GP TRAINER APPROVAL & RE-APPROVAL FAQS
Why has the process of approval and re-approval of trainers altered and what are the standards based on?
The revised Yorkshire and Humber process of re-approval of established GP trainers are based on guidance issued by the Royal College of General Practitioners (RCGP) and the General Medical Council (GMC).
The approval and re-approval criteria derive from and linked to the GMC publications “Generic standards for specialty including GP training” (revised April 2010) and “The Trainee Doctor” (Feb 2011).
All prospective trainers and established GP trainers should be familiar with the criteria against which each piece of evidence will be reviewed for the purposes of their initial approval and subsequent re-approval as GP trainers.
In developing this process for Yorkshire and the Humber, guidance has also been taken from the recent Academy of Medical Educators about professional standards guidelines (2012).
We represent a huge and varied geographical region in Yorkshire and Humber, and thus need a clear and robust process of us ensuring we meet the national requirements set out by the GMC, which can work effectively and within our capacity / resources.
Trainers in Yorkshire and the Humber are based in one of our three areas – West Yorkshire, South Yorkshire and North and East Yorkshire and Northern Lincolnshire. The process to approve and re-approve our GP trainers needs to be clear, simple and work effectively, regardless of locality.
In Yorkshire and the Humber we value our GP trainers who represent a highly skilled, innovative and motivated group of medical educators. We appreciate that most GP trainers are also working clinicians with increasingly huge and competing demands on their time.
You are the people who help to inspire, create and expertly mentor our trainees. You successfully manage this whilst navigating the newer more complex world of workplace-based assessment, and all in the context of this time of rapid change for general practice and the wider NHS. You invest a great deal more passion and energy than this or any process can give you credit for. We think that the GPs we produce at the end of training in Yorkshire and the Humber region reflect the commitment and excellence of our trainers.
This revised process, which reflects the newest recommendations of the GMC, should hopefully also help the Health Education Yorkshire and the Humber to better support you in your role as a trainer within the Yorkshire and the Humber region. We would hope that it provides greater clarity to intending and established trainers and their practices about what is expected of them and why, at each stage of the process, and how this slots in to national recommendations about medical education.
How often do I have to be re-approved as a GP trainer?
All trainers will be formally appointed and then subject to re-approval at an interval of 2 years initially, increasing to 5 yearly intervals going forward after their first re-approval period.
Responsibility for trainer appointment, approval and re-approval within the GP School/HEYH rests with the Dean of Postgraduate General Practice Education, advised by the senior management team of the School for General Practice. Ultimate responsibility for approval however remains with the GMC, which has the power not to approve and to withdraw approval of individual trainers at any time.
Why do I need to be re-approved 5 yearly?
The GMC want to know we have a process in place to quality assure trainers. How we tackle this is up to us as a school. The decision to move to a 5 yearly cycle was made in order to align us more with other processes like revalidation. Many GP schools have stuck with a 3 yearly process but we feel the change to 5 years is justified as we are a huge GP school and feel we can ensure robust enough quality review to mean the most important bits are not lost, whilst directing resources most effectively towards development of our educators. Within each re-approval cycle we would hope you worked through your trainer Personal Development Plan, attended a trainer seminar and submit evidence to support your work as a GP trainer.
Why is there a move to re-approval panels, which are not face-to-face, rather than the routine re-approval visits?
The changes made to the re-approval process have allowed us to review things and direct our local resources in a more useful and appropriate way to best support GP trainers and navigate the new landscape of GP training.
Routine 3-5 yearly re-approval visits were on the whole considered to be extremely useful for those involved in the past and are still done routinely in many GP schools across the UK. However, where some Yorkshire and the Humber trainers traditionally had a re-approval visit we have had to consider the most appropriate use of the resources, and the decision has been made to move towards triggered visiting only, with re-approval for all Yorkshire and the Humber trainers supported by a robust assessment of evidence using our quality management team who will run Trainer Re-approval Panels. The process is still very definitely using triangulation of multiple sources of information submitted as evidence by trainers plus TPD and trainee feedback. We aim to offer a short piece of written feedback following the TRP.
When might I be visited or interviewed face-to-face?
Recommendations for a practice visit will now only be made if issues/concerns relating to the practice or trainer are flagged up by the trainer seminars, as a result of insufficient re-approval evidence, or by individuals involved with any aspect of the training process (trainees are included in this).
In the small number of cases of issues which cannot otherwise be easily or clearly resolved it is felt that further interview would be helpful in resolving this so that a re-approval status recommendation can be made. It is only then that a visit is arranged.
Targeted visits can still be arranged via consultation with individual trainers and practices if significant concerns are raised – these can be from a range of sources e.g. Training Programme Directors, Registrars, or GMC questionnaire feedback. Visits will also be done if a trainer requests a visit – for a review and advice regarding difficulties in training or to help resolve an issue in practice regarding training which cannot be fully resolved without a face-to-face meeting.
**TARGETED VISITS MAY BE ARRANGED AT ANY TIME DURING THE RE-APPROVAL CYCLE AND NOT JUST AT THE TIME THE PANEL REVIEWS THE EVIDENCE. THERE WILL ALWAYS BE PRIOR ARRANGEMENT WITH THE TRAINER AND TRAINING PRACTICE.
What is a Trainer Re-approval Panel (TRP)?
A Trainer approval / re-approval panel works in a similar way to the trainee ARCPs (i.e. an electronic review of all the evidence rather than a face-to-face meeting). Clearly, we do not have a tool quite so sophisticated as the RCGP e-portfolio but we are in the process of developing an electronic database for trainers to be able to submit all their evidence at re-approval.
The panel will review feedback from GPStRs and Training Programme Directors, and will also seek Clinical Commissioning Group and GMC confirmation that there are no serious concerns about the trainer or the practice that may be relevant to the provision of training.
Practice visits will only be routinely undertaken for initialtrainer approvals, and from time to time as determined by the GP School for established trainer re-approvals in the event that specific problems or areas of significant concern are highlighted which cannot satisfactorily be dealt with unless a face-to-face contact is arranged.
Panels will usually be made up of a combination of TPD / GPSTR rep / Admin / GP Tutor or APD.
Panel outcomes may be:
- Re-approval for five years (normally with identification of areas of good practice and recommendations for development)
- Re-approval for less than five years (with identification of areas to be addressed within a specific time period)
- Practice visit to be arranged (if evidence is insufficient or concerns have been identified that require further investigation)
The panel will make a referral to the Locality Lead if major concerns have been identified by the panel that are unlikely to be resolved at a practice visit, or if following a practice visit major concerns remain that prevent the panel re-approving the trainer.
If a trainer demonstrates satisfactory evidence then the Locality Lead can recommend a 5 year re-approval which is then confirmed by the SMT and GMC.
Do I get feedback from the re-approval panel?
When re-approval status is given it will come with some brief but individually tailored written feedback for the GP trainer to highlight areas of really good practice and also identify their on-going individual and practice development needs.
Who decides about my re-approval status?
The GP School senior team, who link directly with the re-approval panels, considers recommendations for re-approval of all GP trainers in the Yorkshire and the Humber region. Provided they are in agreement, they will then ratify the recommendations and inform GMC of the outcome.
The trainer retains a right of an appeal to the Board of the Yorkshire and the Humber School for General Practice should there be any disagreement relating to selection or re-approval.
Why do I have to submit evidence even when things have not altered in my practice?
To support your on-going development needs and ensure we are delivering a quality of training across Yorkshire and Humber which meets national standards. This mirrors other processes such as appraisal and revalidation.
Trainers will be required to complete a self-assessment against standards– collecting evidence and submitting it prior to their re-approval panel. This can be separated into evidence about the educational knowledge and skills of the individual trainer, the experience of the GPST, and the whole practice as a learning environment that supports and develops both trainer and GPST.
A large amount of the information required as evidence for your approval and re-approval as a GP trainer can be taken directly from sources of information which you or your practice have already prepared for other on-going processes, such as your annual NHS appraisal and 5 yearly GMC revalidation, Quality of Framework and Care Quality Commission. This means that although it may appear at first glance that there is a lot of information to collect; you and your practice should already have a lot of it accessible and in electronic form.
In some cases you may not be asked in the first instance to submit all of your protocol documents or detailed descriptions of every process you have in place to support training, but instead you will be asked to declare you have these things in place. The specific documents should be available as they may be requested by the GP School panel should further clarification be needed or concerns be raised.
Will I always be re-approved for 5 years?
Re-approval as a GP trainer is normally granted for a period of FIVE years. Although five years is the maximum possible, and normally the case, it should not necessarily be taken as a given. A number of factors need to be taken in to account such as individual circumstances of the trainer or practice team, or practice as a learning and training environment. Trainers may be appointed for shorter terms to encourage identified necessary improvements in aspects of their teaching and practice.
How often do I need to do equality and diversity training as a GP trainer?
All GP Educators, including trainers, must have up to date equality and diversity training. This must be renewed at least once every three years using an appropriate course/module with different content to that done previously.
What are the Spring and Autumn schools and Primary Care Educators Seminars?
Contact your area office or discuss with your local TPD team for more information about dates for these events. All trainers are usually contacted via email well in advance of the dates and encouraged to book their place.
These are seminars run within the Yorkshire and the Humber region, with different workshops running over 1-2 days, which may be of interest to trainers and may help achieve learning objectives of your educational PDP as a trainer. You do not need to attend the whole day, and can book as suits your individual needs.
When does my re-approval status last from?
Re-approval dates start from the expiry date of the previous approval period. Extensions of up to twelve months may be granted, but usually only in exceptional circumstances, which can be individually discussed.
We suggest that most GP Trainers who have been given a 5-year period of approval will not normally be eligible for extensions, and will need to ensure that their re-approval as a GP Trainer is carried out in good time to avoid losing their trainer status with the GMC.
What happens if the practice loses its only trainer?
A practice may be approved as a learning organisation for a period of up to five years (or 2 years for first time approvals). This is important when practices wish to continue training but a trainer leaves or retires for example, meaning there is a gap where training is not happening in the practice.
Can I ‘port’ my trainer status if I move practices?
Yes, although the approval of both trainer and practice is required in order for a trainer to employ a GP Specialty Registrar in their practice.
If a trainer who has current re-approval status joins an already approved practice then this will usually just involve communication with the Locality Lead and local Training Programme Directors.
If the practice is not already approved then they would need to go through the process of seeking approval, and the first step in doing this is to liaise with the local TPDs, meanwhile ensuring that the trainers re-approval status does not lapse.
What if I have not been working as a trainer recently? (career breaks, sabbaticals, fallow periods, maternity leave, recent move of practice).
- Fallow periods as a GP trainer
GP trainers may request to not take GP trainees for a period of time (trainer ‘fallow’ period) either as an Educational Supervisor or as a Trainer for GP trainees in a placement in the Practice. The request should be directed to the Trainer Selection Committee with the reasons for the request stated, via the appropriate Training Programme Director and Locality Lead. This information should be shared with, and have the agreement of the GP Training Programme Directors in that area and be supported by the GP Associate Postgraduate Dean in your area. A requested fallow period is different from the period of time without a GP trainee that a GP Trainer may experience due to gaps in the rotation where there is no trainee available. GP Trainers who request a fallow period must ensure that they maintain their skills as GP Trainers and state how they will do this in their request. We would not normally consider a request to be fallow for greater than 12 months.
All GP Trainers also have a role as an Educational Supervisor to one or more trainees, and so even if you don’t have a trainee in practice placement with you, you will not be considered fallow for this purpose.
- Maternity leave
As guidance may be subject to change, it is advisable to discuss this with your area office and TPD team based on your own individual circumstances.
- Recent move of practice
Please discuss changes to your circumstances with your area office as soon as you are aware of changes ahead. Each trainer is likely to have specific individual circumstances and no one set of guidance here is likely to fit all.
What are the entry requirements for GPs who are intending trainers?
- MRCGP
- COT DVD to standard
- Postgraduate Certificate from Leeds University / Hull York Medical School / Sheffield University
- Evidence to support their participation in annual NHS appraisal
- Meet the standard required for re-licencing and re-certification (Revalidation)
Are there any special circumstances where alternatives to the suggested intending trainer pathway would be considered?
Intending trainers should have a 2-year exemption from undergoing the COT DVD assessment after a pass at MRCGP.
If you already have significant GP educational experience then some of this experience may count towards the certificate. If you believe you already have significant experiences please contact the GP School/HEYH for further specific advice about your individual circumstances.
What do I do if I want to resign from GP training?
If you are considering resigning inform your area Training Programme Director as far in advance of your proposed retirement date as possible, in order for rotation and succession planning to be implemented. Written confirmation of resignation as a GP Trainer must be sent by letter or e-mail to your locality Deputy Director of Postgraduate GP Education. The retirement will be noted on the agenda of the appropriate meeting of the STC, and confirmed by the subsequent GP School Management Team Meeting (SMT). Following this the GMC will be informed.