All 3,291 trainee rotations set to begin in February have been delayed until 3 March to support the ‘delivery of patient care’ and ‘maintain pastoral and wellbeing support of trainees’ in the capital, according to HEE London. London is among the worst-hit areas in England, with as many as one in 30 people estimated to have the virus.
HEE expects that the pause ‘will last no longer than four weeks’, but is reviewing the 'regularly’ with NHS England and Improvement and the BMA. It said that other regions would continue to make their own decisions based on their circumstances.
Delays to rotations next month represents the second major disruption to training in the last 10 months, after rotations were paused nationally last March during the first COVID-19 outbreak. HEE has recognised the ‘disappointment and anxiety’ the latest decision may cause.
Reduced educational capacity
A letter sent to trainees and educators by HEE explained that an influx of cases in London had created ‘significant challenges for provider organisations in the delivery of clinical care’ and reduced 'educational capacity' to ensure a safe transition for learners.
HEE also identified the potential effect of having people moving around between different settings as a factor which influenced its decision to put off rotations until early March.
The letter, signed by the three postgraduate deans for London, explained that the break would ‘allow time for the London system to become less pressured', and give providers some capacity to facilitate appropriate induction and new starter arrangements - and minimise disruption to current arrangements.
HEE acknowledged that there would be some ‘exceptional reasons’ where a rotation in February 2021 would be necessary for some individuals, including where it would have ‘significant detriment to the mental or physical health’ of a trainee.
Regional postgraduate dean for HEE in London Dr Sanjiv Ahluwalia, said: ‘As a result of the current COVID surge and the unique challenges this has resulted in across London, HEE London has taken the decision to “pause” the rotation of all HEE trainees due to rotate in February 2021 for a period of four weeks to support both the delivery of patient care and to protect maintain pastoral and wellbeing support of trainees. This pause will involve all postgraduate medical and dental trainees.’
In the letter from HEE the capital's postgraduate deans acknowledged the difficulties this could present to trainees and educators, but asked for their continued co-operation. They said: ‘We recognise the disappointment and anxiety that this may cause in our trainees and educational facilities, we hope that the reasons behind the decision remain transparent and focused on the well-being of learners and your role in the delivery of patient care during this challenging time for provider organisations.’
A recent GMC report found that more than 80% of trainees said the pandemic had reduced access to training required to move on in their careers and around three quarters said training had been disrupted in recent months.
The regulator has insisted that trainees must be ‘able to catch up on missed competencies’ without overburdening them or trainers, warning that medical education must be ‘flexible and responsive’ to adapt.