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Quality Framework

Introduction

The purpose of Quality Management is to gather information to ensure that the curriculum is being delivered by trainers to all trainees within the Severn Deanery.

Interested parties:

  • GMC Quality Assurance
  • Deanery Quality Management
  • Specialty Schools Quality Control
  • Trusts Quality Control

The ultimate beneficiaries of a robust Quality Management process are patients who will benefit by being treated by trained doctors who have trained in an environment that provides for their needs.

Links between the relevant stakeholders are as follows: 

 

The Quality Team is committed to achieving the highest standards in the training of junior doctors within the Severn Deanery and adheres to the following processes to achieve this aim.

Quality Team Members

Methods of Obtaining Quality Management Information

Different methods of assessment triangulate of information obtained by the Quality Team.

ARCP/RITA

This process occurs annually and also enables assessors to gather soft intelligence from the ARCP Panels to augment their annual report submission.

Surveys

Surveys elicit standardised information from both trainees and trainers. The Severn Deanery Quality Team uses data from three surveys to inform their Quality Processes

GMC Trainee Survey

This survey runs annually.

GMC Trainer Survey

This survey runs annually.

Severn Deanery End of Placement Survey

This Survey closed in December 2010.

Trainees are requested to complete the GMC Trainee Survey. Trainees are also expected to provide evidence that they have completed the GMC survey at their ARCP/RITA. Failure to provide this evidence without satisfactory explanation may affect the trainee's ability to progress in their training.

The Severn Deanery End of Placement process is managed through. the Deanery. Assessment forms are standardised to allow meaningful comparison between Schools, Specialties and Trusts. GMC and Deanery Surveys are anonymous.

The Severn Deanery is committed to disseminating survey data to stakeholders as quickly as possible to instigate change. Please see the Survey Strategy Document.

Visits

The GMC has reduced the frequency of hospital visiting by Colleges and Faculties. The centralised specialty specific nature of visiting has been lost.

GMC Visits

The Severn Deanery was visited in 2007 and 2010. The Severn Deanery responded to the action plan of PMETB concerning the 2007 visit and will respond to the action plan from the 2010 GMC visit.

The Severn Deanery Foundation School was visited by PMETB/GMC in May 2009.

Deanery Visits

Between November 2006 and May 2007 the Severn Deanery performed 12 visits to Trusts.

The cycle continued between September 2008 and December 2009 when the 12 Trusts were visited by the Severn Deanery.

A Deanery visit ensures that Trusts with trainees have mechanisms in place to allow training to be adequately delivered across all specialities. The Deanery visit should reflect what is happening in a Trust. It should identify and positively reward good practice. It should identify poor practice and set in place strategies to bring about improvements.

The Deanery will visit each Trust every second year. The Deanery will therefore perform 6 scheduled visits to Trusts per year. The process does not preclude "targeted" visits.

Specialty/School Visits 

The purpose of a Specialty/School visit is to determine whether the curriculum is being delivered. The Deanery recognises that different Schools and specialties have different requirements and that a uniform approach is not appropriate. It is suggested that scheduled visits should be no more frequent than every third year.

Triggered visits may be indicated to investigate any findings that cause concern whether from GMC surveys or End of Placement surveys. Visits could also take place to areas where exceptional good practice has been highlighted or simply on a random basis.

Timing of Visits (Specialty/School)

To minimise disruption, visits should be undertaken in postgraduate teaching time, when trainees are available. This should ensure there is little impact upon service delivery. If the frequency of visits is bi-annual or tri-annual then every effort should be made to not visit in the same year as a Deanery visit. Specialty/School visits require external validation i.e. a Specialist from an adjacent Deanery or a College or Faculty representative should accompany the visit.

Paperwork for speciality visits should be minimal but will include results of the most recent Deanery visits: and the Trust Annual Report to the Deanery: information from Annual GMC Trainee and Trainer Surveys: reports from the Training Programme and School.

The Specialty/School visit will report to both the Deanery and to the relevant College/Faculty.      

Visiting Team - Deanery visits to Trusts 

  • Deanery members (including the lead visitor)
  • The Primary Care Head of School or Deputy
  • Foundation Programme Head of School or Deputy.
  • Director of Medical Education from a neighbouring Trust
  • Medical Director from a neighbouring Trust

    This will involve Medical Directors in the process of medical education. The link is enforced through the Learning Development Agreement across the Strategic Health Authority. The Medical Director is involved when his/her own Trust is visited every second year and by visiting an adjacent Trust every second year. The commitment required from any given Medical Director for visits is, therefore, one half-day per year.
  • Lay Representative

Host Team Composition - Deanery visits to Trusts

  • Chief Executive (by mutual agreement)
  • Medical Director
  • Director of Medical Education
  • Foundation Programme Director
  • General Practice Associate Director/Educator
  • Trainee representatives (including Chair of Trainees Forum)
  • Medical Education Manager                             

Specialty Visits

  • Head of School or a nominated deputy (this could be the Training Programme Director from another specialty within the Deanery) (lead visitor)
  • Training Programme Director from the same speciality but an adjacent Deanery (this could be a nominee from the appropriate College or Faculty
  • Specialty Tutors (2)
  • Trainees
  • Primary Care School or Foundation School Representatives (if appropriate)

The composition of these panels should give appropriate external validation of our visiting procedures.

Outcome of Visits

The Deanery visit to the Trust will inform the Deanery and Trust.

The Specialty/School visit will inform both the Deanery and the relevant College/Faculty.

At the end of any Deanery visit, the visiting team will de-brief the host Trust. A major element leading to the success of any visit is that there should be no surprises following the visit. Discussions between the visitors and the Hosts should be frank and transparent.

A draft report will be sent to the Host Institution within 2 weeks of the visit. Once the report has been verified the action plan will be sent out. Outcomes will be one of the following,  

A       Excellent
B       Satisfactory
C       Action Required
C1     Feedback and Action
C2     Action Soon
D       Unsatisfactory/Immediate Action 

The results of the visit will be available to trainees  via the Deanery website. A response from the Trust to the Action Plan will be expected within a defined time, either 3 or 6 months.

Faculty Development

The Deanery will appraise all Directors of Medical Education and Heads of School annually. All those participating in the appraisal process will receive training in appraisal methods. Heads of School will appraise Training Programme Directors.

The Deanery will continue to work with Trusts to provide support and training for trainers in Workplace Based Assessments, Managing Doctors in Difficulty and training support for Educational and Clinical Supervisors. 

Annual Reports to the Deanery

A Director of Medical Education will submit an annual report to the Deanery.

A Training Programme Director will submit an annual report to their Head of School. A Head of School will submit an annual report to the Deanery, accompanied by annual reports from their Training Programme Directors.

The Quality team at the Deanery will submit an annual report to the GMC based upon annual reports from Directors of Medical Education and Heads of School. Findings and actions resulting from GMC surveys will also be incorporated in the annual report to GMC.

Quality Panels

Quality Panels within each specialist training programme will meet annually to evaluate the quality of training provided by each unit within the Specialty Training Programme.

Quality Panels to Evaluate Training Posts

Trainee Support

The Severn Deanery have an Associate Dean for Performance, Dr Mike O'Connor who leads this team and works with trained supervisors in the Trusts. The policies are available on the Deanery web site, under Trainee Support.

Feedback

If you have any suggestions about improvements to this document please contact Stuart Cook, Associate Dean - Quality, Severn Deanery.