Professionalism and Excellence in Scottish Medicine - A Progress Report

Chapter 4

Next Steps

If further progress is to be made in the pursuit of Professionalism and Excellence in Scottish Medicine, a concerted programme of activity will be required on a number of fronts. The following recommendations are therefore directed at the bodies with the power to effect further change in this area, with the important overall aim of improving the patent experience and the overall quality of patient care:

• Scottish Government to:

Promulgate and facilitate implementation of this report, in particular through SMASAC, the Specialty Advisors and the Professionalism and Excellence Group.

• Professionalism and Excellence Group to:

i. Support the Scottish Academy and work with the GMC to ensure explicit recognition of professionalism in all postgraduate curricula.
ii. Work with Scottish Government Health Workforce colleagues to ensure that there is explicit recognition of professionalism in the Workforce 20:20 Vision.
iii. Oversee implementation of all recommendations arising from this report through the development of a workplan.

• Scottish Academy, through member Colleges and Faculties to:

i. Develop a collaborative work programme on promoting professionalism through, rotations, working patterns, and rota design with Scottish Government Health Workforce colleagues.
ii. Promote recognition of Quality Improvement Training in postgraduate training curricula.
iii. Work to encourage a supportive positive culture amongst senior doctors with respect to juniors.
iv. Promote professional behaviour according to principles of the 'Berwick Report' www.gov.uk/government/publications/berwick-review-into-patient-safety.
v. Support and co-host Scottish Clinical Leadership Fellows.

• Medical Schools to:

Ensure that professionalism is a key feature of undergraduate training programmes

• NES to:

i. Review the current 'landscape' of medical leadership and QI opportunities on offer, with the aim of making this more comprehensible and accessible, in particular for trainee doctors.
ii. In conjunction with NHS Boards, build on current paired learning initiatives, to scale these up to involve all trainees, and also offer these opportunities to the consultant workforce. Consideration should be given to pooling resources with Healthcare Improvement Scotland to increase traction in this area.
iii. Continue to support the joint NES/RCGP project on developing leadership in Primary Care beyond 2014.

• NHS Board Chairs to:

Promulgate and facilitate implementation of this report and, in particular, ensure that non-executive directors understand the importance of professionalism and excellence in medicine in relation to the planning and delivery of NHS services, clinical leadership, and education and training.

• NHS Board Chief Executives to:

i. Maximise the contribution of clinicians to quality improvement and service redesign by ensuring that all doctors who have participated in management/leadership training are identified as a resource to their Board.
ii. In conjunction with Medical Directors, facilitate paired learning for clinicians and managers.

• NHS Board Medical Directors to:

i. Provide opportunities for trainees and career grade doctors to undertake leadership roles within local systems with a particular emphasis on paired learning.
ii. Offer placements for Scottish Clinical Leadership Fellows.
iii. Contribute to leadership training locally and nationally.
iv. Ensure clinicians are directly involved in service improvement and are offered appropriate training opportunities (for example QI methodology) to maximise the effectiveness of their contribution.
v. In conjunction with Board Chief Executives and senior medical colleagues, act on the views expressed by trainees and DMEs), particularly in relation to valuing the trainees' contribution to service delivery.

• Directors of Medical Education to:

Facilitate and support implementation of this report, particularly in relation to recommendations relevant to trainees.

• GMC to:

i. Take a lead on the work to develop generic capabilities in line with their role in postgraduate curricula.
ii. Continue to deliver events on medical professionalism at all Scottish Medical Schools to 1^st, 3^rd and 5^th year students.
iii. Host a Clinical Leadership Fellow in its Edinburgh office in 2014.
iv. Continue to take forward the process of agreeing a Memorandum of Understanding with HIS which would support closer working to share concerns where professional standards may be falling short of expectations, with view to completing it in 2014.