NW SuppoRTT Update - June 2020Dr Alison Gale

Associate Dean for SuppoRTT, HEE NW

Housekeeping and programme

• PLEASE TURN OFF MICS WHEN NOT SPEAKING

• Introduction and SuppoRTT Process Dr Alison Gale,

Associate Postgraduate Dean, SuppoRTT - HEE, North West

• The practicalities of returning to training St Helens and

Knowsley NHST, Lead Employer

• Trainee RTT Experience Dr Michelle Keane, ST6 Paediatrics

• LTFT – the basics Dr Shirley Remington, Deputy Postgraduate

Dean, Learner Support - HEE, North West

• Q&As

@NHS_HealthEdEng

@NHS_HealthEdEng

SuppoRTT

SuppoRTT Programme

• Enables doctors returning to clinical training following

a period of prolonged absence:

– To regain their confidence and clinical skills

– Quickly and safely

– Thereby enhancing trainee wellbeing and patient

safety

SuppoRTT funding eligibility

• All doctors and dentists in training in England

• who have an NTN / FTN

• However, principles of the SuppoRTT process should

be made available to all doctors returning after a

prolonged period away from clinical practice

SuppoRTT Programme

• Should be used by all trainees who have had an

absence of 3 months or more, for whatever reason:

– Parental leave

– OOP(R), OOP(C) and OOP(E)

– Sickness

– Bereavement

– Disciplinary action

• Those with shorter absences may also benefit

Pre-absence• >3 months absence

• Meet ES to complete

• Bespoke plan

• Discussion:

- keeping up to date

- KIT days/courses/mentoring

- particular concerns

• Contact

• ?Return to LTFT training

• Communication with ES

• Meet 6-8 weeks before return

• Discuss:• Learning needs

• Bespoke period of supervision

• Rotas

• Encourage KIT / SRTT days

• Course / bootcamp

Pre-return

• Meet with ES

• Review plan

• Review whether targets met –

WPBAs, reflections

• Mutually agree:• Readiness to return to normal

work / training

• Further enhanced supervision

• ongoing support / mentoring

Post-return meeting

@NHS_HealthEdEng

Remember

• Forward all forms to SuppoRTT.nw@hee.nhs.uk

• School and Trust SuppoRTT Champions in post to

help and guide you

KIT / SRTT days

• Up to 10 days

• Voluntary

• Need educational approval in advance

– Meetings/courses

– Induction

– Supervised clinical work

• Paid at basic rate minus maternity pay

• Payment received by completion of form in LEO

toolkit in same calendar month as work undertaken

@NHS_HealthEdEng

Key concerns of all returners

• Confidence- self and support mechanisms

• Being watched and assessed

• Trainers attitudes

• Ability

• Fatigue

• Managing on call / shifts

• Managing home life

Support available

Mentoring and coaching

KIT activities – generic specific

Personalised return plans and Human factors and simulation days- school and more general

E learning for health package on returning and LTFT

Educational support and funding for education while off when supporting return

Pastoral support including LEO

@NHS_HealthEdEng

Contact

SuppoRTT.nw@hee.nhs.uk

@NHS_HealthEdEng

Thanks and Questions

LTFT – The BasicsDr Shirley Remington

Deputy Dean for Learner Support, HEE NW

• Background

• Recent changes to application process

• New application process

• FAQs

LTFT – The Basics

@NHS_HealthEdEng

@NHS_HealthEdEng

Facts and figures

2019-6673 less than full time trainees

12.6% in HEE NW

Rise by 37.9% since 2012

1.7% of foundation doctors

Most common in OH 33% least common in surgery 5.4%

15% of female trainees 2% of male trainees but male numbers rising

Most common in age 30-39 group

70+% are for childcare

Introduced in 1969-

900 trainees in HEE NW

@NHS_HealthEdEng

LTFTT – Types

Eligibility

• Type 1: carer or health including disability

• Type 2: develop special skills / interest

• Type 3: personal choice that meets their individual professional or lifestyle needs (pilot)

Funding types

• Jobs share

• reduced hours post

• supernumerary

Minimum 50% (GMC 2011)

@NHS_HealthEdEng

LTFTT – Types

• New Gold Guide March 2020

• NHS employer guidance - Flexible Training Cchampions

• GMC statement in 2017 re additional work

• Flexible working law change 2014

• New contract effects

• Return to work support

• Emergency Medicine initiative April 2017 and renewed 2018, O&G and Paeds from November 2019 - further roll out anticipated

• Improving junior doctors’ lives

• Updated local policy

• Local locum guidance

@NHS_HealthEdEng

New Opportunities

• TIS

• Local Flexible Training Leads

• New contract

• GMC statement 2017

• EM pilot and extension and roll out

@NHS_HealthEdEng

Process and Tips

• Eligibility - done once

• Start early.

• Talk to School LTFT Lead and TPD

• Build links with local flexible training lead in Trust as soon as you know which Trust and speak to TSTL

• Notice to return to full time or change 3 months

• If returning after break, ensure Trust are aware

• Use SuppoRTT Opportunities

@NHS_HealthEdEng

Key challenges – LTFT Trainee

• Fitting in

• Personal expectations

• Conflicts in WLB

• Finance

• Rigidity - negotiation skills

• Return to work programmes

• ARCPs

• NTS survey 2019 high

percentage say colleagues

unsupportive

• Isolation

@NHS_HealthEdEng

Common Questions - Answers

• Study leave pro-rata with sessional commitment

• Annual leave pro-rata

• On call pro-rata (may do more to max total working week 40hrs)

• Post approval - only needed if training slots exceeded

• RHFT work 50-80% time

• Supernumerary up to 60%~(80 in last year training)

• Slot share 60%

• GMC rule - minimum 50% time

• Responsibilities training programme as full time

• ARCPs / revalidation as full time

• Locums

• Paid employment

• Bank holidays

@NHS_HealthEdEng

How much notice to start? 3 months.

Why do I need to do a new form every time I rotate? So your school, LEO and

team aware/pay.

How do I go full-time again? 3 – 6 months notice, complete and submit a form,

and let your School know in advance

Out of hours and daytime percentage is different which counts towards CCT

Where do I get information? www.nwpgmd.nhs.uk/content/less-full-time-training

If in doubt, ask

FAQs

@NHS_HealthEdEng

Support for trainers and trainees - LTFT

• Supervision of LTFT Trainees e-Learning module

http://portal.e-lfh.org.uk/Component/Details/473676

• HEE NW LTFT

• HEE NW locum guidance

• NHS employers flexible training leads guidance

• Gold Guide

• Academy of Medical Royal Colleges return to practice

• NHS Careers website

• BMA document 2014

@NHS_HealthEdEng

ltft.nw@hee.nhs.uk

@NHS_HealthEdEng

Overall Satisfaction

75.

76.5

78.

79.5

81.

82.5

84.

85.5

2012 2013 2014 2015 2016 2017 2018

FT LTFT

@NHS_HealthEdEng

Thanks and Questions

Top tips for return to clinical practiceMichelle Keane ST6 Paediatrics

My Experience

With the right suppoRTT

Challenges and benefits

Challenges and benefits

Organisational demands Looking forward to more mental stimulation

Anxiety

Overwhelmed Adult company

Guilt Personal fulfilment

Decision-making

Lack of confidence Growth and personal development

Lonely

Tired Prioritisation

Rusty practical skills Team awareness

Feeling of mediocrity Empathy

Its not the same for everybody

Health issuesFamily support

Partner’s job

Nursery times Sleepless nights

Nursery lurgy

Exams CVSpeciality demands/

expectations

Commute OOH/On-calls LTFT

Some practical tips

KIT/ SuppoRTT days

Make contact with work

early to plan your return

Mandatory training- book early

Book some annual leave

Use your commute- podcasts/

audiobooks/ music

Sort childcare early

including a plan B and

don’t feel guilty for using it

Plan meals/ freeze/ slow-cook

Outsource: shopping/cleaning

Arrange an enhanced supervision period

Find balance

Find time for things that are good for you

Accept organized chaos

Be kind to yourself

Lots of people can support you