Document development group.................................................. 2

Contents.................................................................................. 4

PART 1..................................................................................... 7

UKHSA South West Region Health Protection Training – General Information.............................................................................. 7

1.0 Introduction.................................................................... 7

2.0 Scope of policy................................................................ 7

3.0 Placement locations in the South West............................. 9

4.0 Arranging phase 1 mandatory health protection placement............................................................................................ 9

5.0 Arranging extended health protection training placements.......................................................................................... 10

6.0 Induction...................................................................... 10

7.0 Outline of responsibilities and expectations.................... 11

PART 2................................................................................... 14

Phase 1 Health Protection Mandatory Placement – Detailed Outline.................................................................................. 14

8.0 Aims and objectives of mandatory phase 1 placement and supervised on- call.............................................................. 14

9.0 Meeting learning outcomes........................................... 16

10.0  Working in the Acute Response Centre (ARC)............... 16

11.0  Partnership and proactive health protection work........ 19

12.0  Project work............................................................... 19

13.0  Documenting learning experiences.............................. 19

14.0  Mid-Placement Review................................................ 19

15.0 Assessment of competence to participate in the UKHSA South West Region out of hours on-call rota......................... 21

16.0 Continued development of health protection competence post- placement.................................................................. 23

17.0 Arrangements for registrars undertaking supervised out of hours on-call....................................................................... 24

18.0  Placement evaluation and quality assurance................. 26

APPENDIX 1 Guidance for methods of assessment for core health protection competences......................................................... 26

APPENDIX 2: Assessment pro-forma for supervised on-call........ 28

APPENDIX 3 – Examples of formative assessment scenarios...... 31

APPENDIX 4 Supervision Pro-forma.......................................... 32

APPENDIX 5 – A ‘knows-how’ and ‘shows-how’ checklist to support Specialty Registrars in Public Health to develop a wider knowledge of the system of health protection (and show how this knowledge has ..........................................................................

been applied)......................................................................... 33

2.0 Know How Check list...................................................... 34

3.0 Show How Checklist....................................................... 36

4.0 Useful Supporting Reference Materials........................... 37

JESIP Website http://www.jesip.org.uk/home.............. 37

APPENDIX 6 - Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site........................................ 38

APPENDIX 7 – Pre-mandatory training placement meeting agenda/learning agreement.................................................... 42

 

JESIP Website http://www.jesip.org.uk/home

APPENDIX 6 - Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site

APPENDIX 7 – Pre-mandatory training placement meeting agenda/learning agreement

 

List of Figures

Figure 1      Public Health Training Pathway Outlining Health Protection Training

Opportunities

List of appendices

APPENDIX 1 - Guidance for methods of assessment for core health protection competences

APPENDIX 2 - Assessment pro-forma for supervised on-call 

APPENDIX 3 - Examples of assessment scenarios for supervised on-call 

APPENDIX 4 - Supervision pro-forma for Specialty Registrars on placement 

APPENDIX 5 - ‘Knows-how’ and ‘shows-how’ checklist to support Specialty Registrars in Public Health to develop a wider knowledge of the system of health protection

APPENDIX 6 -  Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site

APPENDIX 7 - Pre-mandatory placement meeting agenda/learning agreement

 

Figure One - Public Health Training Pathway and Health Protection Placements

PHASE PHASE 1 (24 months) Year of training   ST1 ST2 Examinations     DFPH*   Knows Knows how/Shows Health Protection placements  Developing knowledge of wider system of health protection through all phase 1 placements. (See Appendix 5). 4-month health protection placement and on-call assessment # Assessment of programme   Assessment of progress will be through examination, workplace-based assessments, annual appraisal and annual review of competence progression (ARCP)   *Two sittings per year **Four/five sittings per year # Mandatory for all registrars

 

3.0   Placement locations in the South West

3.1 For their phase one 4-month full-time equivalent rotation, registrars will be placed in the South West Region Health Protection Team who operate as a team across Bristol and Totnes UKHSA offices and hybrid working (working from home). Registrars will be placed geographically according to their current training rotation as agreed with the South West Public Health Training Program Team. Registrars training in Devon, Cornwall and Somerset will be based at Totnes. Registrars training in Avon, Gloucestershire Wiltshire and Swindon will be based at Bristol. For registrars undertaking an extended  health  protection  placement  on  completion  of  phase  1  and  2 competences, placement location will be determined based on identified training need, but the substantive base will normally be one of the UKHSA South West Region bases (Totnes or Bristol).

4.0   Arranging phase 1 mandatory health protection placement

4.1 Registrars should start their health protection placement after successfully completing the DFPH exam. It is a curriculum requirement that the DFPH exam is passed prior to registrars commencing health protection on call. Additionally, due to time constraints, it is not recommended that registrars routinely sit exams during the placement.

4.2 The South West Public Health Training Programme Team are responsible for producing a timetable outlining health protection training placements. This is to coordinate the flow of registrars required to do the placement and because there are  limited placements within the health protection team. The list  is updated following DFPH exam results. The registrar should then contact the health protection UKHSA South West Region Specialty Tutor (Jonathan Roberts), to arrange a pre-placement meeting (no later than 4 weeks before the tabled commencement date.  The registrar will be assigned a UKHSA placement supervisor (accredited to train through the Training Programme Team) who will be responsible for the duration of the placement working alongside the registrar and their Educational Supervisor.

4.3 The pre-placement meeting between the health protection supervisor and registrar discuss previous health protection experience, identify learning needs and agree a provisional learning contract (See Appendix 7).  As well as a brief introduction to work undertaken in the Acute Response Centre,  the meeting will provide an opportunity to discuss a health protection project to  be completed whilst on placement.  The learning agreement should be agreed  between the registrar, the placement supervisor and the educational supervisor.

4.4 At the pre-placement meeting the registrar should make their health protection placement supervisor aware of  any special needs, e.g. disabilities, part-time work, or any annual leave or study leave they need to take during the placement. The duration of the placement may need to be extended to take account of this.

4.5 At the pre-placement meeting registrars will be provided with induction information and agree with their project/educational supervisor the relevant visits and key individuals/agencies they should meet during their placement. Registrars should commence planning for these visits prior to starting their placement.

4.6 Specialty Registrars in Public Health will have an honorary contract with UKHSA for the duration of their training. This is coordinated by the UKHSA admin team (swhpt@ukhsa.gov.uk) and will be set-up in advance of the placement commencing. Specialty Registrars in Public Health are DBS checked at the start of their training and records are held by the Training Programme Team.

5.0 Arranging extended health protection training placements

5.1 On completion of all phase 1 and  phase  2  competences,  registrars  may consider, with the Training Programme Team, an extended placement in health protection.

5.2 The placements will only be agreed for a minimum period of 6 calendar months. Following discussions with Training Programme Team, the registrar should arrange a meeting with the UKHSA Specialty Tutor for Health Protection at least 8 weeks prior to an anticipated placement start date. At this pre-placement meeting,  a  bespoke  training  programme  and  learning  agreement  will  be developed to address learning needs identified by the registrar.

5.3 Based on identified learning needs, activity supervisors may also be appointed to support the specialist placement from other specialist teams within UKHSA that support health protection delivery (e.g. Radiation, Chemicals and the Environment Directorate) and the Local Authority Public Health Teams.

5.4 Where there is a vacancy and in accordance with the South West Public Health Training Programme Team, registrars on an extended training placement may apply for an ‘Acting-Up’ post. Such posts will be discussed with the registrar during their placement. These posts are advertised to all registrars eligible for an ‘Acting-Up’ post and are not exclusive to those on the extended placement. 

6.0   Induction

6.1 The aim of induction is to enable registrars to become acquainted with the training location, UKHSA organisational structures including the South West Region, roles of team members and roles and responsibilities of external partners.

6.2 Registrars will have a structured induction overseen by their health protection placement supervisor using a UKHSA induction pack provided to them. Registrars with advice from their placement supervisor should familiarise themselves with local  reference materials, resources and local tutorials they can access during this time. 

7.0 Outline of responsibilities and expectations

 

PART 2

Phase 1 Health Protection Mandatory Placement – Detailed Outline

11.0   Partnership and proactive health protection work

11.1 Registrars will be offered the opportunity to attend scheduled meetings with local partners, together with a consultant in health protection or practitioner. The main aims of attendance for registrars are to develop an understanding of key issues, the role of the UKHSA in these contexts, the roles of a range of partners and how the UKHSA works with partners to strengthen the health protection system. This will build on experience gained by the registrar in their other phase 1 placements and their progress against the checklist outlined in APPENDIX 5.

11.2 Examples of meetings may include routine partnership meetings such as Local Authority Health Protection Committees, Local Infection  Control Committees, meetings with environmental health, local water companies and laboratories, port health, clinical strategy groups such as sexual health, blood- borne viruses; public health strategy groups such as immunisation and Emergency Planning such as Local Resilience Forum meetings.

11.3 Opportunities should be made with the placement supervisor to discuss these meetings, context and reflect on learning points.

12.0   Project work

12.1 Registrars will be expected to undertake a health protection project during their placement. The projects chosen will be negotiated between the registrar and their health protection placement supervisor (and where appropriate the educational supervisor of the registrar) and  should  address gaps  in competence. The health protection placement supervisor will oversee their project. The project undertaken may contribute to meeting competences outside of key area 6 in the 2022 curriculum.  

13.0   Documenting learning experiences

13.1 A health protection logbook and summary sheet (for reflections on at least 5 significant cases/enquiries/situations managed) should be completed omitting any personal identifiable information.

13.2 The log and summary sheet should be discussed at 1:1 supervision sessions. The registrar should submit documentation at least 48 hours before the meeting time.

14.0   Mid-Placement review

14.1 As well as regular 1:1 supervision, a formally documented mid-placement review will be scheduled to review placement progress. This will include the registrar’s Educational Supervisor. The mid-placement review will consider progress against competences outlined in the placement learning agreement. It will determine whether an extension might be required to ensure the registrar achieves sign-off for competence to join the out of hours rota. If an extension period is agreed, the project supervisor will notify the South West Public Health Training Programme Team as this might impact on the proposed start dates of other registrars.

14.2 Checkpoints for consideration at the mid-placement review in relation to acute response should include:

14.2.1 demonstrable awareness of the ARC systems and processes;

14.2.2 ability to confidently use HPZone for case and incident management;

14.2.3 demonstrable awareness of the available tools and guidance documents, including local SOPs;

14.2.4 familiarity with the issues and approach required to respond to urgent cases;

14.2.5 demonstrable evidence that registrar is working within their competency levels and  is happy to  consult colleagues as appropriate;

 14.2.6 all mandatory training completed in relation to information governance and takes consistently, clear and concise notes;

 14.2.7 awareness of and has commenced signing into the hunt group when on duty.

15.0   Assessment of competence to participate in the UKHSA South West Region out of hours on-call rota

15.1 Registrars seeking to start supervised out of hours on-call duties need to fulfil the following criteria before they can be assessed as competent for this role:

15.1.1 have passed DFPH of the Faculty of Public Health membership;

15.1.2 Registrars should usually commence out-of-hours supervised oncall once they have demonstrated learning outcomes 1.2, 4.2, 6.1 - 6.6, and 9.2 (the latter must be assessed in the health protection setting event if it has been signed off in another placement).

15.1.3 have successfully completed the formative assessment for supervised on-call (Appendix 2) as evidence to underpin required competences (see 14.1.2);

15.1.4 have maintained (and continue to maintain) a log-book documenting cases and incidents experienced and reflecting on the events as a learning experience regularly with their placement supervisor;

15.1.5 have  experienced  or  received  training  in  a  range  of  common scenarios (APPENDIX 3).

15.2 Formative Assessment will be against performance criteria identified in the Faculty of Public Health Specialty Training Curriculum 2022 using the assessment pro-forma Appendix 1.

15.3     Methods of formative assessment will include:

15.3.1 direct observation;

15.3.2 case based discussion through log-book;

15.3.3 review of case documentation;

15.3.4 feed-back on performance including multi-source feedback.

 15.4 The formative assessment for supervised on-call will be carried out by ahealth protection placement supervisor(s) and/or a senior health protection practitioner deemed by the Deputy Director of Health Protection as competent for this role and using the assessment pro-forma (Appendix 2).

15.5 The purpose of the formative assessment for supervised on-call is to assess that the trainee:

15.5.1 understands the professional responsibilities of being on-call;

15.5.2 understands the roles and responsibilities of key Out of Hours partners and organisations;

15.5.3 has adequate theoretical knowledge of communicable diseases and environmental hazards to support the management of out of hours cases / incidents and undertake a risk assessment;

15.5.4 knows where to find further resources and guidelines, and

15.5.5 can discuss  the  issue  with  the  consultant  on-call  outlining necessary public health action.

15.6     The trainee is not expected to manage the scenario at consultant level but to assist the consultant on-call in effectively gathering information, making a risk assessment and taking appropriate action required under the guidance of the consultant.

15.7 For the assessment for supervised on-call three health protection scenarios will be discussed. Examples of the cases/ incidents that will be used to inform scenarios are presented in Appendix 3. The candidate will be asked to outline their response for the ‘out of hours’ management of the 3 case/incident scenarios and be given 45 minutes on their own to prepare for this. After 45 minutes, the candidate will report each plan back to the assessors who may ask subsidiary questions to clarify information presented. The candidate will have access to HPZone, internet access and other support materials they would routinely be available to those on-call.

15.8 The outcome of this assessment will be provided by the assessors on the same day as the assessment. The pro-forma (Appendix 2) including feedback will be completed by the assessors and given to the registrar within three working days following assessment.

15.9 Should a registrar fail the assessment for supervised on-call, they will be supported to identify further learning needs over an agreed timeframe and arrangements will be made to re-assess with a different health protection placement supervisor and senior health protection practitioner.

15.10 Should they fail this second assessment, the health protection placement supervisor will meet with the registrar’s Educational Supervisor and specialty tutor to discuss this further and agree remedial action required where appropriate. This will be reported to the SW Public Health Training Programme Team for their agreement.

15.11 When the registrar has completed the requirements outlined in 14.1 and is ready to join the out of hours rota, the health protection placement supervisor must inform the South West Public Health Programme Team Training Programme Director in writing with a provisional start date. The health protection placement supervisor will ensure that registrars are not rostered for on-call duties until a start date has been agreed. If a registrar is required to cover a gap in the rota before the agreed start date, the South West Public Health Programme Team will be notified so on-call payment can start from that date.  

15.12  registrars should contact the rota co-ordinator so they can be added to distribution lists and allocated to the next available rota.  Registrars can be available to cover gaps in the current rota or cover sickness if required before the next full rota starts.  

16.0   Continued development of health protection competence post- placement

16.1 Registrars training in the South West should be assessed against LO 6.9 upon entering their ST5 year. It is the expectation that full sign off of LO 6.9 is completed at the start of the final year of training.  The KA10 panel would not expect LO 6.9 to be signed off prior to the review meeting (held 12 months wte prior to CCT) but the Registrar should have a plan and timeline agreed to sign off this outcome. 

16.2   To achieve competence 6.9 registrars will have to meet the following:

16.2.1 undertaken a minimum of approximately 40 on-call sessions as first responder and demonstrate a breadth of out of hours health protection activity and appropriate response through their logbook. A 24- hour weekend shift counts as 2 sessions (e.g. 9 am Saturday to 9am Sunday). This is a guide and breadth of activity and reflection of learning points supersedes quantity of on-call undertaken;

16.2.2 To further develop and maintain competence and meet learning needs at least 3 days per quarter / 1 day per month should be spent with the HPT/supervisor (but preferably in a block of 3 days);   If there are any concerns about the Registrar’s competence on-call the frequency or number of these ‘update days’ can be increased in agreement with the Training Programme.

16.2.3 demonstrated additional Continued Professional Development in health protection (e.g. attending on-call training days / relevant conferences / contributing to or appraising and reporting on relevant papers);

16.2.4 maintained a reflective log-book and met with the health protection trainer at least twice per annum to review this over the period they are on-call.

16.2.5 Demonstrated a wider understanding of the health protection system with reference to how they have used the supplementary knows how and shows how check list whilst engaged in phase 1 and phase 2 placements (Appendix 5). 

17.0   Arrangements for registrars undertaking supervised out of hours on-call

17.0 Specialty Registrars in Public Health who have completed their Health Protection rotation and assessed as competent (as per 14.1) will be invited to join the rota to be the first point of contact alongside the health protection practitioner team. 1.0wte Specialty Registrars will be expected to complete 10 sessions of on-call every three months. Registrars should aim for the majority of the on-call allocation to be Saturday, Sunday or Bank Holidays as these are the days when they are most likely to handle calls to support learning. The remaining t im e will be allocated to week nights. One 24-hour period of on-call will count as two on- call sessions (e.g. 9am Saturday until 9am Sunday). For those working less than 1.0wte, the allocation will be proportionate to hours worked.  The training programme recommends that Registrars undertake at least one episode of bank holiday on-call work in their cycle of training.  Being on-call on a bank holiday gives a different experience and we encourage Registrars to do this as part of their training and learning experience. 

17.1 At these times, registrars on the rota will be the first point of contact for one of the three on-call geographies:

17.1.1 Devon and Cornwall;

17.1.2 Somerset and Dorset

17.1.3 Avon Gloucestershire and Wiltshire.

17.2 As the UKHSA South West Region delivers one acute response service for the South West, a registrar may be required to support any one of these geographies whilst on-call regardless of their site of training.

17.3 UKHSA will provide a mobile phone for the duration they are on the on-call rota. These are available through the Regions’ Business Management Team / Placement Supervisor.

17.4 Registrars will need to complete approximately 40 on-call sessions and demonstrate through their log-book a good breadth of health protection activity and response for competency 6.9 to be signed off, with the expectation that this will occur towards the end of training upon entering ST5 (see 15.1).

17.5 Although the registrar will cover a geographic area of the South West when on-call, they are part of an on-call team and support will be available from the practitioners on the same on-call tier or the on-call consultant at any time.

17.6 Feedback and discussion of any learning points observed for activity undertaken by the registrar should be provided at the earliest opportunity (preferably within 24 hours of the shift).

17.7 Registrars will be expected to record, and report on-call activity undertaken to the health protection practitioner they are on-call with to support handovers.

17.8 Where registrars have been involved in cases/situations over their on-call shift, they will be expected where possible to dial-in to the 9.30am health protection team Sit- Rep on the next working day to handover.

17.9 Registrars are responsible for checking their IT and access to HPZone prior to commencing an on-call shift and flag any issues with the health protection admin team and on-call duty consultant to resolve issues with sufficient time. 

17.10 Registrars on-call will be remunerated as per current arrangements with the South West Public Health Training Programme Team. Once the registrar has achieved their health protection learning outcomes including 6.9, they will no longer be required to undertake health protection on-call. Should they wish to remain on the on-call rota for professional / continued development purposes, this will need to be agreed by the health protection Specialty Tutor and South West Public Health Training Programme Director.

17.11 The following rules as outlined by the South West Public Health Training Programme Team following Doctors in Training hours of work in the NHS Terms and Conditions apply to registrars participating in the out of hours on-call rota:

17.11.1 The maximum length of an individual on-call duty period is 24 hours, and if a Registrar is working in their normal place of work the day after an on-call this duty period must not exceed 32 hours during weekdays and 56 hours following a weekend.

17.11.2 On-call periods are permitted to be worked consecutively in weekdays but only if the intensity of the on-calls is not high and sufficient rest is being achieved.  It is permitted for two consecutive weekend days to be worked.  There must be no more than three on-call periods in any period of 7 consecutive days.  

17.11.3 registrars will not be required to work more frequently than a 1:9 rota;

17.11.4 activity must be consistent with registrars working within their contracted hours;

17.11.5 in the case of a less than full time registrar their contribution must be proportionate to their hours of work i.e. if working 0.6wte they must have on-call duties equivalent to 60% of whole-time registrars;

17.11.6 registrars should also achieve a minimum of 5 hours continuous rest during the hours of 10pm and 7 am.

17.12 If Registrars are breaching these rules they must complete an exception Reporting form and discuss this with their Health Protection supervisor and the Deputy Director.

17.13 The Terms and Conditions for Registrars undertaking on-call shifts on bank holidays does mean that they are entitled to time off in lieu for those shifts.  For each bank holiday they are entitled to one day off as time off in lieu.  Educational supervisors will be required to approve the time off in lieu in liaison with the Health Protection supervisor for the Registrar in order to confirm that the on-call episode took place.   The Registrar should email their educational supervisor, health protection supervisor and copy in the training programme team to inform them that they have worked a bank holiday and they wish to take their time off in lieu at a given date and time.  The Health Protection supervisor should confirm that they did in fact work a bank holiday on-call shift and the educational supervisor should then give approval for the time off in lieu.

The Registrar will be required to record this on the leave Accent system.  The Registrar should add their TOIL date(s) onto the system in the same way they would apply for other leave but enter 0 into the days/hours box and then add a statement in the comments box that this is TOIL.  The Registrar should ensure that they keep the email record of approval from their educational supervisor as confirmation as they would for any other leave.

Similarly if an exception is reported and requires TOIL to be taken then the above process will be used for this also.

18.0   Placement evaluation and quality assurance

18.1 As part of the pre-meeting, the health protection placement supervisor will advise the registrar that they are the first point of contact for discussions about the placement itself and will provide opportunities throughout the placement to discuss concerns or ways to improve the placement experience. This will normally be considered during formal one to one supervision sessions (see Appendix 4) and will involve the Specialty Tutor if required.

18.2 At the end of the Phase 1 placement, the registrar will be asked to provide feedback on the placement as part of an exit meeting (although it is acknowledged that support and supervision will continue whilst the registrar is on the out of hours on-call rota and to achieve remaining competences (namely 6.9).

18.3 The Specialty Tutor will also contact the registrar to ensure all relevant feedback is captured to inform future placements.

18.4 The Deputy Director of Health Protection will formally meet with members of the South West Public Health Training Team and registrar representative(s) quarterly to review health protection placements and ensure that the health protection training policy is being upheld and updated as required.

18.5 All health protection placement supervisors will remain fully accredited. Failure to do so will result in their being removed from the list of UKHSA accredited supervisors until such time that gaps in accreditation are met.

18.6 There will be a named UKHSA South West Region Health Protection Specialty Tutor. This individual will participate in monthly Specialty Tutor meetings convened by the South West Public Health Training Programme Team.

18.7 The Deputy Director of Health Protection will attend quarterly Regional Specialty Committee meetings and report on health protection training activity for the quarter.

18.8 UKHSA South West Region are required to participate in the South West Quality Panel process and following the annual review meeting will maintain an action plan to address matters raised through this process. This will be monitored by the Deputy Director of Health Protection. 

 

APPENDIX 2: Assessment pro-forma for supervised on-call

 

 

APPENDIX 3 - Examples of formative assessment scenarios

 

 

This page was last updated March 18th 2024 (10 months ago)