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Decline in surgical logbook activity, warned RCSI President

Surgical trainee logbooks recorded around 20 per cent less activity in the year to July 2020 compared to the preceding
year, the RCSI President warned the Minister for Health.

In correspondence expressing concern about the pandemic’s impact on postgraduate training, Prof P Ronan
O’Connell informed Minister Stephen Donnelly on 5 November: “In the overall context of Covid-19 this may seem
a minor issue, however there is a growing risk of the loss of one or potentially more years of training with consequent implications for future staffing of the health service at both NCHD and consultant level.”

“In the year to July 2020, surgical trainee logbooks have recorded 20.3 per cent less activity than in the
preceding year. The longer restrictions in scheduled care within the public sector continues, the greater will be
the effects on training.”

The letter followed correspondence to the Minister in late August 2020, signed jointly by Prof O’Connell,
RCPI President Prof Mary Horgan, and then President of the College of Anaesthesiologists Dr Brian Kinirons,
about the risks to training and continuity of care through the outsourcing of scheduled procedures during the pandemic.

In his November 2020 letter, Prof O’Connell wrote that the “substantially increased allocation” to health in the
budget was “welcome”, as was the allocation to the National Treatment Purchase Fund (NTPF) to address growing scheduled care waiting lists.

“However, outsourcing scheduled care to the private sector will reduce opportunities for NCHD training unless specific arrangements are made to maintain access to training. In the UK, at the instigation of the Academy of Medical Royal Colleges, the NHS has agreed with the independent hospital sector that continuity of patient care, education, and training will be included in any outsourcing contract.

“RCSI believes that similar arrangements should be part of any NTPF outsourcing contract.

“I understand that the President of the Medical Council has recently written to you highlighting the Council’s statutory responsibilities regarding training and endorsing the view that all training opportunities must be availed of to protect the integrity of our post-graduate medical training programmes.”

The correspondence was obtained under Freedom of Information law.

Asked if outsourced provision in the private sector included measures to accommodate surgical training, an RCSI spokesperson said the College “did not get any feedback” from the HSE or Department of Health on the arrangements made with the private sector.

The RCSI said it has worked closely with the training directors of each programme to identify ways to minimise any adverse impact on training progression during the pandemic.

This involved looking at prioritisation of surgical lists and working with trainers to ensure that trainees were
getting access to index cases at the right stage of training.

“We supported trainees attending operating lists being performed in the private sector where appropriate.”

A Department spokesperson said it had requested an update via the HSE on the progression of surgical trainees
to assess the impact of Covid-19

“While there was a reduction in the numbers of procedures logged in 2020, the RCSI confirmed all trainees
progressed to their next stage of training in July 2020 and none had their training delayed due to Covid-19 in 2020.”

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