MY BLACK CAT’S HOMEWORK
They are starting to consider “The Role of the Doctor”
And they have scrapped the nasty yellow and blue boxes from last year.
Do you think they have, My Black Cat?
First look at this proposed training structure. It is still a bit confusing and at the moment raises more questions than it gives answers.
POSSIBLE POST-GRADUATE TRAINING STRUCTURE
Now, once you have studied that, download this PDF below.
Study it carefully.
Very carefully.
And once you have done that, scroll down and review the content of two posts we put up last year when we were of the opinion that ALL doctors should be offered training posts.
Tell me whether you think things are moving towards this slowly.
And tell me how the new structure fits in with the skills escalator.
And whether it sets the scene for LEVEL 8 medical consultant practitioners who become inter-twingled with other shady consultant practitioners who have come up the skills escalator.
And tell me whether you think the “expert” consultants will sit at Level 9 of the Skills Escalator?
Do you think they will be real experts in their field?
How many will there be and how do they get there?
Consider the vulnerability of this structure at consultant level.
Consider how easy it would be for Level 9 consultants to be selected for their “leadership” qualities, rather than clinical expertise.
LEADERSHIP is becoming a buzz word.
So, consider what this government might mean by “leadership”
Will you do that, My Black Cat.
Because I’m having a lull for a full week while I try to digest the full implications of the Lords opinions on the BAPIO judgement.
Witch Doctors are not good at reading legal documents.
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Here are the two old posts I want you to read while I’m gone, My Black Cat…….
(The Original MMC diagram has been removed from the link.)
A NEW KIND OF MMC 25 April 2007
LOOK AT HIM. HE’S TAKING A BREATHER BUT STILL WORKING. WHAT’S WRONG WITH THAT?
Interactive version of the MMC Master Plan
Yes, get rid of the scary Yellow Box and the two threatening Pale Blue Boxes too!
They need to be buried for good.
And stop meddling with little fistfuls of feeble competencies.
Many competencies are essential in the development of an Independent Medical Practitioner. But so are attributes.
Collecting a smattering of competences is just a smoke screen that will allow Great Uncle MMC to pretend “Yellow Box Doctors” are “Independent Medical Practitioners.”
Just a smoke screen.
Just a way of fooling everyone that the NHS is not crumbling.
WHAT IS THE ANSWER?
The answer is a single spine training structure with the yellow and pale blue boxes removed and dumped. Permanently. Instead there needs to be, at certain stages, many “taking a breathing space” places for those that need it, when they need it.
Think about it. With a 70% female workforce many Breathing Spaces will be needed. It is better they are planned than happen by default. A significant number of male doctors may choose to get their breath back too.
There are many reasons for occupying a Breathing Space. Pregnancy, children, elderly relatives, physical and mental illness, quality of life issues, quality study time, research, or just a welcome break from the bureaucracy that is the NHS today.
But taking a breather does not mean taking a break. It does not mean not working. It is not a holiday, nor leave of absence. It does not mean leaving and feeling threatened that there is no way back into the system. It does not mean being a second class doctor. It does mean, for some, a slower rate of progression. And a few may, for their own reasons, take a permanent breather, and may never reach their original goal. The choice of the doctor, not the establishment. There is no leaving so there is no problem returning. The door is always open because it was never closed.
This is possible, but as well as altruism and vision, it will need meticulous attention to detail. It is a complex system. It requires many more training posts, many of them moving in and out of part-time hours in time with the Breathing Spaces of any individual. It will need to be personalised and will take a lot of planning locally. However, it is possible and indeed necessary.
And it must be piloted.
Nevertheless, Breathing Spaces are the only way to ensure that the potential of a 70% female workforce will be realised. It is the only way that will give the necessary flexibility dictated by a 70% female workforce.
And a common training spine is the only route that all junior doctors should take to become Independent Medical Practitioners. Any other route has the potential of compromising patient safety.
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COMPETENT CHRISTMAS TREES – 8 August 2007.
CHRISTMAS TREES WITH A MESSAGE (2)
Read this.
“Competency based workforce planning
DH and the Workforce Review Team (WRT) that leads workforce planning across the health care workforce, are now working to develop the ‘Christmas tree’ model as a generic workforce-modelling tool. This will allow national and local workforce planning by individual, local organisations, to assess skills needs and future workforce requirements across levels rather than professions. In the long run this will support the development of competency based workforce planning across the whole healthcare workforce: determining the skills and competencies needed to deliver services and defining these by care group and pathways, rather than specific healthcare professions.
This X-tree modelling approach will enable the roles of the doctors of the future to be captured as part of the multi-disciplinary teams serving patients, and planning the medical workforce could then focus on those roles that only doctors can deliver.“
And below is The Witch Doctor’s interpretation of this:
It is a fact that “Christmas Tree” modelling tools are now being rolled out across the UK.
To the hospital where you work.
Soon the hospital “Talent Spotters” will appear to document the competencies you have already acquired.
It will be slow at first but it will gather momentum.
The Professions are dwindling.
Those remaining professionals will construct protocols, advise, interview, test, examine.
And, take the blame.
As for the medical profession…….
They have to be “Captured” in order to serve.
Captured into the 9 tier Practitioner system between levels 5 to 9.
Many “doctoring” tasks will be removed, so doctors will do what only doctors can do……
Competencies, protocols and clipboards will do everything else. They will become the “talents” of tomorrows health care.
Is this why some groups say we are producing too many doctors?
Probably.
Why then, is Sir Liam Donaldson a voice in the wilderness consistently saying we need more doctors?
Who knows!
Why does The Witch Doctor/CMO Pretender also say we need more doctors?
Because this far-fetched paper exercise is ill-conceived. Its conception is as flawed as a silly old bat without wings. It is more flawed than MTAS. The Witch Doctor can understand why it was conceived. There is a major demographic problem. The stragegic thinking beind this proposed solution to the problem is clever, and on the drawing board is well thought out. It will serve politicians well in the short term. It will make an interesting spreadsheet. Excel diagrams and Powerpoint presentations will love it. However, ultimately, patients will not. Staff will not. This huge undertaking, this elephant in the room, is an unkown quantity, is far too complex, the capability is not present within the NHS to see it through, and demoralised staff will not buy into it. Staff and patients will swim around in a shark infested soup of competencies but the system as it stands will not deliver. Futhermore, it ignores some basic fundamentals of healthcare.
It simply will not work.
In not working it will waste vast amounts of public money.
That’s why we need, and will continue to need more doctors.
That’s why every single junior doctor in this country should be placed within the system so that they are trained to be the very best they can be.
Placed within the system now.
In training posts.
All of them.
Training posts with breathing spaces if necessary.
Training posts which allow these doctors to develop into more than competencies.
Much, much more.
Competencies too. Of course. As it has ever been. Competencies that do not stand alone, but are firmly embedded in the judgement that comes with the experience and excellence earned within the discipline of a sound and learned profession.
A learned profession that this government, and a few slumbering but influential members of the medical profession itself, will soon discard.
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LINK TO UK MISSING KIDS WEBSITE
LINK TO MISSING PERSONS WEBSITE
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