Organisation

The Organisation section of the SEIPS model allows us to examine many different aspects of the organisation of healthcare. It includes high-level pastoral elements such as workplace and safety culture which subsequently underpin and inform how many other activities are performed within a system. It includes more social elements such as teamworking, collaboration, and communication. Finally, it includes technical managerial aspects such as job-planning, rota management, and regulation.

Organisational elements underpin many aspects of the system; how we are trained and regulated, how care teams and pathways are set up and maintained, how problems are identified and addressed.

Activity

Training and Exams

One of the College’s major responsibilities, in conjunction with other Royal Colleges, is in the provision and regulation of surgical training across the UK. RCSEd integrates with the Joint Committee on Surgical Training (JCST) to ensure the depth and quality of training across specialties. Innovative courses, such as the Core Surgical Bootcamp for early year trainees, provide training to improve technical and non-technical skills across multiple areas of surgical practice. Other courses align with specific specialties, anatomical regions, or techniques to meet curricular needs. The College’s webinar series successfully delivers evidence-based updates from experts on a range of subjects.

The College developed its Faculty of Surgical Trainers and Faculty of Dental Trainers to promote and enhance the professional role of surgical and dental trainers respectively. They produced the first-ever set of standards for Surgical and Dental Trainers and work to increase the profile and recognition of evidence-based education.

The College works through the Joint Committee on Intercollegiate Examinations (JCIE) to develop and ensure appropriate bench-marking and validity of surgical examinations – essential tools to set standards for knowledge and practice, integral to the promotion of patient safety. In addition, it holds exams in Dentistry, Pre-hospital Care, Sports and Exercise Medicine, and Retrieval Medicine.

The International Postgraduate Deanery works to develop and deliver local training opportunities for fellows and members across the world. The Deanery, in partnership with the UK and Scottish Government, recruits international medical graduates to UK fellowship posts. The College acts as a trainee sponsor with the General Medical Council (GMC) and quality assures this training.

Quality Assurance

Maintaining high professional standards is a core pillar of College business. RCSEd works to quality assure surgical care provision at every level: training, trainers, courses, exams, professional appointments, and services. Examiners undergo careful selection, extensive training, a period observing an experienced examiner, and complete a probation period before being admitted. Similarly, examinations undergo regular robust psychometric analysis to ensure the highest possible standards are maintained. Annual education strategy meetings review the current education and examination portfolio against governing standards. Our success in these areas has attracted invitation to quality assure further education and examinations internationally.

Through its Standards Office, the College provides external advisors for consultant appointments. It is consulted regularly on issues of quality assurance and revalidation by Government, Medical Regulators, the Care Quality Commission (CQC), and other stakeholders. Regular training programme and service inspection visits are undertaken both within the UK and internationally.

Teams

The College embraces a multi-disciplinary team approach to the delivery of care, recognising teamworking skills as an essential pillar of safe, effective care. It actively promotes effective leadership, communication, and teamworking skills through its suite of non-technical skills courses. The NOTSS taxonomy is embedded in surgical curricula worldwide; the College holds face-to-face masterclasses and has developed the ‘NOTSS for trainees’ web resource.

The PiNTS (Peri-operative Non-technical Skills) course has also been adapted to meet the needs of perioperative practitioners and DeNTS for dental practitioners. The Faculty of Peri-operative Care 2019 conference “Reshaping the surgical team: The integration of the non-medical practitioner in surgery’ signals the College’s intent and vision for the future of surgery, while the Trainee’s Committee has endorsed non-medical practitioners as part of the surgical team in training.

Workplace Culture

RCSEd continues to lead the way in promoting a diverse and inclusive workforce. It provides guidance on subject matters such as less-than-full-time training, pregnancy in surgery, and returning to work. The ‘Let’s Remove it Campaign’ promotes a zero-tolerance approach to bullying and undermining, encouraging frank open discussion on the subject. Anti-bullying toolkits and e-learning modules have been developed, freely available via the College website.

The Anti-Bullying Alliance was formed to share ideas, establish recommendations, and implement interventions across the NHS. The Healthcare Policy Group has consulted on whistleblowing legislation to ensure healthcare workers know how and when to raise concerns, and that these are addressed appropriately. The College has also produced helpful guidance on Speaking Up, Raising Concerns, and Whistleblowing.

Government Policy Engagement

Through a dedicated Healthcare Policy Group there is a close working relationship with key political and policy stakeholders to inform UK healthcare policy. Consultation responses are regularly produced to government, CQC, GMC, and other agencies – ranging from organisation of trauma networks to regulation to integration of primary/secondary care as well as strategic planning of elective and emergency surgery during the COVID pandemic.

During the COVID pandemic, the College has been able to rapidly mobilise its resources to disseminate new and evolving knowledge and use its infrastructure to support frontline staff.