Return to practice documents are for anaesthetic registrars returning to practice after a prolonged period of absence (thank you to the West Midlands Deanery for their documents). These documents aim to assist training supervisors and trainees achieve a structured and safe return to work after a period of absence.
The Absence from Training Form ideally should have been completed before any period of anticipated leave and should be referred to as part of preparation for return to work.
The Preparation for Return Form is to be completed a minimum of 1 month before the trainee returns to work to plan how the re-introduction period should be spent and to help prepare the trainee for their return.
The Record of Re-introduction Form is a record of duties undertaken during re-introduction.
There are no compulsory assessments as part of the return to practice process. The RCoA suggests that trainees who have had less than 12 months anaesthetic experience prior to a period of leave should repeat the Initial Assessment of Competence as part of their return to work. Other grades of doctors may like to use the Anaesthesia List Management Assessment Tool (ALMAT) for theatre lists or the Acute Care Assessment Tool (ACAT) for Intensive Care or the Emergency setting.
For Educational Supervisors / Clinical Supervisors during the re-introduction period
In addition to the questions covered by the paperwork you may like to consider:
Has the period of leave been extended beyond that which was originally planned? If so, what was the impact of this?
How does the doctor feel about their confidence and skills level? Have any new issues arisen since the doctor was last in post which may affect this?
Have there been any changes since the doctor was last in post, within the department, hospital or specialty?
Has a supernumerary period been organised? The Oxford School of Anaesthesia and ICM is supportive of an initial two week supernumerary period [School Board Minutes 13th Sept 2018].
There are no mandatory requirements that dictate what preparation is necessary before returning to work. However, you have a duty to ensure that you are safe to return to practice. It is normal to lack confidence and you can use this period to address any issues, before you may be working solo again.
You may like to consider the following suggestions based on the guidance from the RCoA and AoMRC:
· If you are on maternity leave you are entitled to take up to 10 Keeping in Touch (KIT) Days. These can be used to attend courses you feel would be beneficial, or you can spend them at work re-orientating yourself. Any payment for these days will need to be negotiated on an individual basis with the anaesthetic department responsible for paying your maternity pay. These KIT days cannot be taken during annual leave (even if this is accrued during maternity leave & occurs just prior to your return to work) and so dates will need to be carefully organised.
Courses relevant to anaesthetists returning from a break include:
o RCoA GASAgain (Giving Anaesthesia Safely Again)
o RCoA and AAGBI Core Topics Days
o Health Education England SuppoRTT Return to Training Days
Please apply to the Health Education England Thames Valley RTT Team for funding to attend RTT courses (the RTT budget is separate from the study leave budget).
·Your personal CPD to prepare for returning to work should include:
o Familiarisation with any recent updates to guidelines that have been published during your period of leave e.g. Difficult Airway Society Guidelines, Resuscitation Council Guidelines, GMC Guidance, AAGBI publications
o Revision of the management of anaesthetic emergencies as necessary.
Supported Return to Training
HEE recognises that trainees take time out their training programme for a number of reasons, such as parental leave, OOP, carers leave and sickness. Returning to training, regardless of the reason can be a difficult and stressful time for trainees.
HEE is committed to supporting trainees to return to training after a period of extended absence (3 months or more). The Supported Return to Training (SuppoRTT) initiative aims to support trainees with their confidence, skills and knowledge so that they can safely and confidently return to practice within their training programme.