College statement on DHSC review of rotations and curriculums
The Royal College of Physicians of Edinburgh (“the College”) has given its reaction to the recent announcement on medical training from Wes Streeting, the Secretary of State for Health and Social Care. Mr Streeting stated that the Department of Health & Social Care (DHSC) will lead a review of junior doctors’ rotations and will seek to redesign curriculums.
In a joint statement the College’s Deans of Training, Dr Kerri Baker and Dr Marion Slater, said:
The College welcomes the announcement from Mr Streeting and any steps that can be taken to improve the working lives of doctors, their recruitment and retention and thereby of course patient care.
Work on the distribution of training posts for doctors is already underway, led by NHS Education for Scotland and NHS England, and informed and supported by data from RCPE and other Royal Colleges and Faculties, not only to ensure there are sufficient doctors across our varied geographies but also to rationalise placements, recognising that uncertainty and distant rotations can be disruptive to individuals and their families and friends and can significantly impact wellbeing. Rotation is an important part of training to ensure that doctors are exposed to different pathologies, locations and working practices as well as to ensure that all communities are able to access the high quality care that doctors in training provide.
We would however stress that curriculum writing and redesign should remain under the remit of the Royal Colleges rather than government, with need for deep understanding of curriculum design, educational theory and governance, and GMC requirements. Postgraduate training curricula undergo regular review by multiple stakeholders to ensure they remain up-to-date and fit for purpose and RCPE will continue to deliver and support this integral work. We welcome collaboration to create principles of good practice whilst emphasising that the diverse needs and geography of the population demand that local trainers and education providers retain some flexibility to ensure that appropriate breadth as well as depth is delivered in resident doctors' rotations.
We also emphasise the importance of a four-nation approach - training numbers cannot focus on England alone as curricula and more broadly training is, and should be, a pan-UK matter, and further fragmentation should be avoided where possible.
Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, added:
The new UK Secretary of State for Health and Social Care has recently stated that the ‘NHS is broken’. Training of the medical workforce of the future is a key part of the work of the NHS and we therefore take the announcement we highlight here as recognition that medical training in the NHS is also in need of urgent repair.
Failure to improve medical training in our NHS will only result in further disillusionment of doctors, loss of doctors to this country and to the profession, and future deterioration in patient care.
The specific section of Mr Streeting’s statement of Monday 29th July is below:
“Recognising how disruptive the system of rotations can be for junior doctors, their partners and families, the department will lead a review of the current system, with the intention of reforming the number and frequency of rotations. It will also review and, where needed, redesign curriculums. NHS England will review training numbers, working to address training bottlenecks and make sure the NHS has enough doctors, consultants and GPs for the future.”