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How Educators can Better support Return to Practice

At any given time, approximately 5,000 (10%) of postgraduate doctors are taking approved time out of training. Time out is something to be expected since it can take up to 15 years to complete, but what happens to those who want to make a return to practice? And how can we encourage more to do so?
According to the AoMRC most trainees do take a break from training. This includes the 45% of trainees that take 7 to 11 months for parental leave and 25% that take more than 12 months. But research by Health Education England (HEE) and others finds that those returning to practice find it challenging, and therefore the NHS risks losing knowledge and expertise that could be improving patient care.

A return to practice is daunting
In November 2017, Health Education England undertook research into the consequences of time out. The study found that time out of practice can impact on a clinician’s competence and technical skills, as well as their confidence:

  • Confidence and self-perception of capability are upmost concerns of returners, followed by the availability of pastoral support such as mentorship.
  • A lack of confidence in clinical knowledge is often compounded by a lack of familiarity with the workplace.
  • According to the AoMRC, 90% of doctors have professional or personal concerns about a return to practice.
  • Reduced clinical knowledge and practical skills are a concern for 66% and significant clinical developments during absence are a concern for 49%.

How is the NHS supporting returners?
It’s clear from our work that there is great variation between trusts. Some are putting in place large formal programmes while others are currently doing very little.
This is consistent with HEE research that found that while there are “pockets of really excellent work in some specialties and localities, we heard that the current support for trainee returners is inconsistent across England and, in some places, lacking entirely.”
Inconsistency is an issue. Trainees in any trust, in any speciality should have access to some form of supported return. But, one size doesn’t fit all. Needs vary between speciality, amount of time out reason for time out, the needs of the individual and many other variables. The best way to tackle this is by supporting the educators that will help those returning.
I spoke to a doctor this week who gave me an insight into some of the things that matter to him. Returning to practice as a Senior Registrar in Psychiatry having been working as a locum, he told me he found his return ‘daunting’. Not only the assessments and competence checks but the lack of a peer he could go to for help. “How do shift patterns work now? Where is x-ray? How do I organise to get one done?”
This is a great illustration of how individual needs differ and therefore how educators need to be able to provide varied support.

How we can help
Miad Healthcare is launching a new one-day workshop programme designed to enable clinical and educational supervisors to better support trainees who return after a break.
[Return to Practice – A Programme for Clinical and Educational Supervisors] is an opportunity for educators to share experiences and understand the needs of those returning to practice. The workshop helps participants:

  • Develop their own self-awareness through a psychometric assessment
  • Explore how to improve trainee’s emotional resilience
  • Handle courageous conversations with trainees requiring additional support
  • Develop mentoring and coaching skills and practise giving feedback

Creating better outcomes for doctors and patients
Enhancing Junior Doctors’ Working Lives is a major commitment from the NHS. Actively listening to trainee voices and responding to their concerns and helping to support culture change that will achieve a better work/life balance, will create better longer-term benefits for all. If we can encourage and support more trainees in a return to practice, there will be positive outcomes for the NHS and for patients.
Huge demands are being made on the NHS. We’re asking more from doctors who are working long hours in multi-disciplinary teams while still expecting them to keep supervision and patient safety paramount. It’s therefore critical to make sure they have the support they need; especially when they’re at a personal crossroads – returning to practice.

For more information on Miad Healthcare’s one-day workshop please contact us.

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What Our Clients Say...

  • Ruth Frost, Provider Development Lead/Advisor, Health London Partnerships, NHS England. - Miad were a pleasure to work with, engaging, perceptive and flexible to the changing needs as the programme rolled out. They engaged well with the wide range of General Practice
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