Workforce, training and education
East of England

Frequently Answered Questions

Trainee FAQs

Why have I been referred to the Professional Support and Well-being Service (PSW)?

Referrals to the PSW are made for a number of reasons. This should be discussed with the educator referring you. If you are not aware of the reason for referral, please let us know.  

What happens now?

Once we have received the referral, this will be triaged appropriately, and we will either;

  • email the trainee inviting them to meet with a member of the PSW team at Victoria House, Fulbourn
  • email the trainee inviting them to have a meeting, generally over the telephone with a Non-Clinical Case Manager
  • email the referrer requesting further information or offering advice and guidance for local management.

Who will my case manager be?

Your Case Manager may be a senior clinician from the region or, a Non-Clinical Case Manager, who has a wealth of experience in supporting trainee's requiring additional support, advice or guidance. This will be decided at a weekly triage meeting and will be dependent on the reason for referral. 

Do I have to come to the meeting?

You are not obliged to engage with the PSW, but the purpose is very much about supporting you to make progress with your training. Your engagement demonstrates a professional commitment to your practice. If you don’t engage, you may miss out on valuable opportunities. Should you decide not the engage, the PSW team will inform the referrer.

How do I find time to attend this meeting?

This meeting is about supporting you and helping you progress with your training. As engagement with the PSW may form part of your professional development, it is usually expected that you attend during working hours, and given sufficient notice, your department will make arrangements for you to attend.

What type of support is available?

An individual support plan will be agreed between you and your case manager. Not every trainee seen requires additional support, but possible options include:

  • Communication skills support

  • Independent high level occupational health advice

  • Psychiatric assessment

  • Career Support

  • Psychological Support

  • Neurodiverse conditions screening, assessment and follow up support

  • Attendance at Exam Support Workshops

  • 1:1 Exam Skills coaching

Are the meetings confidential?

Anything discussed with the Professional Support and Well-being Service (PSW) will be treated in the strictest confidence, and will only be shared outside of the PSW with the consent of the trainee. However this is subject to the professional, ethical guidelines of the GMC/GDC and the need to protect patients, self and the public from harm and abide by the law. If the PSW believe that professional, ethical principles or laws are being broken by the individual, the trainee will be advised of this and the contents of the meeting will be shared with the Postgraduate Dean or nominated representative to determine appropriate action including GMC referral.

Are all details held confidentially by the Professional Support and Well-being Service?

Records of any discussions with your case manager are stored securely by the PSW and remain separate to your main training file. Unless required to do so by law, these records, will not be shared with anybody and, only members of the PSW Admin Team will have access to them. 

Who might information be shared with?

We recommend that the agreed Outcomes and Actions of any discussion are shared with your referrer and / or TPD where different. We will also share information with these individuals regarding your level of engagement to ensure appropriate local support. 

How long can I access support?

The length of time a trainee is able to access support varies.

The PSW aims to support trainees throughout the whole of their training should the need arise however, trainees often do not need such continuous, high level support after initial referrals are made to external providers. 

Does the PSW follow any principal guidelines?

You and your case manager are bound by the requirements of the GMC “Good Medical Practice” guidelines and all postgraduate specialty training is referenced by the relevant guidance e.g.  “The Gold Guide”.

Can I refer myself?

A referral from an educator on your behalf enables us to work more collaboratively with the Programme and Employer to explore additional support. Our full referral framework therefore relies on referrals being made by either the Clinical or Educational Supervisor, Head of School, Training Programme Director or Director of Medical Education. However, for trainees that have experienced exam failure on two or more occasions, a self referral "Form E" can be completed. TPD's should still be made aware of any trainee requesting additional support so that they can provide local support in addition to the support accessed via the PSW.

Please Note: The Exam Support put in place is bespoke support and may vary to the support provided to your peers. We do however require a minimum of 12 weeks notice to provide the appropriate support. 


Trainer FAQs

What is the  Professional Support and Well-being Service?

The Professional Support and Well-being Service (PSW) exists to help trainee doctors and dentists get back on track with their training progress. Support may include the dedicated time of Clinical or Non-Clinical Case Managers for 1:1 assessment and support, and, when necessary, access to expert external support. 

What is the role of a Case Manager?

Their role is to assess and manage doctors in training referred to the PSW, by carrying out an objective assessment, based on available information and their own findings. They identify what further action is required and access the relevant support. They then continue to support the doctor in training and monitor their progress, reviewing the situation until problems are resolved. A Case Manager will communicate with relevant parties and document their assessments and actions taken.

How do I identify a trainee requiring support?

Trainees requiring support may display the following behaviours;

The ‘Disappearing Act’: - not answering bleeps; disappearing between clinic and ward; lateness; frequent sick leave.

Low work rate: - slowness in doing procedures, clerking patients, dictating letters, making decisions; arriving early, leaving late and still not achieving a reasonable workload.

‘Ward Rage': - bursts of temper; shouting matches; real or imagined slights.

Rigidity: - poor tolerance of ambiguity; inability to compromise; difficulty prioritising; inappropriate ‘whistle blowing’.

‘Bypass Syndrome’: - junior colleagues or nurses find ways to avoid seeking the doctor’s opinion or help.

Career problems: - difficulty with exams; uncertainty about career choice; disillusionment with medicine.

Insight failure: - rejection of constructive criticism; defensiveness; counter-challenge.

Paice, E (2006)

What are the different levels of concern and how are they dealt with?

Level 1: Low Level Concerns - Trust/Programme to provide Local Support

Level 2: Intermediate level Concerns - Trust / Programme to work with HEE, EoE to provide local support with some input from the PSW. 

Level 3: High Level Concerns - HEE, EoE and the PSW to provide Support in conjunction with the Trust / Programme.

What form do PSW ‘level 3’ concerns generally take?

  • Serious untoward incidents

  • Serious and/or repetitive behaviours (health, conduct or capability)

  • Complaints from patients, relatives or healthcare professionals

  • Poor performance in the workplace clinically, managerially or inter-personally

  • No or limited insight into difficulties

  • High level risk to patients and others

  • Failure to engage in the educational process

  • Erratic behaviour or issues around bullying or harassment

How do I make a referral to the PSW?

To refer a trainee to the PSW, you must complete a Full Referral Framework. If this form is incomplete, it will be returned. 

What happens after I submit the referral forms?

Following submission of a referral form, you will receive an automatic confirmation of receipt.

If the referral is incomplete, this will be returned for correction.

Once we have received the completed referral, this will be triaged appropriately, and we will either;

  • email the trainee inviting them to meet with a member of the PSW team at Victoria House, Fulbourn
  • email the trainee inviting them to have a meeting, generally over the telephone with a Non-Clinical Case Manager
  • email the referrer requesting further information or offering advice and guidance for local management.

When should a referral be made to Occupational Health?

The Occupational Health service can advise on the impact of work on health and of health on work. It is important to take advice when a doctor’s health is considered to have the potential to impact the safe care of patients and, in order to help decide on the appropriateness and manner of a return to work after sickness absence. This support should be provided by the local OH department. However, where there are significant health concerns that might suggest a trainee is unable to complete the curriculum requirements, a referral to the PSW should be made for high level OH assessment. 

Would I ever have to consider informing the next LETB if a doctor in training who has had issues is moving on?

Yes. There is a professional obligation to inform the next LETB if a doctor in training has unresolved issues or ones that could re-emerge and might have an influence on their practice and/or training. This should be done with the doctor’s involvement and ideally also their consent. The most appropriate people to inform would be the DME and Dean.


Friday, 16 November, 2018
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Friday, 16 November, 2018