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Generalised training needed as patients ‘passed round system like parcels’

Medical training in the future must reflect the need of both patients and service providers, a new report released today has argued.

The document, called the Shape of Training report (SoTR) from the UK Shape of Training Steering Group, looked into how medical training could be designed better to improve care outcomes in the UK.

It found that in future training, doctors should be taught general rather than specialised skills, due to the growing nature of community care and the changing demographic of the UK’s population.

The report also called for a “rethink” of the current system, stating that action is required to develop and support the delivery of patient care in a community setting.

“In order to ensure that the doctors of tomorrow have the appropriate skills, competencies and aptitudes to meet changing needs requires a rethink of the current arrangements for postgraduate education and training,” it stated.

This would be necessary to tackle issues such as patients, including the old and frail, being increasingly failed by a system that is ill-equipped and unwilling to meet their needs.

A quote from a Royal College of Physicians report that the SoTR cited as an example said: “Older patients with an ill-defined acute illness and multiple comorbidities are much more commonly encountered on the acute medical take.

“There is increasing evidence of substandard care provided to many older patients with care poorly co-ordinated and reports of patients being moved round the system like parcels.”

The chair of the SoTR, Professor Sir David Greenaway, said that in undertaking the review he discovered a “wide recognition of the need for change” and a “clear consensus about what change should deliver: greater flexibility, better preparation for working in multi-professional teams and more generalists”.

Doctors welcome ‘pragmatic approach’ to training

The BMA backed the report’s “pragmatic approach”, which Dr Jeeves Wijesuriya, the union’s Junior Doctors Committee chair, argued “listened to, rather than undermined” the opinions of professional doctors’ bodies.

“We want to reassure patients and doctors that we continue to oppose any changes which devalue the high standard of medical training in the UK or compromise patient care,” he said.

Dr Wijesuriya added that the government’s recent statement on NHS workforce expansion committed to consulting on any proposal to move the point of registration, despite the BMA resisting attempts to do so – since it would allegedly require significant changes to undergraduate medical curricula and could compromise the quality of training.

“We have argued robustly to preserve the current specialty training structure, and for maintaining the Certificate of Completion of Training (CCT),” the BMA committee chair continued.

“We insisted that amendments to training pathways, if needed, should be made by the royal colleges and faculties. We have also argued for a model of credentialing that does not undermine the CCT or the coherence of training programmes.

“Any move that weakens the current standard of specialty training risks reducing the quality of patient care, and is therefore unacceptable to doctors.”

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