Forget what happened during MMC. Forget that awful ward round. Forget last night’s hellish on-call. Instead, remember those times. Those unforgettable times when you alone saved someone’s life. That feeling is what being a doctor is about. That is why you became a JuniorDr. Join the new JuniorDr community at JuniorDr.com
ARE GREAT MEDICAL LEADERS BORN OR MADE? THE MAGAZINE FOR JUNIOR DOCTORS
Presenting History JuniorDr is a free lifestyle magazine aimed at trainee doctors from their first day at medical school, through their sleepless foundation years and tough specialist training until they become a consultant. It’s proudly produced entirely by junior doctors - right down to every last spelling mistake. Find us quarterly in hospitals throughout the UK and updated daily at JuniorDr.com. Editor Ashley McKimm, editor@juniordr.com Editorial Team Michelle Connolly, Anita Sharma, Muhunthan Thillai, Andro Monzon Newsdesk news@juniordr.com Advertising & Production Rob Peterson, ads@juniordr.com JuniorDr PO Box 36434, London, EC1M 6WA Tel - +44 (0) 20 7 684 2343 Fax - +44 (0) 87 0 130 6985 team@juniordr.com Health warning JuniorDr is not a publication of the NHS, Gordon Brown (if he is still PM by date of publication), his wife, the medical unions or any other official (or unofficial) body. The views expressed are not necessarily the views of JuniorDr or its editors, and if they are they are likely to be wrong. It is the policy of JuniorDr not to engage in discrimination or harassment against any person on the basis of race, colour, religion, intelligence, sex, lack thereof, national origin, ancestry, incestry, age, marital status, disability, sexual orientation, or unfavourable discharges. JuniorDr does not necessarily endorse or recommend the products and services mentioned in this magazine, especially if they bring you out in a rash. © JuniorDr 2009. All rights reserved. Get involved We’re always looking for keen junior doctors to join the team. Benefits include getting your name in print (handy if you ever forget how to spell it) and free sweets (extra special fizzy ones). Check out JuniorDr.com.
W
hile philosophers argue whether a great leader is simply born or can be made, the NHS is hedging its bets. After 60 years helping give birth to medical leaders it has decided to have a go at making some too. It’s true that up until recently doctors neither wanted to be born or made a leader. That was left to the dark realm of hospital bureaucrats who created policies that seemed to make our jobs harder. That is about to change. 2009 is the year that doctors are finally being encouraged to take the reins of our National Health Service. A massive push is underway from a host of organisations to give doctors the leadership and management skills to drive the NHS forward. Among the ambitious aims is to have at least one doctor applying for every chief executive post in the UK. In the United States you’ll find that many hospital CEOs have a clinical background - and also a MBA to their name. It makes sense. Get the people who understand patient care the most to run hospitals. This issue we look at what makes a great leader and why you should become one. Dr Andrew Vallance-Owen, Medical Director of BUPA, shows us that being a medical leader doesn’t necessarily confine you to the basement of an NHS Trust (page 12). We chart his route from medical student to director of the UK’s leading private insurer. We take a look at MBAs, Leadership MScs and offer some advice on how to start moving up that leadership ladder (page 9). If you don’t develop leadership skills as a junior doctor we discover that it might be too late. Be reassured. Becoming a medical leader isn’t about abandoning your clinical practice. Each day we all make management decisions about the care of our patients. Gaining these new skills is about improving that. The NHS is calling out for medical leaders in 2009. It’s your chance to prove that great medical leaders can be made as well as born. Read our guide and get involved.
“After 60 years helping give birth to medical leaders the NHS has decided to have a go at making some too.”
Ashley McKimm JuniorDr Editor-in-Chief ST2 Psychiatry
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EWTD
URGENT ACTION NEEDED TO AVOID ‘DISASTER’ THIS AUGUST
P
atients ‘may die’ if surgery is not exempt from the European Working Time Directive, the Royal College of Surgeons has warned. It also believes the effect on training will be disastrous. With less than 60 days until the 48 hour working week comes into effect on August 1st the latest data shows that the number of rotas reporting compliance with the EWTD actually fell from 78% in March to 72% in April. The Royal College of Surgeons is calling for urgent action by the Department of Health to avoid ‘disaster’ this August: “The EWTD is unworkable, dangerous for patients and disastrous for training. This battle is for the soul of surgery, and must and will be won,” said John Black, President of the Royal College of Surgeons.
John Black President of the Royal College of Surgeons
“This battle is for the soul of surgery, and must and will be won. Patients will ultimately suffer and some may even die if it is not.” “Patients will ultimately suffer and some may even die if it is not. I do not know when, but sooner or later this government or its successor will have to exempt surgery, and I suspect many other specialties too.” EWTD compliance currently varies across the UK. A survey by the DHSSPS Implementation Support Group, responsible for EWTD implementation, found that Northern Ireland had the lowest rota compliancy with just 40% meeting the 2009 limits. 4
NEWS PULSE
In Scotland only 57% of junior doctors are working an average of 48 hours a week.
Losing half a million hours The situation will be exacerbated by the 3000 doctors’ posts that are currently unfilled, says the Royal College of Surgeons. It points out that there are not enough doctors in the UK to staff the NHS under working time restrictions and attempts to recruit doctors from around the world are failing: “Moving to 48 hour working with current staffing means losing half a million hours of doctor-patient time a year from the NHS and the NHS is struggling to cope,” said Black. “The College reported in January that rotas were only being held together by internal locums and were meeting the European regulations on paper alone. It is now becoming apparent the closer we get to the deadline that the Governments predictions on meeting this regulation have been hopelessly optimistic.” It expects the number of clinical rotas that report compliance to fall further as the August deadline approaches. It warns that some Trusts are being tempted to introduce dangerous working practices to meet the demands.
‘Speak out’ to support training The Royal College of Surgeons concerns about training have been echoed by Andy Thornley, Chairman of the BMA’s Junior Doctors Committee. He has called on doctors to make their fears about training known: “We are worried that opportunities for trainees to find the time to learn new
procedures will be lost in the rush to deliver services to patients,” he said. “Junior doctors must raise their concerns if they feel their training or the safety of patients is being adversely affected. We owe it to patients and future generations of doctors to speak out on this issue.”
Alan Johnson Health Secretary
“There is no evidence that greater numbers of trainees are failing their end of year assessments where 48 hour working has been introduced.” Health Secretary Alan Johnson, despite launching a review into the effect of the EWTD in May, failed to acknowledge it put patients at risk: “There is no evidence that greater numbers of trainees are failing their end of year assessments where 48 hour working has been introduced.” The BMA has called for short-term practical solutions to be considered, including the re-introduction of training lists to ensure that trainees assist with procedures which are suitable for their stage of training. It also called for investment in simulators and skills labs to enable doctors to practise techniques using technology which simulates an operation. www.bma.org.uk www.rcseng.ac.uk www.dh.gov.uk
PMETB to merge with GMC Draft legislation for the merger of the PMETB and GMC has been published by the Department of Health. If successfully approved by parliament the functions of PMETB will transfer to the GMC in April 2010. The joint body will be responsible for regulating all stages of medical education from entry to medical school until retirement from practice. www.gmc-uk.org
Military docs wounded by payrise Military doctors and dentists are to receive a 1.5% pay rise this year, significantly lower than the 2.8% awarded to other armed forces personnel. The BMA has warned this is likely to adversely affect recruitment and retention of armed forces doctors - especially the MOD’s plan to double the number of psychiatrists and anaesthetists. www.mod.uk
training
Immigration changes will ‘deprive UK of doctors’
O
verseas medical students studying in the UK could be forced home after their FY2 year putting doctor recruitment under further strain, the BMA has warned. Requirements for Tier 1 immigration in the UK changed in April meaning that doctors now need the minimum of a Master’s degree to be accepted. A medical degree is currently classified as a Bachelor’s degree which could result
Dr Hamish Meldrum BMA Chairman
“Restricting their career options to such an extent represents a huge waste of taxpayers’ money and may lead to affected doctors leaving the UK permanently.”
in many medical students and junior doctors being forced to leave the country. Dr Hamish Meldrum, Chairman of BMA Council, called on the Secretary of State for Health to intervene: “The full implementation of the European Working Time Directive and its impact on junior doctors’ training hours, coupled with a situation in which a proportion of prospective trainees can no longer continue with their training due to ever-tightening immigration rules, is likely to exacerbate rota gaps, putting patient safety at greater risk,” he said. “Restricting their career options to such an extent represents a huge waste of taxpayers’ money and may lead to affected doctors leaving the UK permanently.” Tier 1 replaced the previous HSMP in February 2008 and meant that some doctors were restricted from working. It also led to a sharp reduction in the numbers of overseas doctors coming to the UK - as a result trusts are finding it harder to find locum doctors to fill rota gaps. www.bma.org.uk
Simulating surgery Virtual reality simulators can help surgeons improve performance and reduce operating time, according to research published in the BMJ. The randomised controlled trial carried out in Demark found the performance of novices was increased to the level of intermediately experienced laparoscopists whilst the operation time was reduced by half. www.bmj.com
Shaken not stirred Regularly drinking three units of alcohol a day can double the likelihood of developing essential tremor, according to the Journal of Neurology, Neurosurgery and Psychiatry. The study of 3,300 people in Spain took account of confounders, such as lifetime cigarette smoking and depression. Involuntary tremor is believed to result from the toxic effects of alcohol to the cerebellum. jnnp.bmj.com
Working Conditions
‘No way to pay’ for reduction in US junior doctor hours $1.6
billion would be needed to reduce the hours of medical residents in the USA to an average of 80 hours per week, according to a study published in the New England Journal of Medicine. The research follows a major new report from the Institute of Medicine which includes calls to reduce from 30 to 16 hours the time residents can work without sleep. Despite studies showing that serious medical errors could be cut by as much as 25 percent in medical intensive care units, experts say it is currently unaffordable: “Adopting new restrictions on the work hours of physicians in training would impose a substantial new cost on the nation’s 8,500
physician training programs,” said lead author Dr Teryl Nuckols, at the David Geffen School of Medicine at UCLA. “There is no obvious way to pay for these changes so that’s one major issue that must be addressed.” Currently graduate medical education programs require residents to work long hours, often more than 100 hours per week. Recommendations from the IOM include reducing overall hours to 80 per week, that prolonged shifts should include protected time for sleep and increasing the number of days residents must have off. content.nejm.org
NEWS PULSE
5
Broken bones and finances
NHS
MOST DOCS REMAIN COMMITTED TO NHS AFTER 25 YEARS
F
our out of five doctors continue to work in the NHS 25 years after qualification, according to a study published in the BMJ. The study tracked 32,013 graduates from medical school and found that 88% continued to work in the NHS two years after qualification. This dropped slightly to 81% after 25 year follow-up. The data appears to refute claims that increasingly disenchanted doctors are leaving the NHS. In addition, it found that most of the doctors who had moved outside of the NHS continued to work in medicine, either in the private sectors or overseas. A second study of 7,012 doctors looked at
career progression of men and women in the NHS. It found that although a smaller proportion of women than men progressed to senior posts, and that men progressed more quickly than women to these posts, the career paths of women who had always worked full-time were very similar to those of men. The authors say that, although this data indicates that there is no systematic direct discrimination against women in the NHS, indirect discrimination may remain and might include factors like working conditions that conflict with family life and lack of suitable role models in some specialties. www.bmj.com
nhs
WOMEN TO BECOME MAJORITY OF DOCS AFTER 2017
F
emale doctors will outnumber their male counterparts in as little as eight years, according to a two-year review by the Royal College of Physicians. It warns that the increasing proportion of female doctors could become a major issue for the health service as women are more likely to work parttime and focus on particular specialties. Women currently make up 40% of all doctors but account for only 28% of consultants. Only 8.4% of consultant surgeons are women. “This research has shown that women doctors will soon be in the majority and are now reaching consultant status in greater numbers. It is likely to lead to an increase in part time working. Also, women on average make different specialty choices from men,” said Professor Jane Dacre, Chair of the RCP Working Group. 15 years after graduating the study found that on average, taking into account career
6
NEWS PULSE
60 percent of all US bankruptcies are attributable to medical problems, according to new research due to be published in the American Journal of Medicine. The study, which took place before the current economic downturn, found that an American family filed for bankruptcy in the aftermath of illness every 90 seconds. For 92% of these high medical bills directly contributed to their bankruptcy. www.amjmed.com
Holiday over for overseas ops Sending patients overseas for operations may be putting them at risk as well as costing the taxpayer more money, according to research published in the Annals of the Royal College of Surgeons. The study matched two cohorts of 22 patients undergoing arthroplasties - one in the UK and the other in Belgium. Once the increased probability of complications was accounted for the average treatment cost for the Belgium patients was £180,000, compared with £156,500 for the local group. www.rcseng.ac.uk
MRSA goes private As many as one in four nursing home residents carry the MRSA bacteria, according to research by Queen’s University Belfast. The study, thought to be the largest of its kind studying MRSA in private nursing homes, found that 24% of the 1,111 residents were found be colonised by the bug. Up to 28% of staff also tested positive. www.qub.ac.uk
breaks and part-time working, women provide 60% of a full time equivalent doctor, against 80% for men. The highest proportion of female consultants currently work in GP, Paediatrics and Public Health specialities. The authors noted that these preference rankings are not just a UK phenomenon but are closely matched internationally. www.rcplondon.ac.uk
Give tea time to cool Drinking very hot tea can increase the risk of throat cancer, according to a new study published in the BMJ. The study of 871 participants found that compared with drinking warm or lukewarm tea (65°C or less), drinking very hot tea (70°C or more) was associated with eight-fold increased risk. www.bmj.com
NHS
DOCTORS SWIPE CARDS POSE SUPERBUG RISK
D
octors’ swipe cards are a potential source of hospital-acquired infections, including MRSA, according to research published in the Annals of the Royal College of Surgeons of England. The study, which was the first to look at the contamination of swipe cards, found that 21% of those carried by doctors were contaminated with pathogenic bacteria, including MRSA. Out of the 39 cards sampled those kept in a wallet or the doctor’s pocket were the most contaminated. Only one-third of the cards were carried this way but accounted for two-thirds of all pathogenic bacteria. “Security swipe cards and scanners are contaminated with, and may therefore act as a reservoir for, pathogenic bacteria implicated in hospital-acquired infection,” says Robert Greatorex, senior author of the study at the Queen Elizabeth Hospital in King’s Lynn. “Regular cleaning of cards and scanners with alcohol removes all bacteria and would be a simple method of removing this potential source of hospital-acquired infection.” An accompanying questionnaire found that only a minority of doctors cleaned their cards, despite knowledge that wiping with alcohol removed all bacteria from swipe cards and card scanners.
www.rcseng.ac.uk/publications/annals
NHS
DRUG REP FREEBIES INFLUENCE MED students
S
mall promotional products from drug companies, such as pens and notepads, influence medical students’ attitudes towards pharmaceutical drugs, according to a study published in the Archives of Internal Medicine. The randomised controlled study of 352 third and fourth-year medical students primed half the students by exposure to small branded promotional items for the cholesterol-lowering medication Lipitor, including a clipboard and notepad used when they signed in to study appointments. The test involved matching the brands to attributes - such as pleasant and unpleasant - and reporting their explicit attitudes toward both drugs by completing a questionnaire about safety, superiority, efficacy and convenience. Those exposed to the marketing demonstrated stronger preferences toward Lipitor after exposure to promotional items, whereas the controlled medical school exhibited the opposite response. “Our results provide evidence that subtle branding exposures are important and influential, as the psychology and marketing literature would suggest,” concluded the team at University of Pennsylvania, Philadelphia.
archinte.ama-assn.org
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Wellcome Collection
EXQUISITE BODIES
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uring the 19th century, museums of anatomical models became popular attractions for Europeans seeking an unusual afternoonâ&#x20AC;&#x2122;s entertainment. In London, Paris, Brussels and Barcelona the public could learn about the inner workings of the body through displays that combined serious science with an element of fairground horror. Exquisite Bodies at the Wellcome Collection will reveal how spectacular collections of anatomical models were used not only to teach but also to titillate the public in Victorian Britain and Europe. The collection runs between the 30th July and 18th October 2009. For more information visit:
www.wellcomecollection.org
Dissection of the Head and Neck Joseph Towne c. 1827-79 (Courtesy of the Gordon Museum, Kings College London)
Making Future Medical Leaders Believe you can run the NHS better than Sir Bruce Keogh? Or perhaps you’ve got your future sights set on replacing Sir Liam Donaldson? As a junior doctor finding opportunities to grow your leadership and management skills isn’t always easy. We get some advice on how to gain the experience and qualifications that make a great medical leader.
GET an MBA
E
mbarking on an MBA isn’t a decision to be taken lightly. Entry is competitive, you’ll need to be prepared for plenty of late nights and at 20-40K it may be one of the most expensive investments of your life. But earning these three letters puts you in an elite group of individuals and potentially opens a world of new career opportunities. Doctors with MBAs go on to become
medical directors, health policy makers or start their own business ventures. MBAs were first established in the US but have been growing in popularity here in the UK with over 10,000 new gradates each year - and numbers are increasing among medics looking for a business qualification. An MBA gives you an equal or better management understanding to traditional medical managers. The aim is to give you a grounding in subjects such as economics, accounting, business strategy, leadership and teamwork. Be careful though, undertaking an MBA probably isn’t the most useful qualification if you are planning to focus on a purely clinical career. Getting advice and some experience before signing up is highly recommended. Choosing where you sit your MBA is critical. Unlike other degrees that are viewed equally, the respectability of an MBA depends on the awarding institution - and you’ll find that reflected in the cost - with the London Business School leading the UK rankings in both esteem and price. It’s not just about having an internationally recognised qualification - an MBA also opens key opportunities by the contacts and alumni members you meet. You’ll be learning alongside future world leaders so networking is a key part of the learning process. It’s a tough and expensive degree but if you embark on it for the right reasons and view it as an investment it’s unlikely you won’t find an MBA extremely useful whichever career path you follow.
Emma Stanton SpR Psychiatry and in second year of an Executive MBA at Imperial
“There is an emphasis on team working as most of the assignments require working with individuals from a range of professional backgrounds and often different countries. I have most enjoyed the entrepreneurial module of my MBA which has involved developing an innovative idea into a comprehensive business plan and seeking funding to take it to market.”
You can find a list of the UK’s business schools at Financial Times Global MBA Rankings: rankings.ft.com/businessschoolrankings/globalmba-rankings
FUTURE MEDICAL LEADERS
9
Be a BAMMbino
H
ave you ever wanted to improve the system in which you work? Or ever wondered what a Medical Director really does? Or maybe you are considering a career in Medical Management? Then BAMMbino might just be for you. Formed in February 2008 by a group of three trainees, BAMMbino has grown into a network of over 200 junior doctors who see medical management and leadership as an intrinsic part of their future
careers. An offshoot of the British Association of Medical Managers (BAMM), BAMMbino offers training, support and encouragement for trainees through a variety of events, networking opportunities and regular correspondence. BAMMbino can also help arrange shadowing programmes for junior doctors to allow them to experience what a future career as a clinical leader may involve. The BAMMbino Night School programmes at various locations across the country have also proven to be a popular way to encourage dialogue between junior doctors and top NHS leaders. Having hosted Sir Liam Donaldson (Chief Medical Officer) and Sir Bruce Keogh (NHS Medical Director) as well as co-hosting the “Agents for Change” conference with the National Patient Safety Agency, BAMMbino is attempting to raise the profile of clinical leadership amongst trainees and make medical management a positive career choice. The next event, the BAMMbino Summer School on June 23rd, aims to show
Dr. Mark Simmonds SpR Acute Medicine/ Intensive Care Founding Chair, BAMMbino
“The rapid growth of the BAMMbino network demonstrates that there is a wealth of enthusiasm for clinical leadership amongst junior doctors that has previously been unrecognised and unexploited.” trainees how to gain more experience and get actively involved with the management of their own Trust. Speakers include experts from McKinsey, Harvard Business School and the Department of Health. For more information on joining BAMMbino visit: www.bamm.co.uk
Become a CMO advisor
T
POSTGRADUATE CERTIFICATE / POSTGRADUATE DIPLOMA / MASTERS (MSc)
MEDICAL LEADERSHIP 2009/10 ENTRY
Part-time programmes designed specifically to meet the needs of doctors Designed and delivered by the Royal College of Physicians and the prestigious academic centres of Birkbeck College and the London School of Hygiene and Tropical Medicine (both part of London University), the programme is aimed at doctors aspiring to management positions within the health sector, such as Clinical Directors, Medical Directors or Chief Executives. The deadline for receiving applications is approaching and places are limited; for an application pack please contact Louise Bassett via email at: louise.bassett@rcplondon.ac.uk or telephone 020 7935 1174 x 420.
www.rcplondon.ac.uk/medicalleadership
he Chief Medical Officer Clinical Advisor Scheme is a unique programme set-up by Sir Liam Donaldson that has been expanded this year. It offers a select group of doctors the opportunity to work alongside medical leaders, such as the CMO himself, and gives a unique insight into how management decisions are made and health policies implemented. This year the scheme has been rolled out nationwide and successful candidates will be able to work for a range of public health directors and NHS policy makers, as well as other organisations such as BUPA. Clinical advisors essentially work as apprentices to doctors in senior roles picking up key skills such as policy development, project management, research and analysis. Doctors previously on the scheme have worked on issues such as patient safety in partnership with the WHO, local implementation of organ donation and clinical pathway design. Competition is extremely tough. Those successful applicants are seconded from their current Trust for a year or more keeping their NHS salary. Most doctors return to their clinical posts afterwards but there is the option to continue with some projects. The scheme is open to all doctors from FY1 up to consultant level. Recruitment for this year has closed and successful applicants are due to start their posts in September. Advertisements and application forms for next year’s scheme will be available early in 2010.
www.dh.gov.uk
10
FUTURE MEDICAL LEADERS
MSc Medical Leadership
3M™ Littmann® Cardiology III Stethoscope
A
new Masters Degree in Medical Leadership is launching this October and is open to junior doctors with a minimum of one year of specialist training. The part-time programme is being offered by the Royal College of Physicians (RCP) in partnership with Birkbeck College and the London School of Hygiene and Tropical Medicine. It is aimed at doctors aspiring to be the next Clinical Directors, Medical Directors or Chief Executives says Professor Ian Gilmore, RCP President: “The responsibility for planning and transforming the delivery of health services for a large organisation is a complex one, and one in which doctors should be fully involved,” he said. “With this in mind we have developed this programme to help prepare the next generation of medical leaders, and encourage doctors from a wide variety of backgrounds to apply.” Progressing from a Postgraduate Certificate to a Diploma and then a Masters award, the entire MSc can be completed in two years. The course will be delivered in purpose built teaching facilities at the Royal College of Physicians in London. Applications should be made by 31 July 2009. Warwick Medical School also launched a MSc in Medical Leadership this February but is currently only accepting consultant applications.
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www.rcplondon.ac.uk/medicalleadership
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F
orty doctors are currently piloting a new leadership programme to help create change within their Trusts and local communities. Candidates were selected from acute and mental health SpRs and also primary care GPs. Successful fellows will work full time within their trusts and the local community to assist with local health improvement. The twelve-month fellowships were developed in response to Darzi’s “High Quality Care for All” report published last year. Selected doctors will also complete an education component to gain a postgraduate certificate and be offered mentoring by their local medical directors. The scheme is currently in the pilot phase but if successful the hope is expand it in the future. For more information please contact the Leading for Health team:
leadingforhealth@london.nhs.uk
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Buy now and you will receive a special FREE GIFT *. This Littmann 256MB USB memory card also contains the invaluable Introduction to Heart Sounds educational software, normally only available on CD. This offer is valid from May 1st to Aug 31st 2009 while stocks last, from participating distributors. For a list call 3M Health Care customer services on 01509 613584. *One free gift available on every purchase of a Littmann Cardiology III stethoscope from participating distributors. No cash alternative to this gift. Promoter: 3M Health Care, Morley Street, Loughborough, LE11 1EP. tel: 01509 613584 3M and Littmann are trademarks of the 3M Company © 3M Health Care 2009
3
Profile: BUPA Medical Director Andrew Vallance-Owen
For a company whose mission statement is to help people “live longer, healthier, happier lives” Andrew Vallance-Owen certainly lives that message. He’s a man on his 13th BUPA Great North Run and medical director of the UK’s largest private healthcare company with over 10 million customers around the world.
A
s the medical face of BUPA his primary job is to be responsible for the safety and quality of care but he also represents the group when a medical background is needed. This can be on diverse matters such as discussing how BUPA could assist with a UK swine flu epidemic to a government meeting at No. 10 to influence health policy. Andrew is also a key player in the group’s expansion into emerging markets. In the last few weeks he has been to China, Australia and the Middle East. “There is a lot of international travel which although it sounds exciting can be very tiring,” says Andrew. “The timetable is hectic but I find it fascinating to be working in so many different markets.” It’s the variety of his job that leaves Andrew with no regrets twenty-three years after leaving his clinical career. “I used to love surgery but I’ve thrown off those shackles,” he says. “The best bit about being medical director is never knowing what is going to happen next.”
Medical student to medical director Andrew’s passion for leadership first developed soon after he joined Birmingham medical school back in 1970. He started by running the generic ‘wine and cheese evenings’ as president of the medical society but soon found himself voted in as student president opposing a 30 percent rise in hall fees in a fight that reached the national press. The following year he was running for president of the NUS in a battle against now well known political candidates like Charles Clarke. He lost - but his thirst for politics continued. Andrew joined the BMA’s junior doctor committee and became deeply involved in medical politics. Just prior to becoming a SpR the opportunity arose of a staff post in 12
the BMA. He left clinical practice, took the post and quickly moved up the ranks becoming Scottish Secretary before taking up the post of head of BMA policy in London. After picking up management skills as well as an MBA whilst at the BMA he was approached by BUPA in 1994 who were looking for a new medical director for its BUPA Hospitals division. Describing himself as an ‘NHS person through and through’ Andrew was reluctant: “I’d been a garlic cross person in terms of my attitude to the whole private sector just like many junior doctors,” he said. “But I was greeted by a young, enthusiastic BUPA team with a clear vision. I found that inspiring.”
“I loved surgery. Being out of the operating theatre was tough for the first two years but since then I have never looked back.” Just one year into the post he was offered the position of medical director of the entire BUPA group. He accepted, and has been the medical face of BUPA ever since.
Advising future leaders Making the transition from a clinical role to management wasn’t an easy one says Andrew: “I loved surgery. Being out of the operating theatre was tough for the first two years but since then I have never looked back.” At that time there were no options of part-time training or secondments to gain management experience. Andrew had to make the jump from full-time surgeon to full-time BMA staffer in one go - a huge career shift even for someone who had been as involved in medical politics as he was.
FUTURE MEDICAL LEADERS
Today he encourages anyone keen on following his footsteps to take advantage of the opportunities that are available to junior doctors, such as the CMO Clinical Advisor Scheme. Andrew has recently been interviewing candidates to join Bupa as part of this year’s programme and says he was surprised at the level of leadership and entrepreneurism among junior doctors. Successful applicants will have the option of shadowing Andrew in his post at BUPA.
The future for BUPA Andrew sees an exciting future for BUPA, particularly overseas. He highlights the opportunities of the group’s entry into China but recognises that this will be accompanied by some real challenges. “I am a passionate believer in evidence based medicine and clinical governance but just transferring UK clinical governance policy into China is not realistic. It would not be understood and you couldn’t deliver it, but we are making a start,” he says. He feels that this demonstrates one of the struggles for any doctor who makes the transition into a leadership role - achieving the balance between business and health service delivery. Andrew says he is fortunate that his colleagues at BUPA recognise the importance of the clinical input from his team: “Putting the customer first is absolutely fundamental to BUPA and that means providing the best quality care.” He finds the opportunities that China presents exciting and he doesn’t seem too daunted by the challenges - for someone who will be training at 6am tomorrow for his next BUPA Great Run it’s something he takes in his stride. With that attitude taking the “live longer, healthier, happier lives” message to the world shouldn’t be a problem for Andrew Vallance-Owen.
Difficult colleagues Sara Williams from MPS offers some tips for dealing with challenging encounters of the most difficult kind Advice – what to do with the drunken surgeon?
Good personal conduct, effective communication and respect for colleagues will avert most problems; however, what if the actions of your colleagues could harm patients?
Mina is in an invidious position; she clearly has concerns that Mr Martin, a senior consultant, is operating under the influence of alcohol and these concerns are shared by Margaret, the theatre sister.
The stress of the clinical workload means that mistakes are inevitable, but a distinction needs to be made between matters of personal conduct, poor performance and where a doctor’s performance may be affected by a health issue (eg, depression, substance abuse, etc).
Put yourself in Mina’s position. It is never easy when you suspect a colleague has a health problem that may affect their performance, especially when that colleague is senior, has been recently bereaved and may be the person you would have turned to for a reference. Despite this, you have a duty to protect patients from the risk of harm posed by a colleague’s performance, health or conduct. You must, therefore, make patient safety the priority and act straight away if there is an immediate risk.
The GMC guidance says you should “support colleagues who have problems with performance, conduct or health”, but action should be taken if this causes them to compromise patient care.1 If a colleague is self-prescribing, hurting patients or abusing substances, what should you do? If you believe the actions may put patients at risk, the GMC recommends that you raise your concerns with the medical director or a senior colleague. Local guidelines will be in place to deal with these situations should they arise and all doctors have a duty to make any concerns known.
Margaret clearly shares your concerns and (if time allows) it would be helpful to discuss matters with her before deciding how best to proceed. You might wish to prepare a contemporaneous report outlining your concerns in a factual way. Approach a senior colleague to discuss the matter further. As a last resort, the trust will have a “whistle-blowing” policy which may be appropriate to use in these circumstances. You should be aware that whilst care is taken to safeguard the identity of the whistle-blower it may become obvious to Mr Martin who has raised concerns.
Scenario Thursday morning surgery is about to begin, and Mr Martin, a senior consultant general surgeon, arrives and greets Margaret, a sister in theatre who has worked with him for 15 years. Mina is next to arrive; she is an F1 and aspires to be a breast surgeon. Unawares to Mina, Mr Martin lost his wife a year ago this week when her car hit a tree in slippery conditions.
The alternative would be to approach a senior colleague, such as the clinical director, and outline your concerns in order that he or she can take matters further. The trust will have procedures for investigating and managing such concerns.
Surgery commences and Mina begins to assist Mr Martin in what is her first case of the day. As they work through the list of patients, Mina observes Mr Martin struggle to suture a patient. Her concerns peak when he drops his forceps. Suddenly Mina becomes aware that there is the unmistakable whiff of alcohol. As she moves closer to assist Mr Martin, to her horror, she realises that the smell is coming from him. What should she do?
Remember If you have reasonable grounds to believe that patients are at risk, then doing nothing is not an option. You have done nothing wrong and, provided that you report your concerns in a prompt and factual way, you will not be vulnerable to criticism.
The characters in this scenario are fictitious
Once you have reported your concerns to the Trust, it is up to them to take matters forward in accordance with their procedures. Do not hesitate to contact MPS, as our medicolegal advisers would be happy to advise you in these or similar circumstances.2
Support services doctors Doctors’ Support Network: 0870 7650001 – www.dsn.org.uk
© May/Science Photo Library
Practitioner Health Programme – www.php.nhs.uk The BMA Counselling Service: 0845 9200169 (BMA members only)
References 1
Working with colleagues: Working in teams Good Medical Practice 2006 – www.gmc-uk.org
2
Paragraphs 13 and 44 Page 23 Good Medical Practice 2006 – www.gmc-uk.org
MPS professional support and expert advice 24-hour medicolegal emergency advice line Medicolegal publications – Casebook and New Doctor Risk Management materials including medicolegal booklets
Online resources including factsheets and case scenarios Educational support through discounts with leading publishers Largest international protection organisation
For more information call 0845 718 7187 Or visit www.mps.org.uk The Medical Protection Society Limited. A company limited by guarantee. Registered in England No. 36142 at 33 Cavendish Square, London W1G 0PS. MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.
MPS0865
In association with
NICE MAKES BEST EVIDENCE SEARCHABLE
N
ICE has launched a new free search engine to help doctors find the “most reliable and trustworthy” clinical information on the internet. NHS Evidence aims to help users find the best evidence for treatment pathways, data on prescribing and public health policies. It was developed in response to Lord Darzi’s ‘High Quality Care for All’ report last June and will be available to the public as well as health professionals. Listed material will be assessed by an independent advisory committee to ensure it has been developed using rigorous processes. The site will also award an accreditation mark to the most reliable and trustworthy sources of guidance.
Dermatology Websites
DermLectures www.dermlectures.com
Ambitiously aiming for 300 free video lectures, DermLectures covers the major topics such as viral infections, acneiform eruptions and bullous disease. Great for learning the basics.
Virtual Grand Rounds in Dermatology www.vgrd.org
Read a new case presentation with macroscopic and microscopic images every few weeks, plus your opportunity to join in the discussion online. Highly recommended to keep those dermatology brain cells working.
eMedicine emedicine.medscape.com/dermatology
From the consistently impressive eMedicine team the dermatology section offers one of the best peer-reviewed resources on the net. Make it one of your first stops. “This is just the first stage in the development of an impartial service which will provide the most comprehensive source of relevant and trustworthy information about clinical, non clinical evidence and best practice, at the touch of a button,” said Dr Gillian Leng, chief operating officer for NHS Evidence. “It’s good news that users, including patients, will be able to find the information they need and know that it comes from a credible source - this will ultimately help improve efficiency and ensure all patients receive the best available care.” NHS Evidence will also allow users to browse evidence using ‘topic trees’, upload and share their own content - such as local service models and policies - and to receive alerts about new information. www.evidence.nhs.uk/
14
MEDICAL STUDENTS TECHNOLOGY
DermIS www.dermis.net
The largest dermatology database on the net. Initially DermIS started as a image repository but has expanded to include some useful learning modules on diagnosis and treatment of common dermatological conditions.
British Association of Dermatologists’ Clinical Guidelines www.bad.org.uk/site/622/default.aspx
Part of the wider BAD site these clinical guidelines are a particularly useful learning resource but be careful as some are relatively old and need reviewing. For more key websites in Dermatology - try
HOME COMPUTER SYSTEM AIDS DEMENTIA PATIENTS
STUDENTS GIVE PATIENTS A SECOND LIFE
A
hird year medical students have been diagnosing patients in Second Life as part of a new pilot programme at Imperial College. The clinic is part of the College’s presence in the virtual world that allows ‘residents’ to interact with each other via avatars. As part of the trial students are given five virtual patients to talk to, examine and diagnose. They are also provided with money for tests like chest x-rays and have to decide which tests to carry out on the patients to reach the right diagnosis. “A shortage of doctors and higher numbers of students mean that there is less time for teaching,” said Senior Learning Technologist Maria ToroTroconis. “Virtual patients, especially in threedimensional format, can be of real value in supporting clinical teaching.” Students are based in a virtual respiratory ward where developers have attempted to re-create the real experience as much as possible - even requiring students to wash their hands before seeing patients. First time users have to create an avatar - a 3D representation of themselves. On visiting Imperial’s virtual hospital students are then welcomed by the Head of Undergraduate Medicine, Professor Jenny Higham. They can also teleport to the ‘students union’ and ‘research centre’, where they can
home computer system to help dementia patients safely manage daily tasks is currently being trialled in Norway. The touch screen device prompts patients to take their medications, reminds them when their carer is arriving and whether it is daytime or nighttime - a particular problem for dementia sufferers. It is aimed at elderly who can still live alone but are suffering from the early effects of memory loss. The MPOWER device allows relatives or carers to check whether the patient is responding and its two-way functionality allows them to interact too, explains project manager Marius Mikalsen: “This is also a system for sharing information. The families of these patients are often anxPatients give feedback on ious about how MPOWER device it is going with their parents, and this allows both them and the home help to enter messages that will be automatically displayed by the system.” MPOWER is part of an EU programme developing new equipment to aid the increasing elderly population. The system which has been trialled in the two Norweigan cities of Trondheim and Grimstad is being developed further to include home sensors and GPS to track patients. www.sintef.no/Projectweb/MPOWER
T
Screenshots from Second Life Ward
interact with other users. The pilot is part of a research to find the best e-learning methods for medical training. Initial findings show that while students are generally receptive to working within the learning environment, they have problems with access and need time to feel comfortable interacting with the virtual patients. “Second Life is a reflection of where the Internet is going. The aim is not to replace face-to-face communication, but to enhance the learning experience,” says Maria Toro-Troconis. www.elearningimperial.com
Searching for quality Web resources in medicine? Intute is a free online service guiding you to the best of the Web for education, training and research
www.intute.ac.uk/medicine/ MEDICAL TECHNOLOGY STUDENTS
15
Secret Diary of a Cardiology SpR Monday If you’ve been following this column, you’ll realise that I had just made arguably the most important career decision of my life. As I came up to the end of my SPR rotation I had finally been awarded my MD (for some stupid work about neutrophils that got me a few papers but didn’t really advance cardiovascular science). I was on the verge of applying for consultant jobs when Douglas, my boss and mentor at my mammoth teaching hospital, offered me a job - the only female consultant in a team of five men. There was no way I could say no and after a week of soul searching on the French Alps I accepted his offer. Monday morning was a quick ward round and then paperwork in the afternoon. I left early and went home to catch up on a fantastic novel I had been reading about the life of a thief in Barcelona. It made me want to leave rainy London immediately. I didn’t, and instead I curled up on the sofa with a very large glass of Pinot Noir (I had become tired of Merlot) before dragging myself to bed just before midnight.
* Names have been changed to try to keep our cardiology SpR in a job - though she’s doing a pretty good job of trying to lose it without our help!
Tuesday Clinic this morning was overbooked as usual. One of the consultants called in to say that his daughter was ill so would be in at lunchtime which left me with a couple of useless SHOs (sorry, Core Trainees) and 40 patients to plough through. Most of them were the routine ‘no sex for a month after your heart attack’ and the ‘stop eating pizza or you’ll die’ consultations. We managed to finish just before the diabetes boys had their turn and I grabbed a quick bite from the canteen before an afternoon of echos. I finished the five inpatient requests by three and went over to help the echocardiographers with their work load of outpatients. The word had gotten round that I was to be appointed (or should I say anointed) as the new consultant and people were being extra nice to me. I had decided to return the favour whenever I could - building up a base of trust between colleagues was something I would try and do slightly better than some of my consultant colleagues. I left around six and went home to watch the tennis. A night in with just me, Rafael Nadal and a glass of Pinot.
Wednesday Angio list this morning. I get a round of applause from the cath lab nurses - I think that secretly they all like me (though they never show it) and are happy that I’m going to stay on. I mock shock but actually find the whole thing rather nice. As usual I’m left on my own - after all if I can’t do it now then I’ll never be able to. CCU ward round this afternoon. The lazy core trainee (I call the other one the super-lazy core trainee) has actually managed to chase the troponins from this morning and file them away. I’m impressed until I realise that he discharged another patient who was supposed to stay in for an inpatient angiogram. I give him the look (far better than a dressing down) and he rushes off to call her back in. I finish early and am home by five. A quick change of clothes and head out for a few drinks with some friends. The drinks turn into dancing which in turn leads me to go home with a friend of mine who has just broken up with his girlfriend. We’ve done this before (when he was still going out with her) so it’s not at all awkward but I leave before daybreak to have a shower at home. 16
SECRET DIARY
Thursday A mild hangover that’s quickly suppressed by some codeine that I find on the ward. I’m on-call today and have a twelve hour day shift. This is something I won’t miss. The morning is quiet and by lunchtime we have cleared the board and I spend an hour teaching medical students how to read an ECG. It’s surprising how little some of them know. The evening goes well and the six o’clock ward round is without hitch. I finish the brief handover and am home by ten. There is no more Pinot left and I can’t face a glass of white so I have a ginger beer and crash out.
Friday A quick CCU round this morning and I find myself twiddling my thumbs for the rest of the day. Douglas calls me and suggests we meet for lunch. He asks me how things are going and whether I have any second thoughts about accepting the job. I firmly tell him no, perhaps a little too firmly, and he smiles. Douglas is in his early sixties and an atypical cardiologist. He’s happily married with three grown up children and now has a bunch of grandchildren. He stays here late if a patient is unwell otherwise he spends time with his wife. He does minimal private practice. I’ve often wondered how he’s managed to create such a perfect life. Although my new job represents getting to the very top of my career ladder, I would give it all up in a heartbeat to be a part-time district general cardiologist with a husband, two kids, a dog and a Land Rover with a six rack CD changer, GPS, climate control and heated seats. Douglas smiles at me and I get the sense he knows what I’m thinking. He mentions the prospect of delaying my start by six months. He has a friend in Melbourne who is looking for someone at the end of their training to teach some advanced interventional skills. It would be good for the hospital, he says, for me to come back with some new skills. Would I be interested? I look at him and slowly start to smile.
You look after your patients We’ll look after your finances Tailored financial advice for doctors
• Savings and investments • Retirement planning • Life and income protection • Mortgages and insurance • Banking services Wesleyan Medical Sickness specialises in providing tailored financial advice to the medical profession. Our Financial Consultants are trained to understand the specific needs of hospital doctors and are dedicated to helping you plan for a more secure financial future. What’s more, Wesleyan Assurance Society, our parent company, is one of the financially strongest and longest serving mutuals in the UK. Choose Wesleyan Medical Sickness and you choose a Financial Consultant who is as dedicated to your profession as you are.
To find out more call:
0800 107 5352 Wesleyan Medical Sickness is a trading name of Wesleyan Financial Services Ltd, which is authorised and regulated by the Financial Services Authority. Wesleyan Financial Services Ltd is wholly owned by Wesleyan Assurance Society. Registered No. 1651212. Head Office: Colmore Circus, Birmingham, B4 6AR. Fax: 0121 200 2971. Website: www.wesleyanmedicalsickness.co.uk Telephone calls may be recorded for monitoring and training purposes. HD-AD-12 03/09
Focus on Finance - in association with Wesleyan Medical Sickness
To Buy or Not to Buy I
f you’re looking to get a step onto the property ladder, Ian Morgan National Sales Manager with Wesleyan Medical Sickness, gives some guidance on a couple of types of mortgage that might provide a good option for you. There are indications that the property market is starting to show some signs of recovery. House prices are still falling but at a less dramatic rate and some commentators are predicting that they could even rise again by the end of the year. The Royal Institute of Chartered Accountants (RICS) reported in their April survey that more potential buyers are entering the market and this is beginning to translate into an increase in sales. However it’s still early days and noone can say with full confidence what the future will bring for the property market. It’s unlikely, however, that we will see a return any time soon to the days of small deposits and large loans. Since the fall-out from the sub-prime mortgage fiasco, lenders are being more responsible in their lending, making sure they take on less risky customers and
properties. If you’re thinking of buying a home you should seriously consider the pros and cons of buying versus renting and then decide which is the best option for you. You might find the security of owning your own home appealing but not have the resources to pull together a reasonable deposit. In this case you could see if you’re eligible for the Government’s HomeBuy initiative designed to help first time buyers get into the housing market. HomeBuy To be eligible to apply for HomeBuy, you need to be both a first time buyer and have less than £60,000 a year coming into your household (so if you plan to live with a partner, your combined income would need to be £60,000 or under). There are a number of different schemes available administered through agents. In essence HomeBuy means that you can get a loan on a property, potentially of up to 50% of the buying price. You will then have to cover the remaining cost through a traditional mortgage using an approved high street lender that supports the scheme. You will have to pay a monthly fee on the loan as well the interest on the mortgage in the usual way. When you sell the property you need to repay the loan but you can choose to repay some or all of the loan sooner. In doing so, you reduce the amount that your HomeBuy agent receives when the property is sold. Offset mortgages If you’re in the lucky position to have
savings then now is a good time to consider moving to an offset mortgage as your cash will work harder for you. In simple terms, this type of mortgage works by placing your savings with the same provider as your mortgage. You won’t get any interest on your savings but you’ll only pay interest on the net amount of your mortgage. So, for example, if you have £150,000 mortgage and £20,000 in savings, you would pay interest on just £130,000 of your mortgage. In the current climate, when interest rates are so low, this offers a good way of maximising the return on your savings. Also as you aren’t charged interest on your savings you won’t have any tax to pay on them. Many people find offset mortgages quite complicated but they do offer a raft of advantages to borrowers. You can make overpayments or underpayments on the mortgage, which can be helpful if your situation changes and you can even take payment holidays. They also lower the total interest paid over the length of the loan and shorten the mortgage term because the interest is charged against a lesser mortgage balance. Finding the best mortgage deal for your long-term needs isn’t an easy job. It takes time and effort to trawl the market. You might want to choose a broker to do the job for you. Make sure you go with an organisation like Wesleyan Medical Sickness, which will compare the whole of the mortgage market and not focus on a limited number of providers. Remember that your home may be repossessed if you do not keep up repayments on your mortgage.
The above information doesn’t constitute financial advice and the suitability of any mortgage depends on your personal circumstances. Wesleyan Medical Sickness provides specialist financial advice for doctors. Telephone 0800 107 5352 or visit www.wesleyanmedicalsickness.co.uk
Specialist financial services for doctors • Savings and Investments
• Mortgages and Insurance
• Retirement Planning
• Personal Loans and Bank Accounts
• Life and Income Protection
0800 107 5352 or visit www.wesleyanmedicalsickness.co.uk 18
FINANCE
Weekend Ward Escape to
Brussels People don’t get excited about Brussels. It lacks the elegance of Paris, the nightlife of Amsterdam and is even overshadowed by the romance of it’s own northern sister Bruges. But that’s exactly why Brussels has it’s charm. No-one expects to like it, in fact many visit already certain they’ll be disappointed, but most leave confounded. If you don’t expect to fall in love with the city at the heart of Europe you might just do so. Where to stay? Hotels in Brussels are nothing to shout about. There are the scores of sterile, functional chains catering for the constant trips of politicians to this EU hub. Amigo is the one exceptional hotel in the city and is priced exceptionally to boot so it tends to be the haunt of top politicians and celebrities. If you’re unable to claim on MP expenses try the centrally located and practical George V (Rue ‘t Kint) or NH Grand Place (Rue D’Assaut) instead. Visitors who are more frugal with their budget should try Bruegel (Rue Du St-Esprit) - a newly refurbished youth hostel situated a few minutes from the main square. You can stay in a double room for just 20 euro a night. There is a 1am curfew - but it has it’s own bar which stays open until the last man is standing.
Eating Belga Queen - (Rue du Fosse aux Loups) A stylish (and moderately expensive) restaurant set in a giant converted bank where you can dine with the Brussels elite. The food is typically Belgian and served by
the weird antics of your fellow travellers.
Nightlife Le Bier Circus (Rue de l’Enseignement) - 200 beers which means there’s just enough time to try them all and turn up sober for the Monday ward round. Intimate and with knowledgeable staff it’s the ideal place to savour the flavour of Belgian beer and get esquisitely drunk.
Day Trips
Brussels - Grand Place
waiters dressed conspicuously like monks. Watch out for the transparent toilet doors that confuse many a tourist. Chez Leon - (Rue des Bouchers) Gracing the backstreets of Brussels for over a century Chez Leon is a cheap and cheerful place to sample great ‘moules and frites’ for under 15 Euros a time.
tourist centre and is enclosed in magnificent Baroque buildings. Worth a few hours sipping a hot chocolate while watching
Bruges, which egotistically has dubbed itself the ‘Venice of Northern Europe’ is only an hour by train. 3 million people mob this tiny town of 100,000 every year scoffing the ‘moules et frites’ and sipping on Belgian beers. Nice place for some food, some walking but boring after dark. If you’re looking for some proper nightlife Antwerp is the place where you’ll find the locals. 90 minutes away it’s also a good spot for some hardcore shopping away from the tourist traps of Brussels and Bruges. Find the full Brussels guide at JuniorDr.com
Key attractions
Manneken-Pis
Manneken-Pis - This literally takes the piss! Belgium’s most popular tourist attraction is a tiny bronze statue of a boy peeing. Nobody really knows what he symbolises or why he’s there. More interesting is why the scores of tourists crowded around stare for so long. Grand Place - This is the
Key facts • Population - 2,090,000 • Language - French (85%) and Flemish • Currency - Euro • Belgium produces 172,000 tons of chocolate a year. • World defining ideas from Belgium include the Smurfs, waffles and ‘french fries’.
19
Across:
2 Score for severity of pneumonia; where the pavement meets the road (4) 8 Hospital-acquired (10) 10 His capsule encloses the glomerulus (6) 11 Mobitz type I AV block (10) 13 Syndrome of trisomy 18 (7) 14 Enzymelinked immunosorbent assay (5) 16 Test for folic acid/vitamin B12 deficiency; rhymes with an eskimo’s home (5) 17 Sputum for the layman (6) 18 Lifelong protozoan infection; feline primary hosts (13) 19 Large bloodsucking fly of tropical Africa, can transmit parasites for sleeping sickness (6) Down:
1 Classification system to define spread of ovarian, uterine and cervical cancers (4) 3 Traditional ghost’s greeting of choice; bladder outflow obstruction (3) 4 Benign tumour composed of blood or lymph vessels (7) 5 Very rare mental condition in which the individual believes they are a wolf (11) 6 Type of hernia that involves bowel wall only - not lumen (8) 7 Dark chocolate in red wrapping; neurologist associated with tuberous sclerosis (11) 9 Genus of yeasts that inhabit the vagina and alimentary tract (7) 12 Crackling sound/grating feeling when bone rubs on bone or roughened cartilage (8) 13 Supercilium;
You can find the answers by searching for ‘crossword answers’ at www.juniordr.com
can be waxed or threaded (7) 15 Bile containing (7)
Compiled by Farhana Mann
Medical Report Assessed by Gil Myers
C
learly Mr Simpson exhibits a number of poor lifestyle choices that are having a detrimental effect on his health. His excessive eating, drinking and lack of exercise have resulted in obesity. Mr Simpson also continues to put himself in situations which could result in sustained traumatic head injuries. Without further brain imaging it would be difficult to estimate the extent of this damage. However, it would be remiss not to look beyond the (rather large) surface and think about some of the other possible conditions that Mr Simpson could be suffering from.
Radiation Poisoning Mr Simpson’s hair loss, pronounced skin darkening (around the face and neck) and fatigue could be the effect of chronic exposure to dangerously high levels of radiation. This may be in part due to his own carelessness or because of poor safety control at Mr Burn’s nuclear power plant. Excessive exposure to ionising radiation can cause damage to organ tissue which the body cannot repair. Most symptoms appear after around 15 years - Mr Simpson started work in late 1980s.
Congenital hepatic fibrosis Mr Simpson is yellow. His father is yellow. His wife is also yellow, as are his children. This is suggestive of a genetic condition that is inherited in an autosomal recessive pattern. CHF is such 20
HOSPITAL MESS
MR HOMER SIMPSON a disease and the end result is that jaundice is widespread in the Simpson family. Bart, Lisa and Maggie should consider having their future partners genetically screened to avoid passing this on to further generations - or at least attempting to date someone who isn’t yellow.
Kleine-Levin Syndrome A rare disorder which is characterised by hypersomnia - excessive amounts of sleep, sometimes over 20 hours/day - and compulsive hyperphagia - which can be indiscriminate in its nature and takes in all food sorts. Patients may also show an abnormally uninhibited sexual drive resulting in attempts to perform acts without due care and attention to discovery - for example the Springfield crazy golf course. There is only symptomatic treatment.
Intermittent explosive disorder IED is a behavioural disorder characterised by extreme expressions of anger, often to the point of uncontrollable rage that are disproportionate to the situation at hand. On several occasions Mr Simpson has been reported to have been attempting to ‘throttle Bart’ with only the flimsiest of reasons. He was also smiling. While I am in no doubt that this is learned behaviour there does appear to be an inability to resist resorting to these actions - sometimes more than once in a 30 minute episode.
Writing in the Notes esentative
Colleges unrepr
by the collegDear Editor, e recent backlash th g in t ad re en be I’ve urs from Augus reduction in ho D T n ca I EW e ). th es over ’ Iss 12 p6 as hours slashed ning may take (‘Patients at risk at ncerns th trai co r ei th nd ta represent many unders ey are failing to th el fe I t bu ng hours. They longer ion in my worki ct du re a t an w e lorry drivers of us. I a reason - just lik r fo d ce du re g should surgeons are bein retches neither st ng lo r fo e iv level there is can’t dr n a more selfish O e. at er op to ople, apart from be able pect too. Few pe as e lif of ity al , are supporting the qu this rare occasion on l t en m rn ve representing al the go lleges should be co e th ly re Su that. embers? views of their m
d Name withel l Medicine ra ne Ge 2 ST
Keep our trained
W
hen your hospital food tastes like the remnants of a liposuction procedure and the price bears more resemblance to the cost of a PICU incubator things start to take the biscuit. Here’s our regular column of the best and worse hospital essentials you’ve reported:
Ham sandwich (white bread no salad)
Dr J Aggraw al Surgery
ol
My Cardiology Id
agazine colDear Editor, has her own m R Sp gy lo io rd a superstar Your ca lead the life of es do y nl ai rt ce catching a umn and nd skiing before ke ee w a r fo is the tedi- jetting off tant job. Where ul ns co r he rm mindnumbcab to confi s meetings and es dl en , ns io at P but she is um of dict iet career as a G qu a se oo ch I s? r diaries isn’t ing report and reading he ng ri bo em se e t time please making m self-esteem. Nex y m r fo rs de ne less excitdoing won and pick someo ur vo fa a us of do the rest atology SpR. ing - like a derm ess Elaine Card h Thames rt No R, GP Sp
‘Writing in the notes’ is our regular letters section. Email us at letters@juniordr.com.
£1.19
Newham General Hospital
It’s too expensive to pig out at:
£2.95 Evian water 50cl
doctors here
Dear Editor, I welcome the expansion of th e Medical Traini Initiative that al ng lows overseas do ctors to benefit training in the from UK (‘750 UK training placem for overseas do ents ctors’ Iss 12 p5 ). However, I w like to point ou ould t that overseas doctors who st at medical scho udied ol in the UK ar e being forced to because of chan leave ges to the visa system. Not on many people fe ly do el this is unfair as the goalpost been moved in s have the last few year s but the UK is ing doctors that losthey paid to tr ain. I would su that this situat ggest ion deserves ur gent attention Department of by the Health.
Surely pork is worth more at:
Royal Free Hospital, London
It’s cheaper to stay well hydrated at:
70p
Belfast City Hospital
So expensive you’ll wet yourself at:
95p Sachet of tomato ketchup
Royal Free Hospital
Squeezilicious at:
£Free
St Bartholomew’s Hospital, London
Bet it goes all over your shirt too at:
10p
QE2 Hospital, Welwyn Garden City
Next issue we’re checking the cost of a packet of ready salted crisps, small hot chocolate (takeaway) and an apple. Email prices to hospitalconfidential@juniordr.com.
Colchester General Hospital Colchester doctor’s mess has a flatscreen TV with Sky, microwave, dishwasher, and coffee maker. Off the main mess is a room with three computers. The usual tea, coffee, toast and cereals are provided along with daily newspapers. One plus is having a cleaner. Mess fees are £10 a month with occasional subsidised mess nights out.
JuniorDr Score: ★★★✩✩
HOSPITAL MESS
21
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Enrich your career. Enhance your quality of life. Practice medicine in rural British Columbia, Canada. Variety and challenge, the chance to make a difference in people’s lives, a lifestyle most people only dream about – just a few of the advantages enjoyed by BC’s rural physicians. With its natural beauty, recreational opportunities, clean air and affordable housing, British Columbia offers a quality of life that is envied around the world. Create your future in rural British Columbia. Competitive compensation and benefit packages include signing bonuses, relocation travel, fee premiums, retention bonuses and continuing medical education assistance. For more information and to register, visit our website. Our experienced recruitment consultants can help you match your skills and lifestyle interests to the many exciting opportunities available.
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Health Match BC is a province-wide physician, registered nurse and pharmacist recruitment service funded by the Government of British Columbia, Canada. JOB # H104-9278 SHIPPING DATE: NOV 3, 2008
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The Art of True Learning Approaching the Game Plan Augmenting the acquisition of a CCT with career-enhancing depth
Setting goals & delegating using smarter SMART Improving accountability and the likelihood of completion
New NHS Complaints Procedure Subtle evolution or radical reform?
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Insights Day Understanding the Evolving Healthcare Landscape Providing insight into the evolving healthcare landscape that every doctor should know Compelling Reasons to Attend
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NHS Training Bulletin Your foremost source of Courses, Conferences and Training for Healthcare Professionals Welcome to the June/July edition of NHS Training Bulletin and a major step forward in increasing efficiency and effectiveness in the process of finding and booking courses, conferences & training. Distributed monthly to 27,500 professionals and designed to be read by many more (so please share!), Training Bulletin brings training opportunities into a single location, negating the need to search far and wide. The journal is backed up by a comprehensive online portal of courses, conferences & training at www.NHStraining.co.uk, coupling extensive journal and online reach to a powerful and secure booking and event management system. Just a single registration allows you to book courses from any provider without having to re-enter your details again and again. Inside, youâ&#x20AC;&#x2122;ll find relevant, up to the minute articles, as well as comprehensive listings of courses, conferences and training opportunities, neatly organised by category and by specialty. Each event listing contains a quick line reference allowing you to rapidly obtain more comprehensive information online without the grind of having to hunt for it. Should you decide to attend an event, youâ&#x20AC;&#x2122;ll find booking a breeze.
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Rotating into a New Specialty
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Setting goals & delegating using smarter SMART
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New NHS Complaints Procedure
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NHS Training Bulletin
The Art of True Learning Approaching the Game Plan Augmenting the acquisition of a CCT with career-enhancing depth Few would disagree that working towards specialist qualification has changed radically in recent years and that doctors in training and consultants alike regularly express concern at the depth of experience being grown in today’s upcoming doctors. Although systemic factors adversely affecting learning, such as reducing junior doctor hours to comply with working time directives, are relatively straight forward to identify they are equally difficult to address as an individual. This article focuses on organising principles that re-assert the art of true learning.
The issue to consider Whereas specialist training in the United Kingdom is well organised through PMETB, with ever increasing clarity on structure, process, curricula and requirements, less focus has been directed at the growing differential between obtaining a Certificate of Completion of Training and the breadth and depth of understanding necessary to excel as a consultant. If a trainee devoted their entire attention just to obtaining the necessary assessment that leads to qualification, they would possible pass with ease but be ill-equipped for the challenges they are likely to face as a responsible consultant, often in isolated circumstances with few places to turn for immediate support. Consequently, it is imperative that all doctors in training acknowledge the differences between obtaining their CCT and true learning to the depth necessary to succeed in life as a specialist consultant. The analogy is akin to the A-level student who swots their chemistry exam by intelligent application to the facts around the most likely questions, only to find that they flounder in university when the depth of knowledge determines their likely degree success. There is a balance to be made. Failure to address the registration requirements is equally disastrous, leaving knowledgeable and clinically excellent doctors without or with delayed qualification, adversely impacting their downstream career prospects by inadvertently creating the perception that they have ‘struggled’ when in fact they may be clinically superior to many of their post CCT colleagues. The approach we advocate is based on two key questions:
Trainees unclear of the answers in both questions are placing their future careers at risk. Although we are clearly advocating balance between the two questions, arguably there isn’t a magic formula as to what that balance should be. Instead it is something of a zero-sum game that is very context dependent, meaning that the answer is what the answer is for each question and subsequent failure to achieve the answer is damaging no matter which question you consider. A trainee intending to work in a broad-based capacity in a district general type hospital will have very different requirements in question 2 compared to someone who aspires to the highest academic levels in a complex scientific area within an Academic Health Science Centre, although their question 1 answers may be identical. The concluding point is that you have to get both questions right, which means determining an appropriate game plan for each. The Deanery is extremely helpful in addressing question 1 but question 2 is very much up to you. It is vital that you do not confuse question 1 as giving you the answers to question 2, a lesson many have learned at their peril.
What’s the goal? It is also important to consider the whole goal of progressing through a series of training posts, as this has bearing on how you answer the two key questions and also gives rise to the unbalanced approach to training that can occur. If the goal is simply ‘to get your CCT’ then naturally all effort should be devoted to question 1. However, we think that the goal needs to encompass 3 specific elements:
Obtain your CCT Equip yourself with sufficient
knowledge so as to be a safe, effective doctor in your chosen specialty Provide sufficient depth or specialisation so as to allow you to pursue your chosen career path When all three elements are taken into account you can see the diversification of approaches necessary. Another way of breaking this down is to consider it in terms of levels of depth or complexity. Failure to consider your true goal from a career perspective means that you can easily end up with a CCT but little or no chance of acquiring the type of post you actually want. That chalks this up as a rather vital consideration in our book.
Qualification
Learning aimed at acquiring your CCT and essentially just the key to the locker room
Broad-based, ‘average’ consultant post
The minimum level of knowledge and skill necessary to operate successfully as a ‘standard’ broad-based consultant in your chosen specialty
Highly specialist or special interest
The optimal level of knowledge and skill, usually in specific areas, necessary to fulfil all of your career aspirations
1. What do I need to know or be able to do to ensure that I gain my CCT? 2. What do I need to know or be able to do to excel in my desired post-CCT career path?
Table 1
2
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Wanted...
Are you a leader or a follower? Proactive doctors with an eye for an exceptional opportunity You appreciate the importance of leadership, management & personal development in delivering against your career aspirations. You know that without this on your CV you’ll be in a seriously disadvantageous position. You’re driven by a desire to succeed. We can help you succeed, if you help us succeed. It’s called a win-win partnership and we’re famous for them.
Learning Leadership Programme Would you like to gain access to the full spectrum of renowned Medicology open programmes without having to pay a single penny? Would you like to develop exceptional levels of personal effectiveness? Would you genuinely do great things, if we showed you the very best way? Do you believe that your success in life could be taken to new levels with the right support? Do you believe in the importance of a win-win approach to life?
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What does ‘specialist’ mean in the modern health context? It may not have slipped your notice that the Certificate of Specialist Training has become the Certificate of Completion of Training, inviting a question around where has ‘specialist’ gone? To answer this question we need to briefly consider the direction of travel for consultants in the modern healthcare environment. Under Lord Darzi’s models of care delivery institution there is considerable polarisation in the nature of work undertaken by consultants. Whereas major acute hospitals and specialist hospitals, especially those forming part of Academic Health Science Centres, will see an increase in the volume of complex work they undertake, the traditional DGH will likely see a reduction in complexity as fewer and fewer consultants hand on to specialist interests in non-specialist centres. This has significant implications for those currently in training. In effect, it means we need to train two distinct sorts of doctors and here the reality becomes a bit uncomfortable. The first sort is highly specialist, with knowledge and experience of complex cases and the most severely ill individuals, as well as having an interest in pushing forward knowledge by engaging in or organising research. The second sort is more akin to a ‘worker bee’ consultant, focused on delivery of more basic healthcare and generally without the specialist interest. We’re not proposing this so much as pointing out the implications of Lord Darzi’s stated nature of caseloads proposed in each institution type. If this is an area you are not clear about then we strongly advocate finding out, for instances using the Medicology Insights Programme (more information at www.medicology.co.uk/insights). So, what we are dealing with is the fact that the term ‘specialist’ is coming to mean different things. At a basic level, specialist means that you will be working within a specific specialty and therefore there is a minimum curriculum that you need to address that is already far beyond what may get you your CCT. However, if your aspirations include working in a major acute
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hospital then specialist will mean being able to demonstrate a depth of knowledge and experience in complex disease, most likely in a specific area of your chosen specialty. This latter category requires a highly thought out game plan because competition for these posts will most likely be vigorous. Having the right game plan So, we have established that to pursue your career path of choice requires you to have a well thought out game plan that goes well beyond the basic curriculum addressed by the Deanery. That game plan can only be determined if you have a clear vision of your ideal future role. This is very much the starting point that allows us to break learning into distinct and manageable segments. Furthermore, rather than simply considering the type of role you wish to acquire, it is beneficial to go as far as thinking about the few services and locations that you would ideally like to work in. The more clarity you have, the easier it is to establish the right game plan. To examine the construction of a game plan, let’s consider Bob, whose career aspirations include becoming a respected specialist in complex Crohn’s Disease in a tertiary centre ideally in the North of England. What is clear is that Bob is going to need more knowledge and experience than can be naturally acquired from just obtaining his CCT. Bob’s vision is already quite clear because he knows what sub-specialty interest he wants to develop and where he wishes to work. However, it can be improved further by considering what type of work he will be engaged in, or what his ideal job plan may look like. Bob considers this and establishes the following. Besides his clinical case load, Bob envisions being involved in policy and framework development, regularly speaking at national and international congresses on complex Crohn’s disease and being recognised for improving the practical application of current Crohn’s research. Having clarified this vision, Bob constructs a learning game plan that looks a little like this:
Obtaining my CCT by X date
Learning goal 1 Pass assessments A, B and C by Y date
Learning goal 2 Acquire this specific knowledge for a college exit exam by Z date
Position myself as an expert in complex Crohn’s Disease
Learning goal 3 Acquire this specific knowledge about Crohn’s from rotation 2
Learning goal 4 Become expert at this procedure related to Crohn’s from rotation 3
Guest lecture on Crohn’s Disease on 6 occasions by this date
Write 4 editorials in Crohn’s Disease by that date
NHS Training Bulletin choosing the razzle nights a bit more strategically! If you are working nights, it is difficult to subsequently follow up on what happened to a patient because you are generally not permitted to be there the following day and the patient has often moved on by the time you are back. In these situations, it is important to make a diary note to review what happened in those patients that are important to your learning journey. Finally, the quality of your learning can be enhanced substantially by engaging in reflection. This technique involves asking yourself a series of short questions after each relevant patient episode, including:
What did I learn from that episode? Did I consider all angles or possibilities? Was there anything else I should have done or considered?
With hindsight, what would have constituted optimal care?
What were the most important factors The game plan should clearly identify distinct learning goals delineated by rotations or intended roles, so that Bob knows exactly what knowledge and skills he needs to acquire at what point and the value these deliver for him in his chosen career path. This means that he is better positioned to gain exactly the knowledge and skills from each component of his developmental pathway and is less likely to end up at CCT time with career-limiting holes. Implementing the right game plan Knowing what you want out of a job or rotation is fundamental but you need to get off on the right foot too. On entering a job, we advocate sitting down with your supervising consultant and addressing the following:
Your longer term career aspirations (the vision)
What learning you’d like to gain from this rotation
What learning they feel you need to acquire for CCT progression
What additional learning they feel
you would benefit from, given your desired career path Any barriers or problems that need overcoming, including developing a strategy for them This implementation should be backed up by regular review at time points that allow you to take alternative action if you are not meeting your milestones. Ideally this means the earliest possible goal-setting session with your consultant, an early review 3-4 weeks later to see if there are any implementation problems and then 1 – 2 interim reviews to ensure that knowledge and skills are actually being developed according to plan. Factors influencing learning quality Having a game plan and a clear set of intentions is one thing but when you come to implement it you are now subject to the vagaries of workload fluctuation, other people’s sickness and absence, your consultant’s continually eroding time and the
quality of learning you are having delivered to you. Broadly, the factors influencing your learning, besides yourself, can be split into two distinct categories:
Things that get in the way of your learning
Things that affect the quality of your learning
The commonest overarching factor is service delivery. Your Trust is subject to a series of targets with penalties for breaching them, as well as ever growing restrictions on working hours, as well as being mindful that completed episodes lead to income under payment by results. Whereas the more service delivery (the daily clinical load) you engage in, the more experience you are gaining, it is also easy for this service delivery to obstruct the acquisition of assessments and specifically hamper your attempts to get specific bits of learning that are important to you. If you find yourself in this situation it is important that this is raised as early as possible, whilst there is still catch up time and hence the need for regular and early reviews. It is pointless to pass through a job, not gain the learning you need, feel justified in concluding that your employer didn’t deliver for you when in fact it is your career at stake. It’s your career and so you need to take every active measure to ensure you gain the learning you need. It is important to remember that organised learning sessions will be focused on the generalist and not the specialist. This may not deliver the depth of learning that you require and so it is vital that you have identified where depth is required and developed your own self-directed learning programme to ensure that you amass knowledge in this area. Quality of learning is primarily affected by you. If you are out on the razzle the night before important learning sessions then your knowledge retention is going to be impaired. We’re not saying you have to become a saint but we do advocate
in the episode and how did I address these? Where were the risks in the episode and was I mindful of them or just lucky? Essentially, the clinical arena is awash with learning opportunities if you take the trouble to stand back and acquire the learning. We do appreciate that in the drive for results and the frenetic working environment it is easy to simply forget that you are there to learn as much as there to do. Ensuring success in your post-CCT career What we have described in this extensive article is an approach to structuring your learning so that your learning goals are firmly tied to your career aspirations. Nobody else knows your aspirations quite like you and so this is not a job that someone can do for you. Successful doctors, whether by accident or by design, have taken it upon themselves to acquire the depth of knowledge and skills necessary to be placed top of the pile when it comes to gaining just the post they want. In the modern era there will be increasing numbers of ‘ordinary’ jobs and far fewer ‘special’ ones, meaning you’ll have to compete harder and demonstrate why you are the perfect candidate. Doctors leaving that until CCT is within sight have placed themselves at a considerable disadvantage because a consultant interview is the summation of a long learning journey as well as the start of a new challenge. Perhaps the best analogy is that of Hermione in Harry Potter. She consistently goes above and beyond the ‘curriculum’ in the areas she feels will contribute to her future success and so when faced with a seemingly insurmountable challenge she pulls just the right spell out of her knowledge bank and saves the day. A strategic approach to your learning journey will leave you in the same shape when the learning gets put to the test – when the perfect post for you looms on the horizon. Author: Andrew Vincent Managing Director, Medicology Ltd
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NHS Training Bulletin
Rotating into a New Specialty How much support do you need? The last few years have seen considerable changes in both the way healthcare is structured and delivered, as well as the way in which doctors are trained. Ever increasing demands on service delivery, targets and the latest round of changes, along with statutory requirements such as European Working Time Directive, have all conspired to force into practice new ways of working at a rate faster than the process of considering the impacts. We believe that this is particularly true at the level of junior doctors and no more so than in training. Rotations are short and supervising consultants increasingly busy. Juniors fresh into a new rotation can often find themselves floundering from a combination of:
A specialty that may be new An overwhelming amount to take on board
Immediate, pressing requirements to avoid delays in the patient journey
The ever present spectre of the latest target
At the NHS Confederation Conference this month, healthcare professionals had the future funding gap spelled out to them in no uncertain terms. With this unambiguous statement of the challenges facing us, it stands to reason that everyone will be placed under more pressure to manage the increasing demand on fewer people and with less resources. This could further impact the support juniors receive when entering new rotations and it is therefore vital that we re-think how support is best provided to those entering a new hospital, in a new specialty with a myriad of conflicting personal and services requirements from each role.
Without question, the first few days of a new rotation are vital. They should be a period of settling in, learning the systems, procedures, protocols and methods for getting things done whilst setting learning goals and considering what needs to be achieved in a short stretch of time. Our experience is that this is far from the reality and there is huge variation in induction practice on the ground. Whereas different specialties, and indeed different trainees, will have differing requirements at induction time, there is undoubtedly huge inconsistencies within specialties, let alone across them. Besides rotating into a new specialty, a move may well represent a change of hospital. Each hospital works differently and so trainees also need induction at a hospital level too, if they are to flourish in their new environment. However, concurrent induction programmes need to coordinate to reduce overlap whilst ensuring that important facets don’t fall between the gaps. This is not an insignificant challenge as coordination within a department is difficult enough, without expecting it across departments. The question is what do you need by way of support when entering a rotation and how do we encourage service leaders to ensure that juniors are supported in a manner that contributes to effective learning, growing confidence and clinical safety? I propose that we start by learning about the gulf between ideal and reality. Author: Dr Sara Watkin Medical Director, Medicology Ltd
IMPORTANT RESEARCH PROJECT Improving induction practices in doctors entering new rotations This important research project takes just 15 minutes to complete and will help evaluate what doctors in training ideally want in terms of support and how the on-theground reality differs from this. You will be contributing to improving understanding in a vital area.
Eligibility Persons in the following posts in United Kingdom r FY1 r FY2
To participate, go to: www.medicology.co.uk/research01
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r ST1 r ST2 r ST3
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Medicology Local Bringing our outstanding Leadership, Management & Personal Development courses to you What would you like to see on your doorstep? Medicology Local is a programme of local courses based on an assessed demand in a specific location. The challenge has always been getting people to â&#x20AC;&#x2DC;co-ordinateâ&#x20AC;&#x2122; which is a bit like organising cats at a mouse fest. Medicology takes the stress out of this by leading the assessment of demand, and then creating a local programme based around the specific needs of the doctors in question. This allows you to bring training to your doorstep without any more work than simply suggesting what might be needed in your locality.
To take the first step by finding out more, visit www.medicology.co.uk/local or contact Nick on 01332 821265
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NHS Training Bulletin
Setting goals & delegating using smarter SMART Improving accountability and the likelihood of completion The SMART framework or mnemonic for goal setting has been around for a very long time and there are a great many versions of what the letters stand for. Without question, setting goals or delegating in a structured manner helps goal achievement but we think that the framework needs some optimisation if you are going to derive the full value. We propose a version amended from the commonest representation that may yield greater accountability in those being asked to achieve SMART goals or undertake work delegated to them.
Understanding the SMART framework in overview The origins of SMART are largely unknown but a system very similar to it was described by the management scholar Peter Drucker in his 1954 work entitled The Practice of Management. Since that early formalised description its use has become universal in the setting of goals and objectives. Table 1 outlines the most commonly used terminology, against which we have added our own proposed amendments.
Letter
Common Representation
Proposed Representation
S
Specific
Specific
M
Measurable
Measurable
A
Achievable
Agreed
R
Realistic
Realistic
T
Time-bound
Time-bound Why it is important and how success in it may be recognised
Plus Table 1
Understanding the Components of SMART SPECIFIC Especially relevant when setting goals and objectives with individuals, the purpose of ‘specific’ is to ensure that the meaning of the goal is explicitly understood. Another way of looking at this is to ask yourself “if I gave this goal to 10 different people, how many meanings would I get back?” A good goal has comparatively little variation in meaning from one person to the next, despite different knowledge and skills, different personalities, different agendas or differing seniority. The skilled goal setter places a great deal of emphasis on providing a robust and sufficiently unambiguous description of the goal to ensure it gets achieved exactly as planned, nothing more, nothing less.
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MEASURABLE An important component of the planning, implementation, review and subsequent planning revision process for achieving projects and goals is assessing progress towards the goal. Consequently, it is vital that stages or milestones, along with any performance indicators are built into the goal. Core to successful achievement is knowing where you are against your goal plan, so that you may ascertain whether you are ahead or behind plan and in the latter case whether you need to engage in different or extra activity to catch up. ACHIEVABLE Goals should be attainable (which is also used as the A representation) i.e. that you can create a reasonable plan to get there. However, what defines attainability? Two people could be perfectly capable of attaining a goal but one may believe they are not. Equally, one may formulate a plan that appears difficult to implement. On the flip side, setting goals that are easily attainable tends to reduce their motivation pull and close off the goal setter to greater possibilities. However, from our perspective there is too much overlap between attainable and realistic, which follows, suggesting to us that one or the other needs adapting. REALISTIC When Roger Bannister ran a mile in 3 minutes 59.4 seconds he achieved what nobody thought was possible or realistic. However, his record lasted just 6 weeks before being beaten by John Landy in Finland and so started a psychological landslide – it was possible to run a sub-4minute mile. Within a couple of years 16 people had broken the same record. When you are setting goals, it is vital that the goal recipient believes they can complete the goal or this undermines the whole possibility. However, this is a delicate balance because we know that an easy to achieve goal lacks the motivational pull necessary to overcome inertia. The only true marker of realism is whether it has been achieved before and even that is debatable as Roger Bannister proves. We believe that an effective goal setter picks a goal outcome that is stretching but within grasp with the right plan and effort. Caution needs exercising around technical capability, timescales, resources, competing interests and confidence, balanced with helping the goal recipient see possible roads ahead on goals that are especially stretching.
NHS Training Bulletin
TIME-BOUND If I decide to lose 10 kilos in weight it serves as an enticing goal that conforms to all elements of SMART with the exception of a hard stop in time. That time point is vital because without it I can be continually working towards my weight loss target without ever actually reaching it and yet when I hold the mirror up I can legitimately claim I am simply still on the road and haven’t failed. A distinct time point focuses the mind not only on what has to happen but forces it to consider the timelines too. Goals with a time scale are far more likely to be achieved than those without. Furthermore, the timeframe is often necessary to coordinate goals in a bigger master plan. Distinct dates prove better than stated periods i.e. by 1st July 2009 is better than ‘in one month’, because one month on you can still be working towards your goal with one month still to do – the equivalent of not really having a timescale in the first place, whereas there is no flexibility in the hard and specific date.
Proposed amendments Smarter SMART From ACHIEVABLE to AGREED We believe that the meaning most people attach to ACHIEVABLE is broadly similar to that of realistic and yet SMART as a whole fails completely to deal with the accountability issue – to have a goal does not mean you will work towards it. We propose an amendment to AGREED because in reality there is so much that does need agreeing. When setting a goal with someone it is important to ascertain or agree the following:
Do they understand the goal? What approach might they take? Do they believe they can achieve the goal?
Are there any barriers to achievement
and how can these be overcome? Do they have sufficient training or skills to achieve the goal? Will the proposed activity deliver the desired outcome? Is this the right goal in the bigger picture? What will the monitoring & feedback process look like? It is only when this has been agreed with someone that they are likely to see themselves as genuinely accountable for the goal and therefore compelled to achieve it. Furthermore, by agreeing the above, you have checked understanding, broken down any issues with realism, created a monitoring framework that serves both parties and determined an outline way forward. This removes much of the uncertainty around goal attainment and represents a worthy amendment. THE ADDITION OF PLUS Realism is sometimes replaced with ‘relevant’ and we have some sympathy with the importance of someone believing the goal is rightfully theirs and important for what they do. However, dropping realism in preference to relevance is an unpalatable option because the importance of believing something is possible is well established. We prefer to approach this issue by adding a ‘plus’ element to SMART, naturally indicating that there is ‘more’. This plus constituent consists of two distinct parts:
Why the goal is important How success will be recognised The first element delivers against relevance in that it ensures the recipient understands how the goal contributes to the bigger picture and fits into the scheme of everything else to be done. Furthermore, by demonstrating the absolute benefit achieved through the goal, motivation
is increased and the goal receives the appropriate focus and prioritisation. Essentially it ensures that the goal recipient is committed to the goal both by seeing the possibilities beyond the goal as well as understanding the consequences of not achieving it. The second element involves asking a question around what evidence may be found when the goal is being achieved successfully. This is a useful concept because it not only clarifies the specific nature of the goal but also helps people identify what must be done for the goal to be achieved and provides a basis for performance management against the goal by highlighting suitable measures. The final word Are there any further amendments needed? In truth, we can find a further 17 representations of the letters without considering combinations. However most appear to be either derivatives of the established representations or require a fundamental departure from representations that have been shown to be vital in nature. We draw the conclusion that further amendments might result in a loss of usefulness and consequently should be resisted. The proposed singular amendment, coupled with an important addition, complete the framework’s true purpose – enhancement of goal achievement. What is more difficult to fathom is that given the universal support for SMART, how can we embed this into practice? Author: Andrew Vincent Managing Director, Medicology Ltd.
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NHS Training Bulletin
Training Tips Training Tips is a punchy, bite-sized column aimed at improving training and education delivery skills and standards by focusing on those seemingly insignificant areas that can make a significant difference. If you have your own handy hints that you’d like to migrate into practice then don’t be a stranger, submit them to the editor at editor@nhstraining.co.uk
TIP1 – Harnessing the Hecklers Now, if you’ve trained for any time at all, you’ll realise that it is not uncommon to find someone in your audience that isn’t shall we say ‘completely on your side’. Although you are delivering something that you feel is balanced, accurate and competent, the vibes from this person just aren’t saying good things. Then, as they gather courage, out comes “I just don’t agree with that” or something similar. Your heart sinks and so can your session if you don’t rein things in. I find that before you consider a course of action, it is a jolly good idea to ask the ‘why’ question. Why is this person reacting in this way? Common reasons include:
They were sent on the course (meaning someone told them they were rubbish at something) Cognitive dissonance They really are a misery (meaning their spouse sent them to have an afternoon off) Sadly, there isn’t too much we can do for the latter category except smile, be patient and commit yourself to a large G&T in the bar afterwards. However, the former two provide you with a great opportunity to demonstrate what a great trainer you are. Let’s examine that further. People sent on courses are often reacting from a defensive position i.e. “actually, I am OK”. Even allowing for that, there are some where you think “I’d just love to be a fly on the wall in your department”. However, they can become your greatest fans. If you suspect this is the reason, you can make a number of influencing moves to change the situation. They broadly involve the following 3 steps: 1. Re-position yourself as their ally (for instance, by finding something to agree with them on or publically acknowledging something as an important contribution from them – “that’s a very important point, let’s examine it further...” 2. Create the right conditions for learning (revisit the actual practical benefits they will gain “you will be able to do X, Y and Z more quickly...” 3. Offer to play ‘Mum’ at the tea break (it’s just so hard to be mean to someone who is just plain nice!) Cognitive dissonance is not really heckling. It’s an important learning principle and involves the brain wrestling with the issue of new information conflicting with existing (accepted) information. The heckler is simply someone who wears the tussle on the outside rather than reflecting. Here, it is important to provide more references, give them time to rationalise their thoughts and generally be supportive. The true challenge is overcoming your own emotional reaction to the outburst. That’s what makes a great trainer.
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NHS Training Bulletin
TIP2 â&#x20AC;&#x201C; Nipping â&#x20AC;&#x2DC;Normâ&#x20AC;&#x2122; in the Bud Arguably, â&#x20AC;&#x2DC;Normâ&#x20AC;&#x2122; is also a heckler, but in a well-meaning kind of way. He (or she â&#x20AC;&#x201C; donâ&#x20AC;&#x2122;t write in), would simply like to add their thoughts to everything you say and perhaps debate the full intellectual range of concepts on the table. The danger of Norm is that he can frazzle your time planning and although he will have had an excellent session, you risk the wrath of the rest who do not move on with enough pace. Hereâ&#x20AC;&#x2122;s the tactic to keep Norm on his toes. Step 1 - Take it out of the session (self-sacrifice strategy) â&#x20AC;&#x153;thatâ&#x20AC;&#x2122;s a really interesting point. I donâ&#x20AC;&#x2122;t want you and I to hog the debate though so letâ&#x20AC;&#x2122;s discuss it at breakâ&#x20AC;? (ouch â&#x20AC;&#x201C; there goes your tea break again) Step 2 â&#x20AC;&#x201C; Take it out surreptitiously (sneaky strategy) â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m glad youâ&#x20AC;&#x2122;ve raised that because we have more on that later. Letâ&#x20AC;&#x2122;s discuss it all together thenâ&#x20AC;? (you havenâ&#x20AC;&#x2122;t got anything later but trust me, Norm will never notice) Step 3 â&#x20AC;&#x201C; Diversion strategy (keep him busy on something intellectual) â&#x20AC;&#x153;now I know Iâ&#x20AC;&#x2122;ve seen something on that in this big 600 page book. Can you just flick through and find it for me whilst I deal with the next bit?â&#x20AC;? If none of that is working, you could just say â&#x20AC;&#x153;Norm, these are all interesting points but I am concerned that there are really good things that you need to know that I might get toâ&#x20AC;?. Fortunately, Norm does not like to miss things either and so this is a particularly effective strategy.
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NHS Training Bulletin
Safeguarding Children Getting it right across the NHS Wednesday 21st October 2009, Central London
Description After the heartbreaking events and consequential media frenzy surrounding the catastrophic circumstances of Baby P, few healthcare organisations underestimate the imperative of putting their safeguarding house in order. Safeguarding Children 2009 is designed to serve two vital goals; drawing together insight, information & understanding around the core issues facing health professionals in this area, whilst providing a forum for debate, collaboration and networking by the very professionals implementing child protection services at the coalface.
The Programme - This is a 1 day conference, 5 CPD points
Group Bookings
Cost & Booking Information Consultants & Business Professionals r £215 + VAT early bird r £249 + VAT standard rate
Doctors in Training, SAS Grades & Nursing Staff r £125 + VAT early bird r £175 + VAT standard rate
The early bird rate applies to bookings received more than 56 days before the course date. Book online at www.safeguardingchildren2009.co.uk, email us at: customer.services@medicology.co.uk or book over the phone by calling the customer services team on 01332 821260 12
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£700 + VAT 5 places £1000 + VAT 10 places £1400 + VAT 15 places Please contact Dean at dean@medicology.co.uk or by calling 01332 821261
NHS Training Bulletin
Consultant Interview Skills Training What’s the optimal approach? Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it. Yet they frequently approach perhaps one of the most important events in their life, getting the right consultant job, without considering professional help with preparation and practice. We consider the attributes of an ideal course and how you should best approach it. What should a good course cover? A comprehensive course will cover the following key areas: Applying for a consultant post The importance of the pre-interview visit Preparing for the interview itself Strategies for answering interview questions Question practice Strategies for developing confidence and overcoming fear and anxiety on the day The political agenda and key political topics Presentations Why can’t I just do that myself? You can, but then why didn’t you take the same approach to part 1, 2 or 3 courses? The answer is undoubtedly because you needed focus to your preparation, provided by experts that know what they are doing. You can also practice and ‘test out’ approaches in a safe environment. Finally, on your own you may never cover what you need to know because that assumes you know that you need to know it!
When should I do a course? In an ideal world, before you even apply for your first consultant post but even as late as the few days before will bring significant benefit. However, the earlier you start, up to a year ahead, the more prepared you’ll be. How do I know which course is right for me? Turn to the internet today and you will see a plethora of courses all professing to be the best. To narrow it down, ask yourself the following questions:
Is the course specific, for instance just for consultant interviews in my specialty?
Is the course run by experienced consultants? What is the candidate-to-instructor ratio? (ideally 1 to 6 or similar)
Does the course provide insight into the psychology in interviews?
What post course support is there, for instance wider resource and information or coaching if you are struggling to get appointed?
Choosing the right course is a bit like buying a new car. Of course you want it to look shiny on the outside but the real importance is what’s inside. There you need substance, quality and appropriate back up. You have to live with your choice for a very long time! Author: Dr Sara Watkin Medical Director, Medicology Ltd
CONSULTANT INTERVIEW SKILLS Comprehensive courses with comprehensive support r Specialty-specific r Psychological profiling and feedback r Insightful and comprehensive resource centre r Back up coaching if you are struggling to get appointed
Full information, including which specialties are covered at: www.consultantinterviews.co.uk
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NHS Training Bulletin
New NHS Complaints Procedure Subtle evolution or radical reform? The new shared complaints procedure for both health and social care; ‘Listen, Respond, Improve’ came into force on 1st April 2009. The premise for the change was to make the procedures more personal and flexible whilst ensuring that all those involved in an actual complaint learned appropriate lessons that could be used to improve service provision. We examine the new procedure and invite the rhetorical question – does the revised version represent a subtle evolution or a radical reform.
Despite the need for an apology, which was prominent in the existing guidance too, a significant proportion of the medical profession remain convinced that we should not apologise to patients because this could increase the likelihood of subsequent litigation. However, in both guidance and in law, apologising does not in itself mean admission of a mistake. We can all apologise for the distress caused or the feelings endured, for example “I regret the discomfort experienced ..........” or “I apologise for the anxiety this incident has caused to you and your family”.
Introducing the procedure The new complaints procedure represents a significant attempt to improve the management of patient, carer and public concerns in a complainant-centred manner. Each healthcare organisation will, of course, need to develop its own policy and guidelines based closely on the guidance within the new procedure and it is therefore essential that this is both addressed in a timely manner and appropriately migrated down through the chain to the clinical coalface.
The new procedure seeks to reassert these principles and ensure that an appropriate apology is forthcoming as early as possible in the complaint time course.
Certainly extended from the procedure it replaced, the newer version marries formal complaint handling with the important principle of ongoing feedback, recommending that all organisations providing healthcare develop a variety of mechanisms for receiving feedback on their services, for example 24 hour phone lines, postal questionnaires and feedback stations throughout their organisation. By combining these two principles, the new procedure provides some basis for organisational performance management & improvement through patient & public involvement, as long as provider organisations themselves appreciate the benefits of not only viewing complaints an standalone incidents. Why was there a need for a change in policy? It is well recognised that when complaints are dealt with in an effective manner there is a reduction in legal recourse. Many patients however still do not feel their complaints are adequately addressed or that “it is not even worth bothering as no one will listen”. When people complain, the majority want one or both of two things:
An apology Reassurance that lessons will be learnt and the same thing will not happen again i.e. that they have not complained in vane
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The right to have any complaint they make about NHS services dealt with efficiently and to have it properly investigated The NHS Constitution – the basis for the principles The new NHS Constitution (published January 09) states that every patient and carer has:
The right to have any complaint they make about NHS services dealt with efficiently and to have it properly investigated
The right to know the outcome of any investigation into their complaint
The right to take their complaint to the independent Health
Service Ombudsman, if they are not satisfied with the way their complaint has been dealt with by the NHS The right to make a claim for judicial review if they think they have been directly affected by an unlawful act or decision by an NHS body The right to compensation where they have been harmed by negligent treatment
The NHS constitution also commits to a number of other principles or rights, including that complainants are treated with courtesy and
NHS Training Bulletin
receive appropriate support throughout the handling of a complaint, as well as that making a complaint will not adversely affect future treatment. It also reinforces the two main wishes of the majority of complainants:
When mistakes happen, to acknowledge them, apologise,
explain what went wrong and put things right quickly and effectively To ensure that the organisation learns lessons from complaints and claims and uses these to improve NHS services
How does the new procedure differ from the old procedure? The new procedure differs from the one it replaces in both direct and subtle ways, including:
Patients now have 12 months from the event happening
or becoming aware of the event to complain (previously 6 months). This time period can be extended if it is still possible to investigate the complaint. Reasons for extending the timescales would include such things as the complainant undergoing grieving or other traumas e.g. severe anxiety as a result of the complaint There are now only 2 stages to the complaints procedure; local resolution and recourse to the parliamentary and health service ombudsman. The Healthcare Commission (now the Care Quality Commission) no longer plays a role, although providers will obviously need to consider that complaints in their own right could precipitate the Care Quality Commission ‘taking interest’ in a provider, as Mid Staffs was evidence of Complainants should have initial contact within 3 working days of complaining. At this initial contact it should be acknowledged the complaint has been received. Ideally at that point or an agreed future point the complainant should have their complaint fully listened to, should be asked what they wish to see happen as a result of their complaint, should be asked how they would like their complaint dealt with e.g. face to face or in writing and they should be informed of the plan for and likely time scales involved in reviewing the complaint. The new system allows increased flexibility e.g. to meet with the complainant and/or have a meeting with all parties concerned with the complaint Complainants should be made aware of both the organisation’s Patient Advice and Liaison Services (PALS) and the Independent
Complaints Advisory Service (ICAS) PALS advise complainants on how to take their complaint forward or resolve it informally. They do not take up the complaint on behalf of the complainant ICAS is a free, confidential and independent service which helps parents and carers make a formal complaint about NHS services.
Serious complaints need to continue to be brought to the
CEOs attention and so local policies and education processes need to have clear guidance on what constitutes a complaint that is sufficiently serious as to want this escalation Ideally the investigation report should be reviewed by both the complainant and the staff concerned prior to its final publication. In the past, the complainant received a letter or report but did not have the opportunity to actively contribute to this, increasing the likelihood that complainants could feel not listened to or unfairly judged, which in itself could lead to further escalation The time scale of 25 days for a written response from the CEO has been removed. However it is envisaged that regular contact is maintained with the complainant and all complaints as investigated thoroughly in a timely manner. Where delays beyond 6 months occur, the reasons for this must be communicated to the complainant Lessons should be learnt from all complaints and these should be disseminated through the organisation as appropriate and an annual report produced
This guidance does represent a significant departure from the previous procedure in that it introduces more flexibility under the premise that providers will work collaboratively and openly with complainants, who in turn can escalate complaints to the ombudsman if that is not happening. This does remove some of the rigid formality which in itself could lead to complainants feeling that services are cold and hard, rather than warm and conciliatory. What should I be doing as a front line clinical staff member? It is envisaged that NHS organisations will develop their customer service roles specifically to deal with complaints in the new manner. All front line teams should be encouraged to think in terms of ‘customer service’ anyway, as greater emphasis is placed
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NHS Training Bulletin on the importance of public and patient opinion in everything from outcome measures to assessment of quality to funding and patient choice. When receiving a formal complaint it is essential you follow your local procedure by liaising with your complaints officer or department. However, what simple advice can front line staff heed now, taken directly from Listen, Respond, Improve?
Ask the person how they would like to be addressed – as Mr, Mrs, Ms or by their first name
If someone has phoned you, offer to call them back and give
explanation). Tell them at the outset if their expectations are not feasible or realistic Agree a plan of action, including when and how the person complaining will hear back from your organisation If you think you can resolve the matter quickly without further investigation do so as long as the person complaining is happy with that and there is no risk to other service users For any complaint, remember to check if consent is needed to access someone’s personal records, and let the complainant know the name and contact details of the manager who will investigate their complaint
them the chance to meet face to face to discuss the issue
Ask them how they wish to be kept informed about their
complaint and how it is being dealt with – by phone, letter, email or through a third party such as an advocacy or support service If they say by phone, ask them for times when it is convenient to call and check that they are happy for messages to be left on their answer phone If they say by post, make sure that they are happy to receive correspondence at the address given Check if the person has any disabilities or circumstances you need to take account of (for example, do they require wheelchair access, or are they on medication that can make them drowsy?) Offer to meet the person at a location convenient to them Make the person aware that they can request an advocate to support them throughout the complaints process, including at the first meeting Systematically go through the reasons for the complaint with the person who is unhappy – it is important that you understand why they are dissatisfied Ask them what they would like to happen as a result of the complaint (for example, an apology, new appointment, reimbursement for costs or loss of personal belongings or an
In Conclusion In conclusion, the new procedure is sufficiently different in the direction of open collaboration to make a significant difference to the way patients & public feel in complaint situations. However, the true difference is always in the interpretation and implementation of the procedure. In that, only time will tell whether this quiet revolution is delivering the benefit it is designed to deliver. Further information Further information can be found on the DH website where you can search directly for the following publications:DH_095439 DH_095445 DH_095447 DH_095448 DH_095450 Author: Dr Sara Watkin Medical Director, Medicology Ltd.
Core Skills in Clinical Governance Course
17th September 2009, London 11th November 2009, Birmingham 11th December 2009, London Comprehensive, 1-day course on clinical governance, risk management, audit and improvement. Programme includes:
Previous attendees said: “Very informative, thorough and professionally delivered” Child Practice Facilitator, NHS Manchester
Understanding effective clinical governance
Team approaches to clinical governance & risk Clinical & service risk management Escalating risk in your organisation Ensuring that risks are acted upon
Managing complaints Effective communication skills in the complaint situation Developing clinical improvement strategies Effective use of audit in risk, governance & improvement
Serious incidents Root cause analysis More online...
www.NHStraining.co.uk/102 Low participant numbers, 5 CPD points, expert tutor, engaging
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“Really worthwhile in understanding issues difficult to navigate alone” Consultant Anaesthetist, Hull and East Yorkshire Hospitals
“Go for it and organise it locally” Consultant in Gastroenterology, Hull Royal Infirmary
Why not have your own course? Our innovative in-house and partnership programmes deliver superb value for money whilst truly extending reach. Contact Nick on 01332 821265 or email him at Nick@medicology.co.uk
NHS Training Bulletin
Quality, Governance & Experience 17th December 2009, Friends House, Euston, London
Description
The Programme - This is a 1 day conference, 5 CPD points
Group Bookings
Cost & Booking Information Consultants & Business Professionals r £215 + VAT early bird r £249 + VAT standard rate
Doctors in Training, SAS Grades & Nursing Staff r £125 + VAT early bird r £175 + VAT standard rate
£700 + VAT 5 places £1000 + VAT 10 places £1400 + VAT 15 places
The early bird rate applies to bookings received more than 56 days before the course date. Book online at www.qualitygovernanceexperience.co.uk, email us at: customer.services@medicology.co.uk or book over the phone by calling the customer services team on 01332 821260
Please contact Dean at dean@medicology.co.uk or by calling 01332 821261 www.NHStraining.co.uk
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NHS Training Bulletin
Insights Day Understanding the Evolving Healthcare Landscape Providing insight into the evolving healthcare landscape that every doctor should know Programme Elements
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Compelling Reasons to Attend
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View more details & book online at www.NHSinsights.co.uk or call Bronwyn, Jessica or Sarah at Medicology on 01332 821260 20
www.NHStraining.co.uk
NHS Training Bulletin
Cost:
Event Type:
Event Dates & Locations Date:
Location:
CPD Points:
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Provider:
Web Reference Number Bus & Admin Junior Middle Senior
Allied Proâ&#x20AC;&#x2122;s Junior Middle Senior
Enter Reference: Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
21
NHS Training Bulletin
Getting the best from NHS Training Bulletin For busy professionals, NHS Training Bulletin represents a step change in efficiency when it comes to finding and booking courses, conferences and training. Rather than letting you guess our thinking, we thought we’d just come right out with it, consistent with Training Bulletin’s underlying ethos of getting straight to the point without the time-wasting.
Replacing searching with finding Course, conference & training information is spread far and wide across the physical & digital net from Royal College sites, to leaflets on notice boards, to weekly, monthly & quarterly journals, home and abroad, public & commercial and more. Searching for it represents an industry in itself and so Training Bulletin is designed to short cut the process by bringing as much information into a single location as is humanly possible. Whether you look in the hardcopy journal or online at NHStraining.co.uk you’ll find an array of event information neatly organised by event type and by specialty. As NHS Training Bulletin develops, you’ll find more and more opportunities brought into the convenience of a single point of access.
Comprehensive options NHS Training Bulletin consists of a number of key elements, all designed to make access as simple and personal as possible:
Benefits of NHS Training Bulletin Journal Listings
A robust journal with related articles and neatly organised event
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Online
NHStraining.co.uk is the engine behind the events, searchable, fast and well organised
E-Bulletin
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Notifications
For registered users, be the first to hear about the event types you specify
The system as a whole is designed to be immensely usable without being at all intrusive i.e. on hand when you need it without being in your face.
Make bookings in confidence Our turbulent economic times rightly give rise to caution when booking event places. Will the provider be there when the time comes? Will I lose my limited study leave budget? Is the event really going to happen and indeed is it a real event, not a fraudulent one? NHS Training Bulletin is the solution. All payments taken through Training Bulletin are held in our secure client account on your behalf, until the event has taken place, and then released to the event organiser. This means that should the provider be unfortunate enough to stumble, then your funds are protected and you can simply reclaim them. Equally, this simple but practical solution reduces concerns over fraud by making it impossible for fraudsters to generate bogus events and then run with the money.
Booking with ease When you are ready to book, there is a simple registration process that you only go through once. Once registered, you can book onto any course from any provider simply by logging on to your account. Furthermore, you can track all of your event bookings from a single, convenient location and should your details change then updating all providers is achieved with minimum pain from your control panel. Once registered, you can set up notifications allowing you to be first to learn about new events in your chosen areas, improving time management and ensuring you get a place where places are limited. What’s not to love?
22
www.NHStraining.co.uk
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NHS Training Bulletin
Training Courses & Conference Listings Contents Leadership & Management
22
Personal Development
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View Full Course Programme & Booking Details Online At www.NHStraining.co.uk
Enter the course reference number found on all course listings within the journal into the web reference box at www.NHStraining.co.uk to bring up the full course programme and booking details.
This Month’s Featured Course... Foundation Course in Leadership & Management for FY Doctors Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Gain knowlegde, skills and insight into effective leadership and management, allowing you to become an effective clinical leader. This powerful course is designed to provide a significant foundation whilst recognising your career stage. Giving insight into the Medical Leadership Competency Framework, jointly developed by The Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement, it also provides you with clear guidance on how to go about developing those comptencies throughout your progression. Event Dates & Locations Date: 15th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 99 Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
23
NHS Training Bulletin - Leadership & Management Events
Non-Specific
General
Leadership & Management Core Skills for the Newer Consultant Cost: From £430 + VAT
Event Type: Course
CPD Points: 10
Provider: Medicology Ltd
A raft of practical strategies built into an easy to manage framework that ensures you excel as a consultant, gain the best from your staff and carry yourself with utmost professionalism. This course is designed as an intensive submersion into the key areas necessary to succeed in being an exceptional consultant. Covering everything from new found managerial responsibility to fiscal probity, risk, governance and even the business of health, it acts as a comprehensive framework packed with the practical application of core skills. Event Dates & Locations Location: Date: 1st & 2nd July 2009 London Manchester 9th & 10th September 2009 View more dates online using ref #: 75
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 75 Online at www.NHStraining.co.uk to view more event details and make a booking
Effective Clinical Leadership Non-Specific
Cost: From £430 + VAT
Event Type: Course
CPD Points: 10
Provider: Medicology Ltd
In this intensive 2-day course we marry modern management science in leadership theory with the unique demands of the clinical environment. The demands of a complex team-orientated, patient driven service require clinicians to develop skills in motivating staff clinically, fostering a sense of personal responsibility, performance management and supporting staff, at all levels of performance. Event Dates & Locations Location: Date: 28th & 29th September 2009 London Edinburgh 29th & 30th October 2009 View more dates online using ref #: 8
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 8 Online at www.NHStraining.co.uk to view more event details and make a booking
Management Skills for Junior & Middle Grade Doctors Non-Specific
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Suddenly in a responsible clinical role you find that all the technical & medical knowledge you’ve worked hard to gain is only part of the story when managing people. To progress effectively as a doctor it is essential that you develop competency as a manager and this is a key CV requirement for gaining a consultant post. This one-day comprehensive seminar covers all the essential topics in a practical way, to enable you to really develop your management skills in the clinical context. Event Dates & Locations Location: Date: 29th June 2009 London Manchester 24th September 2009 View more dates online using ref #: 16
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 16 Online at www.NHStraining.co.uk to view more event details and make a booking
Core Skills in Setting Effective Direction for Clinical Teams Non-Specific
Cost: From £215 + VAT
CPD Points: 5
Provider: Medicology Ltd
Effective direction is probably the single most important factor in driving performance and improvement, clinical or otherwise. Whereas it is often viewed as an art, we believe it is more akin to science, with a sound evidence base and known principles. This comprehensive course examines all facets of effective direction, providing you with all the knowledge, skills and practical approaches to ensure you gain the greatest possible performance and achievement from your clinical team. Event Dates & Locations Date: 14th September 2009 27th November 2009
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Event Type: Course
Location: London Birmingham
www.NHStraining.co.uk
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 103 Online at www.NHStraining.co.uk to view more event details and make a booking
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Given the sheer number of operational meetings each person engages in, we cannot afford the current level of meeting ineffectiveness. We spend more and more of our time in meetings and yet people often voice that meetings are a complete waste of time. We can change this. With the right set of skills, processes and strategies an effective meeting is possible everytime. This powerful course will have you running meetings that people look forward to because they achieve. Event Dates & Locations Date: 14th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Allied Pro’s
Junior Middle Senior
Junior Middle Senior
Non-Specific
Effective Meeting Management
General
Leadership & Management Events - NHS Training Bulletin
Enter Reference: 83 Online at www.NHStraining.co.uk to view more event details and make a booking
Essential Leadership for SpR-level Doctors Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
All SpR-level staff are expected to demonstrate a commitment to developing their potential as healthcare leaders. Effective leadership is an essential factor in the successful delivery of healthcare and also a key differentiator for those seeking consultant posts. This course investigates the key leadership issues in both a practical and theoretical sense. Designed to deliver measurable benefits in leading and motivating the staff around you, as well as providing the building blocks to develop as an exceptional healthcare leader. Event Dates & Locations Location: Date: 30th June 2009 London Manchester 25th September 2009 View more dates online using ref #: 10
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Allied Pro’s
Junior Middle Senior
Junior Middle Senior
Non-Specific
Cost: From £215 + VAT
Enter Reference: 10 Online at www.NHStraining.co.uk to view more event details and make a booking
Foundation Course for SAS Doctors Transitioning to Consultant Event Type: Course
CPD Points: 10
Provider: Medicology Ltd
Designed specifically for Specialty Doctors (Staff Grade and Associate Specialist) progressing towards consultanthood through Article 14 of PMETB, this course takes you through the transmission from largely working in health to taking a leadership responsibility for it. The course is structured to assist you in developing the knowledge, insight and skills necessary to thrive in the very different role of consultant. Please note there is considerable overlap between this course and Core Skills for the Newer Consultant. Event Dates & Locations Date: 7th & 8th September 2009 12th & 13th November 2009
Location: London Birmingham
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
Cost: From £430 + VAT
Enter Reference: 130 Online at www.NHStraining.co.uk to view more event details and make a booking
Foundation Course in Leadership & Management for FY Doctors Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Gain knowlegde, skills and insight into effective leadership and management, allowing you to become an effective clinical leader. This powerful course is designed to provide a significant foundation whilst recognising your career stage. Giving insight into the Medical Leadership Competency Framework, jointly developed by The Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement, it also provides you with clear guidance on how to go about developing those comptencies throughout your progression. Event Dates & Locations Date: 15th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
Cost: From £215 + VAT
Enter Reference: 99 Online at www.NHStraining.co.uk to view more event details and make a booking
Leadership Masterclass for Healthcare Professionals Event Type: Course
CPD Points: 10
Provider: Medicology Ltd
One of the cornerstones of effective healthcare performance is the quality of leadership. Leadership Masterclass represents the latest thinking in how to drive groups of people to achieve great things. Focusing on both the leadership of self and others, it provides a deep level of insight into current theory and how it can be deployed in the leadership, motivation and influencing of people. At a practical level, it will help you provide strong guidance to people in a wide variety of scenarios from every day working to a sudden crisis. Event Dates & Locations Location: Date: 7th & 8th September 2009 Birmingham London 16th & 17th November 2009 View more dates online using ref #: 12
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
Cost: From £430 + VAT
Enter Reference: 12 Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
25
Non-Specific
General
NHS Training Bulletin - Leadership & Management Events
Consultant Interview Skills: Paediatrics & Neonatal Medicine Cost: From £299 + VAT
Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 9th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 124 Online at www.NHStraining.co.uk to view more event details and make a booking
Insights Day - Understanding the Evolving Healthcare Landscape Non-Specific
Cost: From £125 + VAT
Event Type: Seminar
CPD Points: 5
Provider: Medicology Ltd
The healthcare landscape is evolving at a pace that few can keep up with, or even appreciate. The raft of changes creeping in represent both tremendous risks and opportunities for the frontline teams taking the trouble to understand their current and evolving environment. This one day programme strips the rhetoric away from the harsh reality of modern healthcare and provides an insight into the drivers of change, likely political manoeuvres and what this really means for secondary/tertiary Trusts and the clinical teams within. Event Dates & Locations Location: Date: 2nd September 2009 London Sheffield 12th October 2009 View more dates online using ref #: 105
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 105 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Mental Health Non-Specific
Cost: From £299 + VAT
Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 22nd September 2009 16th November 2009
Location: London Birmingham
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 121 Online at www.NHStraining.co.uk to view more event details and make a booking
Medical Management & Leadership for Year 4/5 StRs & Senior Specialty Doctors Non-Specific
Cost: From £645 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Comprehensive, in-depth focus on the core principles of effective management and leadership designed to create exceptional clinical leaders. This course is designed to deliver exceptional leaders with highly effective managerial ability, without ever losing sight of the fact that you are first and foremost doctors. Aligned closely with the Medical Leadership Competency Framework, jointly developed by The Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement. Event Dates & Locations Date: 12th - 14th October 2009 14th - 16th December 2009
Location: London Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 98 Online at www.NHStraining.co.uk to view more event details and make a booking
Change Management Masterclass for Health Professionals Non-Specific
Cost: From £430 + VAT
CPD Points: 10
Provider: Medicology Ltd
Plan and implement change effectively, to reduce resistance and disruption, whilst increasing positive support. Leading people through change is probably the toughest job facing any leader, even with formal training. Covering everything from planning an effective change process to ensuring full engagement of the staff, we help you achieve your change goals with minimal disruption to performance and the fastest possible return to normal. It is designed to give you substantial expertise in getting change right. Event Dates & Locations Date: 5th & 6th October 2009
26
Event Type: Course
Location: Manchester
www.NHStraining.co.uk
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 82 Online at www.NHStraining.co.uk to view more event details and make a booking
Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 7th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 120 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Emergency Medicine Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 4th - 6th November 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Web Reference Number Bus & Admin
Junior Middle Senior
Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 109
Accident and Emergency Accident & Emergency
Cost: From £299 + VAT
Non-Specific
Consultant Interview Skills: Medicine (Physicians)
General
Leadership & Management Events - NHS Training Bulletin
Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Emergency Medicine Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 10th November 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 119 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Anaesthetics & Intensive Care Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. The course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 2nd - 4th September 2009
Location: Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Accident and Emergency
CPD Points: 6
Anaesthesia
Event Type: Course
Anaesthesia
Cost: From £299 + VAT
Enter Reference: 108 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Anaesthetics & Intensive Care Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 1st October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Anaesthesia
Cost: From £299 + VAT
Enter Reference: 118 Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
27
General Medicine
General Medicine
NHS Training Bulletin - Leadership & Management Events
Clinical Management & Leadership for Year 4/5: Medicine (Physicians) Cost: From £599 + VAT
Obstetrics and Gynaecology
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. this course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 25th - 27th August 2009 18th - 20th November 2009
Obstetrics & Gynaecology
Event Type: Course
Location: London Birmingham
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 110 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Obstetrics & Gynaecology Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 25th - 27th November 2009
Location: Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 112 Online at www.NHStraining.co.uk to view more event details and make a booking
Oncology
Oncology
Obstetrics and Gynaecology
Consultant Interview Skills: Obstetrics & Gynaecology Cost: From £299 + VAT
Event Type: Course
Event Dates & Locations Date: 2nd October 2009
Location: London
Paediatrics
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 122 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Oncology Cost: From £299 + VAT
Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations
Paediatrics
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success.
Date: 8th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 123 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Paediatrics & Neonatal Medicine Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 26th - 28th October 2009
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CPD Points: 6
Location: Manchester
www.NHStraining.co.uk
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 114 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Pathology & Labs Specialties Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 5th - 7th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Pathology Pathology
Leadership & Management Events - NHS Training Bulletin
Web Reference Number Bus & Admin
Allied Pro’s
Junior Middle Senior
Junior Middle Senior
Enter Reference: 115 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Pathology & Laboratory Specialties Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Date: 30th June 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin
Allied Pro’s
Junior Middle Senior
Junior Middle Senior
Enter Reference: 125 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Mental Health Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 25th - 27th November 2009
Location: Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 111 Online at www.NHStraining.co.uk to view more event details and make a booking
Clinical Management & Leadership for Year 4/5: Radiology Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 26th - 28th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Psychiatry
Event Dates & Locations
Pathology
Provider: Medicology Ltd
Psychiatry
CPD Points: 6
Radioology
Event Type: Course
Radiology
Cost: From £299 + VAT
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 116 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Radiology Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Date: 16th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Radiology
Cost: From £299 + VAT
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 126 Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
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Surgery
Surgery
NHS Training Bulletin - Leadership & Management Events
Clinical Management & Leadership for Year 4/5: Surgery Cost: From £599 + VAT
Event Type: Course
CPD Points: 15
Provider: Medicology Ltd
Welcome to the finest preparatory course available for specialist registrars approaching completion of training. This course is designed to enable you to make a step change in your ability to be effective as a new consultant in your specialty, whilst demonstrating your clear commitment to effective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialtyspecific insight into the challenges you’ll be facing as a new consultant in the evolving health service. Event Dates & Locations Date: 25th - 27th August 2009 18th - 20th November 2009
Location: London Birmingham
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 117 Online at www.NHStraining.co.uk to view more event details and make a booking
Consultant Interview Skills: Surgery
Surgery
Cost: From £299 + VAT
Event Type: Course
CPD Points: 6
Provider: Medicology Ltd
Most people would not even consider taking an exam without acquiring the requisite knowledge, skills and insight in preparation for it and therefore why would you approach perhaps one of the most important events in your life, getting the right consultant job, with any greater uncertainty than there needs to be? You wouldn’t. In fact, we know that you’d want to absolutely ensure you stood the best possible chance of success. That is why we have developed The Medicology Gold Standard Approach to consultant interview success. Event Dates & Locations Location: Date: 15th September 2009 London Birmingham 17th November 2009 View more dates online using ref #: 127
Target Audience Doctors Nurses Junior Middle Senior
Event Type:
Event Dates & Locations Date:
Location:
Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 127 Online at www.NHStraining.co.uk to view more event details and make a booking
Add as many courses as you like absolutely free, you only pay for Provider: bookings made.
Want to advertise your courses?
Cost:
Junior Middle Senior
Web Reference Number
CPD Points:
This is ideal if you are just looking for a few extra participants or don’t want to commit to an expense you are unsure will be recouped then success-only is the route for you. We bring to bear our full promotional capability on your behalf and you only pay for the success we achieve. Target Audience Web Reference Number Doctors Nurses Bus & Admin Allied Pro’s Enter Reference: Find outJunior more by downloading our media Junior Junior Juniorpack Online at www.NHStraining.co.uk to view Middle at www.NHStraining.co.uk/advertise Middle Middle Middle Senior
Senior
Senior
Senior
more event details and make a booking
View Full Course Programme & Booking Details Online At www.NHStraining.co.uk Cost:
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CPD Points:
Target Audience Doctors Nurses
Psychiatry
Junior Middle Senior
Junior Middle Senior
Enter the course reference number found on all course Event Type: CPD Points: listings within the journal into the web reference box at www.NHStraining.co.uk to bring up the full course programme and booking details.
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30
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Provider:
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Event Dates & Locations 01332 821270
Enter Reference:
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Personal Development Events - NHS Training Bulletin
Assertiveness without Aggression Non-Specific
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Helping consultants & juniors successfully assert themselves is an area we approach very supportively, developing capability without ever changing the person inside. It’s so easy for those to whom assertiveness doesn’t come naturally to feel manipulated, bullied and sometimes not quite in control. Despite your exceptional level of knowledge you may suffer low self esteem and a lack of confidence when it comes to being assertive. On the flip side, you probably wouldn’t want to be thought of as rude or forceful. Event Dates & Locations Date: 10th September 2009 4th November 2009
Location: London Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
General
Personal Development
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 23 Online at www.NHStraining.co.uk to view more event details and make a booking
Time Management & Personal Effectiveness for Junior & Middle Grade Doctors Non-Specific
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Aimed specifically at doctors in training, this is probably the most powerful course in personal effectiveness you will find. The successful junior or middle grade doctor needs a unique combination of skills combining a high team orientation with strong time management and organisational skills coupled with a delicate balancing act between learning and delivering. Packed full of practical strategies to plan and prioritise effectively, manage the never ending influx of work and regain effective work-life balance. Event Dates & Locations Date: 5th October 2009 14th December 2009
Location: Birmingham Manchester
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 85 Online at www.NHStraining.co.uk to view more event details and make a booking
Time Management & Personal Effectiveness for Healthcare Professionals Non-Specific
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Creating high achievers with more energy and better work-life balance. You’re probably successful already but I bet it could feel easier! There are many compelling reasons to access strategies and support and very few are about being poor at time management. Packed full of practical strategies to plan and prioritise effectively, manage the never ending influx of work and regain effective work-life balance. Achieve more this year. You deserve it for all your hard work. Event Dates & Locations Date: 12th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 2 Online at www.NHStraining.co.uk to view more event details and make a booking
Presentation & Teaching Skills Non-Specific
Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Gain the confidence and skills to articulate, excel and inspire in presentations & teaching. Presentations and teaching skills form one of the core backbone elements of a successful medical career. Faced with a diverse range of scenarios, from teaching staff to interview presentations right through to a presentation of an international multicentre trial, it is surprising that few have ever received any formal training in this vital area. Presentation and Teaching Skills deals with the core elements of effectiveness in this area. Event Dates & Locations Location: Date: 26th June 2009 London London 2nd October 2009 View more dates online using ref #: 30
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 30 Online at www.NHStraining.co.uk to view more event details and make a booking
www.NHStraining.co.uk
31
Managing Relationships & Conflict in the workplace Cost: From £215 + VAT
Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Do you want to understand people more in order to be more interpersonally effective, as well as developing specific strategies for managing conflict situations? Our ability to get on with our peers and behave in a productive, respectful fashion is one of the key determinants of organisational performance. Self awareness is a key goal to increase effectiveness. This course delivers an advanced understanding of how people are wired, what motivates their behaviour both normally and under situations of conflict and how to deal with this. Event Dates & Locations Date: 8th October 2009 30th November 2009
Location: Manchester London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
General
NHS Training Bulletin - Personal Development Events
Enter Reference: 27 Online at www.NHStraining.co.uk to view more event details and make a booking
Core Skills in Mentoring Medical Professionals Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
Mentoring is perhaps one of the most powerful and effective strategies for realising potential in individuals. Mentoring medical professionals can be an enormously rewarding experience for both mentee and mentor. Adoption of effective mentoring practises can help individuals develop self-reliance in their learning whilst over-coming unfamiliar challenges with support where needed. This course provides an effective mentoring framework from initiation to closure, including all of the practical strategies necessary to make it successful. Event Dates & Locations Date: 13th October 2009
Location: London
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
Cost: From £215 + VAT
Enter Reference: 95 Online at www.NHStraining.co.uk to view more event details and make a booking
Advanced Communication & Influencing Skills Event Type: Course
CPD Points: 10
Provider: Medicology Ltd
Starting with developing a greater understanding of people, this course then translates this into a range of advanced interpersonal skills such as advanced communications, negotiation skills, building rapport, developing effective teamwork & relationships, choosing appropriate language, fostering an environment of respect, as well as developing self-awareness. A busy and invaluable course designed to make you more effective in all of your dealings with people. Event Dates & Locations Location: Date: 7th & 8th July 2009 Manchester London 21st & 22nd September 2009 View more dates online using ref #: 22
Target Audience Doctors Nurses Junior Middle Senior
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Non-Specific
Cost: From £430 + VAT
Enter Reference: 22 Online at www.NHStraining.co.uk to view more event details and make a booking
Communication Skills for Junior & Middle Grade Doctors Event Type: Course
CPD Points: 5
Provider: Medicology Ltd
It is well known that most complaints and litigation come from poor communication process. Equally, clinical mistakes stem from a lack of communication strategy and poor communication style contributes to most interpersonal conflict in the workplace. This fast-paced course is highly effective on improving communication skills essential to junior doctors, handling patients, parents & relatives and dealing with situations where improved communication clarity is likely to lead to improve results and outcomes. A very powerful course. Event Dates & Locations Date: 9th July 2009
Cost:
Location: Manchester
Event Type:
Target Audience Doctors Nurses Junior Middle Senior
Want to advertise your courses? Event Dates & Locations
Date:
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www.NHStraining.co.uk
Location:
Junior Middle Senior
Web Reference Number Bus & Admin Junior Middle Senior
Allied Pro’s Junior Middle Senior
Enter Reference: 24 Online at www.NHStraining.co.uk to view more event details and make a booking
Add as many courses as you like absolutely free, you only pay for Provider: CPD Points: bookings made.
This is ideal if you are just looking for a few extra participants or don’t want to commit to an expense you are unsure will be recouped then success-only is the route for you. We bring to bear our full promotional capability on your behalf Target Audience Web Reference Number and you only pay for the success we achieve. Doctors Nurses Bus & Admin Allied Pro’s Enter Reference: Junior Junior Junior Junior Find out more by downloading our media pack Online at www.NHStraining.co.uk to view Middle Middle Middle Middle Senior at www.NHStraining.co.uk/advertise Senior Senior Senior more event details and make a booking
Non-Specific
Cost: From £215 + VAT
NHS Training Bulletin
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NHS Training Bulletin is supported by Medicology Ltd and is not an official publication/ service of the NHS
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