Excellence Exchange at Hillingdon

Excellence Exchange at Hillingdon

For the third outing of EE, the Quality subgroup headed to Hillingdon Hospital, joined by Khadija and Jonathan. As before we were there to learn more about how they achieve such great things in the School survey, and also see if we could generate some ideas to address the areas that had not done so well.

So, on the 28th February we arrived, and after compulsory coffee and pastries, set to work with their team. It was especially nice to be joined by Stefan, their Medical Education Manager.

Overall Hillingdon had come in the top 10 places to work across London. Why?

Trainees cited the supportive nature of the consultants and how they work out how much support trainees needed. The consultants felt that they got on with each other and this was important – there were no dramas, they go out together and respect each other. This filters down and is noticed by the trainees. Problems are managed collectively, so it’s like a family, they said. The parents model appropriate behaviours.

Hillingdon Paeds also had a very effective LFG and junior-junior meeting, well curated to ensure not just a rant session.

The acute consultant model meant that there could be engagement and learning overnight, and out of hours was not just service time.

Lastly there was a WhatsApp group only for educational purposes, so as to share articles and tweets. This is curated so that there is no natter, just edu stuff.


The Excellence –  What is going well and How has it been achieved?

  1. Educational Supervision

This provides good continuity and comes across as very pastoral. ES and trainee pairings are based on the interests of trainees and ESs.

Es – good continuity; high standard to live up to. Very pastoral. ESs are allocated based on interests.

  1. Work place based assessments

The trust had put a lot of effort into developing these with training, and it was doing well in most departments.

Part of the success was due to their acute consultant model and the engagement of the consultants.


To Achieve further Excellence – Analysis and Action Plan

  1. Rest and food.

There were issues with the physical layout of the trust, but also places to rest at night. Food was only from vending machines at night, and there was no microwave for the paediatric areas.

Action – to buy a sofa bed for the doctors’ office. To plumb in a water fountain. To work with nursing staff to allow blocks of bleep free time.

  1. Outpatient Attendance.

Issues arose from a lack of clinic rooms and issues with having enough staff to cover all of the clinical areas. There was no clear idea of how many clinic sessions a level 1 or level 2/3 trainee should get to over a 6 month period.

Action – take advantage of quieter times in the day and year – so more clinics to be booked for the trainees in the summer than the winter, and develop morning clinic sessions for trainees, thereby freeing them up for busier clinical afternoons.

To develop a “Star Chart” to count times trainees had been to clinic to ensure equality.

  1. Teaching.

This was thought to be already good but can be better. There were geographical issues, with paediatrics being located in 4 different spots in the trust.

Action – Strict timekeeping with handover to ensure teaching can start. This will be monitored. A theme of the month.

Qi – monitor timekeeping. Redevelop one day a week to be more nurse led, for their professional development and freeing up doctor time for teaching.


Excellence Exchange Champions: Luke Nuttall, Becca Gaunt

Review Date: May 2020


Jonathan  Round

Head of School