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Changes to doctors’ training will be modelled

Patients, service users and healthcare professionals should be assured that any proposed changes to training will be properly considered, modelled and costed and consulted upon before any changes are made.

These are the comments of the UK Shape of Training Steering Group (STSG) in the face of mounting criticism over the review of doctors’ training.

The report of the independent Shape of Training Review, led by Professor Sir David Greenaway, was published in October 2013.The review was established to understand whether the way in which doctors are trained meets the current and future healthcare needs of patients across the UK.

The review concluded that the healthcare needs and expectations of patients are changing and the way services are delivered needs to evolve. The review made 19 recommendations suggesting how changes to the structure of medical training can help deliver high quality care for the future. It suggested that more generalists were needed in future, and it controversially suggested that training could be shortened to deliver this.

Critics believe the review could be a way of introducing a cheaper, lower quality consultant grade to deliver seven-day services – a key government aim. It has led to one junior doctor’s online petition igniting opposition from 5,500 doctors who were previously have been unaware of the planned changes.

The STSG was created by ministers to consider the review’s recommendations and make policy proposals, where possible, on the basis of a four-nation consensus.

It has been quick to release a statement outlining its next steps and re-assuring doctors that there isn’t a ‘hidden agenda’.

The STSG has endorsed the following general and specific proposals:

– those aspects of the current training system that have been shown to work well and are fit for purpose should remain;

– any significant changes to medical training should be consistent with the key principles outlined within the Greenaway report, and taken forward in a measured and incremental way to avoid service and training disruption;

– any significant changes to medical training such as alterations to curricula must reflect the UK basis of medical training and be approved by the GMC;

– to expand its membership to include representation from the BMA, employers, patients, doctors in training and chairs of each countries groups.

Commenting on the statement, RCP president Professor Jane Dacre said: “We agree that in future, we will need more doctors with the general medical skills to care for the increasing numbers of patients coming to hospital with multiple medical conditions, particularly frail older patients. To train a good doctor who can provide generalist care together with specialist expertise requires adequate time.

“We are against any shortening of training, as this would affect the quality of the care our doctors can provide. We are pleased that the announcement does not suggest a reduction in the number of years needed to train a doctor, and we look forward to discussing the changes necessary to the curricula to ready our doctors for the patients of the future.”

The STSG said next steps will focus on the following specific activities:

– further work will be undertaken to describe how doctors’ training can be more generic to better meet the current and future needs of patients. This will include a mapping exercise led by the Academy of Medical Royal Colleges and supported by the GMC to look at the extent to which Colleges have or can develop the generic components of their curricula;

– measures to be scoped out, based on evidence collected through pilots, how to further develop the careers of doctors who are outside formal postgraduate training and who are not consultants, such as SAS grade doctors;

– measures to better prepare doctors to work across the interface between primary, secondary care and the community with more flexibility in training between the sectors; and

– the STSG will support the GMC as they develop and pilot credentialing working with all stakeholders with an interest in this aspect of Shape of Training.

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