UK Shape of Training steering group: report annexes

Annex 3: Principles adopted by the UKSTSG

Principles guiding the Implementation of the Shape of Training Review

Context

Each of the UK's 4 nations has committed to working collaboratively in developing implementation actions arising from the Shape of Training review. In seeking to achieve a consensus position on mutually recognised priorities for change, it has been agreed that implementation activities arising from the Shape of Training review must take into account national strategies, policies and structures. While each UK nation may express, communicate and direct their workforce aims and priorities in different ways, it is broadly recognised that there exist some shared overarching principles that helpfully guide the direction of policy in each nation, as well as specific principles relating to how to implement aspects arising from the Shape of Training review .

The UK Implementation Steering Group has therefore agreed that the following broad and specific principles will guide and inform the development of policy for the implementation of the recommendations contained within the Shape of Training Review. These are set out below.

Broad Principles

Person-centred:

• patients to have a stronger voice in shaping the way public services are delivered
• patients cared for with dignity, respect, compassion, openness and honesty

Services:

• services must be better integrated, safe and effective, and informed by best practice and new innovations and technologies
• not change for change's sake, but transformed to deliver better, higher quality outcomes for everybody needing care or support to live well and independently
• models of care to be routinely tailored to individuals' needs in which success is measured by improved patient outcomes rather than by whether processes and systems have been followed
• Ensuring we deliver the right care, in the right places, at the right time

Workforce:

• work in a healthy organisational culture which engages and empowers individuals, in the design and delivery of services, and which values feedback
• staff treat each other with respect and uphold codes of conduct and behaviour
• learning and development systems ensure individuals have the right skills and competencies to work safely and effectively, within multi-disciplinary teams, and is focussed on delivering high quality care and improved health outcomes
• where appropriate, skills and competencies are formally recognised and quality assured

Resources:

• proposals for change must be supported by a cost benefit analysis, assessing proportionality and encompass redistributive considerations

The objectives of Medical education and training in the UK, and the specific principles that will inform consideration of change are as follows:

• to train doctors to deliver safe, high quality and patient-centred clinical care
• the outcomes of training must provide transparency for patients, the public and the service about the levels of capability doctors have attained
• to instil in doctors a sense of professionalism and compassion
• to train doctors to meet the anticipated needs of patients and the service including the development of doctor who can deliver more broad-based care
• to ensure that medical training is flexible enough to be able to adapt to the changing needs of the service, patients and scientific innovation. This will include but not be limited to the recognition of previous learning, education and training should be based on the demonstration of capabilities and not simply upon time. Although experience is an important element of training it should be recognised that the demonstration of competencies and experience are distinct entities
• to embed and promote a career long culture of continuous professional development
• be subject to robust governance and quality assurance arrangements
• to deliver these objectives with the minimum structural change and service disruption
• to be subject to a cost benefit analysis and to take account of affordability