IOM DHSC & MANX CARE

[Gladys]

17 minutes ago, FSM said:

The requirements to be a consultant  are in the public domain.

Just have a look at the relevant royal college website.

Essentially you complete a qualifying medical degree, then 2 years as a foundation doctor. Then speciality training of between six and ten years, speciality exams at entry and exit of training.

I’m “just” a GP. Five years at university. One year as a house officer (2 nowadays) then 3 years postgraduate training. Exams every year at university. Summative assesment at the end of GP training, plus MRCGP exams. Nine years training, qualified in 1998, so 23 years experience post qualification. About 62% of my life so far…

Presumably, there is quite a heavy CPD requirement too?  

[FSM]

4 minutes ago, Gladys said:

Presumably, there is quite a heavy CPD requirement too?  

 

4 minutes ago, Gladys said:

Presumably, there is quite a heavy CPD requirement too?  

Minimum of 50 hours per year. Mandatory training inCPR and safeguarding. Annual appraisal and revalidation every 5 years.

Edited December 18, 2021 by FSM

[Gladys]

4 minutes ago, FSM said:

 

Minimum of 50 hours per year. Annual appraisal and revaludation every 5 years.

People tend to forget, or not know about, CPD.  It is quite a commitment, because that will be the formal CPD requirement, there will be informal CPD too, I suppose.  

[FSM]

32 minutes ago, Gladys said:

People tend to forget, or not know about, CPD.  It is quite a commitment, because that will be the formal CPD requirement, there will be informal CPD too, I suppose.  

Definitely. We all learn something new almost every day. My patients are my greatest teachers. This week I have seen 3 patients with a condition which had me reaching  for the textbooks and making notes for future reference. That’s a fairly average week.If the CPD requirement suddenly changed to 200 hours I don’t think I’d have a problem meeting it.

We also train medical students and junior doctors, teaching someone else always teaches you about yourself.

 

Edited December 19, 2021 by FSM

[James Blonde]

2 hours ago, Kopek said:

I doubt anyone considering working on the Island takes any of your parameters into account?

More likely , arrive here for a specific job or look for work, rent, see how it goes and then make a decision?

Unless married or of that proximity, their first consideration will be, how are they going to enjoy Island Life, which is new to them.

They do not consider your parameters in advance.

Healthcare professionals are in massive demand all across the globe. To think they don't take those things into account is naive. 

There will be hundreds of hospitals that can provide way more on their doorstep than Noble's does or even could. 

These are people who can afford to be picky. 

[Gladys]

There is also the amount of experience they would get here.  If you were a young doctor wouldn't you want a position that would give you lots of new challenges to hone your knowledge? 

Years ago I was told that young doctors, particularly those specialising in orthopaedics and trauma, were attracted to the IOM  because of the challenging injuries from the TT and MGP.  It may have been tripe, but it did kind of ring true. 

[James Blonde]

10 minutes ago, Gladys said:

There is also the amount of experience they would get here.  If you were a young doctor wouldn't you want a position that would give you lots of new challenges to hone your knowledge? 

Years ago I was told that young doctors, particularly those specialising in orthopaedics and trauma, were attracted to the IOM  because of the challenging injuries from the TT and MGP.  It may have been tripe, but it did kind of ring true. 

I imagine they would be interested in a fortnight's secondment to Noble's but that would be about it. All pretty bog standard stuff the other 48 weeks of the year I guess (or 52 once they cancel TT22) 

[Gladys]

1 minute ago, James Blonde said:

I imagine they would be interested in a fortnight's secondment to Noble's but that would be about it. All pretty bog standard stuff the other 48 weeks of the year I guess (or 52 once they cancel TT22) 

I think the care of those injured went on for more than just the race periods.  Anyway, it was what I was told and it made sense at the time. 

[FSM]

28 minutes ago, Gladys said:

There is also the amount of experience they would get here.  If you were a young doctor wouldn't you want a position that would give you lots of new challenges to hone your knowledge? 

Years ago I was told that young doctors, particularly those specialising in orthopaedics and trauma, were attracted to the IOM  because of the challenging injuries from the TT and MGP.  It may have been tripe, but it did kind of ring true. 

Our resident trauma surgeon might want to answer this.. Currently, I imagine a UK trauma centre would provide more exposure to managing these types of injuries.

Otherwise, junior doctors are a heterogenous group. Some want to work in tertiary centres managing the rare and unusual, others relish being a part of the life of a small community. There are a thousand places in the UK which provide the latter, without the inconveniences of the IOM

 

 

[wrighty]

Replying, without quoting, to a couple of points. 
 

Firstly, the criteria to be a consultant here are the same as anywhere in the UK. On the specialist register, and appointed by a panel with a Royal College assessor to ensure the appointee is appropriately qualified. 
 

Secondly, trauma experience here isn’t what it used to be. We used to do our best - in my first year here I put on more pelvic external fixators than I did throughout my entire training. These days I do none, as our major trauma, quite rightly, is shipped across to Aintree. So trainees no longer come here for trauma experience. They’re better served staying in Liverpool. 

[opusManx]

.

Edited January 13, 2022 by opusManx

[Boris Johnson]

On 12/18/2021 at 8:01 AM, wrighty said:

The number of anaesthetists has varied massively over the years. When I started in 2005 there were 6 consultants supported by a few fairly junior anaesthetic trainees. Over the years it became difficult to recruit junior trainees and so these posts were converted to consultants. At the same time, the services offered by the department expanded. In 2005 the ITU was effectively nurse led with occasional input from the anaesthetic department. This changed such that we’ve, quite rightly, had full medical cover. In addition, we now have a pain service, expanded obstetric cover, pre-assessment clinics a critical care outreach service, and a more comprehensive air transfer service (anaesthetists do that too)
 

At its peak, when I was clinical director over the service there were 15 consultants covering a two-tier 24/7/365 rota supported by another 4 non-consultant posts. At that time, about 4 years ago we had just enough bodies to provide all the services we needed without relying on agency locums. 
 

Then - a few retirements. Covid. Recruitment across the UK became difficult (everywhere else had similarly expanded and there simply weren’t the people available to do the jobs) A couple of people just left to work elsewhere - at the height of covid the island was a lonely place if you weren’t here with family. Right now we have, I think, 9 consultants, 3 associates, and a couple of semi-retired consultants who’ve come back to help out. That includes the 4 who now, since being referred to the court, will presumably be unable to work. That leaves us with 6+2+2, trying to keep everything running, compared with 15+4 at the peak when it was just about viable. 

This is a big problem. I cannot see an easy solution. With a pending manslaughter case you probably can’t even use the temptation of bags of cash to get people to work here. And it might yet get worse - relying on a couple of retired doctors (who are both excellent by the way) to fill in is tenuous, they can go at any time, and there is likely to be another retirement soon. 
 

Merry Christmas Everybody. Try not to get ill and need an operation, or an air transfer, or ITU. Manx Care is doing its best to manage the situation, but this really is a perfect storm that even ‘The Wolf’ (I like Pulp Fiction) couldn’t sort. We are still providing emergency cover and ITU, but it’s tight. 
 

[Disclaimer - the numbers here are from memory and are likely to be reasonably accurate, but I haven’t written this post with reference to the last 16 years HR files in front of me so there might be errors]

If this was a UK hospital, would it not be put in Special Measures?

If so is there no way we can implement something similar? Ask the UK to do what it would do in the UK and pay them for it?

 

[finlo]

8 minutes ago, Boris Johnson said:

If this was a UK hospital, would it not be put in Special Measures?

If so is there no way we can implement something similar? Ask the UK to do what it would do in the UK and pay them for it?

 

Ashie said no a little while back.

[wrighty]

59 minutes ago, Boris Johnson said:

If this was a UK hospital, would it not be put in Special Measures?

If so is there no way we can implement something similar? Ask the UK to do what it would do in the UK and pay them for it?

 

If Noble’s was a UK mainland hospital it would have been closed years ago, purely due to the size of its catchment population. So comparisons with what happens across are not that helpful. 
 

Special measures seems to be more about changing the management, having an improvement director, and pairing up with a nearby organisation that is doing well. It could be argued that the Michaels report, the establishment of Manx Care, and all the commissioning of services in the UK go beyond the CQC special measures declaration. 

[Overdose]

@wrighty just pondering something here, do routine operations require four anaesthetists to be present?