The SuppoRTT Process
The Academy of Royal Medical Colleges recommends that planning for a trainee’s return to clinical practice should begin even before the absence. Where possible, i.e. planned absences, the trainee should arrange a meeting with their current ES to conduct a pre-absence planning meeting at least 4 weeks prior to the period of absence.
The purpose of this meeting is to highlight areas that might be challenging for the trainee when they return. It should cover the reason for absence and the expected duration. The trainee and ES should consider how the trainee may stay up-to-date with clinical developments and what (if any) work related activities may take place during their absence. At the time of this meeting, a Pre-Absence Planning form should be completed through Online Surveys. Once submitted, it will generate a PDF version which can be uploaded to the trainee’s eportfolio.
In cases of unplanned absences (e.g. sickness or bereavement), if the period of absence is expected to extend to 3 months or more, we ask that the ES or SuppoRTT Champion completes an Unplanned Absence form via online surveys on behalf of the trainee. The purpose of this is to allow the absence to be logged contemporaneously within the SuppoRTT hub and ensures the trainee is offered the appropriate support upon their return.
Approximately 3 months prior to their anticipated return to training, trainees receive an email from HEE, giving information of the resources available to ease their transition back to clinical practise. Information about this can also be found within these SuppoRTT web pages..
The trainee should be notified of their ES at the returning trust/general practice, two to three months before their return to work. If this has not happened, please get in touch with the department that you are due to return to or your local SuppoRTT Champion. It is the responsibility of the trainee to arrange a pre-return planning meeting with their ES, a minimum of 6 weeks before their return. Depending on the circumstances relating to your leave, you may also be offered an additional meeting with the SuppoRTT Champion.
The aim of the pre-return meeting is to identify any areas of concern which the trainee may have regarding returning to work and create a bespoke action plan to facilitate the trainees return to clinical practice. The Pre-Return Planning form should be completed at this time through Online Surveys. Once submitted, it will generate a PDF version which can be uploaded to the trainee’s eportfolio.
It is strongly recommended that all returning trainees benefit from a period of ten working days of enhanced supervision (if the period of absence has extended beyond 3 months). At the pre-return planning meeting, an action plan should be agreed between trainee and ES about what level of supervision is required and an appropriate support package created. It may include amendments to the type of clinical activities undertaken. For example; trainees who undertake clinics may require a reduced number of patients with a named consultant available to provide help and advice when needed. Trainees in craft specialties may require directly supervised lists. It is also expected that during the period of enhanced supervision, trainees do not undertake out of hours (OOH) commitments unless it is in a shadowing capacity.
During the period of enhanced supervision, the default is for trainees to work their normal daytime rostered hours for the week. If they choose to work an evening, night or weekend shift during their period of enhanced supervision, that is their prerogative. However, their hours should not exceed their standard working hours and they should be working in a shadowing capacity only. The details should be discussed and agreed with their educational supervisor and rota writer prior to their return to work.
In some cases, for example where trainees have undertaken clinical work during their period of absence (eg OOPR/OOPE) a period of enhanced supervision may not be required. If both the trainee and ES agree it is not required, this must be documented within the pre-return planning form, with explicit reference as to how the trainee has maintained clinical competence during their period of absence. We also recognise that for some returning trainees a more prolonged period of enhanced supervision will be required. In cases where there is any deviation from the recommended 10 working day period of enhanced supervision, this must be exception reported (see Appendix 4 of the SOP document) through the SuppoRTT Champion and the SuppoRTT Hub (SuppoRTT_SW@hee.nhs.uk), alongside the trainees Training Programme Director. Approval must be granted by the SuppoRTT Champion before it can proceed. Once approved, trainees not requiring enhanced supervision can immediately return to all usual clinical duties, including out of hours commitments, upon return.
Once the period of enhanced supervision is complete, the trainee should arrange a final meeting with their ES. The aim of this meeting is to review the trainee’s progress since returning (including completion of any work-based assessments agreed at the pre-return planning meeting) and address any concerns or difficulties the trainee may be experiencing. If necessary, the period of enhanced supervision can be extended. If this is required, the SuppoRTT Champion and Training Programme Director (TPD)/Head of School should be notified.
Once the trainee and ES are satisfied with progress, the trainee can be signed off to resume usual clinical duties and out-of-hours commitments. A Post-Return Review form should be submitted. Once the online form is submitted, it will generate a PDF version, which can be uploaded to the trainee’s eportfolio.
Once the trainee has been back at work for a few months, they will be sent a survey about their return-to-work experience. It can be completed anonymously, and we are very grateful for any feedback that we receive.