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POSITION SUMMARY OF ENDOSCOPY TRAINING IN WALES

 

Background

 

In 2006 Welsh Assembly Government supported the development of the Welsh Endoscopy Training Network (WETN). Central funding was allocated to set up regional training centres with backfill arrangements for a Clinical Training Lead, Nurse Training Lead and Local Facilitators. In collaboration with other UK Regional Training Centres a comprehensive programme of JAG-approved training courses has been developed. Central funding came to an end in March 2009. Since this time courses continue to be administered through WIMAT (Postgraduate Deanery).

 

Current progress

  • Course programme provides training opportunities on 1) mandatory Basic Skills Courses, 2) entry level Therapeutic Skills training and 3) Advanced Endoscopy training courses (for SpRs and Consultants).
  • JAG QA Training Committee have published updated recommendations on the requirements of Regional Training Centres (Mar 2010). Though the 'Celtic clause' acknowledges that the JAG visit process is lagging behind that in England, WETN training centres will need to meet expected Global Rating Score (GRS) standards and pass a JAG visit.to maintain JAG approved status
  • Discussion is ongoing with the Postgraduate Deanery and LHBs as to how the previously backfilled Training Leads posts can be adequately recognised and 'badged' as appropriate CPD activity. Review of trainer time allocations, use of individual training facilities and training course time and faculty efficiency has been performed.
  • The WETN provides a valuable resource for advanced endoscopists and trainers, running Training the Trainer, Trainer Update and Advanced Endoscopy symposia for CPD. WIMAT will support an additional Bowel Cancer Screening Training Day in November.
  • In March 2010, the Training GRS Toolkit was launched, to promote progress in Endoscopy Units across Wales in the Training Domain of the GRS.  The web-based JAG e-portfolio has also been rolled out across Wales in order to facilitate assessment, record keeping and feedback in endoscopy training.

 

Ongoing pressures / challenges

Ø      Financial constraints and service pressures on LHBs are creating an environment where recruitment of training faculty (and their release from service activity) is becoming more difficult, even though this is recognised as valid CPD activity

Ø      Ongoing faculty development opportunities will be vital both to support the need for trained faculty on courses and meet the requirements of the Training Domain of the GRS.

Ø      Efforts are ongoing to 'square the circle' and improve co-ordination of available training opportunities across Wales (local Training Leads and Training Centres) and matching these to needs identified at ARCPs (STCs). An inaugural meeting of the All Wales, mutli-disciplinary Endoscopy QA Group has been set for October 2010.

Ø      A considerable workload exists in maintaining the QA requirements on JAG-approved courses and a system of continuous improvement of models and course materials. This is currently met only on a 'voluntary' basis by committed training leads.  LHBs need to recognise the additional time committed to these national activities in job planning.

Ø      Industrial partners are cutting back on 'educational' budgets. Future support for the Advanced Endoscopy Symposia is likely to be scaled down. Courses are heavily reliant on the donation of 'recently out of date' stock from manufacturers.

Ø      Advances in animal model development have provided high quality training opportunities but will require additional technical support to harness their full potential.

Ø      The need for an improved infrastructure for endoscopic sub-speciality training (ERCP, EUS, advanced mucosal resection techniques) has been highlighted

LHBs need to accept that the delivery of endoscopy training lists (which are scaled down to fewer procedures to meet needs of trainees) should be recognised as Direct Clinical Care sessions in job planning.