Trainee Self-service - Training Agreement / Conditions of Joining (Draft)

North East, North West and YH

Sarah Hill
Claire McGovern (NW)

South (WES/TV/SEV/PEN)

Lisa Edwards (TV)
Carla Miners (SW)

London/KSS/SE

Stuart Morris

East of England

Ping Yu (EoE)

Midlands

Gwilym (EM)
Michael ( WM)

NIMDTA

Out of scope?

1

Is the Training Agreement also referred to as the Educational agreement (as per GMC Gold Guide)?

No. See above Background section updated.

10/10: This is referred to as “Conditions of Joining a Specialty Training Programme” (Appendix 2) in the Gold Guide.

Consensus is to stick to the Gold Guide’s wording and future comms to align/refer to this definition.

Educational Agreement is a separate agreement required for each placement which set out the plan for their actual training.

2

Which parties are involved in this "agreement"? Is is between the PGDiT and their Educational/clinical supervisors or both? between the PGDiT and the Local Office? Or between PGDiT and their employer/trust/Postgraduate Dean, TPDs etc.? Or who else with?

The sample EoE agreement implies an agreement between trainee and Postgraduate Dean; the Gold Guide text saying that it “should be the basis of all educational review discussions” (with educational supervisor?).

SW: An agreement between the PGDiT and their Postgraduate Dean. They cannot train without it.
EM: The GMC look at those signed documents.
Educational contract is with HEE.

3

What is the purpose of the Training Agreement? What problem/s does it solve?

Is the purpose answered in the above Gold Guide text? Or do you think it is also being used to solve additional LO issues e.g. providing a valid email address etc.

To hold the trainee accountable to a set of conditions on their behaviour and conduct. (Gold’s Guide definition)
3.45 Trainees will also need to send to the Postgraduate Dean a signed copy of the conditions for taking up a training post (GG9 Appendix 2) which reminds them of their professional responsibilities, including the need to participate actively in the assessment and revalidation processes. These obligations relate to professional and training requirements, and do not form any part of the contract of employment.

4

Is it required per training programme or per placement or anything else?

The Gold Guide paragraph mentions “for each training placement” for an educational agreement.

Per Programme with the flexibility to have it more than 1 time for some programmes. *
There is an expectation in the Gold Guide where there previous submission is still valid.

*Not sure what this means? Why more than 1 per programme? What criteria?

5

When is it required to be completed by the PGDiT?

Prior to starting their programme.
LO’s will normally provide them a deadline.
LO’s then checks the manually compiled list to track who has and hasn’t completed.
We cannot stop trainees from starting if they haven’t completed.
As part of compliance for revalidation at an ARCP, this is checked and trainees chased to complete.
At the moment there is no way to force them to complete to then be given access to systems they need to be able to access.

6

Is it required by both Specialty and Foundation trainees?

The Gold Guide paragraph mentions “based on the requirements of the curriculum for the foundation or specialty training” for an Educational Agreement.

Yes. Foundation trainees (F1 & F2 Standalones) do it on Horus. The title of the agreement is slightly different.

https://supporthorus.hee.nhs.uk/video-tutorials/foundation-doctors/#1326

7

Is there one required for Dental Trainees?

Yes, a different form as required by the GDC Dental Gold Guide.

8

When completed, where/who does this go to?

It is stored against trainees records (e.g. JISC online surveys, word document, PDFs.

9

Who needs to have visibility of this agreement following submission?

Gold Guide says that it “should be the basis of all educational review discussions” which seems to imply visibility for clinical supervisors and LOs perhaps?

Deans and delegates can access the documents. There is no requirement to be sharing it more widely.

There is no counter signatories.

10

Who reviews it?

No one currently. There is nothing to check in the contents of it but only to see who has and hasn’t completed one.
May need to get them to check their Names and programmes on the document. (Not necessarily an issue if done online)

11

How is a PGDiT/Appointees notified of a Training Agreement being required to be submitted/completed by them?

Notified via email with a link or method to complete. Local Office comms.

12

How long is the training agreement maintained?

For the whole duration of the programme. Refer to National TIS Retention Policy.

Validity of which is for the duration of the programme. Changes that take place in between does not invalidate the submission.

13

How is it currently submitted in the Local offices? 

Digitally.

14

Is it currently used by all Local Offices?

Yes.

15

What are the issues with the current way/s it is actually submitted?

• To compile the list of who has and hasn’t completed it

• To chase those that haven’t is time consuming

• Effort and time in Filing/ admin burden.

16

Is the same process followed in all 13 Local Offices?
Please provide a copy of the Form used by your Local Office to ashley.ransoo@hee.nhs.uk / nazia.akhtar@hee.nhs.uk

Different processes and methods by LO’s although there is a national version of the form.

17

Is there a national process and therefore a national version of the form? If not, what are the differences and why?

Different processes and methods by LO’s although there is a national version of the form.

18

How is it ensured that the PGDiT are meeting those statements/clauses they are signing up for? e.g. at ARCP, Revalidation etc...

All interactions and opportunities with trainees (ARCP, Revalidation, etc.)

19

What happens if a PGDiT does not meet (breach) with any of those clauses/statements outlined on the agreement?

Depending on severity, they are reminded of, it could lead to suspension or their license removed, and removed from training.

There is a reporting process (differs by LOs).

20

Can a PGDiT commence training without having the Training Agreement signed? is this verified by anyone at commencement of their training?

Yes.

21

Is the Training agreement looked at or has a dependency on any other Local or national processes/panel, e.g. ARCP, Revalidation onboarding, at rotation etc.?

No dependency.

22

What’s the impact of not submitting or late submission?

Historically obtaining NTN. Not anymore as it’s just an assigned number on the day the programme starts. Trainees can get it themselves.
(https://www.gmc-uk.org/education/standards-guidance-and-curricula/position-statements/national-training-numbers-appendix,
https://www.gmc-uk.org/-/media/documents/arcp-2022-briefing-note-final-2_pdf-92196287.pdf )
In theory, not starting the programme, in practice they are still allowed to start their programme.
Admin burden to keep chasing.

24

What kind of support is there in the Local Offices to manage existing processes? Is this sustainable?

• Sicknesses and short of staff > Chasing of trainees > admin burden.

• Even with an automated process there would still be some admin burden.

• Not sustainable,

25

Could the Training Agreement requirement be met other than by signing a form?

• Trainees are required to have gone through all the text to then sign/digitally acknowledge/tick.

• Where the conditions are updated in the future, the retrospectively submitted ones should remain unaffected.

26

When does a Postgraduate Dean/Delegate need to see a signed Conditions of Joining?

• LaSE: When things start to go wrong with the trainee; e.g. trainee non-engagement with their programme or no show, trainees not following the process, problems with the GMC. Very rare.

  • Trainee has started a programme and not having a valid License to Practice.

  • Getting trainees connected to the correct Designated Body - there is an admin burden.

  • Visas: Non-UK or previous EU trainees having the correct visa to start employment, Gold Guide Appendix - “…comply with immigrations…”, similar but separate to the pre-employment checks

  • Keeping email address up-to-date; e.g. when leaving medical school, Foundation trainees need to ensure they have updated to a new and accessible email address. Higher level trainees alike, need to update their details when they move trusts/employers. (To consider the various emails, master systems etc. and the process to maintain/overwrite systems which maintain email addresses in the to-be flow)

• Dean would then need to see the signed COJ.

27

What interactions would a Postgraduate Dean/Delegate have with a Trainee where one has not been signed?

• Dean would be liaising with Local Office to get it signed.

  • A very small percentage every year. % trainees for LaSE? @Stuart.Morris (Unlicensed)

  • @Ashley Ransoo / @Nazia AKHTAR/UR To engage with the User Group to identify reasons for failing to submit on time

28

What are the issues Postgraduate Deans/Delegates experience with trainees not having signed a COJ and how could the process be made less burdensome for them in the future?

• Covered in #26.

• User-friendly, Accessible, EDI aspects (inclusive) to be considered in the streamlined process and solution

• To involve Deans (Gary Wares), LOs and PGDiTs in the reviews

Health Education East of England

https://heeoe.hee.nhs.uk/faculty/starter-documents/training-agreement

Health Education England East Midlands

https://www.eastmidlandsdeanery.nhs.uk/sites/default/files/training_agreement_em_ext.pdf

PDF/Word

Health Education England West Midlands

https://www.westmidlandsdeanery.nhs.uk/Portals/0/Training_Agreement_v1_ext.pdf?ver=2018-05-01-151747-667

PDF

London

Link--?

Online JISC Survey

Appointee/PGDiT

to be able to send to the Postgraduate Dean a signed copy of the conditions for taking up a training post

any interested parties (e.g. Deans, Delegates & HEE Admins) are satisfied with this as proof of my acceptance to the conditions of Joining.

Local Office Admin

to receive signed COJs prior to a trainee starting their programme

they are formally agreeing to the Conditions of Joining a Specialty Programme as set by the Gold Guide

Local Office Admin

have sight of a signed COJ

it can be shared to the Postgraduate Dean and relevant parties in the event of issues arising during their programme

Local Office Admin

have a national streamlined process to receive signed COJs

current administrative burden from the current process is reduced

Local Office Admin

have standardised communications on instructions to complete “Conditions of Joining a Specialty Programme”

all Local Offices follow the same process with clear guidelines between each Local Office and their trainees

Local Office Admin

ensure trainees signed COJs are maintained against the current version as published by the GMC at a point in time

I have a reliable/definitive way of identifying which version has been submitted by a trainee

Post Graduate Dean / Delegate

ensure that important points are clearly highlighted to the trainee (e.g. email address, immigration details)

they are aware what they are actively adhering to by signing the Conditions of Joining.