdeanerysre@cardiff.ac.uk

14 | DEANERYVIEW the magazine of the Wales Deanery

The Dental CPD Roadshow in CardiffThe Dental CPD Roadshow in Llandudno

Dental CPD Roadshows Make Their Way Around WalesThe Dental Postgraduate section ran a series of roadshows across Wales throughout January 2018, to highlight the changes to the General Dental Council Enhanced CPD (ECPD) scheme.

Five events were held across Wales and one event was held online using Onsync. Delegates were informed about the forthcoming changes being implemented by the GDC from 1 January 2018 for Dentists and the 1 August 2018 for Dental Care Professionals.

Each event explained how the changes will affect them as registrants, and how they and their dental teams can prepare themselves to ensure they meet the requirements of the mandatory scheme to comply with their professional regulation.

The main changes to the scheme are:

w The requirement for all dental professionals to have a personal development plan (PDP)

w An increase in the number of verifiable hours for most professional titles and the requirement to spread the hours more evenly across the five year cycle

w Dental professionals no longer have to declare non-verifiable CPD to the GDC

w The requirement to make an annual statement of CPD hours completed, even if zero hours have been completed for that year

w The requirement to align CPD activity with specific development outcome

w The requirement for professionals to plan CPD activity according to their individual “field(s) of practice”

The events were a great success with a total of 422 dental professionals in attendance. Feedback received so far has also been excellent:

“I feel that my knowledge of the GDC Enhanced CPD scheme had greatly improved since the presentation last night. Thank you.”

“This was a great presentation of the GDC Enhanced CPD starting 2018.”

“It was informative and explained clearly. I can now cascade the information to other DCPs.”

“A well-presented session, straightforward and clear. I thought I knew this topic but I learnt a lot!”

“A very well delivered course, very precise and accurate plus the handouts were useful.”

“The course enabled me to understand the way that CPD is changing.”

As CPD providers, the section has also had to ensure they are following changes to ECPD. Updates have been made to their course booking system, which now enables users to reflect on the course they have recently attended. These comments are then automatically saved to their certificate of attendance, following completion of the online course evaluation form. To date excellent feedback has been received from users about the ease of use of the course booking system and these enhancements will improve their experience even further.

The section propose to run further ECPD events in the summer, ready for the 1 August 2018 implementation date for Dental Care Professionals.

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DEANERYVIEWFurther copies can be obtained by contacting:

The Wales Deanery9th Floor, Neuadd Meirionnydd, Cardiff University, Heath Park Cardiff CF14 4YS.

Tel: 029 2068 7418 email: walesdeanery@cardiff.ac.uk Tw: @WalesDeanery Fb: www.facebook.com/walesdeanery

An electronic version of this magazine can be found at: www.walesdeanery.org

If you require a version of this magazine in another format, or have an article to feature in forthcoming editionsplease contact the above address.

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