CLWRota

Cross-department solo session benchmark

October 2011

Introduction

At the September 2011 Forum the CLWRota team presented several cross-departmental benchmarks. The benchmark presented here compares trainee "solo session" rates, or sessions where trainees are working by themselves, across 16 anaesthetic departments of varying sizes and includes departments at both university and DGH hospitals.

Session delivery

Trainee solo sessions can provide a valuable component of general service delivery. However, many departments are concerned about the potentially detrimental effect on training of too many solo sessions. Finding a balance between training and service delivery is naturally influenced by the type of work done by the department but evidence suggests that trainee solo session rates can be raised with good training outcomes if techniques such as roving "named consultants" are used to actively supervise trainees.

Towards a benchmark

In the absence of firm national guidelines for trainee solo sessions, we believe this initial comparison, showing departments achieving an average of around 7% of all department activity as solo sessions, provides a useful benchmark. It should be noted that some departments with solo session rates above 10% still have excellent training records.

CLWRota presently is used by over 32 NHS Trusts in the UK. As data sets become more mature and the data between them become more easily comparable we expect the average to lift to close to 8.5%.

The boxplots show comparative solo session data for 16 NHS departments over the 12 months to September 2011. Each department boxplot shows the distribution of solo sessions as a proportion of normal DCC sessions over the 12 month period. The body of each boxplot represents the middle 50% of the distribution for the department in question; the dark band shows the median and the whiskers show the outlying 24.65%.

Notes about the data

The boxplots use sessions achieved rather then person-sessions for comparison, and excludes middle grades working as trainees. The data also does not include oncall activity, including daytime oncall activity as defined by the CLWRota system. The cross-department average is the arithmetic mean of all department means.

Support for Trainees in CLWRota

Support for trainee management is an integral part of the CLWRota system. This support includes:

• management of department trainees, including training module assignment and summary reports of activity suitable for the department's college tutor report
• rapid assignment of trainees to lists appropriate to their training modules
• management of solo sessions through explicit mentoring assignment
• management of trainee leave pools
• comprehensive reports including speciality and training module activity summaries, supervision rates, an indication of changes to activity since publication, and detailed lists of each session