The Department is acutely aware of the unprecedented impact of Covid 19 on the delivery of clinical training across the HSC.  We are particularly appreciative of the ongoing contribution of the many training practices.

We are now moving into unchartered territory as, in partnership with the Sub-Deans and colleagues across Primary Care, QUB Medical School plans how best to reintroduce student clinical placements / learning opportunities for the 2020-2021 academic year into a healthcare system that must continue with ongoing management of the challenge of Covid 19.

Looking forwards, Medical Leadership in the Department has agreed, with QUB, several joint principles which will underpin the planning of the return to clinical placements across HSC, in its widest sense, including General Practice.  These are as follows:

(i) The restart of medical and dental education should be fully integrated into plans to rebuild clinical services.  Undergraduate medical students in years 3-5 should restart clinical placements in September 2020.  (This is acknowledged to be a challenging objective and it is accordingly hoped that the operational implications can begin to be tested through a number of small cohorts, initially in some Trusts, during August).

(ii) Students should be facilitated to learn wherever the service is located – whether the service has moved to a different Trust site or independent hospital.

(iii) Students should be facilitated to learn however the service is delivered – whether that is Face to Face or virtually.

(iv) Students should have access to protective equipment to enable them to participate and learn during service delivery.

(v)Students should be provided with mandatory formal education using whatever methods of delivery are the most suitable.

(vi) There should be an increased focus on delivering a high quality of medical education in view of the reduced quantity of experience available.

(vii)There should be increased attention to supervision and support of Students in view of the disruption of normal team structure and service delivery locations.

(viii)Educators and trainers should be facilitated to participate in medical recruitment, examination and assessment processes to enable Students to progress in their courses/programmes and support the flow of highly capable medical and dental professionals into the service.

(Similar principles apply to the delivery of post-graduate training by NIMDTA).

Underpinning all these considerations, the Department obligations to Value for Money and ensuring transparency and accountability under Managing Public Money Northern Ireland remain.

I raise these points as I acknowledge that the potentially radically different curricular timetable in the prospective 2020-2021 academic year may require amendment of the current Supplement for Undergraduate Medical and Dental Education (SUMDE) funding model used to offset the additional costs to the healthcare sector.  Issues to be considered include the following:

1. The impact of the delivery of clinical placements / learning opportunities on the extant “student weeks” model.
2. The need for enhanced technology across all sites to deliver optimal student experiences (eg linking students remotely to clinical experiences in both inpatient and outpatient settings).
3. The recognition within the funding model of the delivery of educational opportunities to all students via online platforms.
4. The appropriate funding of additional simulation sessions to compensate for the reduction in direct clinical environment-based teaching.
5. The impact of social distancing and infection control measures. 

All these considerations will be addressed in discussion with stakeholders.

In the meantime, looking backwards, the Department is required to process, on the basis of the extant arrangements, payments in respect of the period since 13 March 2020 when practices were notified of the cancellation of teaching.

The GP Service Level Agreement states:

1.         No payment shall be given for cancellation more than 2 weeks prior to the intended placement date.

2.         In the event of the University cancelling the placement within 2 weeks of the start date, half the remuneration shall be awarded.

The application of this half remuneration cancellation clause across the various categories of teaching is set out below:

Cohort	Teaching	Description	Impact
Year 1	Communication Skills Group	Workshop 5: 19/03/2020 & 24/03/2020	Half payment award
Year 1	Family Attachment – Examining –	Student Project Marking remotely	Full payment
Year 1	Medical Clinical Skills -Group-based	24/03/2020 & 26/03/2020	Half payment award
Year 1	Medical Clinical Skills -Group-based	21/04/2020 & 23/04/2020	No payment award
Year 2	Medical Clinical Skills -Group-based	20/03/2020	Half payment award
Year 2	Medical Clinical Skills -Group-based	22/04/2020 & 24/04/2020	No payment award
Year 4	CCTV Teaching	06/03/2020 (Group A date 2)	Full payment
Year 4	CCTV Teaching	10/04/2020 & 24/04/2020 (Group B)	No payment award
Year 4	Examining – End of Module	20/03/2020 (Group A) by Zoom	Full payment
Year 4	Examining – End of Module	08/05/2020 (Group B)	No payment award
Year 4	Practice Attachment	Group A ending 19/03/2020 (final 4 days completed with online support)	Full payment
Year 5	GP Assistantship – Cluster Lead (Fri)	27/03/2020	Half payment award
Year 5	GP Assistantship – Cluster Lead (Fri)	From 03/04/2020	No payment award
Year 5	GP Assistantship -Practice Attachment (Mon-Thur)	23/03/2020 – 26/03/2020	Half payment award
Year 5	GP Assistantship – Practice Attachment (Mon-Thur)	From 30/03/2020	No payment award

Workforce Policy Directorate

Department of Health