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So our next speaker is Professor Jill Teeny. She's going to be talking to us on the extended surgical team pilot and hopefully, that will be virtual. So if we just make that link. Um So Jill Tenny is the presidente of the Association of Surgeons of Great Britain and Ireland. She's head of School of Surgery in East Midlands and a clinical advisor to health Education England. She holds an honorary chair, not let him university. Her clinical interests are colorectal cancer and inflammatory bowel disease and her research interests are improving outcomes in emergency surgery training and the extended surgical team she also examines in the Intercollegiate F R C S is a member of General Surgery S A C and a strong links with A C P G B I Neela and Grift. Hello, my name is Jill Tierney and I'm head of the School of Surgery in the East Midlands. And I'm delighted to have been asked to talk acid and I hope your conference is going really well and profound apologies. I can't be there, but I'm delighted to give a talk about the extended surgical team pilot. Before I talk, I'd like to introduce the project team, hopefully. So some of you can put faces to the names you may have had e mails from over the last few months. Our team is led by Paul Sadler, who's the postgraduate dean for Thames Valley Wessex and he's one of the lead dean's for surgery in the country. I'm head of School of Surgery in the East Midlands. And our team is made up with Claire Sutherland, who's an associate postgraduate dean for inter professional learning and an expert of all things A C P related. We have Becky and Jenna from health education England who run the project for us. I'm delighted. We have Fuad Abbott who's an associate postgraduate dean for S A S doctors in the West Midlands. And this year, we were supported extensively by Martin King. The about to be outgoing president's of assets. And last year, we were very much helped by Josh Burke and the team is indebted for the input and engagement from asset throughout this pilot. The background to this pilot. How did it come about? I'm sure some of you are old enough to remember I S T improving surgical training pilot, which was a great idea in theory and was piloted throughout the country. And one or two issues were flagged, there were good. It's and there were about bits as with all pilots, but a real strength of some of the sites involved in I S T was the extended surgical team that workforce who were not necessarily surgical trainees or medics but formed a key part of surgical teams. So with that evidence from I S T that having an extended surgical team can sometimes contribute to the training opportunities for a surgeon. This pilot was funded and founded, the pilot started back in September 2020. There were a few other things going on then, as I'm sure you can all recall, the aim of the pilot was to support the formation of new extended surgical teams in places where they hadn't been before. The application was open to all trusts. And there were a few online events with service leads, nursing leads, trust, finance directors and trainers from any trust in the country who wanted to take part. We explained a bit about the pilot. We showed the evidence from the I S T program and discussed the concept of extended surgical teams trust were then invited to submit bids and the bids had to sort of show how you would support um an extended surgical team member at your site if you had or hadn't been in the I S T pilot. What surgical trainees grades level specialty did you have in your trust? Trust had to put lots and lots of data into these application forms. And they had to give a clear vision for how they would use the financial support that would be given and how they would develop these extended surgical team members within their already structured team of surgical trainees and trainers after a blinded score ing process with a panel of scorers, eight pilot sites were included. This diagram shows the pilot sites and I hope you'll agree there's a decent geographical spread and also spread in the types of hospitals. So we have big teaching hospitals like leads with its new emergency general surgery unit. Um and places like Ipswich where the team members are used in trauma and orthopedics. So a widespread with lots of enthusiastic surgical trainers, keen to look at a novel model and see whether it worked or not these pilot sites became very much a virtual community. And we all meet several times throughout the year online and often in person, there have been visits between sites to share good practice in our pilot sites. The extended surgical team members are deployed. I have to be honest, mainly within the specialty of general surgery and particularly within emergency general surgery units. However, we also have sites with trauma and orthopaedics, cardiothoracic surgery and plastic surgery in these sites. There has been a clear vision for the ongoing professional development of these team members because we want to retain people if we're building them into a part of a team and helping them learn skills. Our year one report was published and the QR code there if you would like to read it is available. Um And it basically showed that the extended surgical team was safe reproducible and acceptable to patient's and staff were realistic. In this pilot team. We know that in some centers, there have been difficulties, there are interpersonal issues. Not all surgical trainees have a positive experience of the extended surgical team. And we wanted to publish this um find out what the difficult areas are and see if we can find um structured ways for getting over these barriers. In some of the sites of the year one report, some service improvements were demonstrated and these seem to center very much around ambulatory care same day, ambulatory emergency care, particularly in general surgery. It was found through online interviews with surgeons in training in the pilot sites that they often got better at place access to workplace opportunities, they could go to theater rather than being stuck on surgical emissions unit clerking all day. It was also found that rotors were sometimes more stable because some of the extra extended surgical team members could act as the level of course surgical trainees for rotors within set areas. As a result of this, we engaged a health economist and a gold standard business case was developed which is available online. And as part of this report for trust to use to make the case for employing extended surgical team members both to firm up rotors and hopefully to improve the quality of the training environment for surgical trainees. We put a series of outputs. There's no point doing something you think is good and not share ing it with everybody is there. So we've published in the trainee bulletin and the bulletin of the College of Surgeons of England. And we also went along with many of you, I'm sure to the future surgery event at the Excel in November, which was great fun in that picture. That's Sarah Door, be one of our pilot team members and Jack's Mallinder, our health economist, essential team members we've recently published are yet to report again. The QR code is there if you want to scan it. And this focus particularly on professional development of the extended surgical team members and barriers to retention within this year too. We've commenced a multi professional supervision pilot which is part of a bigger pilot taking place from health education, England and I'm grateful to Sophie Lewis from asset for her engagement with this part of the project going forwards. We looked at the role and plan to look further at the role of advanced clinical practitioners as clinical supervisors for foundation year one trainees. This is because I'm sure you're aware, there's a huge expansion of medical schools, there will be a huge expansion of foundation doctors and there's a need to create extra clinical supervision capacity for these doctors. This pilot is one of many pilots going on at the moment. A big part of this year was the shared online educational program and I'd like to show this fabulous logo designed by Catherine Smith who actually coordinates hosts and runs the online course surgery training hub. I'm sure anybody who's been to it will agree. It's a fantastic resource. It's available live and on catch up and it has a host of other resources on it. Please copy down that link and visit it R E S T members were also able to go to the shared learning resource with court trainees. We have some key milestones. Towards the end of last year, we managed to obtain some more funding to add some further sites to this pilot. And we felt that it would be useful to identify sites from the nefarious training surveys who might benefit from the opportunity to have extended surgical team members too. Hopefully facilitate the training and education of their core surgical trainees. So specific invitations were sent to sites identified from those surveys and I'm pleased to say that some really high quality bids came and we've now allocated funding to four new sites through the similar sort of bidding process. We're going to have our first network meeting. In fact, by the time you see this presentation, we should already have had our first network meeting of these expanded pilot sites to make a bigger virtual community. We'll have a formal evaluation of the multi professional supervision pilot at the end of that first block of foundation doctors. And we're hoping to develop a package and a resource for all trusts. You might want to introduce this method of working in their trusts. The year three of the pilot will close in December and we hope to have a report of our findings, both the good ones and the bad ones. The successes and the failure to give you a real world picture of this model of working by January 2024. Thank you very much for watching. I would say take any questions, but hopefully I'm lying beside a pool in Cape Town. I wish you all the well with your conference super, I'm really useful there to, to see the journey as, as the E S T progressed. Um and, and its plans for further expansion, an evaluation which is equally important um are.