SuppoRTT Guidance

This page presents the Supported Return to Training guidance for Yorkshire and the Humber. We encourage resident doctors and dentists in training and clinical faculty to familiarise themselves with this guidance.

Other pages in this section:

Contents

Introduction
Eligibility
SuppoRTT framework
- Complex returns
SuppoRTT activities
Pre-absence planning meeting
Pre-return planning meeting
Post-return review meeting
SuppoRTT administration
Annual Review of Competence Progression (ARCP)

Document Status

This is a controlled document. While this document may be printed, the electronic version posted on the SharePoint site is the controlled copy. Any printed copies of this document are not controlled. An official downloadable copy of the PDF SuppoRTT Guidance (PDF) is also available.

This document is not intended to be interpreted as a policy statement. This is a local guidance document for faculty and staff in the Yorkshire and Humber Deanery to enable consistency of application; it is recognised there may be exceptional circumstances when deviation from this guidance may be required.

Introduction

The Supported Return to Training (SuppoRTT) programme has been developed to support resident doctors and dentists and public health registrars returning to training after a prolonged period out of training. The programme aims to enhance the return to work and training experience, and to support safe readjustment to maintain high quality and safe patient care.

This guidance outlines the Supported Return to Training framework and activities within the Yorkshire and the Humber Deanery. The guidance should be applied flexibly considering the resident's individual circumstances including the nature and length of their time out of training, their specialty, stage of training and experience. This is to ensure that they can safely and confidently return to clinical practice and training.

This guidance is intended to help resident doctors and dentists, clinical educators and supervisors understand and apply the SuppoRTT framework. Training Programme Directors and Heads of School are encouraged to promote SuppoRTT and help ensure that returning residents can access Supported Return to Training.

Eligibility

1. Access to the full Supported Return to Training programme (see SuppoRTT activities below) is available to all resident doctors and dentists and public health registrars enrolled on a clinical training programme who have been (or are expected to be) out of training for 3 months or more regardless of the reason. This may include but is not limited to:

Maternity Leave
Shared Parental Leave
Adoption Leave
Carer’s Leave
Out of Programme (Training, Research, Experience, Career Break, Pause)
Long Term Sick Leave or health absence

2. Residents returning to training from suspension may access SuppoRTT after the suspension has been completely lifted by their employer and the GMC.

3. Doctors or Dentists who have been appointed to a specialty training programme and have a gap in training or clinical practice of 3 months or more before the start of their training programme are also eligible to access SuppoRTT.

4. Doctors or Dentists appointed to a specialty training programme who have deferred the start of their training are eligible to access SuppoRTT. Any deferrals must be approved through the deanery deferral process.

5. Out of Programme residents are supported by the SuppoRTT team of their home deanery. Residents on OOP within Yorkshire and the Humber may access SuppoRTT courses within the region subject to availability.

6. Residents who have been out of training for less than three months are eligible to access SuppoRTT courses only.

7. Support for International Medical Graduates new to the NHS will be provided by their employing trust when they start their training programme. Additional support, guidance, and advice is available on the deanery’s Support for International Medical Graduates webpages.

SuppoRTT framework

8. The SuppoRTT programme is framed by a series of meetings with the resident and the appropriate supervisor or educator, which provide a structured and holistic approach to planning the time out of training and the subsequent return. These include:

A pre-absence planning meeting to discuss the arrangements for the time out of training and how (if desired) they will maintain contact with their educators.
A pre-return planning meeting to discuss the arrangements for their return including any plans for a supernumerary and or enhanced supervision period.
A post-return review meeting to review their progress and to discuss any remaining concerns or any further support that may be needed.

Further information about each meeting can be found below.

9. The appropriate supervisor or educator may include but is not limited to the resident’s Educational Supervisor (ES), College Tutor, Clinical Supervisor (CS), Training Programme Director (TPD), Head of School (HoS), Director of Medical Education (DME), or a SuppoRTT Champion.

10. In some circumstances, it may also be appropriate to invite a Medical Education or Medical Staffing / Human Resources contact to attend a SuppoRTT meeting.

11. As part of each meeting, the resident and appropriate supervisor should agree a plan for the time out of training or return which should be tailored to reflect the resident’s individual needs.

12. During the meeting, the discussion and plan should be fully documented using the relevant online SuppoRTT meeting form. The meeting form will then be circulated by the SuppoRTT admin to team to the relevant trust and school contacts.

13. A copy of the form will be uploaded to the resident’s TIS record [TIS is the NHSE Trainee Information System]. Residents should also upload a copy of the meeting form to their e-portfolio.

14. Residents who have been (or are expected to be) out of training for less than 3 months do not need to complete the SuppoRTT meetings or forms with their supervisor.

Complex returns

15. Residents who have taken time out of training for more complex reasons may request a one-to-one meeting with a SuppoRTT Associate Dean for additional pastoral support and guidance.

16. Where a meeting with a SuppoRTT Associate Dean is requested, it should not delay the resident’s return date or other aspects of the return process, such as scheduling the pre-return planning meeting.

17. To request a meeting with a SuppoRTT Associate Dean, the resident or supervisor should complete a Professional Support Referral as early as possible to ensure that any appropriate additional support can be arranged.

SuppoRTT activities

18. All eligible residents (see the eligibility section above) are encouraged to access the activities and resources offered by the SuppoRTT programme and Professional Support which are relevant to their individual needs. Currently, these include:

SuppoRTT courses with topics including refreshing clinical skills, resilience, wellbeing, and managing work/life balance.
SuppoRTT CPD funding for external courses or activities which enable the resident to build confidence or refresh their skills.
Online resources library linking to digital support resources and services.
e-Learning for Health which includes a range of online modules on refreshing clinical competencies and professional behaviour.
Trust and School Trust SuppoRTT Champions who can offer guidance and help resident’s navigate local process and resources.
Local trust Health Toolbox sites to access local guidance, orientation resources, and helpful tips for returning registrars.
The deanery Coaching Programme which can provide up to six free and confidential sessions with a certified coach.
Deanery Counselling and Wellbeing Support with access to counselling services as well as a library of mental health and wellbeing resources.
Deanery Neurodiversity Support including curated resources, supportive courses and signposts to external peer support networks and services.
Deanery Professional Support Referrals which offer a neutral space to explore challenges and help to access the right support and guidance.

19. Eligible residents may participate in these activities at any stage during their absence and within the 3 months after their return.

20. Returning residents may also wish to access local activities and resources including department visits, regional teaching, simulation training, e-learning, mentoring, and shadowing.

21. Residents on parental leave retain their entitlement to study leave which may usually be taken on keeping in touch (KIT) days. (See the national study leave guidance, p5.)

22. Residents on maternity and adoption leave may take up to 10 keeping in touch (KIT) days. Residents on shared parental leave may take up to 20 shared parental leave in touch (SPLIT) days. KIT and SPLIT days are paid by the employing trust. Residents should contact Medical Staffing at their employing trust to book KIT or SPLIT days.

23. Residents on long-term sick leave may use study leave for SuppoRTT activities, but study leave is otherwise not usually permitted during periods of sick leave. (See the national study leave guidance, p5.)

24. Residents taking time out of training for other reasons may be able to access up to 10 supported return to training (SRTT) days to participate in SuppoRTT activities. SRTT days are paid by the employing trust, or time off in lieu may be granted. Residents should contact Medical Staffing at their employing trust to book SRTT days.

Pre-absence planning meeting

25. Before taking time out of training, residents should meet with their appropriate supervisor for a pre-absence planning meeting. This meeting should normally take place about 3 months before the start of a planned absence.

26. Where the absence is unplanned (for example due to sudden illness), the absence planning meeting should be held as soon as is appropriate for the resident.

27. The purpose of the pre-absence planning meeting is to discuss the arrangements for the time out of training, any activities the resident may wish to undertake while out of training, and any concerns they may have about any break from clinical practice.

28. If the resident wishes to maintain contact with the supervisor during their time out of training, the contact method and who will be responsible for initiating contact should be discussed and agreed at the pre-absence planning meeting.

29. To help facilitate the meeting supervisors are encouraged to use the Planning an absence from practice checklist from the Academy of Medical Royal Colleges.

30. During the meeting, the discussion should be documented using the online pre-absence planning meeting form. A copy of meeting form will then be circulated by the SuppoRTT admin to team to the relevant trust and school contacts.

31. The supervisor may provide the resident with a copy of the Individualised Action Planner for the resident to complete to identify what support they may need before their return.

32. Where it is not possible to arrange a pre-absence planning meeting or the meeting is delayed, the resident or their supervisor should complete an absence notification form to register with the SuppoRTT programme.

Pre-return planning meeting

33. When the timeframe for their return is known, the resident should meet with their appropriate supervisor for a pre-return planning meeting. The meeting should normally take place about 3 or 2 months before the estimated return date to ensure that the appropriate arrangements for their return can be made. This includes any arrangements effecting their rota, such as a supernumerary and or enhanced supervision period.

34. In exceptional circumstances, it may not be possible to hold the pre-return planning meeting at this point, in which case, the pre-return planning meeting should take place as soon as appropriate.

35. Where the resident is absent due to health reasons and a complex return is expected, the pre-return planning meeting should take place earlier, if possible, to ensure appropriate arrangements can be made well in advance.

36. The purpose of the pre-return planning meeting is to create an individualised return plan including:

The arrangements for the resident’s return to clinical practice and training
Identifying any learning or training needs and how these will be met
Agreeing any activities or additional support that will be helpful for their return

37. A short supernumerary and or enhanced supervision period to support the resident’s return may also be requested through the pre-return planning meeting and form. See below for more information about supernumerary and enhanced supervision periods.

38. To help facilitate the meeting educators/supervisors are encouraged to use the Planning a return to practice checklist from the Academy of Medical Royal Colleges.

39. During the meeting, the discussion should be documented using the online pre-return planning meeting form. A copy of the meeting form will then be circulated by the SuppoRTT admin to team to the relevant trust and school contacts.

40. The supervisor is responsible for communicating and agreeing any arrangements and adjustments with the relevant contacts and departments; including as appropriate departments, supervisors, rota coordinators, Medical Education, Medical Staffing / Human Resources

Occupational Health

41. If a phased return or Occupational Health support is needed, the supervisor should contact Medical Staffing / Human Resources at the resident’s employing trust as soon as possible to discuss the referral.

42. Any phased return, adjustments or support plans recommended by Occupational Health or Medical Staffing / Human Resources should take precedence. This guidance can be used in parallel with any phased return plans.

Supernumerary period

43. All residents returning from an absence of 3 months or more are eligible for a 3-day supernumerary period on their return to enable them to return to normal duties safely and confidently.

44. A supernumerary period normally starts from the return to training date and allows the resident to be considered as an additional member of the team with no fixed work commitments, enabling them to complete a programme of focused learning and clinical activities. On call duties would not normally be expected during this period.

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

46. The length of the supernumerary period and planned activities should be based on the resident's individual needs.

47. The offer of a supernumerary period should be discussed at the pre-return planning meeting. The supernumerary period can only be requested through the pre-return planning meeting form, and it is important that the need for this support is clearly documented.

48. SuppoRTT will normally fund a standard supernumerary period of up to 3 days. In exceptional circumstances an extended supernumerary period of up to 10 days may be requested. Exceptional supernumerary funding requests will be considered by a SuppoRTT Associate Dean.

49. If the supernumerary period is longer than 14 days, it may not count towards training. This should be discussed with the appropriate Educational Supervisor.

50. Where SuppoRTT funding is agreed, NHS England will pay the approved funding to the employing trust which pays the resident’s salary. The funding will be based on the pay scales for Doctors and Dentists in Training set out by NHS Employers.

51. As resident doctors working in primary care posts are normally regarded as supernumerary, SuppoRTT does not normally fund supernumerary periods for General Practice registrars returning to a primary care placement.

Enhanced supervision

52. We recommend that all residents returning from an absence of 3 months or more have an enhanced supervision period of at least 10 working days to enable them to return to normal duties safely and confidently.

53. Enhanced supervision periods are designed to be short and provide the resident with a greater level of supervision in their practice, which may include focused learning activities and direct observation of clinical activities. Out of hours duties would not normally be expected during this period if adequate supervision is not available.

54. The enhanced supervision period normally runs from the end of any agreed supernumerary period or, where a supernumerary period is not needed, from the return to training date.

55. This period may 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.

56. The length of the enhanced supervision period and planned activities should be based on the resident's individual needs.

57. The offer of an enhanced supervision period should be discussed at the pre-return planning meeting. The enhanced supervision period can only be requested through the pre-return planning meeting form, and it is important to clearly document the need for this support.

58. NHS England does not contribute financially to the enhanced supervision period.

Post-return review meeting

59. The resident should meet with their appropriate supervisor for a post-return review meeting at the end of any supernumerary/enhanced supervision period. Where the resident has not requested a supernumerary or enhanced supervision period, the meeting should take place within 4 weeks of their return to clinical duties.

60. The purpose of the post-return review meeting is to discuss the resident’s progress, review assessments and feedback, address any remaining concerns they have about clinical practice and arrange any further targeted training which may be needed.

61. During the meeting, the discussion should be documented using the online post return review meeting form. A copy of meeting form will then be circulated by the SuppoRTT admin to team to the relevant trust and school contacts.

62. If the resident and appropriate supervisor are satisfied with the resident’s progress, the resident can be signed off and return to normal duties.

63. If the resident and appropriate supervisor agree that an extension to the supervision period is appropriate, additional review meetings should be arranged and documented until both the resident and appropriate supervisor agree the process is complete and the resident can return to normal duties.

SuppoRTT administration

64. Residents must always inform their placement and employing trust about any planned or unplanned absences from work.

65. Residents should inform the relevant deanery rotations team about any absences from training of 14 days or more. If the absence end date changes after this, they should advise the relevant rotations team of the change. Residents may view their placement history, including recorded absences, using TIS Self-Service.

66. Residents who are absent from training should inform the deanery if their email address changes or if they prefer to be contacted using a different email address during their absence. Residents may use TIS Self-Service to check or update the email address in their TIS record.

67. The SuppoRTT admin team will contact eligible residents to inform them of the SuppoRTT programme and of available or recommended activities and resources.

68. When they are due to return to training, the SuppoRTT admin team will also contact eligible residents to prompt them to plan their return.

69. Eligible residents who wish to opt out of SuppoRTT mailshots or notifications can do so by contacting the SuppoRTT admin team.

Annual Review of Competence Progression (ARCP)

70. Senior Faculty and Panel Chairs should familiarise themselves with the local Annual Review of Competency Progression (ARCP) Operational Guidance section on ‘Statutory Leave and the ARCP’ to ensure that the ARCP process is followed correctly in relation to residents taking statutory leave.