Victoria Medical Centre
Pre-Qualification Questionnaire (PQQ)
Table of Contents 1.1Purpose of this document............................................................................................. 3 1.2Organisation of this document.....................................................................................3
2INTRODUCTION AND OVERVIEW..........................................................................3 3THE PQQ PROCESS...............................................................................................3 3.1Issue of the PQQ............................................................................................................ 3 3.2Return of the ‘Conflicts of Interest Declaration’..........................................................3 3.3PQQ Clarification Questions and Answers.................................................................4 3.4PQQ Deadline for Responses.......................................................................................5 3.5PQQ Address for Responses........................................................................................ 5 3.6PQQ Evaluation.............................................................................................................. 5 3.7PQQ Clarification Questions from the PCT.................................................................6 3.8Pre-qualification............................................................................................................. 6
4COMMERCIAL FRAMEWORK................................................................................7 5GOVERNANCE AND ADMINISTRATION................................................................7 6GLOSSARY OF TERMS AND ABBREVIATIONS...................................................8 7INSTRUCTIONS ON COMPLETING THE PQQ.......................................................9 ANNEX APRE-QUALIFICATION QUESTIONNAIRE ..............................................12 Section ADetails of the potential Bidder and its business structure...........................12 Section BLegal and Regulatory.......................................................................................12 Section CFinancial information.......................................................................................12 Section DClinical requirements.......................................................................................12 Section EHealth and Safety.............................................................................................12 Section FWorkforce.......................................................................................................... 12 Section GIM&T 12 Section HEnvironmental Management............................................................................13 Section ILocal Integration................................................................................................ 13 Section JVertical Integration........................................................................................... 13 Section KDeclaration........................................................................................................ 13
ANNEX BClarification Question Template............................................................14 ANNEX CIneligibility conditions summary...........................................................15 ANNEX DMedical leadership..................................................................................17 ANNEX EBackground to General Practice Training.............................................18 ANNEX FOutline Specifications for General Practice training............................20
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PURPOSE AND ORGANISATION OF THIS DOCUMENT
1.1
Purpose of this document The PQQ is designed to secure the necessary reassurances about the capacity, capability and eligibility of potential Bidders to satisfy the minimum requirements of the Victoria Medical Scheme and the successful completion of the procurement process itself. This Pre-Qualification Questionnaire (PQQ) provides: • Background to the PQQ process; • Instructions on completing the PQQ; and • A blank PQQ for completion by interested parties The PQQ responses will be evaluated by the Kirklees PCT and the results will determine which potential Bidders are issued with an Invitation to Tender.
1.2
Organisation of this document This document is intended to be read in conjunction with the Kirklees PCT Procurement Memorandum of Information (MOI), which can be accessed from the Kirklees PCT web page at the following web link: http://www.kirklees-pct.nhs.uk/
2
INTRODUCTION AND OVERVIEW Please refer to the Kirklees PCT MOI for further background information on this Procurement and the factors that will be critical to its success.
3 3.1
THE PQQ PROCESS Issue of the PQQ The PQQ is available, by email, to all Potential Bidders who submitted an Expression of Interest (EOI) in the Victoria Medical Procurement before the EOI deadline. All potential Bidders wishing to bid for the Victoria Medical opportunity must complete and submit a PQQ to arrive before 27 October 2009. The results of the PQQ evaluation will determine which potential Bidders are invited to tender.
3.2
Return of the ‘Conflicts of Interest Declaration’ In order to further ensure a fair and competitive procurement process, the Kirklees PCT requires that all actual or potential conflicts of interest are declared to the PCT by 27 October 2009. Without limitation, such conflicts of interest may be perceived by the PCT to arise in circumstances where:
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• •
A Relevant Organisation or any person employed or engaged by or otherwise connected with a Relevant Organisation has carried or is carrying out any work for the PCT or the DH in the last six months; A Relevant Organisation is providing services for more than one potential Bidder in respect of this project or procurement process.
The ‘Conflict of Interest Declaration’, provided by email with this PQQ document, must be completed by an authorised signatory, in his / her own name, on behalf of the potential Bidder and sent to Kirklees PCT by email to: amanda.duggan@kirklees.nhs.uk 27 October 2009. Kirklees PCT should be immediately notified, by email in the event that any actual or potential conflict of interest comes to a potential Bidder’s attention following the submission of the potential Bidder’s ‘Declaration’.
3.3
PQQ Clarification Questions and Answers A clarification question and answer process will operate during the PQQ stage as explained below. The objective of the PQQ clarification process is to give potential Bidders the opportunity to submit questions to Kirklees PCT where they require clarification on the information contained in the PQQ. Potential Bidders should submit clarification questions via e-mail to Amanda.duggan@kirkleespct.nhs.uk using the template provided at Annex B. Clarification questions received by any other method will not receive a response. The period in which potential Bidders can raise clarification questions commences on the day the PQQ is issued. Kirklees PCT will seek to answer clarification questions within five working days following the day of receipt. Potential Bidders are urged to review the PQQ immediately upon receipt and identify and submit any clarification questions as soon as possible. In order to treat potential Bidders fairly, Kirklees PCT will normally provide an anonymised copy of any clarification questions, and the answers to those questions, to all potential Bidders. This will be provided in digest form, periodically updated and published on the PCT website and/or circulated to all those who have submitted an EOI. Provision will be made for potential Bidders to request clarification in confidence, but in responding to such requests Kirklees PCT will reserve the right to act in what it considers a fair manner and in the best interests of the Procurement, which may include circulating the response to all potential Bidders. Potential Bidders should note that no further information in addition to that provided in the MOI will be provided about the Victoria Medical opportunity at this time. Under no circumstances should potential Bidders approach the PCT, SHAs, DH, their staff or advisers seeking further information in relation to the Procurement generally or the PCT Scheme. Any such approaches (direct or indirect) may result in the potential Bidder’s exclusion from further consideration in the Procurement.
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3.4
PQQ Deadline for Responses The PQQ submission must be completed in accordance with the instructions contained within the PQQ. Completed submissions must be received by 27 October 2009. Failure to return a completed PQQ by the deadline above will normally result in the disqualification of the potential Bidder from participating in this Procurement.
3.5
PQQ Address for Responses The package enclosing the completed PQQ must not indicate the potential Bidder’s identity but must be clearly marked: “Kirklees PCT – PQQ” “Restricted – Commercial” The package should be sent to the following address: Pat Patrice, Head of Corporate Governance and Services, St Luke’s House, Blackmoorfoot Road, Crosland Moor, Huddersfield, HD4 5RH
If proof of delivery is required, then submissions should be presented with a pre-printed receipt that will be signed on arrival. Kirklees PCT (and its agents) will not provide original proof of delivery paperwork.
3.6
PQQ Evaluation The PQQ evaluation criteria and process for the Procurement is outlined below. Potential Bidders should note that Kirklees PCT reserves the right to vary the selection procedure to support continued competition, avoid unnecessary bidding costs, and adhere to subsequent technical or legal guidance, or for other reasons at its sole discretion. The evaluation of responses at PQQ stage will consist of two elements as outlined below: • Preliminary compliance review; and • Detailed evaluation.
3.6.1
Preliminary Compliance Review The information supplied in the PQQ by each potential Bidder will be checked for completeness and compliance with the requirements of the PQQ before responses are evaluated. The preliminary compliance review will check that submissions: • Answer all questions (or explain satisfactorily if considered not applicable); • Are made in the format, medium and quantity requested; and • Have been delivered with a signed declaration. Where, in the opinion of Kirklees PCT, a response is non-compliant, the potential Bidder may be excluded from further consideration. Failure to
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provide a satisfactory response (or any response) to any element of the PQQ may result in Kirklees PCT not proceeding further with that potential Bidder. 3.6.2
3.7
Detailed Evaluation At the detailed evaluation stage, potential Bidders will be assessed against their answers to questions grouped in the following categories: • Capacity and capability including organisation, clinical, local knowledge and the ability to integrate positively with the local healthcare community, workforce, infrastructure and information management and technology; and • Financial and economic standing (including minimum financial and legal requirements).
PQQ Clarification Questions from the PCT Kirklees PCT reserves the right to require potential Bidders to clarify their PQQ submissions in writing. Any such request will be made by e-mail to the potential Bidder’s nominated representative. Such clarification questions do not seek to elicit additional information to that initially requested in the PQQ, nor give potential Bidders an opportunity to correct incomplete or otherwise non-compliant submissions. It is likely that any response to a clarification question will be required within two working days of request. Failure to respond adequately or in a timely manner to clarification questions may result in a potential Bidder not being considered further in the Procurement.
3.8
Pre-qualification Following evaluation of responses to the PQQ, potential Bidders which exceed a pre-specified threshold will be deemed to pre-qualify to tender. It is planned for the PQQ evaluation and short-listing to be completed and the results advised to potential Bidders as soon as possible after receipt of PQQs.
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4
COMMERCIAL FRAMEWORK Please refer to the Kirklees PCT MOI for commercial and other important information about the Procurement.
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GOVERNANCE AND ADMINISTRATION Please refer to the Kirklees PCT MOI for information the governance and administration arrangements to be applied.
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GLOSSARY OF TERMS AND ABBREVIATIONS Please refer to the Kirklees PCT MOI for a glossary of terms and abbreviations used in both the MOI and the PQQ. Where terms are only used in this PQQ, they are explained in the following glossary: Term
Description
NPfIT
National Programme for Information Technology
Services
The activities and outputs required by the PCT to be provided by the Provider
Independent Sector
The sector of private, non-NHS bodies providing healthcare in England
GP Led Organisation
A medical practice or partnership primarily led by general medical practitioners
Consortium
A group of organisations who form a joint venture for the purposes of bidding for a contract and providing Services under that contract [and Consortia shall be construed accordingly]
Service Commencement
The date from which the Provider starts to provide the Services pursuant to the Contract
Nominated Representative
The individual named in Section A.1 of the PQQ to be a point of contact on behalf of a potential Bidder for the purposes of the Procurement process
Clinical Staff
A member of staff with a registered clinical or medical qualification.
Whole Time Equivalent (WTE)
An activity that covers a 37.5 working week. Posts are measured in fractions of WTE.
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INSTRUCTIONS ON COMPLETING THE PQQ
PART A - Declaration Potential Bidders are required to complete and return the ‘Declaration’ which accompanies this PQQ, to be received by 12.00 noon 27 October.
PART B - General The PQQ comprises the sections summarised in the table below: Section
Contents
A
Details of the potential Bidder and its business structure Including Declaration of Consent
B
Legal and Regulatory
C
Financial information
D
Clinical requirements
E
Health and Safety
F
Workforce
G
IM&T
H
Environmental Management
I
Local integration
J
Vertical Integration
K
Declaration
Potential Bidders must complete all parts of Sections A, B, C, D, E, F, G, H, I, J and K of the PQQ and supply any additional or supporting information as required. This PQQ is available to potential Bidders in a downloadable electronic format that enables it to be used as a template for the potential Bidder’s response. No other format should be used. Questions are to be answered in English and in the same order that the questions appear in the PQQ using the same numbering format. Responses to each of Sections A, B, C, D, E, F, G, H, I and J should be created and saved as separate document files, along with the ‘Declaration of Consent’ found in Question A.4. Where the potential Bidder believes a question is not applicable, or cannot be answered, this should be clearly stated and an explanation ‘must’ be provided. No response should be left blank. Where applicable, the terms “Not known”, “Not available” or “Not applicable” should be used and an explanation as to why the question is “Not applicable” is required. If the potential Bidder is unclear as to whether or not a question is applicable to it, then use should be made of the Clarification Question mechanism (see 3.3 above).
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The inclusion of an executive summary, general marketing and company literature or any separate statement of reasons for selection is not required and will not be considered in the evaluation of the PQQ. Potential Bidders should not include any information beyond that requested in the PQQ. A potential Bidder who fails to complete and return a PQQ by the stated deadline will be disqualified from participation in this Procurement, save in exceptional circumstances, where Kirklees PCT may exercise its discretion to allow a potential Bidder to participate. In completing their PQQ submissions, potential Bidders should not assume that Kirklees PCT has any prior knowledge of the potential Bidder, its practice or reputation or its involvement in existing services, projects or procurements. In evaluating PQQ submissions, Kirklees PCT will only consider information provided in response to this PQQ. Kirklees PCT reserves the right to reject any potential Bidder that fails to comply fully with the requirements of the process set out in this document, or which makes any misrepresentation in supplying any information requested. Each potential Bidder is subject to an ongoing obligation to notify Kirklees PCT of any material changes to the information included in its PQQ response, including but not limited to changes to the identity of Relevant Organisations or the ownership or standing thereof. Changes should be notified as soon as they become apparent by email to: Amanda.duggan@kirkleespct.nhs.uk Failure to notify Kirklees PCT of any material changes may lead to the potential Bidder being liable for disqualification. In the event that the potential Bidder notifies Kirklees PCT of a change to its PQQ response, Kirklees PCT reserves the right in its absolute discretion to refuse to allow such a substitution or introduction of information. In exercising its absolute discretion to either refuse or allow such a change, Kirklees PCT may take into account whether such change is material to the delivery of the Services.
PART C - Response guide Each potential Bidder should complete only one PQQ and include information, where relevant, for all Relevant Organisations. It must be noted that the definition “Relevant Organisation” is specific and can be found in the Kirklees PCT MOI glossary. If an organisation fulfils more than one role, it must complete all sections relevant to all roles e.g. a potential Bidder may also be the Clinical Services Supplier and must therefore complete in full both Sections A and D. Potential Bidders will be responsible for the accuracy of all information concerning Relevant Organisations submitted to Kirklees PCT within the completed PQQ. Potential Bidders are requested to provide their PQQ response in both CD and paper copy formats. The signed Declaration (Section J) is to be submitted in paper copy format. Ten (10) CDs should be supplied, each CD containing the potential Bidder’s complete PQQ submission: • One copy of the CD is to be marked as the “Master Copy”;
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•
• • •
Each section of the PQQ response should be submitted as an individual file and named in such a way as to distinguish them from each other and between organisation e.g. “Section 1 – Acme Ltd”, “Section 2 – Company X” etc.; The CD is to include any necessary reports, accounts and other supporting documents which must be clearly referenced; Any supplementary files that are not included within the PQQ response template should be referenced as annexes to the question concerned e.g. “Annex A.9 – Acme Organisation”; Files must be submitted in a fully editable form (i.e. not read only, or password protected) in the formats specified below: File Type
Software Package
Text based documents
Microsoft Word (Version 2000 or later)
Spreadsheet based documents
Microsoft Excel (Version 2000 or later)
Project programme files
Microsoft Project (Version 2000 or later)
Graphics files
PowerPoint (Version 2000) or later
Report and accounts
Adobe Acrobat (pdf), or MS Word (Version 2000 or later)
Three (3) paper copies should be supplied. • Each section of the PQQ response should be started on a new paper and clearly labelled in such a way as to distinguish them from each other and between organisation e.g. “Section 1 – Acme Ltd”, “Section 2 – Company X” etc.; • The paper copies are not required to include accounts but should include other Annexes referred to within the PQQ responses. Failure to provide PQQ responses in the required format or quantity may lead to a potential Bidder’s submission being set aside without evaluation and the potential Bidder’s exclusion from further consideration in this Procurement. The PQQ responses should be accompanied by a printed copy of the page containing the Declaration (Section J), completed, signed and dated by the authorised signatory. Electronic signature of the Declaration is not acceptable.
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ANNEX A PRE-QUALIFICATION QUESTIONNAIRE Double click on icons & then “Save copy as” to a suitable location.
SECTION A Details of the potential Bidder and its business structure
Section A - Project
SECTION B Legal and Regulatory
Section B - Legal
SECTION C Financial information
Section C - Financial Information
SECTION D Clinical requirements
Section D - Clinical
SECTION E Health and Safety
Section E - Health and Safety
SECTION F Workforce
Section F Workforce
SECTION G IM&T
Section G - IM&T
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SECTION H Environmental Management
Section I Environmental Management
SECTION I Local Integration
Section J - Local Integration
SECTION J Vertical Integration
Section K - Vertical Integration.doc
SECTION K Declaration
Section L Declaration
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ANNEX B Clarification Question Template A clarification question and answer process will operate during the PQQ stage as explained in 3.3 Potential Bidders should submit clarification questions via e-mail to Kirklees PCT using the template below. Clarification questions received by any other method will not receive a response.
Annex B CQ Template.xls
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ANNEX C Ineligibility conditions summary SUMMARY OF CRITERIA FOR THE REJECTION OF ECONOMIC OPERATORS PROVIDED BY REGULATION 23 OF THE PUBLIC CONTRACTS REGULATIONS 2006 (SI 2006 No 5) Regulation 23 of the Public Contracts Regulations 2006 (“Regulation 23”) sets out the grounds on which an economic operator must normally be deemed ineligible to tender for, or be awarded a public contract. Notwithstanding that Regulation 23 does not apply to this Procurement, on the grounds that it is for Part B services, the Department of Health reserves the right to reject a bidder if they fall within one of the ineligibility criteria set out in Regulation 23. Rejection under Regulation 23 (1) is normally mandatory when an economic operator has been convicted of any of the following offences: (a) Conspiracy within the meaning of section 1 of the Criminal Law Act 1977 where that conspiracy relates to participation in a criminal organisation as defined in Article 2(1) of Council Joint Action 98/733/JHA; (b) Corruption within the meaning of section 1 of the Public Bodies Corrupt Practices Act 1889 or section 1 of the Prevention of Corruption Act 1906; (c) The offence of bribery; (d) Fraud, where the offence relates to fraud affecting the financial interests of the European Communities as defined by Article 1 of the Convention relating to the protection of the financial interests of the European Union, within the meaning of – (i) The offence of cheating the Revenue; (ii) The offence of conspiracy to defraud; (iii) Fraud or theft within the meaning of the Theft Act 1968 and the Theft Act 1978; (iv) Fraudulent trading within the meaning of section 458 of the Companies Act 1985; (v) Defrauding the Customs within the meaning of the Customs and Excise Management Act 1979 and the Value Added Tax Act 1994; (vi) Destroying, defacing or concealing of documents or procuring the extension of a valuable security within the meaning of section 20 of the Theft Act 1968; (vii) An offence in connection with taxation in the European Community within the meaning of section 71 of the Criminal Justice Act 1993; or (e) Money laundering within the meaning of the Money Laundering Regulations 2003; or (f) Any other offence within the meaning of Article 45(1) of Directive 2004/18/EC of the European Parliament and of the Council of 31 March 2004 as defined by the national law of any relevant State. For the purposes of this Procurement and on the basis of the grounds in Regulation 23(4) a potential Bidder may be deemed to be ineligible to tender where it: (a) Is in a state of bankruptcy, insolvency compulsory winding up, administration, receivership, composition with credits or any analogous state, or subject to relevant proceedings;
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(b) Has been convicted of a criminal offence relating to business or professional conduct; (c) Has committed an act of grave misconduct in the course of a business or profession; (d) Has not fulfilled obligations relating to payment of social services contributions; (e) Has not fulfilled obligations relating to payment of taxes; (f) Is guilty of serious misrepresentations in supplying information further to this or other procurements; or (g) Is not in possession of the necessary licence, authorisation or professional qualification required for the provision of the primary care services covered by this Procurement.
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ANNEX D Medical leadership Role: The Provider will be required to have appropriate arrangements for medical leadership, to include: •
organisational medical leadership for the delivery of safe, efficient and reliable primary care services in all the clinical functions provided within the contract, ensuring that the standards set out within the contract at inception are achieved and that the organisation works towards continuous quality improvement throughout the duration of the contract.
•
leadership and accountability in each Clinical Service Provider organisation for the delivery of a safe, efficient and reliable clinical service achieving the standards set out within the contract at its inception and to improve upon the quality of the service throughout the lifetime of the contract.
•
medical leadership for the delivery of safe, efficient and reliable services in the locality. This may be function-specific or may or may include a range of clinical primary care services.
Objectives: The objectives associated with these arrangements are:
to oversee the recruitment of good quality, competent clinical and other staff and to ensure that there are systems in place for mentoring, appraisal (including of communication skills), professional development and support to promote a culture of patient focus and the pursuance of the highest quality care to ensure that there are performance management systems in place to monitor the quality of clinical care to receive Clinical Governance reports and to ensure that lessons learnt are acted upon to promote a culture of innovation and change in the pursuance of improving quality of care to encourage integration with the local medical fraternity.
It is anticipated that in order to fulfil these requirements the Provider will need appropriate numbers of personnel that are: Mandatory
possess a current and full registration with the General Medical Council (UK) be on the GP register, or other specialist register of the GMC; and Have current and credible experience within relevant specialty fields;
Desirable
Have management training and experience. Have leadership experience and skills
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ANNEX E Background to General Practice Training Introduction At present, GP training is a minimum of three years after completing two years of a foundation programme after graduation. The final year of the programme is spent in practice as a GP registrar with an appointed trainer. A policy of spending 18 months of training in General Practice will increase the need for training places in a GP setting. The placements are funded for the registrar’s salary and some expenses and an educational grant is paid to the supervising trainer. Supervision Postgraduate Medical Training and Education Board (PMETB) standards would be adhered to and quality assurance processes for training would be against these standards. There are two broad types of supervision needed for the GP registrar (GPR). 1. Clinical This supervision is about clinical governance and protecting patients. It means that the supervisor allows the registrar to see cases of increasing complexity with graduated methods of supervision, ranging from direct observation at the intensive end of the spectrum, to a weekly notes’ review at the other end for example. The clinical supervisor will need to make assessments of the registrar and their progress and give feedback. Clinical supervision will need to be modified according to the assessments made. 2. Educational The educational supervisor for the registrar manages their educational programme and integrates the registrar’s learning in all aspects of the practice to the GP curriculum with a planned progress towards passing the exit exam and becoming eligible for a CCT in General Practice. The educational supervisor will need to advise on and monitor the registrar’s learning plan as well as giving more detailed feedback providing reflective and challenging sessions for the registrar through their attachment. Both clinical and educational supervisors would be expected to teach, either in the specific clinical sphere they are supervising or generically within the specialty of General Practice. The clinical and educational supervisor may be the same person. In practice, clinical supervision is often delegated to another doctor but the educational supervisor is normally constant for the whole programme. Experience has shown that doctors can learn clinical supervision skills in two half day sessions whilst developing educational supervisor’s 2 skills takes considerably longer, and the various programmes on offer range from the equivalent of 3 two-day modules to a modular course spread over a year, often linked to a higher educational qualification such as a Certificate in Medical Education. Alternative models of supervision There is growing experience with a different model of GP training whereby some clinical supervision is provided in one practice and the overall educational supervision in another, sometimes called a “hub and spoke model.” The clinical practices agree to provide clinical supervision for the registrar but the educational supervision is provided by a trainer at a
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different practice. This model may be adopted initially in the procurement and can be used as a staging post to full training practice status. Graduation The GPR will have to successfully complete the time and assessments in practice and pass all components of the new MRCGP exam. This comprises an applied knowledge test and a clinical skills simulation that are held, administered and marked by the RCGP. The third component is an enhanced report by the trainer (educational supervisor) that details clinical and professional skills, as well as some independent workplace based assessments like a multi-source feedback from staff and a patient satisfaction questionnaire. The two latter components are likely to be administered centrally but involve the practice in providing feedback on the registrar from both staff and patients. A clinical supervisor might be expected to log a particular skill or competence in the trainer’s report and it is planned that the registrar will collect these details in their electronic portfolio. The educational supervisor will need to keep independent records of the registrar’s progress and fill in the report at the end of the attachment. The educational supervisor will also provide regular appraisals through the year and currently conducts an end of programme appraisal for the GPR that helps them set their learning objectives for their first career level post.
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ANNEX F Outline Specifications for General Practice training A.
Clinical Environment
There are a number of minimal requirements for the clinical and learning environment that must be in place. They include: 1. An efficient system for managing and booking consultations, including coping with urgent or unscheduled access. 2. Adequate consulting rooms (a dedicated registrar’s room is ideal but a consistent room is viewed as adequate), treatment room facilities and staff. 3. Access to the clinical evidence base and support systems through web based access/CD ROMs/books and journals etc. 4. Exemplary clinical record keeping including a. summarisation. b. Clear treatment and management plans c. Health promotion and disease prevention records d. Chronic disease management templates 5. Adequate clinical exposure (for example over 1,000 patients per WTE when including the registrar). 6. Preventative medicine clinics and disease management clinics. 7. A functioning Primary Care team involving a variety of disciplines from and alongside whom learning can take place. 8. An environment that facilitates and stimulates work based learning (defined as: learning at work, for work and from work). B
Competence as a Clinical Supervisor
Clinical supervision is the interaction between an experienced clinician and a doctor (or other health care professional) in training. All doctors reaching the level of certificate of completion of training (CCT) should demonstrate competence in clinical supervision before being awarded a RITA G. This will include the following:
Understanding the principles of adult education Competence in the four stage coaching model Familiarity with the four stages of unconscious incompetence, conscious incompetence; conscious competence, unconscious competence. Competence in giving constructive feedback and educational action planning Understanding of equality and diversity and of how allegations of bullying and harassment arise.
This paper sets out a model for ensuring competence in clinical supervision, which will in turn increase patient safety. The paper specifically does not address competence in educational supervision or skills in effective small group or large group teaching. Foundation Training All doctors entering run through training must be able to help those junior to them learn and refine clinical skills. Therefore all foundation training programmes should include:
basic input in learning styles so that on completion the foundation trainee is familiar with their own preferred learning style and the impact that if might have on their interaction with those that they supervise. basic theory of skills teaching
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principles of effective feedback and educational action planning knowledge of equality and diversity
Specialty Training Specialty trainees will take increasing responsibility for clinical supervision and will progress to teaching craft skills to the more junior trainees. All run-through training programmes should include:
advanced theory of supervision, including the four stages of competence, monitoring and safety basic skills in coaching skills development in giving constructive negative feedback role modelling Understanding of bullying and harassment
Annual reviews should specifically include competence in clinical supervision. Assessments should include direct observation and feedback on supervision of craft skills. Assessments prior to a RITA G must include direct observation of clinical supervision in a typical environment such as a post-take ward round or emergency theatre. Consultants and General Practitioners Health care providers must take responsibility to ensure that all doctors who have responsibility for clinical supervision maintain their clinical and supervisory skills. This should be part of an annual performance review. Role of Trusts, Colleges and Deaneries All Deaneries and Colleges must value the importance of skills in clinical supervision as an integral part of the curriculum. Together they must ensure that all new consultants and general practitioners are competent in clinical supervision. Trusts and practices must ensure that there is effective clinical supervision, which must include demonstration of maintenance of clinical and supervisory skills through appraisal/annual performance review and effective reporting when poor practice in either area is identified.
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