The effect of the introduction of best practice tariff for paediatric diabetes care on service provision and staffing in the West Midlands

AimsTo more fully understand the training experience of less than full time (LTFT) trainees working in psychiatry in the West Midlands Region with the aim of identifying areas that would improve the training experience.BackgroundLTFT training has grown in popularity since its formal introduction in 2007. The greater participation of women in medicine and generational changes in lifestyle expectations are some of the factors behind this trend. Approximately 13% of psychiatry trainees in the UK are training LTFT, bringing the benefit of allowing trainees to balance caring responsibilities or health conditions with continuing their postgraduate training. However it is not without its challenges for trainees which we aimed to explore in this survey.MethodAn electronic survey was sent out to all trainees via email, LTFT trainees of all training grades were invited to respond. Trainees were contacted in the five mental health trusts making up the region. The survey contained 32 questions that covered a range of topics including educational opportunities, perceived attitudes to LTFT trainees and training experience. Data were collected over a six month period in 2019. There were 22 responses to the survey region-wide.Result86% of respondents were working reduced sessions in full-time posts with implications for their clinical workload and 14% responded that their clinical contact time was not adjusted to reflect their working hours. 36% of respondents experienced difficulties attending their formal teaching programme while 82% had attended educational commitments on non-working days. 14% of respondents felt training LTFT did not allow them to meet training requirements while 23% would not recommend LTFT training in the West Midlands to others. Trainees cited difficulties managing a full time workload and not having support from supervisors as reasons for these views. 40% of respondents reported experiencing negative attitudes from seniors and 50% felt isolated from other trainees due to LTFT training status.ConclusionThe survey has developed our understanding of the challenges faced by LTFT trainees and it has been communicated regionally and to employing trusts to promote action. For example, at a trust level, the use of personalised work schedules can address some common difficulties. More effectively communicating sources of support to trainees, sharing best practice and providing networking opportunities are suggested as next steps regionally. New administrative processes to maintain an accurate list of LTFT trainees is vital in implementing this. Improving the information given to trainers is another development area.

Download Full-text

Does the Best Practice Tariff for paediatric diabetes create inequity of service provision and the death knell for any semblance of a UK-wide NHS?

Practical Diabetes ◽

10.1002/pdi.1800 ◽

2013 ◽

Vol 30 (8) ◽

pp. 306-308 ◽

Cited By ~ 1

Author(s):

Lesley Lowes ◽

Kenneth Robertson ◽

Bill Lamb ◽

David Chaney

Keyword(s):

Service Provision ◽

Best Practice ◽

Paediatric Diabetes ◽

Death Knell

Download Full-text

Creative Industries: The Regional Dimension?

Environment and Planning C Government and Policy ◽

10.1068/c0453 ◽

2005 ◽

Vol 23 (4) ◽

pp. 537-556 ◽

Cited By ~ 64

Author(s):

Mark Jayne

Keyword(s):

Best Practice ◽

Central Government ◽

National Level ◽

Creative Industries ◽

The West ◽

The United Kingdom ◽

Development Agenda ◽

Practice Models ◽

West Midlands ◽

The Uk

Creative Industries: The Regional Dimension is one of a series of reports published in recent years by the UK government which outlines the importance of creative industries to economic growth. It is in these terms that central government has promoted the creative industries as a newly recognised and fast-growing sector of the economy, thus seeking to quantify the Cool Britania branding so famously propagated by the then newly elected Labour government. The author unpacks the enthusiasm for the creative industries at the national level, and further investigates how the creative-industries developmental agenda has been unfolding within UK regions. The trajectory of the United Kingdom's creative-industries agenda is contrasted with policy and developmental strategies undertaken elsewhere in the world. It is argued that implementation of a creative-industries agenda at the regional level in the United Kingdom is at best patchy, and there is currently a lack of strategic planning, best-practice models, and empirical research to guide policymakers. The West Midlands is then addressed in more detail, and it is argued that at the regional administrative level, a creative industries development agenda per se is all but lost. The implications of this policy trajectory are discussed.

Download Full-text

The Evolution of a Hand Day-Surgery Unit

Annals of The Royal College of Surgeons of England ◽

10.1308/003588409x432338 ◽

2009 ◽

Vol 91 (7) ◽

pp. 559-564 ◽

Cited By ~ 8

Author(s):

CK Dillon ◽

DL Chester ◽

Peter Nightingale ◽

OG Titley

Keyword(s):

Service Provision ◽

Subsequent Development ◽

Hand Surgery ◽

Day Surgery ◽

Patient Delay ◽

Hand Trauma ◽

Day Case ◽

The West ◽

West Midlands ◽

Bed Days

INTRODUCTION Following the merger of two major units to form a regional centre for plastic surgery in the West Midlands, acute hand surgery referrals reached overwhelming proportions. This study describes audits performed at three time points. The first highlighted the extent of in-patient delay and was instrumental in the subsequent development of a dedicated hand trauma day-case unit. PATIENTS AND METHODS Data were collected on 77 patients in June 2002, 109 patients in November 2003 and 90 patients in November 2004. The day-case unit opened on 1 November 2003. RESULTS The number of bed-days per patient fell from 2.63 to 1.34 (P < 0.001) over the study period. In November 2004, 51% of patients received a day-case procedure. Importantly, if admission was required at initial presentation, the delay to theatre reduced from 1.5 bed-days per patient in June 2002 to 0.6 in November 2004. Overall, the in-patient delay was significantly reduced (P < 0.001) but time from presentation to theatre was not significantly affected (P = 0.119). CONCLUSIONS This series of audits confirmed that a significant number of acute hand injuries are suitable for day-case procedures and that simple audit can lead to a significant change in service provision. Improvements were demonstrated in reduced in-patient delay and total stay. We hope that other units find our experience useful given that it may be possible to apply this approach to other forms of ambulatory trauma.

Download Full-text