Conclusion

Trainers who are supporting trainees returning to work must have appropriate training and support. Complex cases require liaison with multiple parties and must be overseen by experienced TPDs.

Supporting a consultant’s return to work

As alluded to in Chapter 1, in many areas of the UK, it has been trainees and those who support them who have driven the development of formal return to work programmes to support the return to work process after maternity leave. However, having a break from anaesthesia is not unique to trainees and it is equally important that consultants, staff grade doctors, and associate specialists are supported when they return to work. Many of the concerns and issues are common to all, although returning as a consultant has unique challenges as it may have been some time since a consultant was supervised by a colleague. However, the consultant is likely to be returning to a working environment and colleagues that they are familiar with, which can be a significant help.

Below we discuss some of the issues pertinent to returning to work as a consultant. The recommendations made reflect those in the Academy of Medical Royal Colleges report Return to Practice Guidance, April 2012^[7], and the Royal College of Anaesthetists guidance Returning to work after a period of absence, May 2012^[8], which are discussed previously in Chapter 2. Revalidation is discussed separately in Chapter 4.

Devising a return to work programme

A consultant should plan their return to work in conjunction with the clinical service lead for their department. The same principles as discussed in Chapter 4 apply to the design of a suitable return to work programme for consultants, i.e. a pre-leave planning meeting should occur for anticipated leave; a preparation to return meeting should be arranged to plan the return to work; all parties should agree what the goals are and how the process will be recorded and assessed. Several trusts now have guidelines covering the return to work process for consultants^[9].

The first thing to consider is whether there needs to be any change to their job plan because of the reason for the absence. This may not be known initially, especially if they are returning after illness, so there needs to be a strategy developed to enable this to be assessed. Occupational health advice is key in this situation, but in all cases it is vital that realistic expectations are set.

The clinical service lead is ultimately the person responsible for ensuring a safe and effective reintroduction period, but it is worth considering whether there is someone more suitable to oversee the process as it occurs. This person might vary according to the size of the department and any subspecialty area of practice, and may depend on professional relationships and whom the consultant feels most comfortable working with.

It is important to be transparent about the return to work process. As well as the clinical service lead and group manager, the clinicians/colleagues involved will need to be informed, as will the consultant responsible for the weekly and on-call rotas and the departmental admin team. However, confidentiality must be maintained and the dignity of the doctor ensured. It may be that the consultant prefers to deal with a single member of the admin team for example.