Shape of Training Review

The following is the College's response to this consultation.

Anaesthesia is the largest single hospital specialty in the NHS. The Royal College of Anaesthetists is the professional body responsible for the specialty throughout the UK, and it ensures the quality of patient care through the maintenance of standards in anaesthesia, critical care and pain medicine.

The RCoA welcomes the Shape of Training Review and the requirement to continually revisit and reappraise training, quality of training and training delivery in a fast paced, ever changing health care environment.  The RCoA responses to the questions posed by the Review are attached and have been submitted online. Separate responses are also being made by the Faculties of Pain and Intensive Medicine.  In addition, there are a number of key aspects specific to anaesthesia that the College requests to be considered in detail when delivering on the recommendation of the Review:

  • The financial implications of training have to be carefully considered, particularly in the current economic climate.  However the RCoA has real concerns on the implications for patient safety in the long term if training time is reduced.
  • The RCoA Council at their January meeting expressed concerns about the consultation process and that many decisions/recommendations from the review may be politically driven.  The College considers the need for sufficient meaningful external consultation imperative.   Further opportunity for direct engagement  would be welcomed (including contributing oral evidence) as has been deemed essential by the expert group before any recommendations are made to change anaesthetic training, either directly or by implication.
  • The RCoA has already embraced the importance of generalist training and the current CCT in anaesthetics is a generalist based training programme specifically designed to produce independent practitioners capable of service delivery in the secondary care setting.  The current seven year competency based training programme has evolved over time to produce CCT holders capable of independent practice for all clinical scenarios that present to a district general hospital.  The College stands by the seven years programme, particularly as it was increased from six years previously to ensure a high level of competency to meet the generalist agenda . Although there is a focus on specialist training at the advanced levels of training,  this remains embedded in generalist principles and the two are intrinsically linked at the latter stages of the training programme. 
  • Reduction of training would decrease opportunities for trainees to gain a broad based training platform at core level which is widely considered to be beneficial at the early stages of postgraduate medical training.
  • Shortened training would compromise the ability to produce anaesthetists sufficiently capable of safe, independent practice in accordance with the widely held view that 10000 hours of training  plus five  years of experience is the minimum requirement.

The RCoA looks forward to receiving the recommendations that Professor David Greenaway will make at the conclusion of this review and continuing to engage in the debate.

31 January 2013