Mesh Complications Management Training Pathway Pilot Development

This online hub was developed for the pathway, and a registration of interest form was developed for established practitioners and other interested participants to register their interest prior to roll-out of the training pathway.

Please submit your completed registration of interest form to training@rcog.org.uk.

Phase 1 of the pathway implementation focuses on certifying established practitioners who work in specialist Mesh centres and will begin from July 2022. The certification process is outlined as follows:

• Established practitioners submit a portfolio of evidence against the Mesh training pathway curriculum for assessment by a panel. The assessment panel will consist of one member of each surgical specialty.
• Once portfolios are assessed for evidence, the panel will make a decision to sign-off a practitioner, or assess whether further information is required.
• Practitioners who have met the requirements will then be certified by the RCOG, RCSEng, RCSEd and RCPSG to train individuals on the pathway.
• Registration form (Word document)
• Guidance for Mesh Accreditation (PDF)

Please submit your completed registration form to training@rcog.org.uk.

Phase 2 of the pathway implementation focuses on training individuals against the set Mesh curriculum requirements. Established practitioners certified in phase 1 will act as Educational Supervisors for those training on the pathway. It is anticipated that the training pathway will take between 12 and 18 months to complete, depending upon acquisition of competencies. The duration of the training pathway is an indicative timescale as the pathway, as all other postgraduate training pathways, is competency based and not time based. Phase 2 will launch once sufficient numbers of established practitioners have been certified.

The key elements of phase 2 training are as follows:

• Individuals must register and enrol on the training pathway against the relevant eligibility criteria. Individuals should hold a CCT in one of the following specialties:
  • Obstetrics & Gynaecology (Urogynaecology)
  • General Surgery with a special interest in colorectal surgery
  • Urological Surgery
• Individuals on the pathway will train alongside established practitioners at specialist Mesh centres.
• Individuals training on the pathway will be assessed at ARCP style panels at the end of the first year of the pathway. This will determine if further training is required or if an individual can be signed off.
• Once the panel have agreed that relevant competencies have been met, an individual will be certified to practice in this area.
• Those certified will be stored on a College held database.

The GMC have been undertaking an early adopter approach to credentialing with a small number of specialties in the UK. The current credentialing framework is available online.

The long term aim of the Mesh training pathway is to submit this for approval by the GMC. This would involve the following key steps:

• Consultation data and information from phases 1 and 2 for submission through the GMC’s Curriculum Oversight Group (COG) and Curriculum Advisory Group (CAG).
• Undertake further stakeholder consultation as required.

Once approval is received from the GMC, the Mesh training pathway will move to a GMC “approved” credential, which will then feature on the specialist register for those who undertake the pathway. As the pathway will be regulated, there will need to be regular reporting and evaluation of the pathway, dependent upon how long approval is granted for.

Once approval is received from the GMC, the Mesh training pathway will move to a GMC “approved” credential, which will then feature on the specialist register for those who undertake the pathway. As the pathway will be regulated, there will need to be regular reporting and evaluation of the pathway, dependent upon how long approval is granted for.

A communications strategy will be developed to support the implementation of the training pathway, in conjunction with key stakeholders including Patient and Public Involvement PPI groups and the Pelvic Oversight Group.

We have proposed that the fee structure for the Mesh training pathway is based upon the Subspecialty Training Model. The training pathway is an essential for the workforce and as such the fees proposed do not represent an income generating activity for the College.

We are proposing the fees as follows:

Phase 1:

• An applicant fee which is payable by the applicant at the time of registration (amount TBC)
• An annual assessment fee which is payable by the mesh centre (amount TBC)

As outlined above the cost of the assessment will be the responsibility of the unit who has been commissioned to deliver the service and is per person

The fee structure for Phases 2 - 4 will be established over time when the training pathway is rolled out more widely, following accreditation of the established practitioners.

Useful links:

https://www.hee.nhs.uk/our-work/advanced-practice/credentials 

A 'credential' is a training pathway offered to consultants who are on the GMC's Specialist Register to train in a specialist area that was not undertaken prior to the receipt of their specialist registration.

In 2019, the General Medical Council (GMC) developed their Framework for GMC regulated credentials

The framework outlines two key drivers supporting the approval of credentials:

• Unregulated areas of practice where there may be significant patient risks.
• Where the capacity to train doctors is insufficient to meet patient or service needs.

All four UK governments have agreed that credentials are one mechanism that will help to better support the medical workforce.

The GMC are currently working on how credentials will be embedded, including the sign-off and maintenance of credentials. Further information will be provided in due course.

At present, the GMC are working with a small number of specialties to test the framework through an "Early Adopter" process.

Until the "Early Adopter" process has concluded the GMC are not accepting any further credentialing submissions.

See further information regarding the "Early Adopter" process on the GMC website.