SAS development and retention programme SAS development

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Introduction 3, SAS doctors in emergency departments a brief background 4. Cost benefits 5,How can trusts use this toolkit 5, Elements for success a generic model for SAS workforce development 6. in emergency medicine,l CESR training route 7,l Tailor made rotations secondments 8. l Step by step how to implement a staff retention programme 8 9. A success story Derby Teaching Hospitals NHS Foundation Trust 10. l Business and financial modelling 11,l Introducing flexible family friendly rotas 11. l Derby template documents information for download 12. l Useful links 12,2 SAS development and retention programme.
Introduction, This toolkit has been developed by Health Education especially with cost savings They allow trusts to show. England to help improve the retention of Specialty value to their medical workforce improve recruitment. and Associate Specialist SAS doctors in emergency and enhance the skill set of doctors all of which lead to. departments better patient care, It is designed to be used by hospital consultants senior At a time when the NHS faces so many challenges these. clinicians finance directors and administrative staff who initiatives are leading to lower SAS staff turnover in. are interested in or involved with introducing retention emergency medicine and significantly less money spent. programmes on agency locum doctors, Schemes to improve staff retention are underway at. several NHS trusts and are seeing impressive results. Toolkit for implementation 3,SAS doctors in emergency departments. As pressure on emergency departments has increased so too The Royal College of Emergency Medicine RCEM FASSGEM. has reliance on SAS doctors The term SAS doctor includes group identified the following factors leading to attrition. a number of senior doctor job roles associate specialist. doctor specialty doctor staff grade doctor clinical assistant l U. nsustainable rotas with high frequency of out of, general medical practitioner and hospital practitioner hours work.
among others Associate specialists specialty and staff l P oor morale within the department or perceived. grade doctors often work at consultant level lack of respect. This group has been described as the dependable backbone l Poor working environment with high stress levels. of the NHS medical workforce providing high quality safe l Poor pay and conditions. care throughout the 24 hour period seven days a week But. l A perceived inequality with higher specialty trainees. this contribution has not always been valued or supported. The interim report of the Emergency Medicine Taskforce In 2012 the General Medical Council GMC found there. found many of these doctors were working unsocial hours was a lack of information about SAS doctors that they had. had job plans with little or no provision for continuous less access to support than other doctors and were less. professional development CPD and felt unsupported both likely to have their practice formally assessed 1 Yet they. within their department and in their organisation As a are competent healthcare professionals who deliver clinical. result highly experienced doctors were leaving emergency services alongside consultants and other medical workers. medicine for areas like general practice which was seen to They take part in the processes of revalidation appraisal and. hold more opportunities for higher salaries and improved job planning The emergency medicine taskforce claimed a. working hours clear sense of career pathway and the opportunity to pursue. the Certificate of Eligibility to the Specialist Register CESR. NHS trusts began struggling to populate SAS rotas, route see p 7 would enhance the working lives of this. particularly overnight and at weekends This led to a vast. important group, expenditure on locum doctors of variable quality and or. very junior doctors being largely unsupervised in emergency. departments particularly overnight and for extended. periods at weekends,4 SAS development and retention programme. Cost benefits, NHS employers are committed to ensuring that the role In 2013 spending on locums by UK emergency departments. of the SAS doctor is fully acknowledged and respected by was more than 150 million higher than the salary bill for. management colleagues and patients A number of trusts all emergency consultants in Britain 2 and between 2010. have introduced retention programmes by way of achieving and 2013 there was a 60 increase on locum expenditure. this and helping improve the long term viability of work in England alone 3. patterns Health Education England HEE NHS England, NHS Improvement and the RCEM are working in partnership The Derby Hospital retention programme featured as an.
to raise awareness of these programmes and how they are example of best practice in this toolkit is estimated to be. attaining such positive outcomes saving around 330 000 each year for every six doctors. recruited through the scheme These savings are made. This publication draws on the main characteristics of a by converting locum expenditure to PAYE and equate. highly effective scheme at Derby Teaching Hospitals NHS to 1 65m per year for every 30 doctors employed The. Foundation Trust and adaptations of that programme in hospital s emergency care retention rate now stands at 92. order to present a generic model for SAS development that set against a national average of 61 98. focuses on retention Only by making working practices. safe and sustainable will the NHS will be able to attract Elsewhere trusts using the same or adapted models are. and retain the required number and mix of doctors in its reporting savings of around 120 000 150 000 per month. emergency departments also by focusing efforts on reducing agency costs And. several are noting a range of associated efficiency gains. How can trusts use individual level, this toolkit It is predicted that if all trusts in England implemented. retention programmes it would result in the following. This collection of information and resources is a guide for. users to be able to introduce retention programmes into At least 100 additional emergency medicine. their own NHS trusts as a way of tackling the problems doctors employed nationally on CESR style. seen in emergency departments across the country rotations within two years. The toolkit covers the basics that must be in place A more sustainable workforce for some of the. for such initiatives to succeed and achieve substantial most challenged emergency departments. savings improve the work environment and enhance Total cost savings of approximately 5 million by. patient experience converting pay from agency to substantive trust. employed doctors,The documents developed and used by the featured. success story in this brochure Derby Hospital are Successful completion of the CESR process 4 5. available for other trusts to customise and can be years will result in increased consultant numbers. downloaded at www hee nhs uk our work, While this initiative is specific for the SAS workforce in. emergency departments workforce, emergency medicine there is scope for other medical. The completed versions can be used as examples of best specialities to adapt and utilise it. practice and blank versions can be tailored for use at an. Toolkit for implementation 5,Elements for success a generic model for SAS.
workforce development in emergency medicine, Strong clinical leadership is fundamental to any staff These include considerations like the training budget an. retention scheme succeeding In many cases this is needed education and training package time for professional. to challenge the status quo within an organisation in order development a flexible SAS rota senior supervision funding. to establish new methods of practice for consultant mentorship and departmental rotations. There are four main areas that must be considered,l Efforts to make staff feel valued. A trainee s view,l Support for a CESR training route. l The creation of a flexible family friendly rota I feel empowered by the. l The prioritisation of patient care CESR process I don t need. l Secondments,to be pushed I am confident, These workforce developments do not operate in a that I can identify and acquire. vacuum nor do they come about organically they are. the competences I need, clinically led A well planned recruitment strategy ensures.
the fundamentals can be put in place to provide the right to complete the CESR and. structure become a specialist,Dr Aroonkumar Chouhan CESR Senior. Clinical Fellow Trainee Brighton and,Sussex University Hospitals NHS Trust. 6 SAS development and retention programme,The CESR training route. Most retention schemes have education and training On completion the evidence is reviewed by the General. packages built around the Certificate of Eligibility for Medical Council GMC and the Royal College of Emergency. Specialist Registration CESR programme a rotational Medicine RCEM to determine whether there is sufficient. system that allows candidates a mix of training and evidence for entry onto the specialist register. experience, As well as offering potential for work progression to those. This route allows SAS doctors in emergency medicine to who have fallen outside the scope of the medical training. work towards specialist status by completing skills gaps career path the CESR enables doctors from overseas to. while continuing their work as doctors train to specialist status without having to re take their. postgraduate training, The CESR certificate is the equivalent standard of a CCT.
Certificate of Completion of Training which all doctors in It also helps increase the number of emergency medicine. the UK must hold to be eligible for entry onto the general consultants in the NHS without reducing the quality or. practice or specialist register standards of the grade. Doctors who complete this training are able to apply for For a CESR trainee job description trainee advert and. consultant posts helping increase consultant numbers portfolio of evidence requirements please visit. www hee nhs uk our work emergency departments, The CESR process involves a collection of evidence covering workforce. l Knowledge skills and performance For more detail about the CESR programme visit. l Safety and quality www gmc uk org doctors 24630 asp. l Communication partnership and teamwork,l Maintaining trust. The CESR programme runs for approximately four years. with each year being loosely equivalent to traditional higher. specialty training years ST3 6 The timeframe is flexible to. meet the individual needs of the trainee,CESR A consultant s view. One major issue with locum staff is that it is,sometimes difficult to cover shifts at night and. weekends This places an additional stress and,burden on our own staff We want to break.
this vicious circle and believe that the CESR,approach may help in doing this. Health Education England research,Toolkit for implementation 7. Tailor made rotations, CESR trainees gain the required clinical and non clinical Candidates must be registered with the GMC hold a licence. skills they need through tailor made rotations in emergency to practice and be expected to participate in the 24 hour. medicine These are three month secondments in relevant emergency care rota for the duration of the CESR training. specialties like anaesthesia intensive therapy units ITUs. In some cases trainees can benefit from opportunities for. acute medicine and paediatrics, learning and skills development in collaboration with CESR. The secondments are coupled with protected time for an trainees in other locations throughout the country. education package matched to the Fellowship of the Royal. College of Emergency Medicine FRCEM curriculum and a. sustainable rota work life balance, STEP BY STEP How to introduce a staff retention programme.
STEP 1 Identify need do we need a retention programme for our SAS workforce Yes No. Are existing work patterns effective in dealing with current and future demand. Is staff morale low and turnover high, Is the trust struggling to recruit middle grade staff. Is locum spend too high,STEP 2 Who should be involved Yes No. Consultants clinical leads is there enough consultant supervision in. place to ensure trainees are allocated the right amount of mentorship. Medical teams is there the right support among the medical teams in. the clinical areas where rotations will take place e g anaesthetics. paediatrics, Non clinical executive team does the plan have the backing of senior. management e g chief executive medical director finance director and. human resources, SAS doctor trainees are the candidates suitable for the CESR. Do CESR applicants have the right skills mix required by the department. identified during the interview process as part of the clinical. assessment, Is the clinical assessment at interview stage rigorous enough to select the.
right people,8 SAS development and retention programme. STEP 3 Business finance Yes No,Is the trust s senior management supportive. Will the trust fund consultant time, Can a flexible family friendly rota be designed that allows trainees protected study leave. Can electronic self rostering be introduced,Can rotations be facilitated. Who will prepare the financial and business plans to support SAS workforce development.

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