Medical Education update from HEE- educational principles (11/01/21)

Dear Colleagues,

Firstly thank you for your tremendous efforts safeguarding training and trainee welfare in difficult times. We recognise that organisations are not all in the same position and in response to queries about education provision HEE have agreed the principles listed below. Our local approach is to give our DMEs, Heads of Schools, and their teams the flexibility required during these uncertain times, to strive to continue to educate in practical ways wherever possible. The greatest risk here is a failure of clinical supervision. During periods of redeployment trainees working in unfamiliar areas need appropriate and accessible clinical supervision and this is a priority.

Principles for the management of education provision for trainees in Primary and Secondary Care.

The Health Service is under increasing pressure to release trainee time for COVID facing work as Trusts are managing unprecedented numbers of COVID inpatients whilst struggling with high levels of staff absence. Primary Care is similarly facing unprecedented demand whilst coping with COVID – from patients, building limitations, staff absence and the need to deliver the biggest vaccination programme England has ever undertaken and a local rather than national approach is encouraged, recognising that pressures vary between regions and within regions.

·        Teaching should continue where possible and where there is no risk to the delivery of patient services

·        In areas under the greatest pressure (ITU, Respiratory Medicine, Emergency medicine etc), it is recognised that Trusts may be unable to release hospital-based trainees for training

·        All trainees must have access to peer and TPD (including Royal College and Specialty Lead) support and there are good examples of scheduled drop-in sessions, and other initiatives which should be considered

·        Where educators need to move to patient facing roles (see below) there may be a need to combine teaching opportunities across different training programmes

·        Teaching for ST3s in General Practice and hospital trainees at critical progression points must be prioritised, especially support towards upcoming examinations

·        General Practices should continue to deliver weekly tutorials (albeit modified as required), however if pressures are such that this is impossible then a discussion should take place with the local training programme leads

·        It may be possible to facilitate joint tutorials between different general practices and/or for local trainers to work cooperatively to maintain education

·        This can be educationally beneficial for example giving the opportunity for triangulation of feedback for COTs and CbDs

·        Trust-based education sessions should continue where possible-usually on-line and be recorded where possible for trainees to access at a later date

·        Personal study time should be protected where feasible

·        Trainees work schedules should be adhered to unless there are specific local circumstances making this impossible, in which case there should be a discussion with the employer and local training programme leads

·        As in the first wave HEE will support educators who need to prioritise patient facing work

·        Educators should be mindful of their own wellbeing and the need to maintain a sustainable working pattern

·        A discussion should take place with the Head of School to agree priorities for trainees and their supervisors

·        There should be coordination within training programmes and across regions to ensure that trainees still have access to appropriate TPD and wellbeing support

·        Trainees must have access to high quality clinical supervision at all times

·        Supervisors should complete workplace-based assessments when possible

·        Trainees are encouraged to reflect on the additional skills they have gained providing care during the pandemic COVID Self-certificate and Introduction letter COVID Self-certification

Any changes to educational provision should be reviewed regularly and regular provision restored as soon as possible. We are both happy to be contacted for advice on these matters and will support DMEs and all our educators with a practical and common sense approach recognising the limitations placed upon training by current circumstances.