The CPD Standards Office discusses new contracts for junior doctors and why specific training in soft skills should be included in their mandatory CPD requirements.

Sir David Dalton, Chief Executive, NHS Employers, wrote an open letter to the junior doctors on 3rd February 2016 expressing his concerns on the need to reach an agreement to the BMA’s striking action in mid-January. Without an agreement reached, the BMA engaged the 54,000 junior doctor workforce across England to strike again in February.

Junior doctors are unsatisfied with the contract Jeremy Hunt, Secretary of State for Health at The Department of Health and NHS Employers are imposing on them. They believe it is unfair, unsafe and will devalue the service they provide to patients.

The government and NHS Employers aim to modernise the junior doctors working pay system, deliver better education and training services and improve safety standards.

Better Training and Education

Sir Dalton highlighted the need for better training and proper notice of rotational deployment, but this issue was not covered in the press.

Instead, junior doctors have been stigmatised by the media for striking about the amount of little pay they will receive in the new contract (a hashtag ‘#moetmedics’ started trending on Twitter, insinuating they lead extravagant lifestyles anyway).

In fact, what makes their job worth more pay is the quality and the commitment to their patients and the NHS health care service.

In order for them to maintain a high-quality service, the government and NHS Employers have worked with Higher Education England to align education and training to the national curriculum.

Stressed doctors

Junior doctors are reporting high-stress levels because they work incoherent schedules and yo-yo rotas. Before they know it, there are not enough hours in the week to complete their mandatory CPD training.

Sir Dalton says: “Existing contractual arrangements scarcely reference training – instead focusing on the service contribution that trainee doctors make. Issues include how training opportunities can be missed because of work pressures, the inflexibility around leave and the insufficient notice of training placements which make it difficult for doctors to plan their lives, and the lack of consultant presence at weekends which may contribute to a poorer training experience.”

The BMA confirm that junior doctors feel unable to plan their training effectively so that they can have an enjoyable lifestyle. This reflects badly on how training is structured by NHS Employers.

Current junior doctor CPD requirements

The General Medical Council stipulates junior doctors are responsible for their own CPD and must provide evidence at their annual appraisal to remain fit to practice. Also, the 17 Royal Medical Colleges communicate CPD schemes to doctors so they can maintain professional standards in their speciality. For example, The Royal College of Surgeons requires its members to complete 50 hours of CPD annually.

Continuing professional development (CPD) is defined as the intentional maintenance and development of the knowledge and skills needed to perform in a professional context. CPD is the process of improving current skills through methods such as online e-learning modules, mentoring, or instructor-led courses.

In order to make training effective, in their 15 years of training before they move to specialised areas of medicine, CPD training must be structured. This means setting goals, objectives and evaluating skills development to align with the job requirements or prepare for potential promotion.

The reason for the government imposing the new contract without room for further negotiation is that junior doctors are kept to a strict timeline of rotation.

CPD Opportunity for the NHS

The NHS Employers’ training for junior doctors is currently under scrutiny, and there is an opportunity for them to invest in trainers that deliver accredited CPD courses in soft skills.

Yvonne Bignall, Partner, International Medical Training Company, says: “The barrier to entry into the NHS is that there are so many pushbacks for external service providers, and its in-house medical training system is impossible to get business or open a dialogue with.”

“At times, junior doctors have to lead teams, but as newly qualified graduates, whilst they may have medical intelligence, they do not all have the self-confidence or experience in leadership skills for busy teams working under pressure.”

Bignall points out that: “These skills are not just a ‘nice to have’, they are ‘need to have’. No one wants to have a doctor that is brash because they are stressed or one that does not engage with their feelings through good listening.”

Speaking from a personal angle, Bignall says: “We have a family member who is a newly qualified junior doctor and said she does not receive training that could help her professionally.”

In Yvonne’s family’s case, she would benefit from setting her own CPD objectives to fulfil her medical career goals. The demands she will face as a junior doctor to lead a team during A&E, for example, could be daunting unless she prepares herself professionally for them.

The NHS Employers should work with junior doctors to structure CPD learning to develop their professional skills. By strategically aligning individual objectives with business ones, the NHS would benefit as an organisation.

NHS medical training and education schemes should better align CPD courses such as the ones below:

CPD requirements are mandatory for junior doctors to remain legally qualified, and it is important that their modules help them develop effectively and professionally.

The CPD Standards Office assesses trainers against specific criteria based on academic research and accredits them with a high-quality accredited mark.

Amanda Rosewarne, Director of CPD Accreditation and Research at the CPD Standards Office, adds: “Developing soft skills is a crucial training strategy for NHS Employers as junior doctors work in highly pressurised environments and must learn to manage work performance expectations of themselves and of others.”

“We advise medical training providers in our assessment process how to deliver highly effective CPD material to their delegates which is based on a five-year university-led research project. When we have successfully accredited the medical training providers, they can ultimately deliver engaging content that will help junior doctors to continue to practice in confidence.

As the debate between the BMA, the government and NHS Employers continues over junior doctor contracts, training providers have a great opportunity to promote better learning practices for the medical sector.


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