ltft and supportt: the basics event... · 2019. 6. 13. · 15% in hee nw rise by 37.9% since 2012...
TRANSCRIPT
LTFT and SuppoRTT: The BasicsDr Shirley Remington, Deputy Dean for Learner Support
Housekeeping and aims of day
• Seminars
• 1:1 support
• Fire alarms
• Phones
• Privacy
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• Background
• Recent changes to application
process
• New application process
• FAQS
LTFT – The Basics
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Facts and figures 2018 - 5959 less than full time trainees
15% in HEE NW
Rise by 37.9% since 2012
1.5% of foundation doctors
Most common in paediatrics 20% least common in surgery 4%
15% of female trainees 2% of male trainees
Most common in age 30-39 group
71% are for childcare
Introduced in 1969
900 trainees in HEE NW
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LTFTT – Types Eligibility
• Type 1: carer or health including disability
• Type 2: develop special skills/interest
• Approval process unchanged
Funding types
• Jobs share
• reduced hours post
• supernumerary
Minimum 50% ( GMC 2011)
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LTFTT – Types
• New gold guide ( another expected 2020)
• NHS employer guidance-flexible training champions
• 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
• Improving junior doctors lives
• Updated local policy
• Local locum guidance
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New Opportunities
• TIS
• Local Flexible Training Champions
• New contract
• GMC statement 2017
• EM pilot and extension
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Process and Tips
• Eligibility - done once
• Start early.
• Build links with local flexible training lead – specialty and Trust
• Notice to return to fulltime.
• If returning after break ensure Trust are aware
• Use SuppoRTT Opportunities
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Key challenges – LTFT Trainee
• Fitting in
• Personal expectations
• Conflicts in WLB
• Finance
• Rigidity- negotiation skills
• Return to work programmes
• ARCPs
• NTS survey 2018 high
percentage say colleagues
unsupportive
• Isolation
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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 fulltime
• Locums
• Paid employment
• Bank holidays
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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.
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
FAQs
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SuppoRTT
• All schools have policy
• Everyone not working for 3+months
will follow process
• Lots of available support
• Leads in Trusts and schools to
embed process (temporary funding to
start in next few months)
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What actually happens
• Share with school potential dates of absence and if possible return date.
• Discuss what potential return will look like and plan with either ES or TPD
record on form the plan
• Start planning for return – planned events that can be useful while off, KIT days,
School and HEE offers ( don’t ignore emails)
• Keep in touch with school/trust and prior to starting back meet ES to plan what
return will actually look like
• Confirm date of return
• Firm up plans
• Contact Trust and school return champions
• Meet ES and plan against educational needs including any left from prior to break.
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Transition back to practice
• Induction – even if worked in place before - preferably tailored – things change -
policies equipment
• Update elapsed mandatory training
• Regular meeting with ES to confirm progress starting with one prior to start date
• Extra support if needed and increased supervision initially
• Meet ES at planned point post return and agree full resumption of
responsibilities
• First ARCP – if long return does CCT need extending – panel decision
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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
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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
Support for trainers and trainees - LTFT
• eLearning for Health - 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 Royal Colleges return to practice
• NHS Careers Website
• BMA document 2014
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Overall Satisfaction
75.
76.5
78.
79.5
81.
82.5
84.
85.5
2012 2013 2014 2015 2016 2017 2018
FT LTFT
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Contact
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Thanks and Questions
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The Lead Employer Model – Supporting
Trainees Following Time Out of Training
www.sharedservices.sthk.nhs.uk
Time out of training
• Long term sickness cases (+28 days)
• OOP
• Maternity leave (up to 52 weeks + AL)
• SuppoRTT schemes implemented by each
specialty school
www.sharedservices.sthk.nhs.uk
Who does what? – Employment Services
www.sharedservices.sthk.nhs.uk
• Pre-employment checks
• Issue contracts
• Process maternity / paternity / adoption / shared parental leave
• Process excess mileage / removal of expenses
• Process work schedule changes
• Answer generic employment-based queries
Contact: [email protected]
Who does what? – HR Case
Management
www.sharedservices.sthk.nhs.uk
• Provide HR advice and support
• Process occupational health referrals
• Provide guidance about key HR policies including attendance
management, conduct, grievance
• Manage long term sickness cases in line with Trust policy
• Link in with HEE regarding the on-going management and support of
trainees
Contact: [email protected]
Long term sickness
www.sharedservices.sthk.nhs.uk
• The majority of the work the LE does with regards to returning to
training is with trainees who have been off work due to long term
sickness (+28 days)
• ‘Training Clock’ – The difference between returning to work and
returning to training.
• Referrals to Health, Work and Wellbeing
• Working with trainees to implement any restrictions / adjustments
recommended by HWWB clinicians
• Support the trainee in undertaking fewer / restricted duties / working
at a slower pace etc.
• Anything longer than 12 weeks – contractual change
Supportive measures
www.sharedservices.sthk.nhs.uk
• Phased return to work
• Amended hours e.g. varied start / finish times
• Induction / period of shadowing
• LTFT
• Adjustments to duties e.g. no on calls / OOH / night work
• Buddy / mentor scheme within the department / host organisation
• Access to Work input
• Reasonable adjustments – the balance.
Health concerns & The Equality Act
www.sharedservices.sthk.nhs.uk
• Definition of a disability:
• S6(1) Equality Act 2010 – a person has a disability if they have a
physical or mental impairment and the impairment has a substantial
and long term adverse effect on their ability to carry out normal day to
day activities
• EqA Schedule 1 – the effect of an impairment is long term if it has
lasted for at least 12 months, it is likely to last for at least 12 months
• Recurrent conditions
Reasonable adjustments – in line with
the Equality Act
www.sharedservices.sthk.nhs.uk
• Purpose of a reasonable adjustment is to avoid or eliminate a
disadvantage to a disabled person
• What is reasonable will depend on the employer and the
circumstances
• The onus is on the employer to investigate and suggest adjustments
(with advice from HWWB)
• Medical advice can assist
• Access to Work input
Maternity / Adoption and Parental Leave
www.sharedservices.sthk.nhs.uk
• KIT days – Taken during SMP period
• Supported Return to Training days – Taken during AL
• Max. 10 days over the maternity leave period
• Accrued annual leave (calculations)
• Risk assessments – every trimester during pregnancy + upon return
• Support and guidance re breastfeeding
• HWWB support if needed
• Management information – picking up on trainees who resume work
in line with rotation days
• Avoidance of immediate return to duties with less supervision
Out of Programme
• Differentiation between different categories of OOP
• Gold Guide with regards to OOPC
• HWWB input for OOP cases – Declaration + support if needed
• Avoidance of immediate return to duties with less supervision
Any questions
www.sharedservices.sthk.nhs.uk
TOP TIPS FOR RETURNERS
Dr Jenny Barber
ST6 in Obstetrics and Gynaecology
NORTH WEST KIT EVENT
Expectation! Reality!
Top Tips for Returners
Just like riding
a bike?
Anxious
Guilty
Under-confident
Lonely
Looking forward to more mental
stimulation
Adult company
Personal fulfilment / sense of self
Tired
Technical skills
Organisational demands
Decision-making
Better doctor?
Prioritisation
Time management
Team awareness
Empathy
Overwhelmed
Family support
Nursery times
Sleepless nights
Nursery lurgy!
Exams
OOH / On-calls
Specialty demands /
expectations
Portfolio
It's not the same for everyone!
Partner's job
CV
Nursery lurgy!
Commute
Some Practical Tips
• Sort out childcare (including a Plan B!)
• Think about LTFT
• Make contact with work early to plan your return -
Educational supervisor or College Tutor
• KIT days
• Book some annual leave
• Plan meals
• Be open and honest
• Speak to other trainees
• Accept (organised!) chaos
It will be ok
But what if it's not?
• Educational supervisor
• College Tutor
• TPD
• Other trainees
• SuppoRTT programme
And Finally...
Don't make any rash decisions!
Be kind to yourself!