Maternity workforce planning
The RCOG sits on HEE’s Maternity Workforce Steering Group, Work Stream 5 of the Maternity Transformation Programme. HEE were tasked with delivering the vision set out in Better Births, this includes the provision of maternity services based on the future needs of women and babies and the workforce required to deliver them. Through the Maternity Workforce Steering Group the RCOG has been advising on the composition of the O&G workforce and the services it provides, as well as the challenges and threats to the continuity of safe care. We have worked directly with workforce planners to ensure that their modelling is based on accurate workforce data including the number and types of roles that provide maternity services as well as their working patterns.
As a result of this work the Maternity Workforce Strategy - Transforming the Maternity Workforce, signed off as part of the Maternity Transformation Programme in June 2018, contains a reasonably accurate reflection of O&G workforce numbers together with a set of recommendations to address the challenges it faces, now and in the future. Only a 12 to 18 months ago workforce planners were predicting a potential oversupply of O&G consultants and there was concern that training places could be reduced. As a result of our conversations, HEE is now estimating a potential undersupply and is working closely with the RCOG to mitigate this and other risks to the delivery of safe O&G services. Recommendations and actions from the strategy include:
- Future Workforce Planning: Work with the RCOG to assess the workforce needed to deliver O&G services over the next 5 to 15 years, including an assessment of acuity
- Understanding attrition: TheRCOG will sit on a Medical Workforce Steering Group to improve our understanding of the reasons people leave the profession
- Redesigning the consultant model for the future: Working with the RCOG and other bodies, develop a future consultant model which addresses growing subspecialisation and changing work expectations at different career stages. The RCOG will consult with its members to ensure that proposals are informed and fit for purpose
- Developing the role of SAS and Trust doctors: The RCOG will sit on a newly established SAS Doctors Development Group to coproduce a workforce strategy for SAS doctors; areas of focus will include education, professional development and career structure
- New role of obstetric physician: HEE will fund the development of an additional training pathway for obstetric physicians, with plans to pilot this for both established consultants and doctors in training in 2018/19
Reducing attrition from the O&G training programme
In 2017 a member of the Workforce Task Group, Dr Heidi Stelling, conducted a survey and focus groups among O&G trainees to understand their reasons for considering leaving the training programme. The survey, completed by over 500 trainees, showed that factors behind attrition were:
- Poor work-life balance
- Rota gaps
- More out-of-hours working
- Less supervision
- Fewer training experiences
The survey findings are being shared with Heads of Schools and others involved in training to help shape and improve trainee experiences going forward. This is likely to involve an improved team structure, which could address some of their major concerns.
You can read more about the survey findings in our O&G magazine article Retaining Our Workforce, Summer 2018
Training Evaluation Form
The Training Evaluation Form (TEF) is an annual survey conducted by RCOG to gather feedback from trainees on their training experience enabling the College to monitor and improve the quality of training. The TEF survey results, including Deanery and trust level data, are now available to view on the college website for the first time.
Key findings from the 2018 survey included:
- 81% of trainees would recommend their training placement
- Obstetric training is more highly rated than gynaecology
- There is wide deanery variation in some areas such as satisfaction with gynaecology training
- Satisfaction with regional teaching continues to improve
- LTFT trainees are more satisfied with their training than full time
- Reported rates of undermining behaviour are unchanged
- Educational supervision is highly rated with top performing units showing extremely positive feedback for educational supervision
- 29% of trainees felt obliged to work more than their contracted hours with wide deanery variation. Increasing obligation correlated with a reduction in satisfaction in the working environment and overall satisfaction with training.
TEF awards have also been introduced and recognise the achievements of highly performing units in obstetrics, gynaecology, professional development and overall performance. Feedback from these units along with recognised national quality standards for education and training is being used to produce RCOG national quality criteria which will be published alongside the new curriculum. This will enable units to benchmark their provision against best practice.
The feedback from highly performing units has also been disseminated to schools and is available on the college website for others to view and apply, where relevant in their own units.
Return to work support
Returning to the workplace after a period of absence (maternity/paternity leave, out of programme experience, etc.) can be very daunting. Many doctors have expressed concerns that they may have lost clinical skills and not be up to date with developments and changes in practice. Funded by a grant from HEE, the RCOG has developed a Return To Work Toolkit to support O&G doctors returning to work after a period of absence. The toolkit builds on successful courses already running at a regional level and provides information that can be easily accessed by those returning to work as well as those supporting these individuals. The toolkit is relevant to trainees, consultants and SAS/Trust doctors and also contains guidance to enable regions to develop and run their own return to work courses.
The toolkit was put together by a senior trainee, Dr Sukhera Furness, who built on the work of other successful initiatives in this area. Utilising resources such as this toolkit he RCOG is encouraging all trusts to adopt a consistent approach to supporting doctors back into the workplace after a period of absence. This is essential if we are to retain much needed and valued talent and mitigate further workforce attrition.
Visit the Return To Work Toolkit
Increased support for new consultants
Making the transition from trainee to consultant can be an overwhelming and often lonely experience. The RCOG has been working with a group of new consultants to develop resources and networks to ensure new consultants feel better supported, equipped and confident to carry out their roles. This includes refreshing the annual Newly Appointed Consultants meeting, which has been renamed #NEXTSTAGE – Transitioning to Being a Consultant, to include more focus on the non-clinical aspects of consultant roles, including effective leadership, management and team working. Also in development is a New Consultants’ Toolkit for those wishing to set up a local peer group network. The toolkit will contain a template programme, suggested speakers and contacts as well as useful resources.
#NEXTSTAGE - Transitioning to Being a Consultant, takes place on 22 January 2019.
Find out more about our work with new consultants in the O&G magazine article Supporting New Consultants, Summer 2018