Realising Realistic Medicine: Chief Medical Officer for Scotland annual report 2015-2016 appendix

Case studies of applying the personalised, patient-centred Realistic Medicine approach across Scotland.

NHS Education Scotland (NES)

Initial thoughts

Education and training has a significant role to play in ensuring that our trained medical workforce has the skills and attributes required by NHS Scotland - including those set out in Realistic Medicine - while recognising that we work in a context where training curricula are determined and approved across the UK, by medical Royal Colleges, and the General Medical Council. NES currently supports a broad range of areas of education and training beyond the delivery of these core curricula which are of direct relevance to the delivery of Realistic Medicine.

What have we done so far?

Ongoing work within the Patient Safety Group has resulted in a new e-learning resource on Human Factors available summer 2016. Accredited by the Chartered Institute of Ergonomics and Human Factors, this resource will offer NHS and Social Care staff in Scotland an overview of this discipline and its contribution to enhanced wellbeing and performance.

Face to Face workshops covering areas such as 'Human Factors Awareness', 'Why things go wrong (and right) in complex systems' and 'How to respond when things go wrong in complex systems' are available to consolidate and develop knowledge around Patient Safety further. Additional learning options will become available during 2016/2017. Train the Trainer/Master class sessions will also be available to help those directly involved in the education of patient safety discuss the subject in more depth and share educational strategies with colleagues.

Within a complex health and care system, healthcare professionals will need to draw on more than their clinical and technical skills alone. The LaMP programme has been designed by NES to help and support individuals as they develop a range of personal and professional skills and behaviours which will contribute to their effectiveness as a clinician.

The LaMP programme has been designed to offer a blended learning approach which consists of two face-to-face development workshops, an online module and a workplace-based project.

NES in partnership with Scottish Government and a range of partner organisations are now working with the 6th cohort of the Scottish Clinical Leadership Fellow SCLF programme. These one-year Clinical Leadership Fellow posts are an integral aspect of NHS Scotland's approach to developing Professionalism & Excellence in the medical and dental professions. Fellows will have a bespoke opportunity to develop leadership capabilities and contribute to aspects of contemporary health- and care-related activity. The programme aims to provide NHS Scotland with a cadre of doctors and dentists who are committed to living and working in Scotland and have enhanced capability to offer leadership in their work place and potentially at national and international levels.

What next?

A prototype 'train-the-trainers' pack (based on NES enhanced Significant Event Analysis work) has been developed build capacity and capability across NHS Scotland. This work is also contributing to related national programmes on the Reporting and Management of Adverse Events and the Duty of Candour.

NES is developing a spiral educational framework that focuses on preparing doctors to deliver an episode of enhanced communication, specifically tailored to each instance of death and bereavement loss. It considers this from the perspective of the undergraduate, the early postgraduate, the specialist trainee and the trained practitioner. At each level domains reflect the journey of communication episodes: preparing what needs to be known ahead; delivering and recording the information given; reflecting on the professional and personal aspects of the episode; and quality assuring this aspect of care.

Final thoughts

The changing needs of the population and the continued development of new health technologies will mean that the service provided by the NHS in Scotland will change and evolve - meaning staff doing different things, in different ways, and developing new skills. Healthcare professionals will need to ensure that they continue to Realistically meet the needs of patients and their carers, whether in hospitals, at home or in the community.

NHS Education Scotland: A Problem Based Small Group Learning session in progress.

NHS Education Scotland: A Problem Based Small Group Learning session in progress.


Email: Catherine Calderwood

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