10IDENTIFYING CORE COMPETENCIES FOR POSTGRADUATE TRAINING OF UK DOCTORS WORKING WITH CARE HOME RESIDENTS: A SCOPING REVIEW

Abstract

Introduction: In many countries, older people in care homes are looked after by dedicated specialist doctors with specific postgraduate training. In the UK, care is provided predominantly by general practitioners with ad hoc input from other specialists. However no competencies are published to ensure doctors are appropriately skilled. We reviewed the international literature for postgraduate competencies that might be applicable to UK care home practice. Methods: EMBASE, MEDLINE, CAB Abstracts and the Joanna Briggs Institute EBP database were searched using a string combining keywords for core competencies AND post-graduate training AND long-term care facilities, limited to English language papers published after 1997. Abstracts were screened and included if describing postgraduate competencies for doctors working in settings equivalent to UK care homes. Included papers were read in full and competencies extracted verbatim. Competencies were then reworded and combined to remove duplication and reflect the terminology and language of UK care homes. Results: 393 papers were identified. 357 and 17 failed eligibility at abstract and full paper stages respectively. The remaining 19 papers yielded 432 competencies, reduced to 62 following removal of duplicates and rewording. The median (IQR) age of included publications was 4 (4.5-11) years and publications came from the USA (15), Canada (2) and Hong Kong (2). Outcomes were mapped to the General Medical Council Generic Professional Capabilities Framework and covered the domains: professional values and behaviour; administrative skills; communication; dealing with complexity; clinical skills; safe prescribing; healthcare systems; leadership; patient safety; quality improvement; safeguarding; education; and research. Conclusion: This scoping review has provided a systematically-derived list of core competencies for postgraduate doctors working in UK care homes. We now propose to use these as the basis of a Delphi exercise to produce a definitive curriculum for UK care home medicine.