remote & rural education and training · goldfish bowl effect irregular supply of supporting...

Quality Education for a Healthier Scotland

Remote & Rural Education and Training

Ronald MacVicar & Bill McKerrow


A comment on Twitter 27th April 2014



“Wow! View from Glencoe village tonight as drove home to Skye from GB mountain running camp in L'boro”



“Wow! View from Glencoe village tonight as drove home to Skye from GB mountain running camp in L'boro”

“Odd thing here is there is a multi-consultant hospital 10 miles away and many rural GP practices -yet recruitment remains challenging. Mad!”


“NES Supporting Remote & Rural Healthcare”

• NES Board Paper August 2013 • 19 recommendations grouped in

• Promoting awareness and understanding (1 & 2) • Improving recruitment and retention (3 – 9) • Aligning education with workforce plans (10 – 14) • Educational leadership to support service redesign and

improvement (16 & 17) • Leadership of a national Technology Enabled Learning programme

for Scotland (18 & 19)


WHO Global recommendations

• Evidence for four sets of recommendations on increasing access to health workers in remote and rural areas through improved retention

• NES’s 19 recommendations cross referenced to these

• Educational recommendations (3,4, 5, 8, 14) • Regulatory recommendations (7, 10, 11, 12, 13) • Financial incentives recommendations (6) • Personal and professional support recommendations (1, 2, 9, 15,

16, 17, 18, 19)


Recruitment

• Start young (3)


Recruitment

• Start young (3) • Increase access (4)


Recruitment

• Start young (3) • Increase access (4) • Increase UG exposure (5)


Recruitment

• Start young (3) • Increase access (4) • Increase UG exposure (5) • Remove disincentives (6)


Recruitment

• Start young (3) • Increase access (4) • Increase UG exposure (5) • Remove disincentives (6) • Targeted recruitment (7)


Recruitment

• Start young (3) • Increase access (4) • Increase UG exposure (5) • Remove disincentives (6) • Targeted recruitment (7) • Market rural-track training (8)


Recruitment

• Start young (3) • Increase access (4) • Increase UG exposure (5) • Remove disincentives (6) • Targeted recruitment (7) • Market rural-track training (8) • Quality at distance mentoring & supervision (9)


Recruitment

• Start young (3) How? • Increase access (4) How? • Increase UG exposure (5) How? • Remove disincentives (6) How? • Targeted recruitment (7) How? • Market rural-track training (8) How? • Quality at distance mentoring & supervision (9) How?


Aligning Education with Workforce Plans

BILL MCKERROW ASSOCIATE POSTGRADUATE DEAN

CHAIR SCOTTISH SCHOOL FOR RURAL HEALTH & WELLBEING

STEERING GROUP


WORKFORCE PLANNING IN REMOTE & RURAL

RECRUITMENT! RECRUITMENT!! RECRUITMENT!!!


WORKFORCE PLANNING IN REMOTE & RURAL

And

RETENTION!!!!


THE ISSUES

Recruitment difficult per se to remote locations Professional Isolation Work intensity low Requirement to be available high Communication with fellow professionals difficult Skills maintenance Access to CME


SOME FURTHER ISSUES

Goldfish bowl effect Irregular supply of supporting staff Fragile rotas in RGHs High locum costs


SOME SOLUTIONS

Rural undergraduate placements Recruitment to medical school from RR&I locations Rural Track Training in GP GP Rural Fellowships Rural track peri-CCT posts in Surgery, Medicine and Anaesthetics Proleptic appointments to consultant posts Changes to roles and responsibilities for all staff Blended learning approach to CPD Improving communications – digital techology


YOUR THOUGHTS?


NES Actions & Recommendations

Recommendation 10. Target NES Knowledge Services Group expertise and resource in supporting evidence based “knowledge into Action” approaches to workforce redesign and education within rural hospital and rural primary care workforce redesign.

NES Target: An exemplar case of Knowledge into Action will be

established to highlight value within remote, rural and Island workforce redesign by March 2015.



Recommendation 11. Work with professional bodies to develop education that supports establishment of new remote, rural Island specific roles for Rural Nurse Practitioners.

NES Target: Develop a clear education, learning and knowledge

pathway that supports the needs of rural and Island nurse practitioners by March 2015.



Recommendation 12. Work with professional and regulatory bodies to develop education that supports establishment of new remote, rural Island specific roles for Generic (health and social care) Rural Support Worker.

NES Target: An agreed education pathway and resources will be

produced that support needs of new remote, rural and Island specific role of generic health & social care support worker by

March 2015.



Recommendation 13. Develop (and seek GMC approval for) curricula for the education and training of remote and rural medical practitioners.

NES Target: Agreement of curriculum by September 2014 and

approval by the GMC to be sought by January 2015.



Recommendation 14. RRHEAL to develop a proposal for a ‘Remote & Rural Education Passport’; a series of accredited remote and rural appropriate programmes which, as they are accrued, give appropriate qualification and also enhance individuals CV for rural practice.

NES Target: We will establish an evidence based proposal outlining

relevant content and format for a series of remote, rural and Island health education and learning units which when combined form a credible rural education passport.



Recommendation 15. Highlight rural community and RGH workforce and education needs within the NES Corporate Plan and Strategic Framework

NES Target: NES corporate plan and Strategic Framework clearly

state remote, rural and Island workforce and education needs.


NES STRATEGIC APPROACH

Where next?


EDUCATIONAL LEADERSHIP TO SUPPORT SERVICE REDESIGN & IMPROVEMENT

Recommendation 16. Establish and support a ‘Rural General Hospital workforce and education support/knowledge network’ in response to identified service and workforce needs to include a series of NES RGH Workforce and Education Network Events.

NES Target: 1.NES will establish a RGH workforce and education

network in response to identified needs by March 2015. NES Target: 2.NES will design and deliver three learning events for

RGH workforce by March 2015.


EDUCATIONAL LEADERSHIP TO SUPPORT SERVICE REDESIGN & IMPROVEMENT

Recommendation 17. Support the Scottish School of Rural Health & Wellbeing to deliver on an increased range of education, training and research programmes in response to priority workforce and education needs.

NES Target: Co produce 2 new education packages for R&R workers.

Recruitment of 3 Higher Degree students working on new R&R research projects.


Scottish School for Rural Health & Wellbeing

“A national school of excellence for advancing knowledge, skills and support to promote excellence in rural health education, training, research and innovation”


SCOTTISH SCHOOL for RURAL HEALTH & WELLBEING

UNIVERSITIES

HEALTH BOARDS

NHS Education

for Scotland

INDUSTRY

COUNCILS

Professional

Groups

FUNDING BODIES

Structured Alliance

Steering Group

Education and

Training Working Group

Research and

Commercialisation Working Group



EDUCATION & TRAINING REMOTE & RURAL HEALTHCARE EDUCATIONAL ALLIANCE (RRHEAL)

Specific education packages for RR&I workers and communities Learning from other remote areas – Northern Peripheries Programme “Rural Passport” Concept “Why Rural” Initiative



RESEARCH & COMMERCIALISATION PhD Proposals from University Partners Research collaborations with the Digital Health Institute Evaluative research on Healthcare provision in R&R communities Evaluation of Integration of Health & Social Care provision



INSTITUTE OF REMOTE HEALTHCARE Primary interests – REMOTE Healthcare Offshore Desert Arctic & Antarctic High Altitude to Underwater


INSTITUTE OF REMOTE HEALTHCARE

EDUCATION No set standards for remote healthcare providers Potential for education and accreditation of remote healthcare workers

RESEARCH Healthcare challenges in remote areas Infectious diseases Diabetes Trauma



JOINED UP APPROACH Building on a collaborative ethos Combining Skills, Knowledge and Expertise Addressing issues relevant to all aspects of R&R Care POTENTIAL FOR KNOWLEDGE TRANSFER – R&R to Urban CHANGING THE PARADIGM – from Healthcare Delivery to Supporting

Health & Wellbeing


BETTER TOGETHER! COLLABORATION IS THE KEY!!

remote & rural education and training · goldfish bowl effect irregular supply of supporting...

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