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Centre for Remediation Support and Training

CRST


INSTITUTE OF MEDICINE

Centre for Remediation Support and Training

Objectives:
- Improving Health and Wellbeing – Making the NHS the Best Place to Work
- A comprehensive approach to mentorship and pastoral care. Supporting doctors with difficulty and those with enhanced learning needs

The NHS Peoples Plan aims to make NHS the best place to work and supporting the workforce is a key part of the Peoples Plan. COVID-19 has had a huge impact not only on communities but the healthcare workforce. NHS staff have continued to deliver exceptional service but the strain on their physical and mental healthcare beginning to appear. This has further highlighted the need to provide a structured mechanism of support to healthcare staff and the Centre aims to provide mentorship and advisory services.

The General Medical Council, through its Fitness to Practice procedures, may offer advice or apply sanctions to doctors where standards of good medical practice are not adhered to. The Medical Practitioners Tribunal Service (MPTS) again may enforce sanctions, including warnings or suspension, in case of Fitness to Practice procedures. The Royal Colleges will also provide a detailed action plan following a comprehensive assessment. 

In many cases, the issues around poor performance relate both to clinical practice and professionalism including teamwork, communication, interpersonal skills and leadership. 

There is, at present, no formal mechanism for addressing these concerns and Trusts will request neighbouring Trusts or other centres to provide the retraining and address issues around professionalism. There is, therefore, a total lack and a huge gap, in any provision for following up the implementation and delivery of any retraining needs identified and ensuring a safe return to clinical practice. The number of complaints received by the NHS has increased by 5% in the last year. A survey of BMA members showed that around 17% of doctors with current or recent complaints reported anxiety or depression. Research also found that after a complaint, doctors may adopt a more defensive approach to clinical practice.

Many have linked complaints and the complaints process and mental illness, such that those who receive a complaint are much more likely to develop anxiety, depression, suicidal thoughts and sadly, completed suicides. Sir Norman Williams, in his review of the Gross Negligence Manslaughter report, recognised the impact and intense pressure of such scrutiny due to a complaint or any health concern investigation and stressed the importance of regulators in health care needed to be alert to the impact that these processes have on the registrants.

One in three of the NHS workforce has felt unwell due to work-related stress. The rate of depression among training doctors is around 30%. Doctors’ psychological distress impacts patient care and the healthcare system as a whole.

Delivering Professional Excellence and Support

CRST will focus on embedding a culture of dignity and compassion to promote and enhance the physical and mental well-being of staff through the faculty of CESOP and the Centre for Remediation and through working in partnership with academic institutions, universities, regulatory bodies, leadership and professional organisations.

CRST addresses both clinical and professional issues by providing a suite of bespoke interventions for the clinician. These will range from:

 

  • OVERSEEING AND ARRANGING CLINICAL PLACEMENTS IN NHS HOSPITALS IN THE NORTHWEST AND PROVIDING GUIDANCE, MENTORING, SUPPORT AND TRAINING ON PROFESSIONALISM AND RESILIENCE
  • ENHANCED APPRAISAL & AND RETURN TO WORK PLAN
  • REVIEW OF LEARNING NEEDS AND WORK READINESS
  • WELL-BEING ASSESSMENT LEADERSHIP AND COMMUNICATION
  • TEAM BUILDING AND SUPPORTING TEAMS

 

  • WELCOME AND INDUCTION FOR HEALTH PROFESSIONALS NEW TO THE UK GUIDANCE AND SUPPORT WITH ENTRY TO THE SPECIALIST REGISTER
  • MENTORING CENTERS ON DEVELOPING AND EMPOWERING MENTEES TO REALISE AND ACHIEVE THEIR OBJECTIVES AND ASPIRATIONS. REMEDIAL ACTION AND SUPPORT AND PASTORAL CARE WILL HELP INTERNATIONAL MEDICAL GRADUATES (IMG’S) TO ADJUST TO THEIR LOCAL HOSPITAL AND COMMUNITIES
Remediation


Due to the inconsistencies in the process of individual Trusts, doctors in difficulty don’t have fair and equitable access to remediation. Providing suitable remediation packages can be challenging, often difficult, and very expensive (NHS Confederation 2011).

A key recommendation from the Department of Health’s remediation steering group 2009 states that a single organisation is required to advise and, when necessary, to coordinate the remediation process and case management to improve consistency across the service.

 

Vulnerability, BME, SAS, Sessional and Locum doctors


CRST recognises the increased vulnerability of certain groups of doctors, especially those from a BME background, sessional and SAS doctors, locum and locum peripatetic doctors.  The Centre will embed and deliver on the principles of equality, fairness and inclusion in all aspects of its work and delivery.

 

Mentorship


The benefits of mentoring doctors are well recognised (NHS Mentoring Framework 2009, GMC Modernising Medical Careers survey 2011, NHS Guide to Mentoring
2014) and mentorship has been identified as beneficial for doctors internationally and across specialities. 

The process of mentoring can improve an individual’s personal and professional development and motivate and encourage them to develop the skills needed to achieve their goals, thus having an impact on ultimately improving their ability to deliver an effective patient-centred service.

The CESOP and Centre for Remediation scheme will be widely available for all doctors whatever their grade will be available for at least 6-9 months. It will consist of a structured programme that can be tailored to the individual doctors’ needs allowing them to maximise their potential and achieve their own predefined goals.

For more information about the CRST, please see: 

Meet the Team

Sanjay Arya

Professor Sanjay Arya

Consultant Cardiologist & Medical Director
Wrightington, Wigan & Leigh NHS Foundation Trust

CRST Case Studies

To understand how we have supported healthcare providers back into safe practice, please view our case studies below: