This section has great ideas and plans from foundation trainers across the UK on how to best deliver the Foundation Programme Curriculum in innovative ways.
Send us your examples of good practice
This section is for trainers participating in the Foundation Programme. All the documents and ideas in this section have been sent in by educational faculty around the country.
If you have examples of good practice in implementing the Foundation Programme, please send them to us using this form and send to email@example.com. Don’t forget to let us know how or why the practice has worked well for you.
Please note that these suggestions and ideas are not endorsed by the UK Foundation Programme Office, they are simply solutions that have been submitted by those working within the Foundation Programme. Everyone works differently, so these submissions are simply shared ideas that might help you discover your own good practice.
- Walk in a patient's shoes
- UKFPO/NACT Joint Sharing Good Practice Conference 2014
- Shadowing in the Foundation Programme
- Foundation Programme Taster Templates in Psychiatry
- A pilot study of how to get F1s to complete their e-Learning for Health modules
- Change of post form (Foundation)
- Guide to involving junior doctors in clinical audit
- The Educational Supervisor and careers advice booklet
- MOT form (Careers planning form for trainees)
- Reducing Medical Errors
- Sharing Good Practice conference 2011 presentations
- Implementation of assessment
- IT and Quality Assuring Foundation Training
- Interprofessional Preceptorship Programme
- Simulation sessions a success
- Assessment guidelines in Worthing
- Radiology in the Foundation Programme
- Educational Supervisor’s pack from King’s College Hospital
- Shared posts and critical care placements
- Action Learning Groups
- Electronic "Team Assessment of Behaviour" (E-TAB)
- Post take ward round assessment and feedback process
- Postgraduate qualification in non-clinical skills for F2 doctors
- Interprofessional Team-based Action Learning
- LNR Deanery Simple Guide to Foundation Programme Training in General Practice
- Multi-site tutorial
- Four monthly Foundation Programme portfolio review
At Torbay Hospital we ask FY1s to Walk in a Patient’s shoes, to encourage them to better understand the patients’ perspective.
We deliver small group sessions facilitated by more senior doctors, involving them in patient experience activities such as navigating to clinic, mobilising on crutches or tasting nutritional supplements. Guided reflection and feedback has confirmed the value of these sessions and identified specific changes in behaviour that the FY1s intend to make as a result.
This sort of learning helps our doctors to move from considering ‘what is the matter with you’ to instead consider ‘what matters to you’.
Please click here if you would to read more about this project.
The UKFPO and NACT UK hosted another successful Sharing Good Practice conference on Wednesday 11 June 2014 at the Holiday Inn Regent's Park. The day was well attended by faculty and trainees from across the UK, who shared their examples of good practice in foundation training via a series of plenary sessions, workshops and poster presentations.
Quality Improvement projects of Clinical Innovation
Blinded by the Light: inclusion of the lens of the eye in routine CT head examinations across a NHS Foundation Trust; an audit Dr Jack Roberts, St Peter’s Hospital, Chertsey
Red Cell Transfusion in Critical Care: an audit on recent British Society of Haematology Guidelines, Dr Kate Kendrick, Bristol
The use of the National Early Warning Score (NEWS) in an Old Age Psychiatry Unit, Dr Priya Rajyaguru, North Bristol NHS Trust
Saving Time, Saving Brain: Assessment of out-of-hours stroke patients via ‘telemedicine’ versus face-to-face evaluation, Dr Louise Dawson. Dr Julia Fordham and Dr Lizzie Griffiths, Dorset County Hospital
Quality Improvement projects of service innovation
Improving the efficiency of dental general anaesthetic theatre lists at Great Ormond Street Hospital, Miss Kate Parker, Great Ormond Street Hospital, London
Prevention of dehydration of hospital in-patients, Dr Philippa Johnstone, Royal Worcester Hospital
A Collaborative Approach to Case Management in frequent attenders to the emergency department, Dr Catriona Reid, West Middlesex University Hospital
Anaphylaxis: The empty audit box, Dr Karim Amer, King’s College Hospital, London
Uptake of SLE in Foundation, Dr David Kessell & Dr Sonia Panchal, Academy of Medical Royal Colleges
Developing a Foundation Year One (FY1) Doctor Post in a Crisis Resolution and Home Treatment Team, Dr Holly Blair, St George’s Hospital, Newcastle upon Tyne
The Multi-Disciplinary Team: improving communication for a smoother patient journey, Dr Josh Coats, Ninewells Hospital, Dundee
3 D’s: Delirium, Dementia, Depression – what you need to know, in context, Dr Damien Bezzina, Queen’s Hospital, Burton
University Hospitals of Leicester Doctors in Training Committee ‘Enhancing Quality Improvement Programme’ (EQIP), Dr Alex Till, Leicester Royal Infirmary
Foundation Year Teaching: building foundations for the future in a district general hospital, Dr Bella Ryle and Dr Francesca Eddy, Royal Hampshire County Hospital
Announcing …. An ‘Engagement’ with Management at Royal Hampshire County Hospital, Dr Jessica Walding and Dr Katie Ayres, Royal Hampshire County Hospital
Does Handover Education improve quantitative patient outcomes? Dr Daniel Monnery, Royal Liverpool University Hospital
Poor Inter-Professional Communication: an opportunity for SBAR, Dr Saurabh Singh, Royal Free Hospital, London
Teaching Clinical Governance, Miss Claire Young, Cumberland Infirmary, Carlisle
Mobiquette’ – a patients’ perspective, Dr Lydia Hayden, Cardiff
An Innovative Approach to Local Quality Management: joint undergraduate/Foundation programme quality visits to Local Education Providers (LEPs), Dr Jon Scott, Health Education North East
The Isle of Wight Teaching Programme: a triumvirate approach to developing the clinical teacher and preparing the medical student, Dr Neena Singh, St Mary’s Hospital, IOW
Posted May 2013
Dr Clare Van Hamel, Foundation School Director, and Dr Lara Jenner, F2 doctor, from Severn Foundation School, recently conducted a survey to find out new F1s' opinions on induction and shadowing. Twenty-two of the twenty-six foundation schools participated, with a total of 1,832 F1s in their first four weeks of training completing the survey. Please click here to download the survey report, with suggestions for shadowing best practice.
Posted March 2012
As part of its recruitment campaign, the Royal College of Psychiatrists is committed to increasing exposure to psychiatry in the Foundation Programme. It is anticipated that there will be an increase in the number of F1 and F2 posts in psychiatry over the next few years. It will however remain the case that not all foundation doctors will be able to undergo a psychiatry placement. Therefore, as part of the Recruitment Strategy, the college is committed to increasing access to “taster weeks“ in psychiatry in the hope of increasing exposure to, and ultimately applications to, the specialty.
To facilitate this the RCPsych has asked each college faculty to produce a template for a taster week in its specialty. It is asking divisional recruitment representatives, along with their divisional managers, to circulate these templates to the membership within their own division requesting that individual members offer taster weeks. Those willing to offer a taster week will liaise with their local foundation school and Foundation Training Programme Directors and complete the appropriate template for their specialty. Please click here to download the templates
We hope that this will result in an increase in access to tasters and be beneficial in terms of recruitment to the speciality.
Posted February 2012
A pilot study took place at Charing Cross Hospital to encourage F1s to complete their e-Learning for Healthcare modules. A F1 was nominated each week to prepare one of the modules to teach to their peers. This meant that trainees not only completed the necessary modules but developed their teaching skills at the same time. Please click here to read full details of the study.
Arvind Cheesman, Medical Education Manager, Charing Cross Hospital
Reviewed December 2012
Keeping track of post changes is challenging not least at a time when a number of trusts in the School are undergoing major reconfigurations. We need to track changes so that we can ensure that post details offered to trainees are correct and ensure that the Intrepid Database is properly updated. This form used by Birmingham Foundation School asks for the details and reason for the change but also tracks who has agreed the change and whether the FSD has given the final approval at which point the change becomes effective. It also provides a paper/e-mail trail should problems arise.
The Health Quality Improvement Partnership has produced new guidance to aid and support the requirements in the Curriculum for foundation doctors to take part in clinical audit. Please click here to download the guide.
Please click here to download a copy of London Deanery's 'Educational Supervisor and careers advice booklet'
Please click here to download the MOT form from London Deanery
Updated January 2012
Severn Deanery have set up a ‘Sharing Notable Practice' section on their website. Here are two examples of best practice that can be found in this section.
Full Blood Tracking Project at Great Western Hospitals NHS Foundation Trust
Implementation of an electronic blood tracking system was completed in March 2008, for compliance with new legislation stating that blood for transfusion should be fully traceable from donor vein to recipient vein, for a period of no less than 30 years.
The new process involves various computer and alarm systems to ensure the right blood is delivered to the right patient; and that time out of prescribed temperature controls is not exceeded or expired.
Blood Transfusion processes have not only been made safer with the new system - additional benefits are now being realised in a reduction in costly blood wastage.
More information on the implementation can be found via the following link: http://www.foundation.severndeanery.nhs.uk/about-us/sharing-notable-practice/
Electronic Discharge Summary System at Great Western Hospitals NHS Foundation Trust
The background to the implementation of the Electronic Discharge Summary System was to improve the patient discharge process ensuring a smooth transition of care for patients when they leave hospital after an inpatient admission.
An electronic solution was developed and tested and a 6 week pilot commenced in May 2007, followed by Trust-wide roll-out over the next 6 months.
The new system’s benefits include a legible discharge summary at the point of discharge and methods of electronic transmission to assist with guaranteeing delivery to primary care within 48 hours of patient discharge.
To read the full articles please follow the link: http://foundation.severndeanery.org/reducing_medical_errors
All the presentations from the the joint NACT/UKFPO conference on Sharing Good Practice are now available.
Social Induction - an innovative induction programme for foundation trainees (Mr Rags Subramanian/Dr Subir Mukherjee)
Peer-led e-portfolio training (Dr James Wigley)
Re-structuring of the Foundation Teaching Programme at Leighton Hospital (Dr Andrew Wilson/Dr Vanessa Jackson)
The next step - career planning in the Foundation Programme (Dr James Heaton)
Princess Royal University Hospital have created a guidance document on quality assuring the assessment process in the Foundation Programme. Click here to download it.
Dr Andrew Long, Princess Royal University Hospital,
We have been interested in the on-line appraisals system used in the West Midlands (see below for details). In the North Western Deanery we have instituted a complete web-based system for administering and quality assuring foundation training in teaching and non-teaching hospitals. The system allows trainees to complete all aspects of their assessment and appraisal on-line as well as use the foundation documents electronically. The system is known as Horus-FP and you would be most welcome to have a look at our website: http://www.csc.umist.ac.uk/horus/FP/
Dr. Jon Miles, Associate PG Dean, North Western Deanery.
Somerset Academy is currently piloting an interprofessional practical training programme (incorporating Foundation Year One) which allows doctors to maximise learning opportunities. Foundation doctors are supported by a buddy from another discipline through interprofessional reflective practice.
A key component of the programme involves workshops and lectures that are delivered interprofessionally, to support the core dimensions and learning outcomes of Foundation Year One. Candidates also have the benefit of using CCTV to record and analyse their practice to enhance their competence.
The programme has not been without challenges most notably shift patterns and rotas which impact on the consistency of group numbers, however, it has been well received by all participants who have commented on the value of working and learning together, and it has received keen interest from other institutes.
Jane Reid, East Somerset NHS Trust,
At Hope Hospital the Trust Foundation Tutor has implemented simulation training into the teaching sessions. To date our foundation year ones have completed simulation sessions on a wide range of topics - including ACS with the Nurse Clinician for ACS, Palliative Care with the Community Care Team and Consultants. The trainees enjoy the sessions that we run through our simulation centre, as they get a chance to act out different situations they may have been in with their peers and work through the ways of treating people.
Another tactic which works well for us is that we hold peer presentations every week before the teaching session, facilitated by the Foundation Programme Tutor. Each week the foundation doctors take turns at presenting an interesting case for discussion, as well as a ’Drug of the Week’ - where they present information on a drug used within their speciality. This is endorsed and attended with their ward pharmacist and is great for stimulating discussion.
Liza-Marie Kimber, Hope Hospital, Salford,
We have created various assessment guidelines for DOPS, to ensure consistency in assessment for both foundation doctors and assessors. Other trainers might like to use them as a base to develop their own guidelines.
Click to download the relevant guidelines from Worthing PGMC
- Blood cultures;
- Cannula Assessment;
- Shared posts and critical;
- Arterial Blood Gas Sample;
- Blood Transfusion Blood Products;
- Intravenous Injection Antibiotic;
- Subcutaneous Injection;
- Venepuncture assessment.
Dr Gordon Caldwell, Worthing Postgraduate Medical Centre
In Portsmouth we feel it is particularly important that trainees have an understanding of how the radiology department works and how radiological investigations fit into the patient journey.
We have devised an afternoon session for our F1 trainees whereby they come to the department and are asked to speak to a patient who is about to undergo a radiological investigation eg ultrasound, CT, MR or barium study. They are asked to determine how much the patient understands about the investigation, what the patient is expecting and how much the patient understands about the relevance of that investigation. The trainee will then look at the notes and see what they think about the relevance of the test, watch the test being done, discuss the technique with the operator (who may be radiologist, sonographer or radiographer) and then ask the patient again for their views. The group (of approximately five trainees) then meet with a consultant radiologist for a de-brief followed by an informal radiology tutorial on x-rays.
What have we found? The trainees have been a little sceptical about the benefits of talking to a patient about their expectations and fears before a radiological investigation, but have been surprised by the patients’ responses. Many patients expressed considerable anxiety before painless, non-invasive tests, such as ultrasounds. One patient had spent a sleepless night worrying about it. The F1 doctor admitted that he was horrified that he had not properly communicated with his patient and several of the trainees expressed satisfaction at having the time to properly talk to a patient and get the patient perspective, as well as learning something about the investigations which they glibly request.
We feel we are teaching radiology in a practical way and incorporating other skills such as communication and reflection in our sessions. We are also building up the team ethos by involving many different personnel in the training process and not restricting this to doctors only.
Dr Penelope A L Gordon, Portsmouth,
Kings College Hospital have created an information folder for their Educational Supervisors. Click here to see a copy of their information pack that you may want to adapt to suit your hospital.
Jo Hiley, King’s College Hospital,
Newcastle Upon Tyne Hospitals NHS Trust has implemented two best practice tools that are working well for them. Click here to view full details.
- Shared posts. They have shared posts with the Northumberland Vocational Training Scheme (NVTS). It allows them to offer top quality training for both Foundation and NVTS trainees and means that from August 2006 they will effectively have 27 additional GP placements on offer for trainees graduating from Foundation Year One.
- Critical care placements. The trust has created a four-month critical care attachment in both Foundation Year One and Foundation Year Two. This has proved extremely popular with the trainee doctors who said that they felt more confident in responding to emergencies when they returned to the general wards.
Alyson Williamson, Medical Education Services Manager,
Salisbury Healthcare NHS Trust have devised an innovative approach to delivering generic skills within the Foundation Programme curriculum. They use action learning groups to create a learner centred and problem based way to improve practice and patient safety. The Foundation Doctors are guided while working together to design and implement improvements to aspects of care that they considered unsatisfactory during their early weeks in the hospital. It is real life experiential learning that leaves a legacy for the service, as well as helping the doctors understand the complexities of the NHS and introduces them to new knowledge and skills. Click here for full details on the project.
Salisbury Healthcare NHS Trust
TAB, one of the multi-source feedback assessment tools, is well established in the West Midlands. As a paper exercise it does require a fair amount of work by programme administrators, but an electronic solution has now been developed. Building on the model developed at Birmingham Heartlands Hospital by Phil Bright and his team, the West Midlands Deanery is now piloting a new electronic TAB system, based on the Deanery’s server, accessible by assessors, trainees, educational supervisors and administrative staff online. Click here for the full article on E-TAB in the Foundation Programme.
Dr Andrew Whitehouse, West Midlands Deanery, Birmingham.
Post take ward round assessment and feedback process - Honourable mention in the Best Practice Competition
Dr Gordon Caldwell has created a post take ward round instant assessment and feedback process which is working well at Worthing Postgraduate Medical Centre. It has encouraged an effective post take ward round, which offers objectives and learnings for trainee and trainer. Dr Caldwell said the time invested in round assessment has yielded rewards including quicker ward rounds. The time saved can then be used for more teaching or for increased communication with the patients.
Dr Gordon Caldwell, Worthing Postgraduate Medical Centre
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A new postgraduate award in non-clinical skills is being run at a number of NHS trusts in the West Midlands, as part of the Foundation Programme for F2 doctors that started in August 2005. The course was developed by the deanery’s Institute for Clinical Leadership in partnership with the University of Birmingham to help trainees meet the non-clinical competences set out in the Foundation Programme curriculum. It consists of 10 three-hour sessions and covers key areas such as time management, breaking bad news, team work and team roles and effective communication. The qualification will be awarded upon completion of the course.
"Junior doctors undertaking the postgraduate award will have a greater awareness of managerial and leadership roles much earlier on in their careers," said Peter Spurgeon, Director of the Institute for Clinical Leadership. "This will create a new platform on which we can develop other non-clinical awards for specific specialties."
Professor Peter Spurgeon, West Midlands Deanery,
Updated January 2012
Inter-professional Team Based Action Learning (ITAL) has been developed in Durham over the last eight years. It provides three days of protected time to support evidence-based integrated pathways of care, including patient safety, clinical governance, literature searching and the critical appraisal of research. Practitioners from different teams and from both sides of the community-secondary care interface develop their roles and responsibilities in the setting of an agreed clinical problem, breaking down stereotypes and professional boundaries and developing skills in team working, leadership and coaching. The programme ends with the learners presenting their ideas for better management of the clinical problem.
We offer the ITAL programme nine times a year. It is mandatory for trainee doctors in the first year, but is also attended by nurses and midwives (for whom it is “role-essential”), doctors at other grades and practitioners in other disciplines. The benefit to training is maximised by repeating these themes in disparate educational activities over the two years of the foundation grade.
ITAL continues to evolve, especially since our colleagues in community practice joined the Trust. One afternoon in the three days is spent in a clinical ward setting with a much larger multidisciplinary team, working on The Patient’s Journey (which focuses on hospital-acquired infections), care and communication at the end of life, or patient safety in various clinical contexts. The evaluations have been consistently good.
Peter Cook, Senior Lecturer in Medicine, University Hospital of North Durham,
LNR Deanery Simple Guide to Foundation Programme Training in General Practice - Honourable mention in the Best Practice Competition
Updated December 2011
This guide has been developed by LNR deanery for their use. This simple guide is a framework that each practice can build on and adapt to suit their specific circumstances. Click here to download a PDF version of the guide.
In East Kent Hospitals Trust, we have three main sites/hospitals: QEQM Hospital - Margate, Kent and Canterbury Hospital - Canterbury and William Harvey Hospital - Ashford, all having a number of F1s and F2s. All three centres of education use video conferencing of appropriate tutorials. It means that each group receive their tutorials at the same time and avoids duplication of teaching because of rotation between hospitals.
In addition this has saved travelling time between the sites saving considerable time and costs.
We also brief our speakers with video conferencing tips prior to their session which they have found very useful.
Rags Subramaniam, Medical Education Manager, QCCS - QEQM,
Updated December 2011
At the Royal Bournemouth and Christchurch NHS Foundation Trust they perform a four monthly review of the portfolio of foundation doctors to identify problem cases early and be able to deal with any issues relating to satisfactory completion of the foundation years. Click here to view an overview of the procedure, actions taken and advantages.
Dr. Michael Vassallo Foundation Programme Director, Royal Bournemouth and Christchurch NHS Foundation Trust