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Background

Adaptability in staff skills and approach have been key to the NHS’ system-flexible response to the COVID-19 pandemic. Learning from improvements in cross-discipline, speciality and organisational communication, rapid training and redeployment, we aim to harness the unpredictability of the last year to pivot on the findings of the Future Doctor programme, creating a development offer for doctors during their first five years following qualification.

The programme builds on existing Medical Education Reform Programme initiatives from Health Education England (HEE) to develop a universal wraparound professional development offer aiming to enhance current training, with a focus on embedding generalist skills early on in medical careers, allowing a broader future career for all doctors in training – increasing flexibility for all. The programme outcomes have been set to address a number of key 21st Century health needs:

  • to support future doctors to feel confident in meeting the complex demands of the healthcare landscape, while promoting self-care at individual, team and organisational levels across all healthcare professions;
  • to address health inequalities and support equitable healthcare delivery across maturing integrated care systems including remote, rural and coastal regions;

  • to feel confident in co-delivering ‘whole person’ care for patients with multiple conditions;

  • be fluent in shared-decision making and personalised care;

  • become authentic, collaborative leaders and colleagues with a thorough grounding in human factors and team science;

  • understand and address population health and care needs in the communities they serve by harnessing data, technology and contemporary research methodologies;

  • apply their learning to address local health priorities and specific needs such as homelessness, poverty, migrant health and other social justice agendas;

  • become system literate across organisational boundaries with cross-cutting interests and skills in informatics, digital health and epidemiology.

The development offer has been designed to deliver the GMC Generic Professional Capabilities through innovative blended learning opportunities, supplementing specialty training and enhancing generalist skills. Each of the seven HEE regions has looked at their areas of health priority and drafted a proposal for a pilot programme to start in August 2022, with small segments of defined modular content being released from August 2021 for trial and iteration across the delivery network.

Each pilot will be supported by a lead educator with defined administrative support to translate the educational concept into reality. A supporting programme of careers and cultural engagement will use existing generalist-skilled “champions” to promote the learning opportunities to participants, educators, healthcare organisations and the wider system. Shared work and learning will be captured via a trailblazer network as well as a multi-faceted evaluation and monitoring programme including “living lab” co-design approaches.

The programme is being designed and co-created with stakeholders across the health and care system and the mixed delivery model will provide a multitude of opportunities across the healthcare professions and their non-clinical colleagues to benefit patient care. There is a linked academic research stream to ensure benefits are fully evaluated and challenges addressed.

A core tenet of the team’s approach is for representative members of patients and the public, current and future doctors, educators, all healthcare professions, the NHS and partner organisations to be involved in every aspect of development. The team are exploring how to integrate the development offer into undergraduate medicine through collaboration with the new medical schools. We also plan to support the trailblazers to work with integrated care system leaders, so that these enhanced generalist skills become increasingly valued and rewarded within a wide range of flexible and sustainable career paths.

Our approach does not alter established curricula or training pathways. We are neither creating a new generalist specialty nor diminishing the role of either specialist or general practitioners; rather delivering on a new vision of professional practice for the 21st Century – working collaboratively to reduce health inequalities and support delivery of care across all types of health and care settings.

The programme will ensure that “future doctors” and their multi-professional colleagues are empowered to deliver high quality healthcare, changing the current landscape of delivery and boundaries to work across all systems, effect change within the communities they serve and ultimately to improve health outcomes for all.