NES GP Returner Programme
NHS Education for Scotland
Policy Statement on
Returners to General Practice
NES Policy Statement on Returners to General Practice
Definition
For the purpose of this paper, a returner is defined as a doctor who has certification of completion of GP training by the competent authority and current full registration with the GMC with a licence to practice, and inclusion on the GMC GP Register, and in addition has not been working in clinical General Practice for the preceding two to five years or more.
For doctors who have been out of practice for five years or more, a six month period of supervised practice (whole time equivalent) is recommended. A shorter period of supervised practice will be required for those out of practice between two and five years depending on the candidate’s exposure to work and CPD activities. All attachments will take place in approved training practices.
Background
GPs require career breaks for a variety of reasons. Supporting re-entry of such doctors back into General Practice is a stated priority for the NHS.
Funding for returner training is the responsibility of the SHAs in England and NES in Scotland, although such funding is contained within global budgets and no longer ring-fenced. Guidance for doctors considering returning to the GP workforce is available from the General Practitioners Committee of the BMA.
There is no requirement in legislation for a GP to undergo a period of returner training, and a doctor wishing to work as a GP in the UK only requires to be on the GMC’s GP register and the Performer List in the Health Board area that they wish to work.
Doctors applying to join the Performer List are required to produce their certification from the competent authority, GMC registration and two clinical references. There is no process at Health Board level to check for continuity of clinical experience by the applicant.
Employers have a duty of care to the public to ensure that doctors working in their service are fit to do so, and individual GPs have a duty to ensure that they are not working beyond their competence and that their skills are kept up to date.
NES Returner Programme versus the COPGED Induction and Refresher Scheme
The NES Returner Programme differs from the COGPED Induction and Refresher (I&R) Scheme, which covers a diverse group of doctors including UK returners, EU GPs, Article 11 overseas GPs and GPs with performance problems.
The COGPED I & R Scheme requires completion of the national GP selection MMT along with completion of a simulated surgery as an entry assessment, and completion of the RCGP AKT as an exit assessment.
However both policy documents suggest a 6 month period of supervised practice or equivalent after 5 years out of practice, and a shorter period of training time for those out of practice between 2 and 5 years dependent on the candidate’s exposure to work and CPD activities. All placements are in approved training practices.
Entry to NES Returner Programme and required assessments
Entry to the Scheme is dependent on recommendation by the local Director of Postgraduate GP Education (or nominated deputy) and availability of funding from the NES central GP budget.
NES Returner requirementsEntry assessments / Interview with GP Director or nominated deputy
CV and two clinical references
Health and criminal self disclosure forms
Disclosure Scotland check (PVG)
Funding Application form: see Appendix 1
Assessment during placements / RCGP WPBA tools used as determined by trainer (to include at least 4 x CBD and 4 x COT, multi-source feedback (MSF) and patient satisfaction questionnaire (PSQ) during the attachment)
RCGP PEP at start of attachment and repeated as necessary
West of Scotland Peer Review of Video consultations (to include at least 4 consultations)
Exit assessments / Completed Educational Review Document from Educational Supervisor
External assessments
RCGP PEP
The Personal Education Planning tool (PEP) was launched by RCGP Scotland in 1992. It has evolved through paper-based and CDROM formats into a web-based facility that was rolled out across the UK in 2007.
From its inception, PEP has been a formative self-assessment tool suited to all GPs. There is no pass nor fail outcome to the test, but comparison with peer performance is possible. It is perceived that, because of its non-summative and educational approach, it is generally trusted by the GP community.
PEP’s primary objective is to identify the learning needs of individual GPs by the use of AKT (Applied Knowledge Test) – style items or questions. The items are a mix of SBAs (Single Best Answers) and EMIs (Extended Matching Items). The assessment covers all clinical aspects of the GP Curriculum, as well as management and ethical issues. PEP’s secondary objective is to provide relevant evidence-based feedback and electronically-linked reference material, immediately on completion of each item. Those achieving scores significantly below peer averages can be asked to repeat the relevant modules later on in their attachments. There are also PEP+ modules for GPs wishing to pursue specific interests at a higher level.
Further information here:
RCGP-PEP
West of Scotland Peer Review of Video Consultations
Developed in West of Scotland, the national peer review of video consultations provides formative feedback to GP returners on 4 clinical consultations. This has been established since 2002 for general practice CPD and is also used with candidates entering the Scottish Prospective Educational Supervisors Course (SPESC). Recent requirements for safe storage of digital data and correct handling of Patient Identifiable Information have resulted in changes to the process required to prepare and submit video consultations for peer review. It is recommended that GP returners use the process developed by the National Training Development Group Please note however that the requirements for GP returners are to submit 4 consultations only.
Further information is available here:
WestOfScotlandPeerReview
SPESCPeerReviewGuide
Appendix 1
Application Number
GP Returner
Name
Phone number
GMC number
Date Request Made
Region
Deanery lead contact Name
Phone number
Estimated Start Date
Estimated End Date
Full/Part Time %
No. of sessions
Other info regarding the request
Budget Authorisation
Authorisation Date
Actual Start Date
Actual Leaving Date
Cancellation Reason
Cancellation Date
5
June 2013