How the obstetrics and gynaecology department at the Royal Bolton Hospital used the national training results to improve training

The obstetrics and gynaecology department at the Royal Bolton Hospital (RBH) was placed into our enhanced monitoring process in 2019. This decision was made with HEE Northwest following poor national training survey results in 2018. National training survey indicators that received below average scores included clinical supervision, rota design, handovers, and provision of adequate experience. The department also received several national training survey free text comments that reported a lack of supervision and overly intense workloads. 

What action was taken?

HEE Northwest visited the department and held discussions with trainers and trainees, helping to understand the factors which were contributing to the poor survey results. Trainees reported that there was a lack of support and supervision, and that they felt their learning wasn’t prioritised.
The department implemented improvements at the site to address trainees’ concerns. We then monitored these improvements through visits to the department and by analysing the free text comments in the national training survey. It was evident that the obstetrics and gynaecology department had made a significant effort to improve the situation and had worked with the trainees to develop an action plan of dynamic changes. 

Changes include:

  • trainees are now involved in updating induction materials and ensure that they contain all the necessary information
  • trainees now input into the rota design and can request protected time to gain theatre experience and attend teaching
  • increasing the number of consultants now work in the department to address short staffing at a senior level. This has helped to increase on-site consultant presence from 98 hours to 138 hours, providing supervision and support to trainees.
  • splitting emergency cover for working hours for obstetrics and gynaecology, which has improved supervision and increased consultants’ input into patient care
  • the creation of a core consultant group dedicated to GP Trainee clinical supervision
  • consultants took part in leadership coaching and are more proactive in identifying learning opportunities 

What was the outcome?

Staff in the department provided assurance these improvements were sustainable and outlined plans to further resolve issues with support and handovers. These improvements were also evidenced in the 2022 national training survey, and the department was removed from enhanced monitoring later that year.