DRAFT SuppoRTT Guidance

This is a draft page. For the current Supported Return to Training Guidance, please see: Process, Guidance and Forms

Other pages in this section:

Contents

Document Status
Introduction
Overview of the SuppoRTT Process
- Absence Planning Meeting
- During Absence
- Initial Return Meeting
- Complex Returns
- Supernumerary Period
- Enhanced Supervision
- Review Meeting
Annual Review of Competence Progression (ARCP)
CPD Funding Guidance

Document Status

This is a controlled document. Whilst this document may be printed, the electronic version posted on the internet, this is the controlled copy. Any printed copies of this document are not controlled. As a controlled document, this document should not be saved onto local or network drives but should always be accessed from the NHSE Yorkshire and the Humber Deanery website.

Introduction

NHS England has developed the Supported Return to Training (SuppoRTT) programme to support resident doctors returning after a prolonged period out of training. This includes absences such as parental leave, sickness and health reasons, and Out of Programme (OOP) opportunities. The SuppoRTT programme aims to enhance the return to work and training experience to ensure that resident doctors can safely and confidently return to clinical practice and training. In this way SuppoRTT also aims to help maintain high quality and safe patient care.

This guidance outlines the Supported Return to Training process and activities within NHSE Yorkshire and the Humber Deanery. The guidance should be applied flexibly taking into account the resident doctor's individual circumstances including the reason for their absence, the length of the absence, their specialty and stage of training. Any phased return or training plans recommended by Occupational Health or Human Resources (HR) should take precedence. This guidance can be used in parallel with any phased return plans.

It is recommended that the principles outlined within this guidance are adopted by all Schools and Specialities for all PGDiTs (Foundation to Higher Speciality).

Please note, for the sake of brevity, the term ‘PGDiT’ within this document is used to refer to postgraduate Doctors, Dentists and Public Health Registrars in training.

Eligibility

Resident doctors are eligible for Supported Return to Training if they are expected to be or have been out of training for three months or more. Resident doctors returning from an absence of three months or more may be entitled to a supernumerary period and or enhanced supervised period. Resident doctors wishing to access the supernumerary period and or enhanced supervision period must refer to this guidance and complete the relevant forms.

Resident doctors who are absent for a shorter period may still access SuppoRTT courses. All resident doctors are eligible to access the deaneries' coaching, counselling and well being, and professional support services.

Overview of the SuppoRTT Process

detailing the main stages, from absence planning to post-return to training and the meetings required at each stage. see the Initial Return Meeting Flowchart of Responsibility for a visual representation of the full process to be followed.

Where absence lasts for at least three months, all PGDiTs are encouraged to enter the NHSEYH SuppoRTT programme and engage with it during their absence. This enables access to support resources and activities. This enables access to; clinical and non-clinical activities and courses.

For the purpose of this document, ‘Appropriate Educator/Supervisor’ can be categorised but not limited to; Educational Supervisors (ES), College Tutors, Clinical Supervisors (CS), Foundation Programme Directors (FPD), Training Programme Directors (TPD), Head of Schools (HoS), Directors of Medical Education (DME), SuppoRTT Champion.

Prior to Absence

It is recommended that an absence planning meeting should take place three months prior to the start of the PGDiT’s period of planned absence. If the absence is unplanned, this meeting can take place later.

During Absence

All PGDiT’s are encouraged to access the activities offered via the SuppoRTT programme, including access to a coach. Funding to attend appropriate external activities may be accessed via the SuppoRTT CPD Funding Process.

Prior to Return

Once a timeframe for return is known, the PGDiT will be required to attend an Initial Return Meeting. It is advised that this takes place 8-12 weeks prior to the estimated date of return, allowing enough time for the return to training to be organised e.g., rota coordination.

Review of Return

Towards the end of the supervised period the PGDiT and appropriate Educator/Supervisor will have a Review Meeting to discuss the PGDiT’s progress, review assessments, address any concerns and arrange any further targeted training.

Absence Planning Meeting

At least three months before the start of the absence, we recommend that the PGDiT meets with the relevant educator/supervisor for an absence planning meeting. The purpose of this meeting is to discuss how the PGDiT may wish to keep in contact with their educator/supervisor (if appropriate for their circumstances) and highlight any concerns they may have about their future return to training. If maintaining contact is agreed, it should also be confirmed who will be responsible for initiating contact and what the preferred method of contact is.

In the event of a sudden illness or unexpected absence, it may not be possible to schedule an absence planning meeting in advance of the absence. In these circumstances the absence planning meeting should be held as soon as is convenient.

We encourage educators/supervisors to use the Academy of Medical Royal Colleges (AoMRC) absence planning questions and actions to help frame the discussion.

The meeting should be documented using the online absence planning meeting form. When submitted meeting forms are received by the deanery SuppoRTT team who will circulate the the form to the relevant contacts. A copy of the absence planning form will be added to the PGDiT’s personal file. The PGDiT is also advised to upload a copy to their e-portfolio.

The appropriate educator/supervisor may also share a copy of the Individualised Action Planner with the PGDiT. The Individualised Action Planner is designed to help the PGDiT identify and note any support they may need before their return.

During Absence

During their absence, eligible PGDiTs are encouraged to access and participant in SuppoRTT resources and activities relevant to their needs. PGDiTs can participate in the programme of activities and events at any stage during their absence. This may include but is not limited to:

SuppoRTT courses which focus on (but are not limited to) refreshing clinical skills, resilience, wellbeing, and managing work/life balance.
SuppoRTT CPD funding for specialty specific courses or events (not already provided by us) which would help support your return to training.
The deanery Coaching Programme can provide up to six free and confidential sessions with a certified coach who can support and challenge you.

The deanery SuppoRTT team will contact PGDiTs by email during their absence to share information about available activities organised or supported by the SuppoRTT programme. PGDiTs may also be contacted by their educators/supervisors to inform them of available resources or activities.

They will also be signposted to SuppoRTT and prompted to plan their return to training.

If on parental leave, the use and payment of Keeping In Touch (KIT) and Shared Parental Leave in Touch (SPLIT) days is to be confirmed and agreed with the PGDiT’s Employers.

NHSEYH recognises that PGDiTs may also wish to attend speciality specific courses / events / meetings outside of the regional SuppoRTT programme that will aid in their return to training. PGDiTs can apply for individual funding from the SuppoRTT budget to attend such events via the SuppoRTT CPD Funding Process.

Initial Return Meeting

It is advised that the PGDiT and appropriate Educator/Supervisor have an Initial Return Meeting within 8-12 weeks before the estimated date of return. Where a PGDiT is absent owing to health reasons and a complex return is anticipated, we recommend having this meeting sooner to ensure appropriate arrangements are in place well in advance.

The aim of the Initial Return Meeting is to create an individualised plan of return which will consist of identifying and discussing:

Specific concerns about returning to the clinical environment.
Learning & training needs (including possible assessments or courses that the PGDiT should attend).
The need for a supernumerary and/or period of enhanced supervision.

Appropriate Educators/Supervisors are encouraged to use the Academy of Medical Royal Collages (AoMRC) return to practice questions and actions (see Appendix B) to help facilitate the discussion at this meeting.

Discussions should be fully documented on the Initial Return Meeting form. This is an electronic form, and a copy is automatically sent to the SuppoRTT team upon submission. The PGDiT is advised to upload a copy to their e-portfolio.

It is the responsibility of the Appropriate Educator/Supervisor to communicate and agree any adjustments required with the relevant departments /
individuals, i.e., medical departments/supervisors/medical education and rota coordinators.

Under exceptional circumstances it may not be possible for a PGDiT to arrange this meeting within the 8-12 week time frame. It is imperative that any plans for the PGDiT’s to return over a shorter period are communicated immediately to the SuppoRTT team and relevant departments, i.e., medical departments / supervisors / medical education teams and rota coordinators.

Complex Returns

PGDiTs who have been absent for more complex reasons may request a one-to-one meeting with a SuppoRTT Associate Dean who may be able to offer the PGDiT additional pastoral support and guidance. This should not delay the PGDiT’s return date or affect any other aspects of the return process as detailed above. However, the sooner this meeting can take place the more likely additional suitable support can be arranged. Such a meeting can be requested by emailing england.suppo-rtt.yh@nhs.net.

Supernumerary Period

A supernumerary period is typically described as a short, intense period where the PGDiT is considered as an additional member of staff to help them return to normal duties safely and confidently. During this time, it is expected that the PGDiT will have no fixed work commitments enabling them to complete a programme of focused learning and clinical activities. The length of the supernumerary period and activities within it will be bespoke to the PGDiT dependent on their needs.

This period could include, but is not limited to, familiarisation of work environment, IT setup, shadowing a senior member of staff.

This period may not count towards training time if longer than two weeks. This should be discussed with the appropriate Educator/Supervisor.

All PGDiTs returning from a period of absence of six months or more, are entitled to a three-day supernumerary period running consecutively from their return to training date (excluding GPPGDiTs in practice posts*). Salaries will be paid by the employing Trust. NHSE YH will contribute to the salary based on figures set out in the NHS Employers pay scales document. The Trust will be reimbursed each quarter via the Education Contract.
The PGDiT and appropriate Educator/Supervisor should discuss the length of supernumerary period required and this should be detailed in the Initial Return Meeting Form.
In exceptional circumstances the appropriate Educator/Supervisor may request an extended supernumerary period, lasting longer than three days. The reasons for this request should be detailed in the Initial Return Meeting Form. The request will be reviewed by a SuppoRTT Associate Dean and an approval decision will be provided by the SuppoRTT team via email.

If a supernumerary period is not requested, clear evidence as to why must be documented on the Initial Return Meeting Form.

*GPs returning to in-practice posts can request supernumerary funding if there are extenuating circumstances, and the decision is at the discretion of the Associate Deans.

Enhanced Supervision

A period of enhanced supervision is typically described as a short, intensive period of focused learning activities and direct observation of clinical activities with the aim of enabling PGDiT to return to normal duties safely and confidently. It is expected that during this time PGDiTs may not be required to undertake any out of hours arrangements if adequate supervision isn’t available. The length of the enhanced supervised period and how it is used is bespoke to the PGDiT, dependent on their needs.

This period could include, but is not limited to, peer, senior team or consultant supervision covering areas such as routine ward work, outpatient clinics, clinical skills, emergency and out of hours work.

It is recommended that all PGDiTs returning from a period of absence of three months or more are provided with a period enhanced supervision. This is to run consecutively from their return to training date or the end of their supernumerary period.
The PGDiT and appropriate Educator/Supervisor should discuss the length of enhanced supervision required and this must be detailed in the Initial Return Meeting Form.

If an enhanced supervised period is not requested, clear evidence as to why must be documented on the Initial Return Meeting Form.

Please note NHSE YH do not contribute financially to enhanced supervision.

Review Meeting

The PGDiT and appropriate Educator/Supervisor should meet to review the PGDiT’s return to practice, at the end of any supernumerary/enhanced supervision period. Where the PGDiT has not requested a period of supernumerary or enhanced supervision, the meeting should take place within four weeks of their return to clinical duties.

The aim of the Review Meeting is to discuss the PGDiT’s progress, review assessments and feedback, address any remaining concerns and arrange any further targeted training.

All discussions are to be documented on the Review Meeting Form. This is an electronic form, and a copy is automatically sent to the SuppoRTT team upon submission. The PGDiT is advised to also upload a copy to their e-portfolio.

If the PGDiT and appropriate Educator/Supervisor are satisfied with the PGDiT’s progress, then the PGDiT can be signed off and return to normal duties.

If the PGDiT and appropriate Educator/Supervisor agree that an extension to the supervision period is appropriate, additional Review Meetings should be arranged and documented until both the PGDiT and appropriate Educator/Supervisor agree the process is complete and the PGDiT can return to normal practice.

Annual Review of Competence Progression (ARCP)

All PGDiTs will undertake an Annual Review of Competence Progression (ARCP), however, there are occasions where PGDiTs may have more than one ARCP if they have taken a period of absence from their training programme. NHSE recommends that an ARCP is arranged at the following periods:

In the case of a planned absence: the PGDiT must undertake an ARCP two months prior to the start of the absence.
In the case of an unplanned absence: the PGDiT and appropriate Educator/Supervisor must arrange an ARCP when applicable.

This will review the period from the last ARCP to the start of the PGDiT’s absence.