How the national training survey helped to improve foundation psychiatry trainees’ experience at Rotherham, Doncaster and South Humber NHS Foundation Trust
The national training survey results for 2021 and 2022 showed that the quality of foundation psychiatry training at Rotherham, Doncaster and South Humber Foundation Trust (RDASH) had deteriorated.
Foundation year (FY) trainees reported issues with obtaining adequate experience in their post, meeting their curriculum requirements and teamwork, with these areas receiving below average scores.
Areas that had previously received above average scores, such as clinical supervision and supportive environments, also dropped. Similar areas of concern were also flagged in Health Education England’s National Education and Training Survey (NETS).
The department discussed these results with the FY trainees, to gain a more complete understanding of the issues and to gather their views on potential improvements. They highlighted:
- the lack of variety in training was affecting their experiences, with limited exposure to specific areas such as community and child and adolescent psychiatry
- most of their time was spent completing routine non-medical tasks, which had little benefit for their learning
- trainees felt unable to request advice directly from covering senior colleagues
- FY trainees were unaware of the escalation arrangements and there was a lack of clarity on how to report concerns
- a consultant vacancy in the department was impacting the support available to trainees.
What action was taken?
The department collaborated with HEE Yorkshire and Humber and the trust’s management team to improve the support and supervision available for the new intake of trainees. As a result, several changes to staffing were made. This included:
- increasing the consultant presence and appointing a senior nurse to a clinical role so there is better supervision and support
- a specialty doctor was appointed to support with routine issues and to improve the variation of doctors at different training levels working in the department
- a robust rota for consultant cover was developed, improving access to support for trainees.
The trust’s management also increased its contact with FY trainees so they could ensure they were receiving varied experience across areas of psychiatry. Inductions are now also more targeted so that trainees are aware of the escalation pathways and supervision requirements.
What was the outcome?
The department responded effectively to the feedback and identified ways they could better support FY trainees. They implemented these changes within four months of receiving the feedback and ran an internal survey to capture progress. This found:
- trainees thought that supervision is now very good and there are more opportunities to discuss clinical work with consultants
- placements are providing an improved overview of different areas of psychiatry
- trainees’ experience working in the department has improved and they would recommend the post to their peers.
The 2023 national training survey results will enable the department to assess the impact of the interventions, highlighting areas that are working well and where additional changes are required. This insight will help it to continue building upon improvements and maintain high quality training.
