HEE asks doctors for input on ARCPs
Authors: Abi Rimmer
Publication date: 15 Aug 2017
ARCPs are frustrating the profession, says Health Education England’s Wendy Reid, who wants a fairer, less bureaucratic process. Abi Rimmer reports
When Wendy Reid talks about the moment she realised that changes were needed to the way junior doctors are assessed every year, she becomes more animated. “There was clearly an issue with the ARCP [annual review of competency progression], and I started this conversation some time ago in a public lecture,” Reid said.
“At the very end of the lecture a very articulate paediatric cardiothoracic surgeon stood up and said that she had had 13 years of RITAs [reviews of in-training assessment] and ARCPs, and no one had ever said if she was any good. It really encapsulated in my mind the need to do something about this.”
Junior contract dispute
The incident clearly stuck with Health Education England’s director of education and quality, and helped to spark HEE’s review of ARCP, which began in March. The ARCP, the annual assessment of postgraduate trainees’ progress against a set of standards, has been causing problems for trainees for a while. These came into focus, Reid said, during discussions with junior doctors in the wake of last year’s dispute over their contract.
Reid emphasises that the ARCP is a simple skills assessment with a narrow focus. It isn’t a careers clinic, and it should not be the place where trainees learn about how well they are doing, she says.
“What our paediatric cardiothoracic surgeon needed, I think, was to know how good a doctor she was in the broadest professional sense. That to me is what a more thoughtful appraisal type approach [not the ARCP] could help her with.”
She added, “We are professionals, we are qualified doctors, and we [at HEE] need to make sure that we have a way of giving doctors that constant feedback and development and support within their training programme.”
One of the main concerns about the ARCP—on which HEE has already received feedback—is that it is delivered differently in different and specialties and geographical areas. Reid has a clear response. “We’re going to make sure it’s fair and equitable across all specialties and across all regions,” she said. “It’s an absolute given. We can’t do this work and continue with the inconsistencies.”
Despite asserting that HEE’s work on the ARCP will not be “the Wendy Reid review,” the consultant gynaecologist has clear views on where the process has gone wrong. For example, she is critical of the amount of bureaucracy that has become a part of the process. “I’ve seen trainees queuing up with piles of printed material, wearing their best suits, looking like they’re going to have a viva. This should be a simple sign-off and a conversation saying, ‘Well done.’”
Another criticism is that the ARCP is just a box ticking exercise and that some trainees who have otherwise done well don’t pass because they haven’t been able to tick one box. “I absolutely want to remove the sense of failure because you haven’t ticked a box,” Reid said. “If you haven’t ticked the box because you’ve not done something, that is not something you should find out at the last minute.”
She says that HEE will look at how it can get educational supervisors more engaged in ensuring that trainees are able to remedy any holes in their learning before they get to their ARCP. “What we are learning is that the role of educational supervisors is tough. What we don’t want to do is to state, ‘The educational supervisor must . . .’ but I think we need to learn from this report about what the best practice is.”
HEE’s call for evidence closes at the end of this month. By January it will produce a report on its findings, and doctors should begin to see changes to the ARCP process from next year.
“We’re not going to wait for every bit of every recommendation to be agreed and completed. So there will be some very simple, tangible changes that HEE is in charge of,” Reid says. “The more help we get from doctors telling us how we might do it, the better.”
Submit your views
As part of its work, HEE is now asking junior doctors, and others, to submit their views on the ARCP, in a call for evidence. Respond at [Link] .
Abi Rimmer The BMJ