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  1. Surgical training "out-dated" - college

    One of the UK’s surgical colleges is to abandon the “apprenticeship” method of training, it was announced today.

    Surgical trainees are to be taught by accredited consultants using new surgical standards for the first time, the Royal College of Surgeons of Edinburgh (RCSEd) announces.

    The launch of the Standards for Surgical Training, which will be revealed at the College’s Birmingham Centre, comes as the RCSEd claims that many aspects of surgical training are "outdated" and must change to ensure patient safety.

    RCSEd President Ian Ritchie said the initiative, which will see trainee surgeons taught using standards developed specifically by the RCSEd’s Faculty of Surgical Trainers (FST), will focus on the quality rather than the quantity of training.

    He said the old style apprenticeship model of training no longer met the needs of a changing NHS.

    “Training has to be delivered in a more structured, consistent and educationally sound way, focused on patient care,” he said. “The end product of training, after all, must be a surgeon who provides first class, safe patient care.”

    “This can only help to address concerns around the effects of the European Working Time Directive, which has capped the number of hours a surgeon can work,” he said.

    Michael Moran, of the RCSEd’s trainees’ committee, which represents trainees across the UK, welcomed the introduction of standards for consultant trainers.

    “There are many exceptional trainers across all surgical specialties, but there are also consultants who only allow their trainees to do operations they already know and rarely take the time to train them on an operation from start to finish,” he said.

    “This limits the development of a trainee’s skills and knowledge. In some cases we are being trained by excellent surgeons, but far from excellent surgical trainers.”

    Welcoming the new trainee standards, Sir Bruce Keogh, NHS medical director for England who is due to speak at the Birmingham College today, said: “They provide evidence that the profession can adapt in the right way, at the right time, driven by the right people – those who deliver our health service.

    “If it was not obvious before, this makes clear the importance of consultants who can provide training to the same standard.”

    The Standards for Surgical Training, which have been approved by the General Medical Council (GMC), are divided into seven framework areas, each with a number of key elements.

    Five of the areas apply to a named clinical supervisor, and all seven to a named educational supervisor. The Standards will ensure that consultants who provide training should be able to: prioritise patient care while delivering high quality training; challenge poor practice and promote improvements; support underperforming trainees; and plan the best training for trainees at all levels.

    Mr Craig McIlhenny, FST surgical director who led the development of the Standards, said a more professional surgical landscape provides high quality patient care, and a service that is able to respond and adapt to seven-day working.

    “Learning to be a surgeon can only be done on the job, and this is often in an emergency setting,” he said.

    “The Standards will give trainers a framework of excellence that will ensure tomorrow’s surgeons have the practical skills and technical knowledge they need – and importantly, a professional attitude.”

  2. Midwives set for second strike

    Midwives and other NHS workers are to stage further industrial action next month over pay, it has been announced.

    A four hour strike early on Monday November 24th will be followed by a week of disruption.

    The Royal College of Midwives, taking action for the first time in its history, will follow the strike with restrictions on overtime and a requirement that midwives take all their breaks.

    It said midwives would only work overtime if they were assured they would be paid for it.

    It is one of nine unions taking action in protest at the government's refusal to allow an across the board 1% pay rise.

    RCM chief executive Cathy Warwick said: : “Our action in October was very effective in showing the level of discontent amongst midwives and that the goodwill that midwives gives to the NHS every day is worth far more than the 1% pay increase. Announcing these further dates of action shows that we are determined that enough is enough, NHS staff deserve fair pay.

    “Last time the RCM worked very hard to meet with employers to discuss our action and to ensure that mothers and babies were not put at any risk; we will do exactly the same for the action in November. I want to reassure women expecting a baby that midwives will continue to look after them and that they will be safe. ”

  3. Pharmacy hope to relieve winter pressures

    The NHS is hoping pharmacists will help reduce pressure on hospitals and GPs over the winter, according to plans announced today.

    A six-week campaign is to encourage people to seek early advice from the pharmacy when they feel a cold or flu or other minor condition coming on.

    Named "under the weather," the campaign will be aimed especially at elderly people and those with existing lung problems.

    NHS England deputy chief pharmaceutical officer Dr Bruce Warner said: “Pharmacists and their teams are well trained and well placed to be able to offer advice to people seeking help.

    "They can provide medicines advice and support for minor ailments, advise you about how to manage a long term condition and tell you if something needs more urgent medical attention from your GP, or even your local hospital.  

    “You don’t need an appointment and many have consultation areas so your local pharmacy is a good place to start when you’re feeling unwell."

    The campaign was backed by NHS England clinical director for acute care Professor Keith Willett.

    He said: “Every winter, doctors and nurses see a big increase in the number of older and frail people who are admitted to hospital because of respiratory or other chronic conditions usually worsened by immobility, the cold and viral illnesses.  

    “People often don’t seek advice for wheezes, coughs and sneezes because they don’t think it’s serious enough, or they don’t want to waste their pharmacist’s time.  But no problem is too small for your local pharmacist, who is a highly trained and trusted source of health advice.”

  4. Community trusts get upgrade

    Three new NHS Foundation Trusts were created yesterday - marking a new step in a programme stalled by scandals and financial troubles.

    For the first time two community NHS trusts have been given foundation status.

    One trust runs services throughout Derbyshire and the other, the Bridgewater, runs services in Lancashire and Cheshire.

    The third approval went to the Royal United Hospital, Bath.

    Miranda Carter, of the Foundation Trust regulator, Monitor, said: "Millions of patients could now have a greater say over their healthcare and the new foundation trusts will have greater freedom to provide services that meet the needs of local people.

    “The authorisation of trusts which provide healthcare in the community is proof that foundation trust status is attainable by all types of health care organisation.”

    Dr Kate Fallon, chief executive of the Bridgewater Trust, said: “Now we will have more freedom to look for better ways of meeting our own patients’ particular needs and priorities."


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