Learner / Educator Meeting to discuss progress of action plan following the Triggered Visit to review Oncology posts at Royal Cornwall Hospitals NHS Trust (November 2017)
1st August 2018
Dr Martin Davis (Chair), Associate Dean for Quality, HEE-SW
Ms Jane Bunce, Quality Manager, HEE-SW
Dr Alastair Thomson, Consultant Oncologist, RCHT
Dr Chris Williams, DME, RCHT
Mrs Johanna Gilbert, Senior Manager Medical Education, RCHT
Mrs Trudy Eddy, Office Manager, RCHT
The 2017 GMC National Training Survey (NTS) and HEE-SW Quality Panel process had previously highlighted a number of trainee concerns within the clinical oncology programme at Royal Cornwall Hospitals NHS Trust (RCHT). A Triggered Visit had taken place on 20th November 2017 and the full report following this visit can be accessed on the HEE-SW website.
Requirements following the visit included:
- Department to continue with plans to instigate a daily board round.
- Department to arrange some training on breaking bad news.
- Department to improve induction to ensure roles are clear and clarify who trainees should contact to provide necessary assistance and support.
- Formalise start time of the Acute Oncology Service and identify learning opportunities for trainees in this service.
A Learner/Educator meeting took place on 1st August 2018 to review progress against the above action plan.
Update on action plan
The results of the 2018 GMC NTS indicate that the department is headed in the right direction in terms of improvements.
AT confirmed that Board Rounds happen on most days, although consultant involvement can be variable and they do impact on clinic timings. It is not felt feasible to cancel any clinic slots due to strict cancer waiting times. ARCP feedback in this respect had been good. Consultants continue to do a weekly ward round for their own patients.
The department has employed a Clinical Fellow who has slotted in to the vacant SpR post. This vacancy had previously caused some issues. This additional appointment means that all patients will now be covered by a middle grade, in addition to a consultant.
AT recognised that workload is still high and 1 consultant is on sick leave and 1 has started maternity leave. A consultant interview has been scheduled for the end of August 2018.
AT confirmed that trainees are provided with encouragement to contact consultants for help and consultants are being encouraged to get to know their trainees. A recent F2 trainee fed back that support had been better than expected in the post and the experience has positively informed their career choice.
A middle grade now covers the chemo unit and oncology service meaning there is less pressure on GP and Foundation trainees. This also creates some time for attendance at clinics.
There is a Friday afternoon formal handover, which supports patient care, but also provides an opportunity for trainees to get to know consultants.
Exception reports are low in Oncology and it was reported that this seems to be an accurate indication that workload is OK.
AC confirmed that trainees are not expected to break bad news alone and all consultants would make themselves available for that.
Messages regarding support and educational opportunities to be repeated consistently every 4-months through induction and registrars.
- Review feedback at next Quality Panel
- Board round to continue and CW to help maintain momentum if necessary
- Trust to continue to monitor trainee feedback
- HEE-SW to continue to monitor through the Quality Register