Incidents and concerns logging

A key part of the revalidation process is to check any Serious or Untoward Incidents (SUIs) or other concerns that are subject to ongoing investigation.

Sources of this information are:

• Trainee Self-Declaration (Form R Part B)
• Employers report (aka. Live reporting, Exit report, Collective exit report)
• ARCP Outcome form (Panel concerns) - this should reflect incidents declared in Form-R or Employer's reports, as these form part of the evidence for ARCP
• Supervisor's report (Educational note)
• GMC Concerns List
• Ad hoc notifications from others e.g. ...
  
  

Local teams log the information in different ways - spreadsheets or one or two have bespoke databases (Access for GNC Concerns - Thames Valley; Sharepoint combined concerns log - North East). East Midlands has a highly developed spreadsheet system which uses macros to auto-populate their revalidation management tool (also a spreadsheet) - more info below.

While teams talk about the logs/datatbases as the source off their information, ultimately the actual source is usually an unstructured email or email form which is manually input into one or other of these logs/databases once it arrives with HEE. ** I will add format to the above list of data sources in due course with examples if I can get them**

The exception to this is Form R Part B - this is where trainees declare any incidents or complaints that they have been involved in. A version of this has been developed for Intrepid (trainee self-service) but is not widely used.

Much of this information (with the exception of the GMC Concerns list) is reviewed by the panel at the time of ARCP - and the panel will note any things that are of concern on the ARCP Outcome form. Therefore, in theory a revalidation officer is generally interested in reviewing issues and concerns that have arisen since the last ARCP - although some we've spoken to do like to see an overview for the whole revalidation period (i.e. the period between Revalidations - some trainees will have 2 during their time under HEE if initial GMC date is >1 year before their CCT, and in theory could be 3 if their training is extended by a long period).

UPDATE FOLLOWING HICOM VISIT 9 AUG

Intrepid does have functionality for ‘Employer report fragments’ (Employer reports from placements, which should be input manually against the placement - but not a lot of data in there, which may mean not a lot of incidents, or few using it - none of our Reval officers has mentioned it, so likely to be latter?).

ARCP outcome information is held on Intrepid (including the Outcome 'form' which is held as separate data fields) - it is therefore possible to extract the Panel concerns comments field in addition to the Outcome code.

USER REQUIREMENTS

Checking evidence of incidents and concerns is the central part of the revalidation process - as such, revalidation administrators often become the administrators for this information, even though it is also used for other functions such as trainee support, and especially ARCP.

Users who do not currently have a locally-developed single database/spreadsheet logging system for incidents and concerns have confirmed that this would be a good way to add value (KSS & London).

Although there is functionality available on Intrepid to manage this information, there is little evidence that it is being used. Therefore, there is no single source within HEEs or common process across HEEs to retrieve this data for the TIS Revalidation service - without it it will be more difficult for the new revalidation service to improve the processes already employed by HEE local teams in any significant way, as administrators will still be required to visit a number of systems and files to review evidence, which is the most time consuming part of the job.

There are a number of options to consider:

• TIS Revalidation in Beta does not tackle Incidents & Concerns logging but provides functionality simply to note what's viewed elsewhere
• As above, but with a clear plan within wider TIS to add Incidents & Concerns logging so that revalidation administrators can predict improvements in the service that will help with buy-in
• User Intrepid data on Incidents and Concerns to feed into TIS Revalidation and thus provide an incentive for local teams to implement and use this Intrepid functionality. HEE to drive business change within teams involved (wider than just revalidation teams) and to invest in improvements to Intrepid functionality where this is found to be truly 'not fit for purpose'
• Develop an Incidents and Concerns logging function within TIS - initially take feeds from Intrepid where available (e.g. ARCP Outcomes) but with a view to migrating all initial data input to TIS (e.g. Form-R, Trust reports) - initially by HEE administrators to replace their existing local systems, but eventually at the source (e.g. Trusts direct input of their exception reports).

ARCHITECTURE

If we do develop a single Incidents and Concerns logging function, it would make sense for this to sit outside revalidation, as it is a resource that would be shared between a number of HEE Trainee processes, e.g. trainee support, ARCP:

• Different roles (e.g revalidation admin, ARCP admin) may be responsible for input and management of the data than those who use it
• Some of the information, specifically GMC Concerns, is highly sensitive and would therefore require granular permissions set  for example ARCP administrators may not be authorised to view GMC Concerns, whereas they would require easy access to both input and review Employer reports and Form-Rs
• Trainees should (eventually) be able to complete their Form-Rs within TIS as part of their ARCP preparation, but would not have a view of the database (tbc - may have a view of their own records on it, even where these are GMC?)
• Etc

NEED A NICE DIAGRAM BY RORY/HUBERT HERE