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

triage 3

THE MAGAZINE FOR JUNIOR DOCTORS

Presenting historyJuniorDr 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.

editorAshley McKimm, editor@juniordr.com

editorial TeamMichelle Connolly, Anita Sharma,

Muhunthan Thillai, Andro Monzon

newsdesknews@juniordr.com

advertising & ProductionRob Peterson, ads@juniordr.com

JuniordrPO Box 36434, London, EC1M 6WA

Tel - +44 (0) 20 7 684 2343

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team@juniordr.com

health warningJuniorDr 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

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a rash. © JuniorDr 2009. All rights reserved.

Get involvedWe’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.

ARE GREAT MEDICAL LEADERS BORN OR MADE?

“After 60 years helping give birth to medical leaders the NHS has decided to have a go at making some too.”

Ashley McKimmJuniordr editor-in-ChieF

st2 psyChiatry

What’s inside

0409141516

2021

LATEST NEWS

MAkING FUTURE MEDicAl lEADERS

TOp DERMAtOlOgy WEbSITES

TREATING pATIENTS IN SEcOND lifE

SECRET DIARY OF A cARDiOlOgy SPR

HAl 9000 GETS A CHECk-Up

HOSpITAL cONfiDENtiAl

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 medi-cal 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. Gain-ing 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.

news pulse4

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 actu-ally fell from 78% in March to 72% in April.

The Royal College of Surgeons is call-ing 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.

“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, responsi-ble for EWTD implementation, found that Northern Ireland had the lowest rota compli-ancy with just 40% meeting the 2009 limits.

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 doc-tors in the UK to staff the NHS under work-ing 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 inter-nal locums and were meeting the Europe-an 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 hope-lessly 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 con-cerns 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 train-ing 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 doc-tors to speak out on this issue.”

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 num-bers of trainees are failing their end of year assessments where 48 hour working has been introduced.”

The BMA has called for short-term prac-tical 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 simula-tors and skills labs to enable doctors to prac-tise techniques using technology which sim-ulates an operation.

www.bma.org.uk

www.rcseng.ac.uk

www.dh.gov.uk

tell us your news. Email team@juniordr.com or call 020 7684 2343.

URgENt ActiON NEEDED TO AVOID ‘DISASTER’ THIS AUGUST

John Blackpresident oF the royal College oF surgeons

“this battle is for the soul of sur-gery, and must and will be won. patients will ultimately suffer and some may even die if it is not.”

Alan Johnsonhealth seCretary

“there is no evidence that great-er numbers of trainees are fail-ing their end of year assess-ments where 48 hour working has been introduced.”

ewTd

news pulse 5

Virtual reality simulators can help surgeons improve perfor-mance and reduce operating time, according to research published in the BMJ. The randomised con-trolled trial carried out in Demark found the performance of novices was increased to the level of inter-mediately experienced laparosco-pists whilst the operation time was reduced by half.

www.bmj.com

TraininG

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 clas-sified as a Bachelor’s degree which could result

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 Europe-an Working Time Directive and its impact on junior doctors’ training hours, coupled with a situation in which a proportion of prospec-tive 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 leav-ing the UK permanently.”

Tier 1 replaced the previous HSMP in Feb-ruary 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

IMMIGRATION CHANGES WILL ‘DEPRivE UK Of DOctORS’

Draft legislation for the merg-er of the PMETB and GMC has been published by the Depart-ment of Health. If successfully approved by parliament the func-tions of PMETB will transfer to the GMC in April 2010. The joint body will be responsible for regu-lating all stages of medical educa-tion from entry to medical school until retirement from practice.

www.gmc-uk.org

Regularly drinking three units of alcohol a day can double the likelihood of developing essential tremor, according to the Journal of Neurology, Neurosurgery and Psy-chiatry. The study of 3,300 peo-ple in Spain took account of con-founders, such as lifetime cigarette smoking and depression. Invol-untary tremor is believed to result from the toxic effects of alcohol to the cerebellum.

jnnp.bmj.com

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 - espe-cially the MOD’s plan to double the number of psychiatrists and anaesthetists.

www.mod.uk

pMETb to merge with GMC

Simulating surgery

Shaken not stirred

Military docs wounded by payrise

Dr Hamish MeldrumbMa ChairMan

“restricting their career op-tions to such an extent repre-sents a huge waste of taxpay-ers’ money and may lead to affected doctors leaving the uK permanently.”

$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 medi-cal 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 pro-grams require residents to work long hours, often more than 100 hours per week. Recom-mendations 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

‘NO WAy tO PAy’ FOR REDUCTION IN US JUNIOR DOCTOR HOURS

workinG CondiTions

news pulse6

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

60 percent of all US bankrupt-cies are attributable to medical problems, according to new research due to be published in the Ameri-can Journal of Medicine. The study, which took place before the current economic downturn, found that an American family filed for bankrupt-cy in the aftermath of illness every 90 seconds. For 92% of these high medical bills directly contributed to their bankruptcy.

www.amjmed.com

Drinking very hot tea can increase the risk of throat cancer, according to a new study published in the BMJ. The study of 871 par-ticipants 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

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 Roy-al 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

broken bones and finances

MRSA goes private

Give tea time to cool

Holiday over for overseas ops

F our out of five doctors continue to work in the NHS 25 years after qualifi-cation, according to a study published

in the BMJ.The study tracked 32,013 graduates from

medical school and found that 88% contin-ued to work in the NHS two years after qual-ification. This dropped slightly to 81% after 25 year follow-up.

The data appears to refute claims that increasingly disenchanted doctors are leav-ing 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 propor-tion 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 dis-crimination against women in the NHS, indi-rect 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

MOST DOCS REMAIN COMMITTED TO NHS AftER 25 yEARS

nhs

F emale doctors will out-number their male coun-terparts 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 part-time 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

breaks and part-time working, women pro-vide 60% of a full time equivalent doctor, against 80% for men.

The highest proportion of female consul-tants currently work in GP, Paediatrics and Public Health specialities. The authors not-ed that these preference rankings are not just a UK phenomenon but are closely matched internationally.

www.rcplondon.ac.uk

WOMEN TO bECOME MAJORity Of DOcS AFTER 2017

nhs

D octors’ swipe cards are a potential source of hospital-acquired

infections, including MRSA, according to research pub-lished 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 con-taminated with pathogenic bacteria, including MRSA.

Out of the 39 cards sampled those kept in a wallet or the doc-tor’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 poten-tial 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

S mall promotional products from drug companies, such as pens and notepads, influence medical students’ attitudes towards pharmaceutical drugs, according to a study pub-

lished 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 medica-tion 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 prefer-ences 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 lit-erature would suggest,” concluded the team at University of Penn-sylvania, Philadelphia.

archinte.ama-assn.org

DOCTORS SWiPE cARDS pOSE SUpERbUG RISk

DRUg REP fREEBiES INFLUENCE MED STUDENTS

nhs

nhs

D uring the 19th century, museums of ana-tomical models became popular attractions for Europeans seeking an unusual after-

noon’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 fair-ground horror.

Exquisite Bodies at the Wellcome Collection will reveal how spectacular collections of anatomi-cal 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)

EXQUISITE BODiES wellCome ColleCTion

9Future MediCal leaders

E mbarking on an MBA isn’t a decision to be taken lightly. Entry is compet-itive, 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 poten-tially opens a world of new career opportu-nities. 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 gra-dates each year - and numbers are increas-ing 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 econom-ics, 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 internation-ally 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 which-ever career path you follow.

You can find a list of the UK’s business schools at Financial Times Global MBA Rankings:

rankings.ft.com/businessschoolrankings/global-

mba-rankings

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

Emma Stantonspr psyChiatry and in seCond year oF an exeCutive Mba at iMperial

“there is an emphasis on team working as most of the assign-ments require working with indi-viduals from a range of profes-sional backgrounds and often different countries. i have most enjoyed the entrepreneurial module of my Mba which has involved developing an innova-tive idea into a comprehensive business plan and seeking fund-ing to take it to market.”

Future MediCal leaders10

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 consider-ing 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

f u t u r e

careers. An offshoot of the British Associa-tion of Medical Managers (BAMM), BAM-Mbino offers training, support and encour-agement 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 pro-grammes 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 host-ed Sir Liam Donaldson (Chief Medical Offi-cer) and Sir Bruce Keogh (NHS Medical Director) as well as co-hosting the “Agents for Change” conference with the Nation-al Patient Safety Agency, BAMMbino is attempting to raise the profile of clinical leadership amongst trainees and make med-ical management a positive career choice.

The next event, the BAMMbino Sum-mer School on June 23rd, aims to show

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 BAM-Mbino visit:

www.bamm.co.uk

T 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 pub-lic 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 develop-ment, 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 appli-cants are seconded from their current Trust for a year or more keeping their NHS salary. Most doctors return to their clini-cal posts afterwards but there is the option to continue with some projects.

The scheme is open to all doctors from FY1 up to consul-tant 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

bE A BAMMbino

POSTGRADUATE CERTIFICATE / POSTGRADUATE DIPLOMA / MASTERS (MSc)

MEDICAL LEADERSHIP2009/10 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

Dr. Mark Simmondsspr aCute MediCine/intensive Care

Founding Chair, baMMbino

“the rapid growth of the baM-Mbino network demonstrates that there is a wealth of enthu-siasm for clinical leadership amongst junior doctors that has previously been unrecognised and unexploited.”

bECOME A cMO ADviSOR

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A new Masters Degree in Medical Leadership is launching this October and is open to junior doctors with a mini-mum 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.

www.rcplondon.ac.uk/medicalleadership

F orty doctors are currently piloting a new leadership pro-gramme 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

MSc MEDICAL LEADERSHIp

bECOME A DARzi fEllOW

Future MediCal leaders12

A s the medical face of BUPA his pri-mary job is to be responsible for the safety and quality of care but he also

represents the group when a medical back-ground is needed. This can be on diverse matters such as discussing how BUPA could assist with a UK swine flu epidem-ic 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, Aus-tralia 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 dif-ferent 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 shack-les,” he says. “The best bit about being med-ical 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 Birming-ham medical school back in 1970. He started by running the generic ‘wine and cheese evenings’ as president of the medi-cal 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 doc-tor committee and became deeply involved in medical politics. Just prior to becoming a SpR the opportunity arose of a staff post in

the BMA. He left clinical practice, took the post and quickly moved up the ranks becom-ing 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 him-self 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 sec-tor just like many junior doctors,” he said. “But I was greeted by a young, enthusias-tic BUPA team with a clear vision. I found that inspiring.”

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 operat-ing 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.

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 Chi-na but recognises that this will be accompa-nied 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 col-leagues 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 lon-ger, healthier, happier lives” message to the world shouldn’t be a problem for Andrew Vallance-Owen.

pROFILE: bUpA MEDICAL DIRECTORANDREW vAllANcE-OWENFor 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.

“I loved surgery. Being out of the operating theatre was tough for the first two years but since then I have never looked back.”

Difficult colleaguesSara Williams from MPS offers some tips for dealing with challenging encounters of the most difficult kind

Good personal conduct, effective communication and respectfor colleagues will avert most problems; however, what if theactions of your colleagues could harm patients?

The stress of the clinical workload means that mistakes are inevitable,but a distinction needs to be made between matters of personalconduct, poor performance and where a doctor’s performance maybe affected by a health issue (eg, depression, substance abuse, etc).

The GMC guidance says you should “support colleagues who haveproblems with performance, conduct or health”, but action should betaken if this causes them to compromise patient care.1

If a colleague is self-prescribing, hurting patients or abusingsubstances, what should you do? If you believe the actions may putpatients at risk, the GMC recommends that you raise your concernswith the medical director or a senior colleague. Local guidelines will be in place to deal with these situations should they arise and alldoctors have a duty to make any concerns known.

Scenario Thursday morning surgery is about to begin, and Mr Martin, a seniorconsultant general surgeon, arrives and greets Margaret, a sister intheatre 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 inslippery conditions.

Surgery commences and Mina begins to assist Mr Martin in what isher first case of the day. As they work through the list of patients,Mina observes Mr Martin struggle to suture a patient. Her concernspeak when he drops his forceps. Suddenly Mina becomes aware thatthere is the unmistakable whiff of alcohol. As she moves closer toassist Mr Martin, to her horror, she realises that the smell is comingfrom him. What should she do?

Advice – what to do with the drunken surgeon? Mina is in an invidious position; she clearly has concerns that Mr Martin, a senior consultant, is operating under the influence ofalcohol and these concerns are shared by Margaret, the theatre sister.

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 bereavedand 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 harmposed by a colleague’s performance, health or conduct. You must,therefore, make patient safety the priority and act straight away ifthere is an immediate risk.

Margaret clearly shares your concerns and (if time allows) it would be helpful to discuss matters with her before deciding how best toproceed. You might wish to prepare a contemporaneous reportoutlining your concerns in a factual way. Approach a senior colleagueto discuss the matter further. As a last resort, the trust will have a“whistle-blowing” policy which may be appropriate to use in thesecircumstances. You should be aware that whilst care is taken tosafeguard the identity of the whistle-blower it may become obvious to Mr Martin who has raised concerns.

The alternative would be to approach a senior colleague, such as theclinical director, and outline your concerns in order that he or she cantake matters further. The trust will have procedures for investigatingand managing such concerns.

RememberIf 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 yourconcerns in a prompt and factual way, you will not be vulnerableto criticism.

Once you have reported your concerns to the Trust, it is up tothem to take matters forward in accordance with their procedures.

Do not hesitate to contact MPS, as our medicolegal adviserswould be happy to advise you in these or similar circumstances.2

Support services doctorsDoctors’ Support Network: 0870 7650001 – www.dsn.org.uk

Practitioner Health Programme – www.php.nhs.uk

The BMA Counselling Service: 0845 9200169 (BMA members only)

References1 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

For more information call 0845 718 7187Or visit www.mps.org.uk

24-hour medicolegal emergency advice line

Medicolegal publications – Casebook and New Doctor

Risk Management materials includingmedicolegal booklets

Online resources including factsheets andcase scenariosEducational support through discounts with leading publishersLargest international protection organisation

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

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The characters in this scenario are fictitious

MPS0865 How to.qxd:Template - Junior Doctor 5/27/09 3:48 PM Page 1

MediCal studentsteChnology14

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 devel-oped in response to Lord Darzi’s ‘High Quality Care for All’ report last June and will be available to the pub-lic 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.

“This is just the first stage in the development of an impartial service which will provide the most compre-hensive source of relevant and trust-worthy information about clinical, non clinical evidence and best prac-tice, at the touch of a button,” said Dr Gillian Leng, chief operating offi-cer for NHS Evidence.

“It’s good news that users, includ-ing patients, will be able to find the information they need and know that it comes from a credible source - this will ultimately help improve efficien-cy and ensure all patients receive the best available care.”

NHS Evidence will also allow users to browse evidence using ‘top-ic trees’, upload and share their own content - such as local service mod-els and policies - and to receive alerts about new information.

www.evidence.nhs.uk/

DermLectureswww.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.

eMedicineemedicine.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.

british Association of Dermatologists’ Clinical Guidelines www.bad.org.uk/site/622/default.aspx

Part of the wider BAD site these clinical guide-lines are a particularly useful learning resource - but be careful as some are relatively old and need reviewing.

Virtual Grand Rounds in Dermatologywww.vgrd.org

Read a new case presentation with macroscop-ic and microscopic images every few weeks, plus your opportunity to join in the discussion online. Highly recommended to keep those dermatology brain cells working.

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.

NicE MAkES bEST EVIDENCE SEARCHAbLE

dermaToloGy websiTes

in association with

For More Key websites in derMatology - try

MediCal studentsteChnology 15

A home computer system to help demen-tia 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 par-ticular 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 Mari-us Mikalsen:

“This is also a system for shar-ing information. The families of these patients are often anx-ious about how 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 hird year medical students have been diagnosing patients in Sec-ond Life as part of a new pilot pro-

gramme 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 giv-en five virtual patients to talk to, exam-ine and diagnose. They are also provid-ed 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 Toro-Troconis.

“Virtual patients, especially in three-dimensional format, can be of real value in supporting clinical teaching.”

Students are based in a virtual respi-ratory ward where developers have attempted to re-create the real experi-ence as much as possible - even requir-ing students to wash their hands before seeing patients.

First time users have to create an avatar - a 3D representation of them-selves. On visiting Imperial’s virtual hospital students are then welcomed by the Head of Undergraduate Medi-cine, Professor Jenny Higham. They can also teleport to the ‘students union’ and ‘research centre’, where they can

interact with other users.The pilot is part of a research to find

the best e-learning methods for medi-cal training. Initial findings show that while students are generally receptive to working within the learning environ-ment, they have problems with access and need time to feel comfortable inter-acting 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 experi-ence,” says Maria Toro-Troconis.

www.elearningimperial.com

Searching for quality Webresources in medicine?

www.intute.ac.uk/medicine/

Intute is a free online serviceguiding you to the best of the Web for

education, training and research

HOME COMpUTER SYSTEM AIDS DEMENtiA PAtiENtS

STUDENTS GIVE pATIENTS A SEcOND lifE

PaTienTs Give feedbaCk on mPower deviCe

sCreenshoTs from seCond life ward

seCret diary16

* 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!

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 fan-tastic 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.

Tuesday Clinic this morning was overbooked as usual. One of the con-

sultants 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 col-leagues. 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 bet-ter than a dressing down) and he rushes off to call her back in. I fin-ish 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 danc-ing 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.

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 teach-ing 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 inter-ventional 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.

SECRET DIARY OF A cARDiOlOgy SPR

You look after your patientsWe’ll look after your finances

Wesleyan Medical Sickness specialises in providing tailoredfinancial advice to the medical profession. Our FinancialConsultants 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 longestserving mutuals in the UK.

Choose Wesleyan Medical Sickness and you choose a Financial Consultant who is as dedicated to your professionas you are.

• Savings and investments

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• Mortgages and insurance

• Banking services

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 ownedby Wesleyan Assurance Society. Registered No. 1651212. Head Office: Colmore Circus, Birmingham, B4 6AR. Fax: 0121 200 2971. Website: www.wesleyanmedicalsickness.co.uk Telephone calls maybe recorded for monitoring and training purposes.

HD-AD-12 03/09

Tailored financial advice for doctors

To find out more call:

0800 107 5352

FinanCe18

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 proper-ty 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 buy-ers are entering the market and this is begin-ning to translate into an increase in sales.

However it’s still early days and no-one 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 ini-tiative designed to help first time buyers get into the housing market.

HOMEBUyTo 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 num-ber of different schemes available adminis-tered through agents. In essence HomeBuy means that you can get a loan on a prop-erty, potentially of up to 50% of the buy-ing price. You will then have to cover the remaining cost through a traditional mort-gage 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 prop-erty you need to repay the loan but you can choose to repay some or all of the loan soon-er. In doing so, you reduce the amount that your HomeBuy agent receives when the property is sold.

OffSEt MORtgAgESIf you’re in the lucky position to have

savings then now is a good time to con-sider moving to an offset mortgage as your cash will work harder for you. In simple terms, this type of mortgage works by plac-ing 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 mort-gage 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 maxi-mising 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 advan-tages to borrowers. You can make overpay-ments or underpayments on the mortgage, which can be helpful if your situation chang-es and you can even take payment holidays. They also lower the total interest paid over the length of the loan and shorten the mort-gage 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 organisa-tion 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 repos-sessed if you do not keep up repayments on your mortgage.

Specialist financial services for doctors• Savings and Investments

• Retirement Planning

• Life and Income Protection

• Mortgages and Insurance

• Personal Loans andBank Accounts

0800 107 5352 or visit www.wesleyanmedicalsickness.co.uk

focus on finance - in association with Wesleyan Medical Sickness

TO bUY OR NOt tO BUy

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

waiters dressed conspicuous-ly like monks. Watch out for the transparent toilet doors that confuse many a tourist.

Chez Leon - (Rue des Bouch-ers) 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.

key aTTraCTions

Manneken-Pis - This lit-erally 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

tourist centre and is enclosed in magnificent Baroque build-ings. Worth a few hours sipping a hot chocolate while watching

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 knowl-edgeable staff it’s the ideal place to savour the flavour of Belgian beer and get esquisitely drunk.

day TriPs

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 lo-cals. 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

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.

WEEkEND WARD ESCApE TO

brussels

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

where To sTay?Hotels in Brussels are noth-

ing 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 locat-ed and practical George V (Rue ‘t Kint) or NH Grand Place (Rue D’Assaut) instead. Visitors who are more frugal with their bud-get should try Bruegel (Rue Du St-Esprit) - a newly refurbished youth hostel situated a few min-utes 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 mod-erately expensive) restaurant set in a giant converted bank where you can dine with the Brussels elite. The food is typ-ically Belgian and served by

brussels - Grand PlaCe

manneken-Pis

hospital Mess20

MR HOMER SiMPSON

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 pOISONINGMr Simpson’s hair loss, pronounced skin darkening (around

the face and neck) and fatigue could be the effect of chronic expo-sure 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 can-not repair. Most symptoms appear after around 15 years - Mr Simpson started work in late 1980s.

CONGENITAL HEpATIC FIbROSISMr Simpson is yellow. His father is yellow. His wife is also yel-

low, as are his children. This is suggestive of a genetic condition that is inherited in an autosomal recessive pattern. CHF is such

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 SYNDROMEA rare disorder which is characterised by hypersomnia - exces-

sive amounts of sleep, sometimes over 20 hours/day - and com-pulsive hyperphagia - which can be indiscriminate in its nature and takes in all food sorts. Patients may also show an abnor-mally 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 DISORDERIED is a behavioural disorder characterised by extreme expres-

sions 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.

Assessed by gil Myers

MEDICAL REpORT

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;

can be waxed or threaded (7) 15 Bile containing (7)

aCross:

down:

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 Enzyme-

linked 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)

you can find the

answers by searching

for ‘crossword answers’

at www.juniordr.com

Compiled by farhana Mann

hospital Mess 21

Surely pork is worth more at:

£1.19 Newham General Hospital

It’s too expensive to pig out at:

£2.95 Royal Free Hospital, London

It’s cheaper to stay well hydrated at:

70p belfast City Hospital

So expensive you’ll wet yourself at:

95p 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.

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:

Colchester doctor’s mess has a flatscreen TV with Sky, microwave, dish-washer, and coffee maker. Off the main mess is a room with three com-puters. 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: ★★★✩✩

Ham sandwich (white bread no salad)

Evian water 50cl

Sachet of tomato ketchup

‘Writing in the notes’ is our regular letters section. Email us at letters@juniordr.com.

Writing in the Notes

colleges unrepresentative

Dear Editor,I’ve been reading the recent backlash by the colleg-

es over the EWTD reduction in hours from August

(‘Patients at risk as hours slashed’ Iss 12 p6). I can

understand their concerns that training may take

longer but I feel they are failing to represent many

of us. I want a reduction in my working hours. They

are being reduced for a reason - just like lorry drivers

can’t drive for long stretches neither should surgeons

be able to operate. On a more selfish level there is

the quality of life aspect too. Few people, apart from

the government on this rare occasion, are supporting

that. Surely the colleges should be representing all

views of their members?naMe witheld

st2 general MediCine

Keep our trained doctors hereDear Editor,

I welcome the expansion of the Medical Training Initiative that allows overseas doctors to benefit from training in the UK (‘750 UK training placements for overseas doctors’ Iss 12 p5). However, I would like to point out that overseas doctors who studied at medical school in the UK are being forced to leave because of changes to the visa system. Not only do many people feel this is unfair as the goalposts have been moved in the last few years but the UK is los-ing doctors that they paid to train. I would suggest that this situation deserves urgent attention by the Department of Health.dr J aggrawalsurgery

My cardiology idol

Dear Editor,Your cardiology SpR has her own magazine col-

umn and certainly does lead the life of a superstar

- jetting off for a weekend skiing before catching a

cab to confirm her consultant job. Where is the tedi-

um of dictations, endless meetings and mindnumb-

ing reports? I choose a quiet career as a GP but she is

making me seem boring and reading her diaries isn’t

doing wonders for my self-esteem. Next time please

do the rest of us a favour and pick someone less excit-

ing - like a dermatology SpR.

elaine Cardess

gp spr, north thaMes

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NHS Training Bulletin

www.NHStraining.co.uk

June & July Edition

Register your details

WIN A

LAPTOPPage 11

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 ProcedureSubtle evolution or radical reform?

Consultant Interview Skills TrainingWhat is the optimal approach?

Rotating into a New SpecialtyHow much support do you need?

2 www.NHStraining.co.uk

NHS Training Bulletin

medicology

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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

Compelling Reasons to Attend

5

www.NHStraining.co.uk 1

NHS Training Bulletin

Welcome to the June/July edition of NHS TrainingBulletin and a major step forward in increasinge�ciency and e�ectiveness in the process of �nding 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 atwww.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, you’ll �nd 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, you’ll �ndbooking a breeze.

We do hope you enjoy your new found e�ciency but spend the time-saving wisely!

Mr Andrew Vincent Dr Sara WatkinManaging Director Medical Director

& Editor in Chief

Event Listings

NHS Training Bulletin Your foremost source of Courses, Conferences and Training for Healthcare Professionals

How to contact us...

Sian ParrottAdvertising & Salessian@nhstraining.co.uk

Tel: 01332 821271

Andrew J VincentManaging Directorandrew@medicology.co.ukTel: 01332 821270

Sara L WatkinMedical Director & Editor in Chiefsara@medicology.co.ukTel: 01332 821270

NHS Training BulletinOxford House, Stanier Way, Wyvern Business Park, Derby, DE21 6BF

NHS Training Bulletin is supported by Medicology Ltd and is not an o�cial publication/ service of the NHS

This Issue...The Art of True Learning

Approaching the Game Plan

Rotating into a New Specialty

Setting goals & delegating using smarter SMART

Training Tips

Consultant Interview Skills Training

New NHS Complaints Procedure

2

6

8

10

13

16

Leadership & Management 22

Personal Development 30

2 www.NHStraining.co.uk

NHS Training Bulletin

The Art of True Learning Approaching the Game PlanAugmenting the acquisition of a CCT with career-enhancing depth

Few would disagree that working towards specialist quali�cation 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 a�ecting learning, such as reducing junior doctor

hours to comply with working time directives, are relatively straight forward to identify they are equally di�cult 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 di�erential between obtaining a Certi�cate 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 quali�cation, 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 di�erences 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 �nd that they �ounder 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 quali�cation, 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:

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?

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 di�erent requirements in question 2 compared to someone who aspires to the highest academic levels in a complex scienti�c 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.

Quali�cationLearning 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 speci�c areas, necessary to ful�l all of your career aspirations

Table 1

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 e�ort should be devoted to question 1. However, we think that the goal needs to encompass 3 speci�c elements:

Obtain your CCTEquip yourself with su�cient knowledge so as to be a safe, e�ective doctor in your chosen specialtyProvide su�cient 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 diversi�cation 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.

www.NHStraining.co.uk 3

NHS Training Bulletin

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4 www.NHStraining.co.uk

NHS Training Bulletin

What does ‘specialist’ mean in the modern health context?

It may not have slipped your notice that the Certi�cate of Specialist Training has become the Certi�cate of Completion of Training, inviting a question around where has ‘specialist’ gone? To answer this question we need to brie�y 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 signi�cant implications for those currently in training.In e�ect, it means we need to train two distinct sorts of doctors and here the reality becomes a bit uncomfortable. The �rst 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 �nding 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 di�erent things. At a basic level, specialist means that you will be working within a speci�c 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

hospital then specialist will mean being able to demonstrate a depth of knowledge and experience in complex disease, most likely in a speci�c 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 bene�cial 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 clari�ed this vision, Bob constructs a learning game plan that looks a little like this:

Obtaining my CCT by X date

Position myself as an expert in

complex Crohn’s Disease

Learning goal 1Pass assessments A, B and C by Y date

Learning goal 2 Acquire this speci�c knowledge for

a college exit exam by Z date

Learning goal 3Acquire this speci�c knowledge

about Crohn’s from rotation 2

Learning goal 4Become 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

www.NHStraining.co.uk 5

NHS Training Bulletin

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 o� 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 rotationWhat learning they feel you need to acquire for CCT progressionWhat additional learning they feel you would bene�t from, given your desired career pathAny 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 in�uencing 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 �uctuation, 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 in�uencing your learning, besides yourself, can be split into two distinct categories:

Things that get in the way of your learningThings that a�ect 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 speci�cally hamper your attempts to get speci�c bits of learning that are important to you. If you �nd 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 justi�ed 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 identi�ed 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 a�ected 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

choosing the razzle nights a bit more strategically! If you are working nights, it is di�cult 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 re�ection. 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 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 �rmly 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 VincentManaging Director, Medicology Ltd

6 www.NHStraining.co.uk

NHS Training Bulletin

Rotating into a New SpecialtyHow 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 � nd themselves � oundering from a combination of:

A specialty that may be newAn overwhelming amount to take on boardImmediate, pressing requirements to avoid delays in the patient journeyThe ever present spectre of thelatest 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 con� icting personal and services requirements from each role.

Without question, the � rst 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 di� erent specialties, and indeed di� erent trainees, will have di� ering 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 di� erently and so trainees also need induction at a hospital level too, if they are to � ourish 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 insigni� cant challenge as coordination within a department is di� cult 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 e� ective learning, growing con� dence and clinical safety? I propose that we start by learning about the gulf between ideal and reality.

Author:Dr Sara WatkinMedical Director, Medicology Ltd

IMPORTANT RESEARCH PROJECTImproving induction practices

in doctors entering new rotations

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www.NHStraining.co.uk 7

NHS Training Bulletin

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NHS Training Bulletin

Setting goals & delegating using smarter SMARTImproving 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 SMARTframework 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.

Understanding the

Components of SMART

SPECIFIC

Especially relevant when setting goals and objectives with individuals, the purpose of ‘speci�c’ 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 di�erent people, how many meanings would I get back?” A good goal has comparatively little variation in meaning from one person to the next, despite di�erent knowledge and skills, di�erent personalities, di�erent agendas or di�ering seniority. The skilled goal setter places a great deal of emphasis on providing a robust and su�ciently unambiguous description of the goal to ensure it gets achieved exactly as planned, nothing more, nothing less.

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 di�erent 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 de�nes 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 di�cult to implement. On the �ip side, setting goals that are easily attainable tends to reduce their motivation pull and close o� 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-4-minute 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 e�ective goal setter picks a goal outcome that is stretching but within grasp with the right plan and e�ort. Caution needs exercising around technical capability, timescales, resources, competing interests and con�dence, balanced with helping the goal recipient see possible roads ahead on goals that are especially stretching.

Letter Common Representation Proposed Representation

S Speci�c Speci�c

M Measurable Measurable

A Achievable Agreed

R Realistic Realistic

T Time-bound Time-bound

Plus Why it is important and how

success in it may be recognised

Table 1

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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 �rst place, whereas there is no �exibility in the hard and speci�c 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 su�cient 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 importantHow success will be recognised

The �rst element delivers against relevance in that it ensures the recipient understands how the goal contributes to the bigger picture and �ts into the scheme of everything else to be done. Furthermore, by demonstrating the absolute bene�t 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 clari�es the speci�c 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 �nal word

Are there any further amendments needed? In truth, we can �nd 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 di�cult to fathom is that given the universal support for SMART, how can we embed this into practice?

Author:Andrew VincentManaging Director, Medicology Ltd.

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NHS Training Bulletin

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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 insigni�cant areas that can make

a signi�cant di�erence. 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 HecklersNow, if you’ve trained for any time at all, you’ll realise that it is not uncommon to �nd 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 �nd 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 o�)

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 �y 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 in�uencing moves to change the situation. They broadly involve the following 3 steps:

1. Re-position yourself as their ally (for instance, by �nding 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 bene�ts they will gain

“you will be able to do X, Y and Z more quickly...”

3. O�er 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 con�icting with existing (accepted) information. The heckler is simply someone who wears the tussle on the outside rather than

re�ecting. 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.

NHS Training Bulletin

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TIP2 – Nipping ‘Norm’ in the BudArguably, ‘Norm’ is also a heckler, but in a well-meaning kind of way. He (or she – don’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. Here’s the tactic to keep Norm on his toes.

Step 1 - Take it out of the session (self-sacri�ce strategy) “that’s a really interesting point. I don’t want you and I to hog the debate

though so let’s discuss it at break” (ouch – there goes your tea break again)

Step 2 – Take it out surreptitiously (sneaky strategy) “I’m glad you’ve raised that because we have more on that later. Let’s discuss it all

together then” (you haven’t got anything later but trust me, Norm will never notice)

Step 3 – Diversion strategy (keep him busy on something intellectual) “now I know I’ve seen something on that in this big 600 page

book. Can you just �ick through and �nd it for me whilst I deal with the next bit?”

If none of that is working, you could just say “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 to”. Fortunately, Norm does not like to miss things either and so this is a particularly

e�ective strategy.

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NHS Training Bulletin

Consultants & Business Professionals

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The Programme - This is a 1 day conference, 5 CPD points

Cost & Booking Information

Safeguarding ChildrenGetting it right across the NHS

The early bird rate applies to bookings received more than 56 days before the course date.

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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.

www.NHStraining.co.uk 13

NHS Training Bulletin

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 postThe importance of the pre-interview visitPreparing for the interview itself Strategies for answering interview questionsQuestion practiceStrategies for developing con� dence and overcoming fear and anxiety on the dayThe political agenda and key political topicsPresentations

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 � rst consultant post but even as late as the few days before will bring signi� cant bene� t. 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 speci� c, 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 strugglingto 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 WatkinMedical Director, Medicology Ltd

Consultant Interview Skills TrainingWhat’s the optimal approach?

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Full information, including which specialties are covered at: www.consultantinterviews.co.uk

Specialty-speci� c

Psychological pro� ling and feedback

Insightful and comprehensive resource centre

Back up coaching if you are struggling

to get appointed

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NHS Training Bulletin

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 �exible 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.

Introducing the procedure

The new complaints procedure represents a signi�cant 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.

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 bene�ts 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 e�ective 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 apologyReassurance that lessons will be learnt and the same thing will not happen again i.e. that they have not complained in vane

New NHS Complaints Procedure Subtle evolution or radical reform?

Despite the need for an apology, which was prominent in the existing guidance too, a signi�cant 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”.

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.

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 e�ciently 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 satis�ed 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 a�ected 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

The right to have any complaint

they make about NHS services

dealt with e�ciently and to have it

properly investigated

www.NHStraining.co.uk 17

NHS Training Bulletin

receive appropriate support throughout the handling of a complaint, as well as that making a complaint will not adversely a�ect 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 e�ectively

To ensure that the organisation learns lessons from complaints and claims and uses these to improve NHS services

How does the new procedure di�er from the old procedure?

The new procedure di�ers 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 Sta�s 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 �exibility 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, con�dential 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 su�ciently serious as to want this escalation

Ideally the investigation report should be reviewed by both the complainant and the sta� concerned prior to its �nal 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 signi�cant departure from the previous procedure in that it introduces more �exibility 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 sta� member?

It is envisaged that NHS organisations will develop their customer service roles speci�cally 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

18 www.NHStraining.co.uk

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 o� cer or department. However, what simple advice can front line sta� 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 � rst name

If someone has phoned you, o� er to call them back and give 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?)

O� er 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 � rst meeting

Systematically go through the reasons for the complaint with the person who is unhappy – it is important that you understand why they are dissatis� ed

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

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

In Conclusion

In conclusion, the new procedure is su� ciently di� erent in the direction of open collaboration to make a signi� cant di� erence to the way patients & public feel in complaint situations. However, the true di� erence is always in the interpretation and implementation of the procedure. In that, only time will tell whether this quiet revolution is delivering the bene� t 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_095439DH_095445DH_095447DH_095448DH_095450

Author:Dr Sara WatkinMedical Director, Medicology Ltd.

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:

Understanding e� ective 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

E� ective communication skills in the complaint situation

Developing clinical improvement strategies

E� ective use of audit in risk, governance & improvement

Serious incidents

Root cause analysis

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www.NHStraining.co.uk/102Low participant numbers, 5 CPD points, expert tutor, engaging

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www.NHStraining.co.uk 19

NHS Training Bulletin

Consultants & Business Professionals

£215 + VAT early bird

£249 + VAT standard rate

Doctors in Training, SAS Grades & Nursing Sta�

£125 + VAT early bird

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The Programme - This is a 1 day conference, 5 CPD points

Cost & Booking Information

Quality, Governance & Experience

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

Description

Group Bookings

£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

17th December 2009, Friends House, Euston, London

20 www.NHStraining.co.uk

NHS Training Bulletin

Insights DayUnderstanding the Evolving Healthcare Landscape Providing insight into the evolving healthcare landscape that every doctor should know

Programme Elements Compelling Reasons to Attend

5

View more details & book online at www.NHSinsights.co.ukor call Bronwyn, Jessica or Sarah at Medicology on 01332 821260

www.NHStraining.co.uk 21

NHS Training Bulletin

Cost:

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

Provider:

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date: Location:

Online at www.NHStraining.co.uk to view more event details and make a booking

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Event Type: CPD Points:

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NHS Training Bulletin

Getting the best from NHS Training BulletinFor busy professionals, NHS Training Bulletin represents a step change in e�ciency when it comes to �nding 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 �ndingCourse, conference & training information is spread far and wide across the physical

& digital net from Royal College sites, to lea�ets 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 �nd an array of event information neatly organised by event type and by specialty. As NHS Training Bulletin develops, you’ll �nd more and more opportunities brought into the convenience of a single point of access.

Comprehensive optionsNHS Training Bulletin consists of a number of key elements, all designed to make

access as simple and personal as possible:

Journal Listings A robust journal with related articles and neatly organised event

OnlineNHStraining.co.uk is the engine behind the events,

searchable, fast and well organised

E-BulletinA monthly bulletin tailored to you e.g. Consultants in

Paediatrics, with quick links to event details

Noti�cationsFor registered users, be the �rst 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 con�denceOur 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 easeWhen 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 noti�cations allowing you to be �rst 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?

Bene�ts of NHS Training Bulletin

array of event information

intelligently organised to help you �lter swiftly

and improving e�ciency

really happens, protecting your hard fought budget and reducing �nancial risks

meaning no more lost details

simultaneously from your control panel

to receive information about new events

www.NHStraining.co.uk 23

NHS Training Bulletin

Training Courses & Conference Listings

Contents

This Month’s Featured Course...

Foundation Course in Leadership & Management for FY DoctorsCost:

Gain knowlegde, skills and insight into e�ective leadership and management, allowing you to become an e�ective clinical leader. This powerful course is designed to provide a signi�cant 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

99

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

15th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

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.

Leadership & Management 22

Personal Development 30

NHS Training Bulletin - Leadership & Management Events

24 www.NHStraining.co.uk

Leadership & ManagementCore Skills for the Newer ConsultantCost:

A raft of practical strategies built into an easy to manage framework that ensures you excel as a consultant, gain the best from your sta� 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 �scal probity, risk, governance and even the business of health, it acts as a comprehensive framework packed with the practical application of core skills.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

75

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

1st & 2nd July 2009

Location:

London9th & 10th September 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 75

Event Type: Course CPD Points: 10

No

n-S

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E�ective Clinical LeadershipCost:

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 sta� clinically, fostering a sense of personal responsibility, performance management and supporting sta�, at all levels of performance.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

8

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

28th & 29th September 2009

Location:

London29th & 30th October 2009 Edinburgh Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 8

Event Type: Course CPD Points: 10

No

n-S

pe

ci�

c

Management Skills for Junior & Middle Grade DoctorsCost:

Suddenly in a responsible clinical role you �nd that all the technical & medical knowledge you’ve worked hard to gain is only part of the story when managing people. To progress e�ectively 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

16

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

29th June 2009

Location:

London24th September 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 16

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

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Core Skills in Setting E�ective Direction for Clinical TeamsCost:

E�ective 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 e�ective 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

103

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

14th September 2009

Location:

London27th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

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Leadership & Management Events - NHS Training Bulletin

www.NHStraining.co.uk 25

E�ective Meeting ManagementCost:

Given the sheer number of operational meetings each person engages in, we cannot a�ord the current level of meeting ine�ectiveness. 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 e�ective meeting is possible everytime. This powerful course will have you running meetings that people look forward to because they achieve.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

83

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

14th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

c

Essential Leadership for SpR-level DoctorsCost:

All SpR-level sta� are expected to demonstrate a commitment to developing their potential as healthcare leaders. E�ective leadership is an essential factor in the successful delivery of healthcare and also a key di�erentiator for those seeking consultant posts. This course investigates the key leadership issues in both a practical and theoretical sense. Designed to deliver measurable bene�ts in leading and motivating the sta� around you, as well as providing the building blocks to develop as an exceptional healthcare leader.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

10

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

30th June 2009

Location:

London25th September 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 10

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

c

Foundation Course for SAS Doctors Transitioning to ConsultantCost:

Designed speci�cally for Specialty Doctors (Sta� 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 di�erent role of consultant. Please note there is considerable overlap between this course and Core Skills for the Newer Consultant.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

130

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

7th & 8th September 2009

Location:

London12th & 13th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 10

No

n-S

pe

ci�

c

Foundation Course in Leadership & Management for FY DoctorsCost:

Gain knowlegde, skills and insight into e�ective leadership and management, allowing you to become an e�ective clinical leader. This powerful course is designed to provide a signi�cant 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

99

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

15th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

c

Leadership Masterclass for Healthcare ProfessionalsCost:

One of the cornerstones of e�ective 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 in�uencing 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

12

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

7th & 8th September 2009

Location:

Birmingham16th & 17th November 2009 London Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 12

Event Type: Course CPD Points: 10

No

n-S

pe

ci�

cG

en

era

l

NHS Training Bulletin - Leadership & Management Events

26 www.NHStraining.co.uk

Consultant Interview Skills: Paediatrics & Neonatal MedicineCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

124

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

9th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

No

n-S

pe

ci�

c

Insights Day - Understanding the Evolving Healthcare LandscapeCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

105

From £125 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

2nd September 2009

Location:

London12th October 2009 She�eld Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 105

Event Type: Seminar CPD Points: 5

No

n-S

pe

ci�

c

Consultant Interview Skills: Mental HealthCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

121

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

22nd September 2009

Location:

London16th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

No

n-S

pe

ci�

c

Medical Management & Leadership for Year 4/5 StRs & Senior Specialty DoctorsCost:

Comprehensive, in-depth focus on the core principles of e�ective management and leadership designed to create exceptional clinical leaders. This course is designed to deliver exceptional leaders with highly e�ective managerial ability, without ever losing sight of the fact that you are �rst 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

98

From £645 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

12th - 14th October 2009

Location:

London14th - 16th December 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

No

n-S

pe

ci�

c

Change Management Masterclass for Health ProfessionalsCost:

Plan and implement change e�ectively, 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 e�ective change process to ensuring full engagement of the sta�, 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

82

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

5th & 6th October 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 10

No

n-S

pe

ci�

cG

en

era

l

Leadership & Management Events - NHS Training Bulletin

www.NHStraining.co.uk 27

Consultant Interview Skills: Medicine (Physicians)Cost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

120

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

7th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

No

n-S

pe

ci�

c

Clinical Management & Leadership for Year 4/5: Emergency MedicineCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

109

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

4th - 6th November 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Acc

ide

nt

an

d E

me

rge

ncy

Consultant Interview Skills: Emergency MedicineCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

119

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

10th November 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

Acc

ide

nt

an

d E

me

rge

ncy

Clinical Management & Leadership for Year 4/5: Anaesthetics & Intensive CareCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

108

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

2nd - 4th September 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

An

ae

sth

esi

a

Consultant Interview Skills: Anaesthetics & Intensive CareCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

118

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

1st October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

An

ae

sth

esi

aG

en

era

lA

cc

ide

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& E

me

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nc

yA

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NHS Training Bulletin - Leadership & Management Events

28 www.NHStraining.co.uk

Clinical Management & Leadership for Year 4/5: Medicine (Physicians)Cost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

110

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

25th - 27th August 2009

Location:

London18th - 20th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Ge

ne

ral M

ed

icin

e

Clinical Management & Leadership for Year 4/5: Obstetrics & GynaecologyCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

112

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

25th - 27th November 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Ob

ste

tric

s a

nd

Gyn

ae

colo

gy

Consultant Interview Skills: Obstetrics & GynaecologyCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

122

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

2nd October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

Ob

ste

tric

s a

nd

Gyn

ae

colo

gy

Consultant Interview Skills: OncologyCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

123

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

8th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

On

colo

gy

Clinical Management & Leadership for Year 4/5: Paediatrics & Neonatal MedicineCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

114

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

26th - 28th October 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

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Leadership & Management Events - NHS Training Bulletin

www.NHStraining.co.uk 29

Clinical Management & Leadership for Year 4/5: Pathology & Labs SpecialtiesCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

115

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

5th - 7th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Pa

tho

log

y

Consultant Interview Skills: Pathology & Laboratory SpecialtiesCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

125

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

30th June 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

Pa

tho

log

y

Clinical Management & Leadership for Year 4/5: Mental HealthCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

111

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

25th - 27th November 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

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Clinical Management & Leadership for Year 4/5: RadiologyCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

116

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

26th - 28th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Ra

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Consultant Interview Skills: RadiologyCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

126

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

16th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 6

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NHS Training Bulletin - Leadership & Management Events

30 www.NHStraining.co.uk

Clinical Management & Leadership for Year 4/5: SurgeryCost:

Welcome to the �nest 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 e�ective as a new consultant in your specialty, whilst demonstrating your clear commitment to e�ective leadership. It is packed with the knowledge and skills that you’ll need to competently achieve, as well as specialty-speci�c insight into the challenges you’ll be facing as a new consultant in the evolving health service.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

117

From £599 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

25th - 27th August 2009

Location:

London18th - 20th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 15

Su

rge

ry

Consultant Interview Skills: SurgeryCost:

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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

127

From £299 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

15th September 2009

Location:

London17th November 2009 Birmingham Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 127

Event Type: Course CPD Points: 6

Su

rge

ry

Cost:

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

Provider:

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date: Location:

Online at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

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Cost:

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DoctorsJuniorMiddleSenior

Provider:

NursesJuniorMiddleSenior

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Allied Pro’sJuniorMiddleSenior

Date: Location:

Online at www.NHStraining.co.uk to view more event details and make a booking

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Cost:

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DoctorsJuniorMiddleSenior

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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.

You can also book over the phone by calling:

01332 821270

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Personal Development Events - NHS Training Bulletin

www.NHStraining.co.uk 31

Personal DevelopmentAssertiveness without AggressionCost:

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 su�er low self esteem and a lack of con�dence when it comes to being assertive. On the �ip side, you probably wouldn’t want to be thought of as rude or forceful.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

23

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

10th September 2009

Location:

London4th November 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

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Time Management & Personal E�ectiveness for Junior & Middle Grade DoctorsCost:

Aimed speci�cally at doctors in training, this is probably the most powerful course in personal e�ectiveness you will �nd. 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 e�ectively, manage the never ending in�ux of work and regain e�ective work-life balance.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

85

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

5th October 2009

Location:

Birmingham14th December 2009 Manchester Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

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Time Management & Personal E�ectiveness for Healthcare ProfessionalsCost:

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 e�ectively, manage the never ending in�ux of work and regain e�ective work-life balance. Achieve more this year. You deserve it for all your hard work.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

2

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

12th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

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Presentation & Teaching SkillsCost:

Gain the con�dence 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 sta� 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 e�ectiveness in this area.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

30

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

26th June 2009

Location:

London2nd October 2009 London Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 30

Event Type: Course CPD Points: 5

No

n-S

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NHS Training Bulletin - Personal Development Events

32 www.NHStraining.co.uk

Managing Relationships & Con�ict in the workplaceCost:

Do you want to understand people more in order to be more interpersonally e�ective, as well as developing speci�c strategies for managing con�ict 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 e�ectiveness. This course delivers an advanced understanding of how people are wired, what motivates their behaviour both normally and under situations of con�ict and how to deal with this.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

27

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

8th October 2009

Location:

Manchester30th November 2009 London Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

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Core Skills in Mentoring Medical ProfessionalsCost:

Mentoring is perhaps one of the most powerful and e�ective strategies for realising potential in individuals. Mentoring medical professionals can be an enormously rewarding experience for both mentee and mentor. Adoption of e�ective mentoring practises can help individuals develop self-reliance in their learning whilst over-coming unfamiliar challenges with support where needed. This course provides an e�ective mentoring framework from initiation to closure, including all of the practical strategies necessary to make it successful.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

95

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

13th October 2009

Location:

LondonOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

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Advanced Communication & In�uencing SkillsCost:

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 e�ective 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 e�ective in all of your dealings with people.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

22

From £430 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

7th & 8th July 2009

Location:

Manchester21st & 22nd September 2009 London Online at www.NHStraining.co.uk to view

more event details and make a booking

Enter Reference:

View more dates online using ref #: 22

Event Type: Course CPD Points: 10

No

n-S

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Communication Skills for Junior & Middle Grade DoctorsCost:

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 con�ict in the workplace. This fast-paced course is highly e�ective 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.

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

24

From £215 + VAT Provider: Medicology Ltd

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date:

9th July 2009

Location:

ManchesterOnline at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: Course CPD Points: 5

No

n-S

pe

ci�

c

Cost:

Target Audience Web Reference NumberEvent Dates & Locations

DoctorsJuniorMiddleSenior

Provider:

NursesJuniorMiddleSenior

Bus & AdminJuniorMiddleSenior

Allied Pro’sJuniorMiddleSenior

Date: Location:

Online at www.NHStraining.co.uk to view more event details and make a booking

Enter Reference:

Event Type: CPD Points:

Want to advertise your courses?

Add as many courses as you like absolutely free, you only pay for

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

and you only pay for the success we achieve.

Find out more by downloading our media pack

at www.NHStraining.co.uk/advertise

Ge

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www.NHStraining.co.uk 33

NHS Training Bulletin

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DoctorsJuniorMiddleSenior

Provider:

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DoctorsJuniorMiddleSenior

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Date: Location:

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Cost:

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DoctorsJuniorMiddleSenior

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Date: Location:

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DoctorsJuniorMiddleSenior

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Date: Location:

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DoctorsJuniorMiddleSenior

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DoctorsJuniorMiddleSenior

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DoctorsJuniorMiddleSenior

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DoctorsJuniorMiddleSenior

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NHS Training Bulletin is supported by Medicology Ltd and is not an o�cial publication/ service of the NHS

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