National Reporting System

The 2023 FICM Specialty Registrar Survey highlighted certain issues experienced by some Intensivists in Training (IiT) in the UK. We want to ensure an effective escalation process is in place to address any concerns doctors on the UK ICM CCT Programme may have that cannot be resolved locally through the standard reporting processes. The following outlines the mechanisms by which issues and concerns must be raised, moving onto the next step if a satisfactory resolution is not achieved, or you do not feel comfortable discussing with the person in that step:

1. Educational Supervisor
2. Faculty Tutor
3. Regional Advisor
4. Training Programme Director
5. Regional STC Intensivist in Training Representative
6. FICM StR Sub-Committee IiT Representative
7. FICM’s Training, Assessment and Quality Committee (FICMTAQ) via the National Reporting System.

NB: If the matter directly involves one of the individuals or roles mentioned, you may bypass that specific step and proceed to the next appropriate level in the escalation pathway.

The decision to escalate via the Deanery (TPD -> Postgraduate Dean) or FICM (FT -> RA) route depends on the nature of the concern. This will be appropriately determined by the RA &/or TPD. 

Examples:

• Bullying – local employer policies and routes of escalation
• Contract issues – local/single employer
• Training issues – FT initially, TPD if the issue affects the overall training goals in the programme +/- RA, RA if training issue has a wider regional / curricular concern (and/or as support for TPD).

When considering who to escalate to, please take time to consider which route is the most appropriate given the nature of the concern. There may be some concerns that need raising via one route but need other key educators to be sighted on and/or involved in the issue. For certain concerns, it is important to remember that the local employer will have channels to raise issues that include the Clinical Lead/Director and/or Director of Medical Education.

The National Reporting System (NRS) should not be conducted in parallel to any local processes, for example, ARCPs. Appropriate time should be given for regions to address issues locally first, as you will be required to evidence this when submitting items for consideration via the NRS. Any doctor currently training on the ICM CCT Programme may make a submission (although we recommended discussing the issue with your regional IiT representative/FICM StR Sub-Committee IiT Representative first). Once you have submitted a report to the NRS it will be escalated to the elected FICM IiT representatives, who will, if appropriate, further escalate to the Chair of FICMTAQ and the Lead Regional Advisor, where further enquiries and actions will result as appropriate.

The process for using the NRS to submit a training issue for review is as follows:

1. A submission via the NRS should be completed by either the regional STC IiT rep or an individual IiT as part of which they must confirm that local escalation/discussion has already taken place, and no resolution achieved. NB: If an IiT wishes to submit a report to the NRS but wants to remain anonymous then they can do so. In these instances, we would want our elected FICM IiT Lead Representative (or their Deputy) to contact the relevant regional STC IiT rep regarding the issue, so they can support that doctor.
2. The submission is received by the elected FICM IiT Lead and Deputy (and FICM secretariat) and, subject to the above conditions, taken forward.
3. Where appropriate (this will be assessed by the FICM IiT Lead/Deputy), the report will then be shared with FICM’s TAQ Chair and Lead RA. If not appropriate for escalation, then this will be fed back to the reporter.
4. Further action will be agreed by FICM’s TAQ Chair and Lead RA – this may involve direct contact with the local RA or Faculty Tutor.
5. Actions and outcomes will be agreed between local trainers and FICM’s TAQ Chair and Lead RA.
6. FICM’s elected IiT Reps will be kept informed of the issues and their outcomes to identify any trends or themes in the kinds of problems raised. These can then be discussed with FICMTAQ as required. However, they will not be directly involved in any proceedings/discussions with local trainers.
7. Outcomes, trends or themes from the NRS submissions will be discussed with the FICMTAQ Committee & and will be disseminated through the ICM RA network, as required.

Click here for the names and contact details of all our Intensivist in Training representatives.