Guidance for using PSW

It is not uncommon for a postgraduate doctor, dentist, pharmacist or advanced care practitioner (ACP) in training to have some personal or professional difficulties during their training. The PSW (formerly Doctors in Difficulty) was developed to help support these professionals overcome short term difficulties and progress with their training. We are separate to the training programme and trust/primary care provider. 

2. Scope 

This guidance applies to all doctors, dentists, pharmacists and ACPs in training with  NHSESW, and their supervisors. However, the appropriate policy of the relevant employer (for example, occupational health, disciplinary or grievance policy) would need to be followed as applicable. Those individuals covered by this document, may be employed by a number of different organisations and have placements within a number of different host training organisations (LEPs). Therefore, this guidance document provides a common approach for all. 

Trust employed doctors not on a training programme should follow their own Trust policies and procedures. 

We are able to support and continue to support individuals, who have already accessed our service, for up to6months after leaving their training programme in order to help with transition, following completion of training, or to another job outside the training programme.  

 3. Aim 

Our aim is to support those postgraduate learners, training within NHSE’s programmes to get ‘back on track’, if they find themselves struggling at any point. We aim to provide the right support, by the right people at the right time. 

We provide support and wellbeing advice to the educators and supervisors in the southwest, via a PSW network and are continually updating our online resources for all. 

Our future plans are to prevent as many of the support concerns as possible, by promoting an open dialogue with those in training and their trainers, their own support networks and colleagues about wellbeing issues. 

4. The structure 

5. The Team 

 7. Confidentiality 

The meetings with a case manager or external provider will be confidential and separate to your training supervision. 

The only time a confidence may be broken will be if the individual is a risk to themselves or others.  This is to protect patients and the individual. 

If confidentiality needs to be broken, this will be discussed with the individual and their responsible officer to decide the next course of action. 

Complex cases may be discussed confidentially with other members of the PSW team for advice and support. 

 8. Process Map 

9. Referral process 

Referral information is on our website- please review this as it has the documents you will need to self-refer. 

Educational Supervisors are also able to refer you to the service.  

For pharmacists and ACPs in training, your supervisor and training programme director will refer you if appropriate.  

If after 2 further e mails the individual does not engage with the service, the supervisor referring will be informed of the non- engagement. This is to enable the supervisor to discuss other options with the individual. 

If the individual does engage- no more information will be shared with the supervisor and future dialogue and support is confidential (unless agreed by the individual it can be shared). 

If an individual is already being supported, their permission will be sought as to whether they would like their supervisor informed that they are already being supported. 

10. PSW and the ARCP 

It is hoped that those doctors likely to get an unfavourable outcome at ARCP will have already been referred to our service. If not, letters will be given out to the individual after their ARCP recommending and giving information about our services if required. 

The process of the ARCP is stressful for many doctors and we would encourage individuals to come and have a chat about support available. 

11.Arranging a case manager meeting 

We aim to respond to the referral within 2 working days of receiving the referral and provide a link to the meeting booking list. The individual is able to choose and book a suitable time and date to provide an initial meeting with a case manager within 3 weeks 

12. Conduct of the initial case manager meeting 

The individual will have a virtual meeting with a case manager for about an hour. 

The individual should be enabled to attend in work time. 

This is currently via MS Teams, but may return to face-to-face in the future 

The case manager (CM) will use active listening and coaching style questioning to understand the current concerns and enquire about some background history. This is to help decide on the most appropriate resources for the individual. The CMis non- judgemental and non-discriminatory. 

The individual will be referred, as appropriate, to one or more of the following externally provided services: 

A summary letter will be sent to the individual within 7 working days of the meeting. This is for the individual, and they can share the contents with their supervisor if necessary. The individual is given 10 working days to respond to any inaccuracies, before it becomes a true record of the meeting. 

13. Responsibilities of the case manager 

To maintain confidentiality 

To log on promptly for the meeting 

To have a good internet connection and be undisturbed 

To explain about their concerns and background  

Be respectful with the people they interact with, whether it is an administrator in the team, their case manager or service provider - they are all there to support you.   

NHSE southwest is able to provide support for the following services: 

The case manager will send a routine follow up e mail as agreed by both parties. 

17. Closure of cases 

PSW is only intended to provide short term support during training and generally work towards closing a case between 9 to 12 months. 

If there has been no contact with an individual after 2 e mail communications, the 3rd communication will enclose a case closed evaluation form and ongoing support information. 

18. Data storage 

E mail correspondence, referral forms, letters and any other information relevant to the case will be stored within the NHSE SharePoint system in accordance with GDPR and destroyed 6 years after your case is closed. 

This information is only accessible to the PSW team to allow for cross cover if necessary.

19. Urgent support 

Individuals needing urgent support will be signed posted to their local emergency department, GP or crisis team. 

20. Lines of accountability 

The Senior Team are accountable to the Regional Postgraduate Dean and for the Professional and Well-Being Services report on business through the various meetings below:  

PSW reports to the Senior Education Team (SET) every 3 months 

21. Other functions of PSW 

For those in postgraduate medical education we currently also provide peer mentor training OR assist with linking an individual with a mentor 

We also provide workshops and short courses / webinars on a number of topics  

22. Quality assurance 

This is provided by: 

Weekly business and review meetings with our action tracker 

Review of our referral forms to check basic data for us to know who is accessing our services and to make sure we are following equality and diversity guidance 

An evaluation form when the case is closed, to enable us to get feedback and continually improve our services. 

23. Supporting supervisors/educators 

We support our supervisors, educators, team members and other stakeholders via the following groups: 

Quality 

24. Unhappy with our service 

If you are unhappy with any part of our service or wish to give us feedback; please contact us at the e mail below.