Like innumerable other emergency departments (ED) in the UK, Leicester faced difficulties with recruitment and retention of medical staff at all levels.

What did we do?

The delivery of international recruitment by a core team concentrating on processes of recruitment, support, training and integration of this staff group into the workforce and the retention of junior grade doctors (with time growing our own future middle grade/senior workforce), including constantly reviewing practice for improvements to ensure patient safety and staff satisfaction.

What we do :

  • A 3 month supernumery induction to enable experience of NHS systems and national/ local practice before being counted in rotas with an educational supervisor allocated with regular meetings;
  • Completion of work based assessments;
  • Competency sign off
  • 360 degree multi source feedback
  • Suggested reading materials to enhance learning
  • Access to EM3 were accompanied by wearing a yellow badge ”doctor in induction” so staff were easily identifiable for support / guidance.
  • Other pastoral efforts including help with accommodation, banking, registering with a GP and cultural acclimatisation including a welcome guide to facilities and surrounding Leicestershire area.

After the initial 3 month induction which includes:

  • Educational supervisor regular meetings
  • Completion of work based assessments
  • Competency sign off
  • 360 degree multi source feedback
  • 3 monthly feedback meetings with the international Consultant lead / General Manager
  • Career advice, access to study events, leave and study budget (mirroring a training programme with access to case base discussion clinics , clinical audits, shop floor teaching)

Monthly Drop in clinics were arranged for pastoral support .

In 2015, an allocation of a buddy was introduced at induction, who had been through this recruitment to offer further pastoral support and acclimatization. Opportunities were given for a 3 month rotation to acute medicine within the 12 month initial contract. At the 6 month feedback meetings if competencies were on track and there was 2 way agreement, contracts were extended for a further 2-3 years.

Additionally, 2015 saw the development of a clinical attachment programme in a structured format leading to employment, social media for enhancement in recruiting, 1st Hospital Trust Grade Conference, introduction of Certificate of Eligibility for Specialist Registration programme (CESR) and the introduction of monthly international training events.

2016 has seen the development of mentoring/buddy training for medics, setting up of LEAD-it social media sites twitter ( @LEADit_) and face book (https://www.facebook.com/LEADitUHL), monthly compassionate care events,  roll out of practice across the wider trust and region . 3 month secondment opportunities extended beyond acute medicine.

Leics ED training

Key Outcomes:

  1. Reduction in the number of vacant training/trust posts.
  2. Reduction in temporary staff usage lowering premium spend.
  3. Improvements in the productivity of ED with international graduates compared to temporary staff.
  4. Reduction in risk to patients (safety), service (targets) & Trust (reputation) due to the number of vacancies / use of temporary staff which are now filled by this scheme.
  5. Improved reputation of ED as a good place to work and be trained as evidenced by an increase in the number of applicants for advertised posts.

About the Author:

Deputy Head of Operations for Emergency Care at University Hospitals of Leicester & Associate Improvement Manager with ECIP , ITU Nurse by background with interests in Service Improvement, Bereavement Care and Workforce . 2016 HSJ Value winner in the Workforce category and overall Fab Award winner - Harlty Larkin with LEADit .

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