The Covid-19 pandemic has meant some trainees have had difficulty accessing their usual medical education and training. They have been unable to acquire new competencies and maintain existing ones. Education and training must be under-pinned by robust educational and clinical supervision and increased pastoral support.  The working environment also needs to be conducive to training as outlined in the BMA Fatigue and Facilities Charter.

The Midlands’ Charter, first published at the end of 2020, outlined our commitment to prioritise the restoration of postgraduate medical education and training impacted during the Covid-19 pandemic. It recognises the determination of providers to restore and reset education and training and to establish the Midlands region as a beacon for postgraduate education.

The Midlands’ Charter has recently been updated (January 2022) to showcase the brilliant work that has happened since the last publication over a year ago. It is a testament to all involved in the Charter that powerful change has happened to improve the lives of medical trainees. We hope this publication provides examples of the type of work done, and how this has helped drive positive change. These inspirational examples should be used and built upon in the future to continue to drive change not only within the Charter but across the wider NHS.

Over the next six months the Midlands’ Charter team will be looking as to how we can further update the Charter to be fit for the post-Covid world, to further embed these principles into the region as part of our ambition to be a beacon of excellence in post-graduate medical education. As part of this review, we will be increasing the focus of the Midlands’ Charter on issues of equality and diversity. If you want to be involved in this process then please get in touch with the team – england.midlandsworkforce@nhs.net.

By implementing the Charter, providers commit to:

1. Ensuring adequate experience 

• Consult with trainees and schools when making rota changes likely to impact on training.
• Consult with Health Education England (HEE) at the earliest opportunity when planning service reconfiguration.
• Ensure that trainees have access to NHS contracted work conducted in the independent sector with training opportunities equal to those provided within the NHS.
• Facilitate bespoke employment arrangements to allow trainees to catch up on curriculum competencies.

2. Providing educational support 

• Use the consultant job planning process to ensure sufficient time is given for educational and clinical supervision.
• To continue to provide employer support/counselling services with full access for trainees.
• Ensure provider IT systems enable access to HEE provided teaching platforms.
• Ensure medical education and training is represented and discussed at executive board level. 

3. Creating a supportive training environment 

• Create quiet, non-clinical areas for trainees to attend virtual teaching.
• Commit to ensuring trainee representation in leadership, management and employee networks.
• Provide high quality rest, sleep and changing facilities.
• Commit to providing 24-hour access to food.
• Make the necessary changes to educational and common areas to allow them to become Covid-secure.
• Commit to ensuring adequate time is given to trainees for educational supervision and other supporting activities, such as conducting audits and research.

Many of our trainees must catch-up on missed training opportunities to ensure that the workforce is ready for the future, and as outlined in the NHS People Plan (August 2020).

‘Employers should fully integrate education and training into their plans to rebuild and restart clinical services, releasing the time of educators and supervisors to continue growing our workforce; supporting expansion of clinical placement capacity during the remainder of 2020/21; and also providing an increased focus on support for students and trainees, particularly those deployed during the pandemic response. For medical trainees, employers should ensure that training in procedure-based competencies is restored as services resume and are redesigned to sustain the pipeline of new consultants in hospital specialties.’

Source: We are the NHS: People Plan 2020/21 – action for us all (August 2020)

Trainees from the Midlands region are recognised for their professionalism, agility and flexibility during the Covid-19 pandemic, and along with other clinical and non-clinical colleagues, they continue to provide quality care in often challenging environments.  The Charter further aims to ensure their education, training and wellbeing is centre of discussions.  We are committed to investing in their development and progression.

This will ensure the safety of our patients, attract innovators and future leaders to the Midlands region and create a long-term and sustainable first-class health service adaptable to the needs of the future.

As a supplement to the Midlands’ Charter, please refer to the Working Environment and Wellbeing Guide. This provides a more comprehensive insight into the training environment.  The guide has been uniquely developed with trainees across the Midlands region, in collaboration with NHS England and NHS Improvement and Health Education England in response to frequently faced challenges.

Download the two publications:

• Midlands’ Charter – UPDATED: January 2022
• Working Environment and Wellbeing Guide