Information for Trainers
The following pages are for the benefit of trainers and trainees in the East of England region and designed to provide help and guidance when you are considering referring a doctor in training to the PSU.
Almost all medical and dental trainees will complete their training years meeting educational standards and performing their role without concerns being expressed about their professional performance. However there may be situations where a trainee’s progress gives cause for concern and referral to the Professional Support Unit (PSU) is required.
The aim of the PSU is to support trainees, trainers and other colleagues, working collaboratively to maintain patient safety while ensuring that doctors receive the support they need to overcome any issues, and achieve successful completion of training. The PSU can commission individually targeted support in a variety of different areas, as well as supernumerary training in exceptional circumstances.
Doctors referred to the PSU will be allocated a case manager to discuss the issues raised in the referral, and to ensure that all perspectives are taken into account when formulating a support plan. The allocated case manager will remain involved for as long as this is required.
Trainers - For further information please visit the FAQs for Educators pages
Trainees - For further information please visit the FAQs for Trainees page
Any trainee doctor in an East of England training post can be referred to the Professional Support Unit. A trainee may be referred by their trainer, Clinical or Educational Supervisor, TPD or Head of School when concerns have been identified through supervision, monitoring or unsatisfactory ARCP outcomes.
It is important that all possible steps are taken to identify and act on early warning signs of a trainee with performance concerns. Early identification will reduce potential risks to the trainee, colleagues, patients and the organisation.
Causes for poor performance vary widely but key areas include
- Clinical performance - knowledge, skills, communication
- Personality and behavioural issues – professionalism, attitudes
- Sickness and ill-health
- Life events – bereavement, family or personal problems
- Environmental issues – organisational, workload, bullying and harassment
- Lack of engagement with education and training
You are encouraged to discuss the referral and the reasons behind the referral with the trainee, this may increase their willingness to engage in the process. If a trainee is reluctant to be referred then a case manager could informally discuss their situation with them.
The Next Step
Once a referral to the PSU takes place it will be triaged and advice may be given particularly for Level 2 concerns. For all referrals, the PSU will request that a Performance Support Framework is completed. Following triage and where appropriate, the trainee may be assigned a Clinical Case Manager, and will be invited to a meeting or to take part in a telephone call to discuss the concerns raised . All discussions will be documented. An example of the items discussed in the review meetings can be seen in Appendix 2 of the Professional Support for Doctors in Training Guidance, the PSU will undertake a further process of review and development of an action plan.
Following the meeting we will write to the trainee outlining the notes of the meeting, advice given, support offered and plan agreed. We will also request that a 'Consent Form' is completed, which will protect confidentiality and provide consent to share the information with named parties. On request we will keep certain details of the meeting confidential, providing it is not in breach of personal or patient safety.
An individual support plan will be agreed between the trainee and the case manager however, not every trainee will require additional support.
Professional Support Unit Aims and Objectives
- To offer advice, guidance and support to trainees in their professional context
- To promote early identification of issues which may lead to referral to the Professional Support Unit
- To provide clinical and educational supervisors with a clear structure for identifying and addressing the issues
- To establish clear lines of responsibility for all trainers involved in managing trainees
- To provide access to experts who can deal with specific areas
- Managing risk
- Clear standards and a code of practice, with accountability
- Supporting infrastructure
- Early identification and timely intervention
- Continuity and communication
- Identifiable success criteria
- Robust audit and evaluation
- Quality assurance (internal and external)
Other than a brief summary sent to the referring doctor, information divulged to the Professional Support Unit (PSU) will only be shared outside of the PSU where the concerns raised are considered to be in breach of the professional and ethical guidelines of the GMC/GDC. This includes the need to ensure the safety of patients, self and the public as well as abide by the law. If the PSU believes that professional ethical principles or laws are being broken by the individual, the trainee will be advised of this and information will be shared with the Postgraduate Dean or nominated representative to determine appropriate action.
All information held by the PSU is kept in full compliance with the Data Protection Act and the NHS Code of Confidentiality.
Equality and Diversity
The aim of the Equality & Diversity strategy is to ensure that the Health Education East of England is fully compliant with legislation and required GMC standards, thus avoiding unfair discrimination and potential compensation claims in employment or training.