Laying The Foundations for Good Medical Practice

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What is ‘Laying The Foundations’ (LTF)?

Developed by the Health Informatics Unit, the RCP Education Department, and a team of doctors and medical educationalists, LTF is a unique self-contained, off-the-shelf educational resource designed for small group learning. It is presented as a portfolio of 12 exercises that cover generic subject areas:

  • Record keeping
  • Communication with colleagues and patients
  • Ethics
  • Career development
  • Team-working
  • Patient safety
  • Prescribing

These are subject areas identified by the Chief Medical Officer for the foundation years of training in his review of medical training Modernising Medical Careers:

It is endorsed by:

  • The Chief Medical Officers of England and Wales
  • The Academy of Medical Royal Colleges through its information group (ACIG)
  • Royal College of Physicians (RCP)
  • Royal College of General Practitioners (RCGP)
  • Royal College of Anaesthetists (RCA)
  • Royal College of Psychiatrists (RCPsych)
  • Faculty of Occupational Medicine (FOM)
  • The Commission for Health Improvement (CHI)
  • The National Patient Safety Agency (NPSA)
  • The Conference of Postgraduate Medical Deans (COPMeD)

Who is it for?

Educational tutors, Postgraduate Deans, Medical Directors, Chief Executives, and Postgraduate Managers should all be interested in LTF. Other clinicians are welcome to buy a copy if they wish. We recommend at least two copies per hospital.

It is intended that educational tutors will use LTF to teach junior doctors from any specialty. Tutors may be College Tutors, Clinical Tutors, or indeed any doctor that has an educational role.

  • Benefits to patients:
    Junior doctors will gain skills in communication and ethics. Their standard of record-keeping should be much improved with a resulting benefit to patient safety.
  • Benefits for junior doctors:
     They will develop many of the generic skills and knowledge required for good medical practice, and be able to plan their future career development.
  • Benefits for tutors:
    Tutors are presented with a clear step-wise programme. If the portfolio is used correctly, they will meet many of the requirements for revalidation laid out in the GMC’s Good Medical Practice for Physicians (and other specialties)
  • Benefits for management:
    The Commission for Health Improvement (CHI) will accept LTF as evidence of training during its reviews. Adoption of practices recommended in LTF will reduce the hospital’s risk profile and result in more accurate data for monitoring purposes.

How do I know that it will work?

During development it was piloted in 15 hospitals in England and Wales. There was very positive feedback from participating Tutors and junior doctors. There is also a continuous process of evaluation and feedback from participating sites to ensure that the material is up to date and effective. The feedback is published in the secure site for users to review.

How much does it cost?

It is on sale at £200. This covers the cost of publication and printing.

What do I get for my money?

LTF consists of 2 ring-bound folders containing the 12 exercises, and a foldout guide that tutors can easily take home to help plan sessions.

There is a support website that provides electronic copies of all the handouts and reference material, as well as links to websites cited in the exercises.

A training course is planned for tutors who wish to maximise the benefits from the package. This will require booking in advance through the RCP’s Education Department. The cost of attending will not be included in the package price.

LTF is not static. The support website will be continually developed with additional resources. Continuous feedback will be collected and reviewed. There are plans for developing electronic exercises and expand the content to meet other needs.

Who are the sponsors?

The Royal College of Physicians has covered the cost of development. 24 RCP tutors, one Professor and one SHO have donated their time in writing and piloting the material.

The NHS Information Authority provided funding for evaluation via an educational grant to the Academy of Colleges Information Group.

Where can I get a copy?

From the RCP Publications Department.

How can I find out more about LTF?

Read an article published in Hospital Medicine in October 2003.

For more detailed information please email Dr Robin Mann at the Health Informatics Unit: [robin.mann@rcplondon.ac.uk]


Updated 5 March, 2009