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NW SuppoRTT Update - June 2020Dr Alison Gale
Associate Dean for SuppoRTT, HEE NW
Housekeeping and programme
• PLEASE TURN OFF MICS WHEN NOT SPEAKING
• Introduction and SuppoRTT Process Dr Alison Gale,
Associate Postgraduate Dean, SuppoRTT - HEE, North West
• The practicalities of returning to training St Helens and
Knowsley NHST, Lead Employer
• Trainee RTT Experience Dr Michelle Keane, ST6 Paediatrics
• LTFT – the basics Dr Shirley Remington, Deputy Postgraduate
Dean, Learner Support - HEE, North West
• Q&As
@NHS_HealthEdEng
@NHS_HealthEdEng
SuppoRTT
SuppoRTT Programme
• Enables doctors returning to clinical training following
a period of prolonged absence:
– To regain their confidence and clinical skills
– Quickly and safely
– Thereby enhancing trainee wellbeing and patient
safety
SuppoRTT funding eligibility
• All doctors and dentists in training in England
• who have an NTN / FTN
• However, principles of the SuppoRTT process should
be made available to all doctors returning after a
prolonged period away from clinical practice
SuppoRTT Programme
• Should be used by all trainees who have had an
absence of 3 months or more, for whatever reason:
– Parental leave
– OOP(R), OOP(C) and OOP(E)
– Sickness
– Bereavement
– Disciplinary action
• Those with shorter absences may also benefit
Pre-absence• >3 months absence
• Meet ES to complete
• Bespoke plan
• Discussion:
- keeping up to date
- KIT days/courses/mentoring
- particular concerns
• Contact
• ?Return to LTFT training
• Communication with ES
• Meet 6-8 weeks before return
• Discuss:• Learning needs
• Bespoke period of supervision
• Rotas
• Encourage KIT / SRTT days
• Course / bootcamp
Pre-return
• Meet with ES
• Review plan
• Review whether targets met –
WPBAs, reflections
• Mutually agree:• Readiness to return to normal
work / training
• Further enhanced supervision
• ongoing support / mentoring
Post-return meeting
@NHS_HealthEdEng
Remember
• Forward all forms to [email protected]
• School and Trust SuppoRTT Champions in post to
help and guide you
KIT / SRTT days
• Up to 10 days
• Voluntary
• Need educational approval in advance
– Meetings/courses
– Induction
– Supervised clinical work
• Paid at basic rate minus maternity pay
• Payment received by completion of form in LEO
toolkit in same calendar month as work undertaken
@NHS_HealthEdEng
Key concerns of all returners
• Confidence- self and support mechanisms
• Being watched and assessed
• Trainers attitudes
• Ability
• Fatigue
• Managing on call / shifts
• Managing home life
Support available
Mentoring and coaching
KIT activities – generic specific
Personalised return plans and Human factors and simulation days- school and more general
E learning for health package on returning and LTFT
Educational support and funding for education while off when supporting return
Pastoral support including LEO
@NHS_HealthEdEng
Thanks and Questions
LTFT – The BasicsDr Shirley Remington
Deputy Dean for Learner Support, HEE NW
• Background
• Recent changes to application process
• New application process
• FAQs
LTFT – The Basics
@NHS_HealthEdEng
@NHS_HealthEdEng
Facts and figures
2019-6673 less than full time trainees
12.6% in HEE NW
Rise by 37.9% since 2012
1.7% of foundation doctors
Most common in OH 33% least common in surgery 5.4%
15% of female trainees 2% of male trainees but male numbers rising
Most common in age 30-39 group
70+% are for childcare
Introduced in 1969-
900 trainees in HEE NW
@NHS_HealthEdEng
LTFTT – Types
Eligibility
• Type 1: carer or health including disability
• Type 2: develop special skills / interest
• Type 3: personal choice that meets their individual professional or lifestyle needs (pilot)
Funding types
• Jobs share
• reduced hours post
• supernumerary
Minimum 50% (GMC 2011)
@NHS_HealthEdEng
LTFTT – Types
• New Gold Guide March 2020
• NHS employer guidance - Flexible Training Cchampions
• GMC statement in 2017 re additional work
• Flexible working law change 2014
• New contract effects
• Return to work support
• Emergency Medicine initiative April 2017 and renewed 2018, O&G and Paeds from November 2019 - further roll out anticipated
• Improving junior doctors’ lives
• Updated local policy
• Local locum guidance
@NHS_HealthEdEng
New Opportunities
• TIS
• Local Flexible Training Leads
• New contract
• GMC statement 2017
• EM pilot and extension and roll out
@NHS_HealthEdEng
Process and Tips
• Eligibility - done once
• Start early.
• Talk to School LTFT Lead and TPD
• Build links with local flexible training lead in Trust as soon as you know which Trust and speak to TSTL
• Notice to return to full time or change 3 months
• If returning after break, ensure Trust are aware
• Use SuppoRTT Opportunities
@NHS_HealthEdEng
Key challenges – LTFT Trainee
• Fitting in
• Personal expectations
• Conflicts in WLB
• Finance
• Rigidity - negotiation skills
• Return to work programmes
• ARCPs
• NTS survey 2019 high
percentage say colleagues
unsupportive
• Isolation
@NHS_HealthEdEng
Common Questions - Answers
• Study leave pro-rata with sessional commitment
• Annual leave pro-rata
• On call pro-rata (may do more to max total working week 40hrs)
• Post approval - only needed if training slots exceeded
• RHFT work 50-80% time
• Supernumerary up to 60%~(80 in last year training)
• Slot share 60%
• GMC rule - minimum 50% time
• Responsibilities training programme as full time
• ARCPs / revalidation as full time
• Locums
• Paid employment
• Bank holidays
@NHS_HealthEdEng
How much notice to start? 3 months.
Why do I need to do a new form every time I rotate? So your school, LEO and
team aware/pay.
How do I go full-time again? 3 – 6 months notice, complete and submit a form,
and let your School know in advance
Out of hours and daytime percentage is different which counts towards CCT
Where do I get information? www.nwpgmd.nhs.uk/content/less-full-time-training
If in doubt, ask
FAQs
@NHS_HealthEdEng
Support for trainers and trainees - LTFT
• Supervision of LTFT Trainees e-Learning module
http://portal.e-lfh.org.uk/Component/Details/473676
• HEE NW LTFT
• HEE NW locum guidance
• NHS employers flexible training leads guidance
• Gold Guide
• Academy of Medical Royal Colleges return to practice
• NHS Careers website
• BMA document 2014
@NHS_HealthEdEng
Overall Satisfaction
75.
76.5
78.
79.5
81.
82.5
84.
85.5
2012 2013 2014 2015 2016 2017 2018
FT LTFT
@NHS_HealthEdEng
Thanks and Questions
Top tips for return to clinical practiceMichelle Keane ST6 Paediatrics
My Experience
With the right suppoRTT
Challenges and benefits
Challenges and benefits
Organisational demands Looking forward to more mental stimulation
Anxiety
Overwhelmed Adult company
Guilt Personal fulfilment
Decision-making
Lack of confidence Growth and personal development
Lonely
Tired Prioritisation
Rusty practical skills Team awareness
Feeling of mediocrity Empathy
Its not the same for everybody
Health issuesFamily support
Partner’s job
Nursery times Sleepless nights
Nursery lurgy
Exams CVSpeciality demands/
expectations
Commute OOH/On-calls LTFT
Some practical tips
KIT/ SuppoRTT days
Make contact with work
early to plan your return
Mandatory training- book early
Book some annual leave
Use your commute- podcasts/
audiobooks/ music
Sort childcare early
including a plan B and
don’t feel guilty for using it
Plan meals/ freeze/ slow-cook
Outsource: shopping/cleaning
Arrange an enhanced supervision period
Find balance
Find time for things that are good for you
Accept organized chaos
Be kind to yourself
Lots of people can support you