Problems to be solved

• Large number of doctors work in public hospital system outside of co-ordinated training systemNo regulation of skills capabilityPotential risks to patient safety

• Lack of career pathways for ‘non-specialist’ doctors leads to exit from JMO & CMO roles to ‘locum’ work

• No system to acknowledge, reward or develop new skills for ‘non-specialist’ health professionals in a standardised fashion.

Hospital Skills Program

• About 1400 NSW doctors working as non-specialist medical staff in hospitalsCMOs, locums, MMOsPrimarily in critical care areas

• Need for skills recognition and/or training emerged through EM training review and locum review

• Aim : systematically develop training & professional recognition for non-specialist medical staff Initially doctors, initially ‘Hospitalist & critical care

CMOsThen mental health, aged care, palliative carebuilds on existing workforceLater can be extended to others

Hospital Skills Program : Principles• Safe patient care by health professionals

Not in a vocational training program Not attained specialist qualifications

• Ensure capabilities are matched to job requirements, especially for ‘locums’

• Provide a respected career pathway for those who do not seek a specialist career Facilitate doctors remaining in public hospital workforce Reduce expenditure on ‘locums’

• For IMGs ( AMC or AoN) Opportunity to assess & enhance clinical skills

PGY1 PGY2 PGY3 PGY4 PGY 5 and above

Intern

Specialist

Junior Registrar Senior Registrar Senior Registrar

IMET Allocation process

OR

Hospital Skills Program

Level 2 Level 3 Level 4

OR

Locum

Resident

Specialist Training Program

Hospital Skills Program : a new career path

? Link salaries to capabilities

Hospital Skills Program

Assurance of capability :Recognise skills ; new learning to increase skills

Record skillsStandardised training CV

Clinical experience, courses completed, skills recognised

Match required skills against job requirementsPosition description eg.ED CMO, to list skills neededEmployer access to IMET held training CV

Hospital Skills Program : training program

• Skills training to take place largely in the workplace

• State wide HSP training & education committee

Set standards, clearly define single program, RPL

• Area or hospital director of ‘Non-Specialist’ Medical Staff

eg. CMO

AHS boundaries

HSP program co-ordinator

‘Non-specialist’ support officer

Hospital Skills Program : training program

• Education program

Hands –on ( hospital +/- simulation centre )

Cognitive ( various possible providers)

Certificate of skills recognition ( AHS & IMET, ?

others)

• Role of IMET

Development & consultation

Implementation

Governance & oversight

Hospital Skills Program : can apply to

• Medical staffCMO / MMO; IMGs – AMC & AoNCasual medical staff (‘locums’)Rural GPsJMOs – ?match with national ‘core curriculum’Medical students

• Senior nurses, including nurse practitioners• ?ambulance officers & paramedics• ?’physician assistant’ or ‘hospitalist’ health care workers

HSP : way forward

• ConsultationLarge working group & advisory group DoH WLDBGMCT Medical Board –feedback to comeCEC – feedback to comeCEs

• Planning session with all parties• Identify potential funding sources• Start with specific group & tasks, eg CMOs in ED

Later role out to other groups