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Page 12 | Bulletin 93 | September 2015 ficm@rcoa.ac.uk www.ficm.ac.uk Recruitment Tom Gallacher, Chair, FICM Recruitment Sub-Committee In the 2015 Recruitment Round, 137 posts were available and 120 were subsequently filled, giving an overall fill rate of 88%. There were further candidates appointable to Intensive Care Medicine but due to the requirement for both specialty programmes of a dual programme to be in the same deanery, some deaneries were oversubscribed whilst others were undersubscribed. Recruitment took place over three days in April, with 240 candidates invited for interview, and was again held at The Hawthorns – West Bromwich Albion’s football ground in Birmingham. For the first time, Scotland was able to offer posts via the national recruitment process and thus with all four nations involved for the first time the process was truly national. In 2015, we introduced for the first time a quality assurance process for the recruitment round. This comprised a small group of experienced interviewers who observed the various stations across the multiple streams in an attempt to confirm that they were consistent in their assessment of candidates or to identify any inconsistencies in order to inform next year’s process. As part of this quality assurance, and in addition to the trainees’ postinterview feedback forms, we invited formal structured feedback from the interviewers, as well as inviting the interviewers to feedback to us any other issues they feel may improve the 2016 process. A quality assurance report has been produced, and this and the comments and suggestions we received from the interviewers was reviewed by the Recruitment Sub-Committee and where appropriate the suggested changes have been incorporated into next year’s process. Our interview process was attended by a lay observer on each of the three days, and formal feedback was very positive with only a few minor recommendations for improvement which have been discussed by the Recruitment Sub-Committee. We are pleased to announce that the Faculty of Intensive Care Medicine has been in discussions with the General Medical Council, and that the latter have agreed to remove the ‘18-month rule’. This is the requirement for a trainee to commence training in their second specialty of a dual programme within 18 months of commencing their first specialty in order to be awarded dual CCTs. This now means that a CESR(CP) will no longer be required in order to gain entry to the specialist register for the second specialty to which the trainee is appointed – regardless of the length of time which has passed from their appointment to their first specialty programme. Though this was always merely a paperwork issue in that both a CESR(CP) and a CCT allow entry onto the specialist register it was a source of confusion with some trainees interpreting this as an absolute time limit for appointment to a dual programme with ICM. However, and very importantly, as has already been mentioned in previous articles, the Faculty have agreed in conjunction with our partner Colleges that no trainee will be permitted to commence a dual training programme with ICM if they will have commenced ST6 before 3 August 2016. This has been well publicised in advanced in order to avoid any trainee wishing to dual train being prevented from doing so. However, the new upper limit on seniority for recruitment to a dual programme will become effective for the 2016 Recruitment round.
Page 13 | Bulletin 93 | September 2015 fpm@rcoa.ac.uk www.fpm.ac.uk News from the FPM Beverly Collett, Chair, FPM Professional Standards Committee The FPM Professional Standards Committee is responsible for pain medicine matters relating to good practice documentation, revalidation, policies relating to patient safety, competencies, clinical audit, doctors in difficulty, events, the website, and policy endorsement. This article provides an update. Core standards The FPM Board decided that there was a need for publication of a comprehensive document defining standards for pain management services in the United Kingdom. This had been preceded by the publication of the 'Guidelines for the Provision of Anaesthetics Services' (GPAS) documents, which encompassed relevant guidelines for anaesthesiadelivered acute and chronic pain management services. However, there was interest from bodies external to the RCoA for the FPM to become instrumental in advancing standards for all multi-professional groups involved in the delivery of pain management services. The ongoing changes to the NHS make this a timely undertaking. Variations to commissioning structures across the UK create the need for a set of standards for clinicians and commissioning bodies to ensure safe, equitable and quality care for patients. The chapters of the document have been written by 45 highly respected multi-professional clinicians, with an introduction and a concluding background section. Standards – items already embedded in practice or of overriding necessity for good care and Recommendations – aspirational or desirable features that may become standards for future versions. The document has been extensively peer-reviewed and sent out for wide consultation. It will be a web-based dynamic document. The projected publication date is November 2015. Conducting quality consultations in pain medicine The clinical consultation, previously described as ‘the central act of medicine’, is the bedrock of professional practice in pain medicine. The interaction between patient and clinician underpins assessment and management and so will impact on healthcare outcome. The specialist pain consultation is typically a complex interaction. The assessment is not only biomedical but will also explore relevant psychological and social aspects. Clinicians need to navigate the challenge of busy clinics with high patient distress, adopting a patientcentered approach to facilitate a shared understanding of the pain problem. The exceptional document 'Conducting Quality Consultations in Pain Medicine' is an excellent resource which will facilitate clinical excellence in this element of core practice. Patient information leaflets Patient information for pain medication is on the FPM website. Work is underway to produce information leaflets for interventions. Pain in secure environments The first training day for healthcare professionals (mainly GPs and nurses) working in prisons took place in July 2015, with further days planned for September and November. Since startup funds come from Public Health England, this is currently an England-only initiative. The FPM is exploring running courses in Scotland, Northern Ireland and Wales, and broadening the scope to other groups of staff, such as those working in nursing homes and residential care. ASK2QUESTIONS The Faculty agreed to lead on the development and implementation of national standards and criteria for the identification, assessment and initial management of complex pain. ASK2QUESTIONS is a short prescreening tool to help clinicians decide if they need to more fully assess a person presenting with pain. If pain is classified as complex, then fast-tracking patients into appropriate treatment may prevent chronicity and reduce morbidity. This tool could be used by GPs, district nurses, physiotherapists and Emergency Department staff. ASK2QUESTIONS is being piloted and discussion is underway to validate the tool within an academic setting. WHO Checklist for pain medicine procedures Most pain clinicians will use a theatre WHO Checklist when undertaking procedures, but these are not ideal for pain interventions. A WHO Checklist for Pain Medicine procedures is in development. Drugs and driving In March 2015, a new law came into effect, creating zero tolerance to driving with certain drugs, including cannabis, ketamine, or diamorphine in the body. Some benzodiazepines (including clonazepam, diazepam), methadone and morphine are included in the medical drug category and have blood levels set at a higher level than the zero tolerance group. It is recommended that clinicians read the guidance available on the Department of Transport website www.gov.uk/drug-driving-law.
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