Training Programme

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					ST Training Programme
      Description




    MARCH 2010



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          Training Programme Description and
              Prospectus – Healthwork Ltd

1) Introduction and Background
Healthwork is an occupational health provider based in the North of England.
Healthwork is led by 3 consultant occupational health physicians (Dr Shaun
Austin, Dr Shahed Khan, and Dr Tok Hussain). Healthwork also employs 5
occupational health nurses and an number of administrative staff (including an
office manager, administrators, a bookkeeper and secretarial staff).

Healthwork provides occupational health services to a number of clients spread
throughout the North of England including:

      Durham Constabulary
      Merseyside Fire and Rescue Service
      North Cheshire Hospitals Trust
      Salford Hospitals Trust
      South Manchester NHS Trust
      Greater Manchester West NHS Mental Health Trust
      The Park Cake Bakeries
      Leeds City Council
      Manchester City Council
      Bury Metropolitan Council
      Communisis Transactional Print Services
      Bristol Myers Squibb Pharmaceuticals
      Chester University
      ADS (Addiction and Dependency Solutions)
      Stateside Foods
      Soreen
      TRW Automotives
      Tensar International
      Sappi Papermills
      Callender Aeroparts
      Lucite International
      Unison Engine Components
      Learoyd Packaging
      Weir Minerals


Healthwork has offices in Leeds, Manchester and Liverpool.



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Healthwork is committed to providing high quality occupational health services.
Healthwork is also committed to provide a high quality environment for teaching
and training of junior doctors.




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2) Training Programme – Healthwork Training
   Post
Year 1(ST3)

Months 1 to 3

      Familiarisation with Healthwork (induction) to occur over a one month
       period
      We will ensure that the trainee joins SOM/FOM/ALAMA/ANHOPS
      Prepare for part 1 MFOM examination to be taken at end of year 1, with
       enrolment of necessary courses at the academic centres
      Sit in with OHP‟s and OHA‟s (on the job learning)
      Agree year 1 objectives
      Workplace visits x 3 (write up x1 for logbook)
      Start to see own patients
      Attend occupational respiratory clinics (Richard Barraclough or Jenny
       Hoyle)
      Attend trainee meetings locally in Leeds or Manchester
      Attend an audit course
      Initial training from Healthwork Health and Safety Manager


Months 3 to 6

      Run own clinics
      Attend case conferences with SK/TH/SA
      Begin workplace based assessments (WBA) process
      Perform at least 1 audit
      Attend occupational dermatology clinics
      Workplace visit x 1
      Assess 1 health surveillance programme

Months 6 to 12

      Apply for part 1 membership
      Prepare for part 1 membership examination – extra targeted study time
       will be made available for this examination which will be taken towards the
       end of year 1. Take part 1 examination in year 1.
      Visit HPA for public health/environmental health experience
      Arrange external WBA
      Write up 1st First Aid assessment
      Write up 2nd workplace visit

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Year 2 (ST4)

      Set learning objectives for year 2
      Begin to consider topic for MFOM dissertation, and by the end of year 2
       submit the proposal to the FOM.
      Write up 2nd first aid assessment
      Write up 3rd and 4th workplace visit assessments
      Write up 2nd Health surveillance programme
      Write up one more audit
      Write up environmental assessment
      Attend contract meetings and case conferences with TH/SA/SK
      Attend clinics to fill in any clinical gaps



Year 3(ST5)

      Build up complexity of cases such as dealing with complex psychosocial
       and ill health retirement cases
      Attend modular Healthwork business management course
      Write policies under consultant supervision
      Perform a health promotion exercise and
      Write up an environmental assessment
      Develop team leadership skills
      Become involved in committee based work
      Gather data for the dissertation and by month 30 submit dissertation
      Months 30 to 36, complete dissertation
      Attend case conferences and contract meetings alone
      Attend Manchester medico legal course


Year 4 (ST6)

      Act with greater independence dealing with complex cases
      Greater involvement in business issues
      Prepare for Part 2 membership
      Attend relevant MFOM part 2 revision courses
      Supervise Healthwork junior doctors
      Take part 2 membership during this year.




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Indicative Job Plan


           Monday        Tuesday       Wednesday Thursday           Friday

 am        Clinic     Clinical   Clinic              Clinic         Clinic Leeds
           Manchester supervisionLeeds               Durham         Mixed
                      with Dr SK Mixed               Police         referrals
                                 referrals           Constabulary
 pm        Admin       Clinic in Admin               Personal       Admin either
           either from Leeds or  either from         study          from Leeds
           Manchester Manchester Leeds or                           or
           or                    home/CPD                           home/CPD
           home/CPD

The clinical aspect of the trainees work will involve work with a number of
different clients offering a variety of work and experience. The clinic in Leeds
involves mixed referrals from a number of different Healthwork clients. We will
vary the clinical sessions to include NHS sessions and local authority work during
the course of the training.

Attendance at relevant short courses on Occupational Medicine issues will be
encouraged.




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3) Meeting Generic Standards for Training
Domain 1. Patient safety

The trainee will be supervised and only allowed to perform assessments once
the clinical and educational supervisors are content that the trainee has the
relevant level of competence to perform that type of assessment. We intend to
gradually expose the trainee to more difficult clinical scenarios and more complex
occupational health issues over time. Initially the trainee will be very closely
supervised and will be observed in the clinical setting. The clinical supervisor or
educational supervisor will always be available for the trainee to contact (either in
an adjoining room or by telephone contact). We will ensure that trainees are
aware of the importance of high quality safe patient care.

Dr Khan and Dr Hussain will be educational and clinical supervisors, with Dr
Austin acting as clinical tutor. All 3 of these doctors are competent in training.

The trainee will be trained initially in aspects of occupational health law such as
consent and confidentiality. Once we are happy with the level of competence
demonstrated by the trainee, the trainee will then be allowed to see patients
alone.

The working hours will 0900 to 1700 from Monday to Friday, with no out of hours
or on call commitment.

Domain 2. Quality Assurance, Review and Evaluation

The post will be under the umbrella of the Healthwork Clinical Governance
protocol. We will ensure that arrangements for the training are in line with all
FOM recommendations. Healthwork systems of work comply with the European
Working Time Directive, Data Protection Act and Freedom of Information Act.

Domain 3. Equality, Diversity and Opportunity

Healthwork is an equal opportunity employer. At the recruitment stage, we will
ensure that all our processes comply with relevant employment law, the Disability
Discrimination Act, Race Relations (Amendment) Act, Sex Discrimination Act,
Equal Pay Acts, and the Human Rights Act.

During the tenure of the post, Healthwork will act as a responsible employer
ensuring that the post is adjusted appropriately for trainees with well-founded
individual reasons for being unable to work full time to work flexibly. Healthwork
is happy to provide training on a part time or flexible basis, and this will be
advertised during the recruitment process. Healthwork is committed to the


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provision of reasonable adjustment must be made for trainees with disabilities, or
other needs.

Domain 4. Recruitment, selection and appointment

Healthwork is happy to work with the deanery to ensure that recruitment
processes are fair and transparent. We will choose candidates based upon:

      The candidate being a fully registered medical practitioner or hold limited
       registration with the General Medical Council
      The candidate being fit to practise.
      The selection process being fair and transparent

The training post would be advertised through deanery and in the BMJ (and
possibly the SOM). We will then work with the deanery for the shortlisting and
interviewing process.

Domain 5. Delivery of curriculum including assessment

We will ensure that the trainee is trained according to the training curriculum set
by the Faculty of Occupational Medicine (see section 4).

The trainee will learn in a variety of methods including:

      Practical clinical experience during routine occupational health clinics with
       the backup and support of Dr Khan.
      One to one training meetings with Dr Khan on a weekly basis
      Learning through participation in the Manchester based distance learning
       course.
      Attendance to appropriate courses during the training post.
      Meetings and practical sessions with other occupational health
       professionals (such as OHA‟s, counsellors, physiotherapists, occupational
       hygienists, trade unions, health and safety advisors, and managers).
      Meetings with other trainees will be encouraged
      Attendance at hospital out-patients clinics to fill knowledge gaps and
       consolidate knowledge in particular dermatology, respiratory, psychiatric,
       and infectious disease clinics).

The trainee will have regular feedback from Dr Khan on their performance.
Workplace based assessments (WBA) will be performed regularly.

Domain 6. Support and development of trainees, trainers and local faculty

The trainee will attend a one month long induction at Healthwork during which
they will become familiar with Healthwork processes, their expected duties, the
curriculum, reporting arrangements, and will have the opportunity to meet all

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other staff. During this time, the clinical supervisor (Dr Khan) will discuss with the
trainee the educational framework and support systems in the post and the
responsibilities of the trainee, as well as setting of aims and objectives for the
trainee to achieve in the post (in line with the training plan shown above).

Dr Khan will be the designated educational supervisor. Dr Hussain will be the
clinical supervisor. Healthwork will help and advise the trainee with compilation
and completion of their logbook and learning portfolio. Dr Khan will meet the
trainee initially on a weekly basis and throughout the programme these meetings
will occur at least monthly (to discuss progress and to discuss outstanding
learning needs and how to meet them).

The hours of work will be 0900 to 1700 from Monday to Friday. There is no out
of hours, weekend or on-call commitment. The working pattern and intensity of
work will be appropriate for learning and will alter as the trainee progresses.

We will encourage the trainee to be involved in the clinical audit process,
including personally participating in planning, data collection and analysis. We
will provide training in audit, and then expect the trainee to perform audits
regularly. We will also provide the trainee with time to attend audit meetings with
other clinicians. The trainee will be able to attend relevant, timetabled,
organised educational meetings or other events of educational value to the
trainee, as agreed with the educational supervisor, and will be given protected
time for this activity. The trainee will be able to take study leave as needed. We
will provide the trainee with relevant management training during year 4 of the
training programme.

Dr‟s Khan, Hussain and Austin currently take an active part in the Yorkshire STC
for Occupational Medicine. Healthwork will ensure that the educational
supervisors, clinical tutor, and college tutor have resources and time available for
training related matters.

Healthwork has a history of successfully training trainees in Occupational
Medicine.

Domain 7. Management of Education and Training

The trainee will on a day to day basis follow the aims and objectives set out by
the educational supervisor. The trainee will have assessments through the
ARCP process as organised by the deanery.

Dr Hussain will be responsible for supporting the training programme in general.

Responsibilities will be as follows:

Dr Khan – to ensure day to day training

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Dr Hussain - to oversee the training process and discuss with the trainee and Dr
Khan any performance issues

Dr Austin – to ensure that the training programme complies with the FOM
curriculum.

Domain 8. Educational resources and capacity

Healthwork has offices in Leeds (Princess Exchange, Princess Square, Leeds,
LS1 4HY.), Manchester (27 Byrom St, Manchester, M3 4PF), and Liverpool
(Bridle Rd, Bootle, Merseyside). We will expect the trainee to set up an office at
home and we will fully equip the trainee in this respect. The secretarial support
will be shared between the trainee and the other doctors and nurses. The trainee
will work between these offices as well as on employer worksites. Thus the
trainee will not have a single office, but will have office facilities at home, and at
our bases in Leeds, Liverpool and Manchester. Our offices are fully equipped
with clinical facilities and equipment which the trainee will use. We will also
provide the trainee with clinical equipment which the trainee can use on employer
worksites (such as stethoscope, sphygmomanometer, peak flow meter,
ophthalmoscope, otoscope, etc). We will provide the trainee with a laptop, USB
modem (to allow connection to the internet anywhere), mobile phone, and a
printer. We have library facilities in our offices in Manchester and Liverpool. The
trainee will also be able to access the extensive library facilities of an academic
centre during their training.

Healthwork holds regular educational meetings for all clinicians, and we will
expect the trainee to be actively involved in participation at these meetings. We
will also encourage the trainee to attend all other relevant educational meetings.

Domain 9. Outcomes

We will provide the trainee with regular feedback regarding performance during
meetings with the educational supervisor.




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4) Meeting Specific Standards for Training in
   Occupational Medicine
We believe that we are able to provide a training post where a trainee will be able
to attain all the core competencies in accordance with the FOM curriculum. We
will do this as follows:

During the course of the training, there will be a balance of different modes of
learning from formal teaching to experiential learning “on the job”. The methods
that we will employ are shown below, but flexibility in the approach to training
will be important as we intend our training programme to be tailored to the
individual trainee based on the trainees previous experience, progress, and
individual learning styles and needs.

Training methods that we will employ:

   1) Work-based experiential learning

             occupational health clinics. After initial induction, the trainee will
              begin the clinical assessment of patients/workers referred to
              Healthwork or to occupational health department of our client
              companies. The degree of responsibility taken by the trainee will
              increase as their competency increases. Cases will be selected by
              Dr Khan, who will review the outcomes of assessment, including
              the letters written to managers.

             hazard and risk assessment of in the workplace. Trainees will be
              encouraged to visit and assess a large variety of workplaces. As
              can be seen from the profile of Healthwork, we are able to provide
              the trainee with a variety of workplaces where workplace
              assessments can be performed. The trainee will be expected to
              write a report following workplace assessments which will be
              discussed with Dr Khan. Selected reports of workplace
              assessments will form part of the evidence for the Annual Review
              of Competence Progression (ARCP).

             meetings with managers and human resources advisers. This will
              take place initially in the presence of Dr Khan and/or Dr
              Hussain/Austin. Healthwork currently regularly meets with
              managers and HR professionals to discuss cases and workplace
              issues, so it will be easy to incorporate this into the trainees
              experience. As the trainees experience increases meetings will
              take place without Dr Khan or Dr Hussain.


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         meetings with health and safety practitioners. Healthwork employs
          a health and safety practitioner, so the trainee will be able to benefit
          from meeting regularly with her.

         meetings with Trades Union officials. Healthwork has links with
          trades unions officials (Fire Brigades Union, Police Federation,
          UNISON). Meetings will be organised for the trainee to attend with
          either Dr Khan or Dr Hussain.

         Attendance at employer health and safety committees, and hospital
          infection control committees.

         multidisciplinary working in Healthwork. We employ OHA‟s and a
          health and safety manager. We also have links with
          physiotherapists and counsellors. The trainee will therefore on a
          daily basis experience the work of the other members of the
          occupational health team.

         vocational rehabilitation of individual workers. This will begin at a
          very early stage of training, under supervision of Dr Khan.

         preventive occupational health activities such as health promotion
          and health surveillance will be undertaken by the trainee with our
          clients in conjunction with our OHA‟s.

         clinical governance

         the management of occupational health services, including the
          management of personnel, contracts and tendering for contracts.
          This aspect of training will gradually increase over the 4 year
          training post.


2) Off-the-job education (approx 10 days per year)

         Attendance at relevant courses, linked to educational and personal
          development plans
         Attendance at regional and national specialty meetings, such as
          those organised by the Faculty of Occupational Medicine, the
          Society of Occupational Medicine, the Royal Society of Medicine
          and Specialist Associations (ANHOPS, ALAMA, etc.)
         Examination preparation courses
         Private study

3) Other educational and training activities (approximately 36 days per year).


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             Attendance at local postgraduate meetings.
             Presentations to educational meetings (initially at local SOM group
              meetings)
             Research and audit projects
             Lectures and small group teaching to Healthwork OHA‟s
             Critical appraisal and evidence based medicine working with Dr
              Hussain and utilising his experience as an assistant editor
             Attendance at OP clinics e.g. rheumatology, orthopaedics,
              psychiatry, respiratory medicine, dermatology, rehabilitation
              medicine, toxicology,
             Spending time with an occupational hygienist

   4) Other activities will include:

             Secondment to other training organisations if there are skill gaps
              that cannot be met in Healthwork
             Independent self-directed learning. Trainees will be expected to use
              this time in a variety of ways depending upon their stage of
              learning. (e.g. preparation for assessment and examinations,
              appraisal, feedback and reflection, reading, maintenance of
              personal portfolio, or for audit and research projects)

How will Learning Occur

      Learning from practice

The trainee will spend a large proportion of work based experiential learning
involved in supervised clinical occupational health practice in occupational health
services and in a variety of workplaces. The job-plan above is indicative and as
the trainee progresses, our intention is to move the trainee to work with different
employers. There will therefore be opportunities to work within several different
types of organisation Examples of the type of employer that the trainee will work
with are the NHS, manufacturing industry, transport, retail, higher education,
Local Authorities, Police and Fire Services.

The trainee will therefore be exposed to a variety of management and
communication styles, different teams, and a range of occupational and
environmental hazards. This will support the development of several curriculum
competencies.

      Learning from peers

We will encourage the trainee to meet with other trainees, both within the
Yorkshire/Manchester region and nationally. Healthwork would be happy to
facilitate regional trainee meetings.


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      Learning in formal situations

The trainee will be encouraged to attend conferences and meetings in
Occupational Medicine within the UK. The trainee will be expected to enrol on an
academic course in Occupational medicine.

      Personal study

Time will be provided for personal study.

      Specific teacher inputs

The trainee will meet with Dr Khan regularly. The trainee will also receive
specific inputs from other non Healthwork teachers as part of the training
programme , in preparation for formal examination.



Linking Training to Occupational Medicine Core Competencies and training
domains

1) Clinical Practice

We will provide close initial training in history taking, examination and record
keeping skills in occupational medicine. On the job experiential training as well
as teacher specific inputs and attendance at specific courses will help the trainee
in managing chronic disease, disease prevention, and assessment &
management of occupational hazards.

We will organise attachments with the Health protection Agency (with whom we
have a link Dr Marco Petrovic) to facilitate learning relating to the environmental
issues related to work practice.

Teacher specific inputs and attendance at courses will help the trainee with
communication skills, team working and leadership skills, and ethical/legal issues
(we will also arrange for the trainee to spend time at an employment tribunal as
well as attend the Manchester medico-legal course)

2) Rehabilitation

On the job experiential training as well as teacher specific inputs and attendance
at specific courses will help the trainee in management of disability &
rehabilitation, chronic disease management, and in assessment of disability and
fitness for work.

3) Clinical Governance

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The trainee will be expected to work within the Healthwork clinical governance
framework. We will encourage evidence based practice and will expect the
trainee to participate actively in audit processes (after appropriate training).
Healthwork has a complaints management system. We will expect the trainee to
be involved with training and education of occupational health staff.

4) Framework for Practice

The trainee will learn about the definition, scope and functions of occupational
health services.

We will provide on the job training and with specific teacher inputs, teach the
trainee about ethics, communication, relationships with professional colleagues
and occupational health law. This will be consolidated by attendance at the
university of Manchester medico legal course.

Healthwork has various contracts to provide advice to pension schemes
(including private pension schemes, LGPS, Police pensions, Fire-fighters
pension scheme). The trainee will be trained in doing this type of work.

Dr Hussain and Dr Austin are appointed doctors for the HSE, and the trainee will
be provided with training opportunities relating to Lead, Asbestos, COSHH and
ionising radiation. The trainee will be expected to become an appointed doctor.

5) Promoting work ability

Our OHA‟s are involved in health promotion and health surveillance activities.
We will arrange for the trainee to initially observe these activities and over time
take responsibility for health promotion and health surveillance activities.

6) Research and teaching

The academic course centre will provide education to the trainee regarding
research and research methods. Also Dr Hussain as assistant editor to
„Occupational Medicine‟ will provide training on research.

We will expect the trainee to provide teaching to our OHA‟s and we will in year 3
or 4 send the trainee on a „teaching the teachers‟ course.

7) Business

In year 4 of the programme, we will expose the trainee to various business
aspects of Healthwork including operational management of Healthwork,
financial and business planning, marketing, tendering processes, negotiating



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contracts/service level agreements, presentations to employers, and personnel
management.

8) Personal Professional development

We will work with the trainee to encourage them to look at continuous self
development, by using improving time management and decision making skills,
by using reflective practice, and by encouraging lifelong learning.




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