Return to Work

Taking time out of the surgical environment for a number of reasons is very common, and the return to work in surgery has both technical and non-technical challenges. Confidence, knowledge and surgical skills can all be affected and the pace of life within theatres can be daunting to those who have just returned. This webpage aims to link you to current information to support those returning to work, and to highlight areas of best practice.

The Royal College of Surgeons of Edinburgh is committed to supporting its Members and Fellows at all stages of their career, and whilst we recognise that most of the current initiatives are aimed at trainees, we are trying hard to extend this to Consultants and SAS doctors. We welcome any feedback at comms@rcsed.ac.uk and are keen to promote any resources or evidence of best practice.

We have in-depth guidance on the following:

Returning to training after an absence

Around 10% of postgraduate doctors in training take approved time out of programme at any time. (HEE Supported Return to Training Report) There can be a number of reasons why trainees take time out. Absences may be planned or unplanned and can be for differing lengths of time. Some of the most commons reasons for having time out of training are:

Parental leave/caring responsibilities
Illness
Further study/research

Further information regarding taking time out of programme and who is eligible can be seen in “A Reference Guide for Postgraduate Specialty Training in the UK (Gold Guide 2016)”

Planned absence/requesting time out of programme

All requests need to be agreed by the Postgraduate Dean in advance so trainees are advised to discuss their proposals as early as possible.

To find local guidance for applying for time out of programme you should look at the websites of the HEE Local Education and Training Boards, NHS Education for Scotland (NES), the Wales Deanery and Northern Ireland Medical and Dental Training Agency (NIMDTA).

Support for those returning to training

There is help and guidance available for planning your return to training. RCSEd is here to provide you with support and information in addition to the information available from your Deanery/LETB.

There is information available on this website, links to further information and if you would like to discuss specific issues about returning to training you can contact your local Regional Surgical Adviser (RSA).

Any trainee who has had a period of more than three months away from work can be considered for support on return to training. Many returners have concerns regarding their clinical competence, current knowledge and colleagues’ perceptions when returning to training Additionally, many returners experience a lack of confidence after taking time out Putting in place a comprehensive returning to training plan and talking to others who have been through the process can alleviate these worries.

HEE outline the following periods associated with time out of work, where you should speak to your Educational Supervisor and / or TPD to get the support you need

Pre-absence period (if absence is planned eg parental leave or research)
Absence period
Prior to return
Transition period back into training
Return Review Meeting

It can be difficult for surgical trainees to take up the option of having regular ‘keeping in touch’ days until immediately prior to returning to training due to caring or research commitments, or due to illness. It is therefore necessary for trainees to have a bespoke package, suited to their circumstances and skills. Different Deanerys/LETBs offer different forms of support and you will need to find out what is available to you locally.

Many regions will already have one of these plans in place and may have a formal Return to Work programme. Even if this is in another speciality, there may be overlap (eg Human Factors workshops) so it is worth investigating what is on offer.

Returning to work as a Consultant or SAS grade after an absence

Most of the current funding in the UK to support doctors coming back to work is only available for trainees. The RCSEd has approached both NHS England and NHS Education for Scotland to ask for this to be extended to Consultants and SAS grade doctors. Although this is under review, if you are a consultant or SAS grade doctor who has been away from work you could ask your own Trust or Health Board if they would fund you to attend any existing programmes available for trainees.

JCST Advice

JCST has produced guidance on specialty and core trainees returning to training.

It advises:

If possible, meet with your Training Programme Directors (TPD) before you go out of programme and complete a “Planning an absence from practice” checklist.

Plan interim meetings with your TPD (minimum annual review).

Meet with your TPD again 3 months prior to returning to training to review your learning and agree targets and complete the “Return to practice” checklist.

Plan follow up meetings 6-8 weeks and 1 year post return with your TPD.

Health Education England (HEE)’s Supported Return to Training (SuppoRTT)

HEE reviewed supported returning to training as part of the Enhancing Junior Doctor’s Working Lives programme in 2017. The programme is in its early phases and has undertaken research into returning to work.

HEE’s proposal is to provide a financial resource to each HEE local office to procure bespoke support for returning to training.

HEE found that a supernumerary period / supervised phased return with no on call commitments; a properly administered and joined-up exit interview, KIT process and re-entry; and access to a designated mentor or coach were the preferred support options preferred by returning trainees.

HEE has developed a defined process and more centralised co-ordination to ensure that individuals can easily access support, much of which is currently available but can be difficult to access.

At the moment, in some areas you may need to be proactive in defining and accessing the support you feel would be beneficial. Plan out what your ideal support package would look like and share this with your TPS or AES to produce an individualised plan.

Keeping in Touch (KIT) Days

KIT days may be taken by individuals on parental leave are paid to be in the workplace in order to keep up to date with workplace activities. Up to 10 days can be taken during the parental leave period (not within the first two weeks of birth for new mothers). It can include training or other activities which the individual and employer feel can facilitate a smooth return.

Many individuals find these days extremely useful as they can ensure you stay connected to the workplace. You can use these days to take part in training which can help you to keep up to date in your specialty area and maintain confidence in your professional abilities.

Although KIT days are only available for those on parental leave, if you are looking to do a formal research programme there may be the option for you to have an honorary NHS contract. Not only will this maintain your entitlement to sickness benefits, and allow you to continuing paying into your NHS pension, it will enable you to undertake clinical work such as on-calls, or theatre lists, clinics etc which can help keep you up to date.

If you have been off sick and unable to work, your Occupational Health department can arrange for you to have a phased return.