The Medical Response

The Medical Response

The response of the NES Medical Directorate to the COVID-19 pandemic was swift and all -encompassing. All educational activity was paused and both trainees and NES staff were redeployed. We had to engage in a step-change in communications to ensure that all stakeholders were kept informed during a period of rapid and frequent change. We updated our website pages on a daily basis, added a comprehensive list of FAQs, conducted a series of webinars with different trainee and trainer groups and introduced a very busy COVID-19 e-mail enquiry form and portal.

We engaged in and supported the production of new educational material to support clinicians working with COVID-19 patients, supported shielding staff and worked very closely with colleagues in the other UK Statutory Education Bodies and others to produce new guidelines for ARCPs, national recruitment and examinations.

During the initial covid pandemic phase, members from the Scottish Quality Safety Fellowship created resources on stress, resilience and having difficult conversations, these are all available on the QI Zone.

Relatively early in the lockdown period, a small group of the Medical Directorate Team was charged with starting to look at how we might go about reversing many of the changes that had to be made. A Business Recovery Steering Group was established involving all five workstreams in the Directorate. Each workstream in turn established a small Business Recovery Working Group to establish what needed to be done to get us back to the new ‘business as usual’ and when.

Three phases of recovery were identified:

• Phase 1 – Mission Critical – what needed to be done to allow us to restart normal activity at the beginning of August 2020?
• Phase 2 – Recovery – what needed to be done to remediate changes from August 2020 and for the following 12 months?
• Phase 3 - Development – What could be done to encourage different, more efficient, more effective and more financially responsible ways of working in the light of the COVID-19 experience, thereby defining a new BAU model in the medium to longer term.

Phases 1 and 2 required us to identify what activity had been paused or amended and when it needed to be restarted. We had to identify critical actions and sequencing, resources, staffing and manpower, finances, timescales, individual ownership, key communications and risk management. We had to determine what work would have to be done with UK partner organisations and other stakeholders.

Phase 3 requires us to identify what new ways of working worked well and which didn’t. We also had to consider what reforms in educational delivery would be required and how could NES drive such reforms, including identifying new models of working across health and social care. We have to determine what new digital tools might be required to deliver our core work and what new digital approaches and platforms might be needed to deliver education and assessment remotely.

Progress in addressing these issues has been considerable to date.

A number of key activities have now safely resumed including annual progression assessments for trainees, remote professional development education and elements of the Scotland Deanery Quality Management function.

Our Quality Improvement Team have been working with and supporting the NES Technology Enabled Learning group network and developing and delivering virtual teaching sessions about Microsoft Teams and online facilitation. This session and other useful facilitation resources are also available on the QI Zone as two 30-45 minute videos that we hope will be of assistance to our colleagues at NES and across NHS Scotland.

In the process of undertaking this work, we quickly identified a number of cross-cutting themes which impacted on many of the workstreams. These fell in to three broad categories:

• Communications
• Staff wellbeing
• Digital

We have reviewed our approach to communications and aim to improve how we communicate to trainees, Training Programme Directors and Associate PG Deans. We also plan to review and update the Scotland Deanery website layout and content.

In terms of staff wellbeing we need to develop a plan to ensure and maintain NES staff and trainee wellbeing; to ensure ongoing NES staff training and development and work to ensure catch-up on lost NES staff and trainee training opportunities.

Finally, we need to make some urgent and substantial digital developments to ensure that we can continue to deliver high quality education and processes to our stakeholders. These fall into five broad categories:

• Turas development
• E-learning developments
• Other product developments
• Digital platform support and development
• Miscellaneous

We are working with the NES Digital Team to prioritise which developments are pressing and to explore how these various requirements can be delivered.

In summary, business recovery has been challenging for the Medical Directorate but the structured approach we have taken has clearly helped with the good progress we have achieved to date.

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