Issue Date / July 2014
Version / V1-2014 / Approved / July 2014
Equality Impact Assessment Date / TBA
Review Date / May 2015
Welcome and Introduction......
- Why this guide has been produced
- How it can be used
- Feedback & Keep In Touch
- Revalidation Recommendation
- Notify GMC of your new Responsible Officer
- Your future appraisal......
- Revalidation ePortfolio
- Royal College of General Practitioners
- Good Medical Practice
- Recording Your CPD
- NHS Appraisal
- Role
- Location
- Interested in Clinical Commissioning?......
- Mentors
- Feedback
- Learning Sets
- Groups
Induction & Refresher and Retainer Schemes ......
- Other Agencies
Appendix: Checklist / Template for Trainer-Facilitated ST3 Appraisal ...... / 3
4
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7
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27-29
Introduction
Why this guide has been produced:
GP Training is very well supported by the General Practice Specialty School within Health Education England (KSS LETB) but learning and professional development do not cease with the celebration of the arrival of one’s Certificate of Completion of Training!
HEKSS (formerly KSS Deanery) has always promoted good quality CPD (continuing Professional Development) for GPs in Kent, Surrey and Sussex, and the arrival of Revalidation and Clinical Commissioning has made us even more aware of the need to support all GPs with lifelong learning and help them meet the requirements of the NHS annual appraisal system.
We hope you feel that your progress has been well-supported by your local Trainer and GP Programme Directors and want to reassure you that HEKSS continues to support your lifelong learning throughout your career as a GP.
You are hopefully very familiar with the GP training components of the HEKSS website…this pack will hopefully encourage you to explore other pages on the same site….pages within the CPD section.
How it can be used:
This resource pack is designed to inform and interest…perhaps even intrigue. You can learn something about the way we support Continuing Professional Development for established GPs but you will also read a few top tips and helpful suggestions….and see a number of links to sites where more information is available.
IMPORTANT THINGS TO DO WHEN YOU COMPLETE YOUR GP TRAINING
AND COMMENCE YOUR NEW POST
Important Feedback on your training programme
and enabling us to keep in touch
We do hope that you enjoyed your training experience as a GPStR in Health Education Kent, Surrey & Sussex (KSS Deanery) and it is important to us that you complete the final feedback survey on your recent GP placement. This feedback is hugely important to the GP School in order to continue to develop the quality and appropriateness of our training programmes and placements.
If you have not yet done, so please complete the survey on line; to do this please copy and paste the link below into your web browser, then scroll to the bottom of the page where you will be asked to choose the link to give feedback – then select the feedback survey for the GP placement. The survey can be completed anonymously (you have the option of including your contact details). This can be saved part way through and takes around 15 minutes to complete.
In addition, the survey will ask you what your new post plans are and this information is important to HEKSS to be able to get early indications to support workforce planning. In addition, if you provide us with your details it will enable us to remain in contact with you to share information relating to how the Post Certification GP School can support you as a new GP principle in KSS including information on new principle support groups/preceptorship programme opportunities/mentoring and other support available. In addition you can always email the CPD Manager with your details.
Revalidation Recommendation
andNotifiying the GMC of your new Responsible Officer
Since 2012 all doctors are required to be revalidated on a five yearly basis. For doctors in training revalidation occurs every five years or at CCT where the time in training has been less than five years. As you complete training you should anticipate a recommendation for your Responsible Officer to the GMC for this to occur. As a GP trainee your Responsible Office is the Dean Director of HEKSS.
On occasions the Dean Director may not be able to recommend revalidation at CCT. This is most likely due to outstanding processes such as investigations into serious incidents, inquests or coroner hearings. Revalidation and CCT award are separate processes so it is perfectly possible to obtain a CCT but not have a recommendation for revalidation. A lack of revalidation at CCT should not impede your ability to proceed into independent practice unless there are restrictions from other sources such as the GMC.
When you start your next post, your “designated body” for appraisal and revalidation purposes will change to the organisation in which you spend most or all of your practice. For those of you working as locums you are advised to discuss this with your agency. You will need to inform the GMC of your new designated body and find out who is your Responsible Officer and then update yourdetails through your GMC Online account (please do not do this until your training period has finished) but it is important that you do update the GMC with your new RO details immediately after your completion date.
After this, you will need to have a regular appraisal which is based on our core guidance for the profession, Good medical practice, and start collect supporting information to demonstrate how you are meeting the GMC professional standards, details of which are available on the GMC web site (more information available later in this pack).
If you are not in a position to revalidate you will also need to inform the Revalidation Officer of HEKSS with the details of your new Responsible Officer so that we can complete a transfer of information for the new RO.
Medical Indemnity
On becoming a GP principal you will need to advise your medical indemnity provider of the change in your status to independent practitioner and arrange appropriate cover.
National Performer List
To continue to practice as a GP in the UK you must maintain your registration on the National Performer List. The list is national and you only need to be registered once: most people hold this registration in the geographical area where they undertake most of their work. You are advised to contact the Area Team you are registered with as a GP Trainee to make them aware of your CCT and update your registration to come into effect as you exit GP Specialty training.
How HEKSS supports doctors through independent practice:
The Post-Certification GP School works in collaboration with the NHS England Area Teams for Kent & Medway and Surrey & Sussex to ensure GPs are prepared for Revalidation and receive the support they need for high quality professional development. The School also recognizes the developmental needs of GPs and others engaging with Clinical Commissioning and has produced a number of learning and support systems to help GPs understand commissioning and contribute to the work of their Clinical Commissioning Groups (CCGs).
The School is increasingly aware of the need to promote education and training for everyone working within primary care teams. Patient-centred care requires teamwork and excellent communication between professionals involved in patient pathways.
Your role as a future GP will be as team player and at times as team leader and concepts of collaborative working and shared leadership are integral to the culture and philosophy of the organization.
This guide concentrates on the GP components of our work as these are of most pressing concern to you at this point in your career but there will be some reference to the wider work of the school as we encourage multi-professional learning.
We aim to help GPs manage the transition from well-supported trainee to independent practitioner and self-directed learner!
Support for your future appraisals
GP Trainees undergo annual appraisal and in their last year their educational supervisor ensures they experience the NHS appraisal process that they will experience every year thereafter.
What will your appraiser actually do?The Area Team should send you information about your appraisal which includes details of how to choose your appraiser on-line. Perhaps ask colleagues for their recommendations but do not delay choosing your appraiser as your first appraisal may be less than a year post-certification. Once linked to an appraiser you can confirm arrangements for your first appraisal directly with them
For new GPs the NHS appraisal process is the first educational initiative following the completion of their e-portfolios. HEKSS supports the Area Teams in the development of the appraisal process.
Working with our two Area Teams (Kent and Medway, Surrey and Sussex), the Post-Certification GP School tries to ensure that every GP in Kent, Surrey and Sussex has a productive and appropriate annual NHS appraisal that looks at the needs of patients, the needs of the individual GP, the needs of the practice, and the needs of their locality.
It also supports individual GPs and Practices in enhancing care through developing and achieving their learning plans.
Development as a GP in the year immediately after certification is likely to be focused on needs driven by patient care, personal enthusiasm and service imperatives.
Most new GPs are likely to choose the RCGP Revalidation Portfolio as it does provide some limited continuity with their Training Portfolio and is provided at no additional cost by the College. All GP Appraisers are familiar with the RCGP portfolio and can provide you with advice on how best to populate the document pages if you are uncertain (you will be able to choose your NHS Appraiser through an on-line arrangement once your Area Team has contacted you).
Further support for certain components is available through a combinedHEKSS/RCGP Faculty initiative. Revalidation Facilitators can meet one to one with GPs to give support and advice on the quality/data collecting component (i.e. clinical audit) and on the Peer review section (often referred to as Multi-source feedback).
One participant’s feedback:
For further information contact: Sarah Wright SET/SWT Events Administrator l: (020) 3188 7409
More information available via these useful links:
RCGP Home
Guide to Revalidation
Supporting information for appraisal and revalidation: guidance for General Practitioners
Further information and guidance is also available in the GMC ‘GMP Framework for appraisal and revalidation’ and ‘Supporting information for appraisal and revalidation’ documents.
GMP Framework for appraisal and revalidation
Supporting information for appraisal and revalidation
Continuing Professional Development
•CPD is a continuing learning process that supports GPs to stay up to date and maintain and improve their standards across all areas of their practice and at all times of their career development.
•CPD encourages and supports specific changes in the quality and delivery of a doctor’s practice from professional, patient and service requirement perspectives.
•CPD includes any educational or professional activity directed towards developing the knowledge, skills, attitudes and personal effectiveness necessary to improve practice. Professional expertise demands a continuing awareness of new concepts, values and technologies.
•It is important for doctors to update themselves not only on the evidence base, but also on opinion and consensus. Equally they must be aware of local needs.
•The ultimate aim of CPD is to support doctors to improve the care they provide to patients through their own personal development.
Good Medical Practice
It is important to remember that all your future appraisals will be based upon the GMC’s body of work ‘Good Medical Practice’ and your ability to present your learning clearly and concisely to your appraiser will be enhanced by a thorough knowledge of that body of work. All the components within NHS annual appraisal can be mapped to one of the following four domains:
- Domain 1: Knowledge, skills and performance
- Domain 2: Safety and quality
- Domain 3: Communication, partnership and teamwork
- Domain 4: Maintaining trust
The GMC’s website allows you to download the 2013 updated version of Good Medical Practice in various formats and also has interactive examples you can explore
Recording your CPD:
Another component of your future Appraisal Portfolio will be you CPD log. You are expected to record at least 50 GP-related CPD points per annum. Your CPD log should ideally give a brief description of the learning undertaken with some reflection upon the relevance of the learning to your role as GP…and if possible mention of how this learning has impacted upon the care you give your patients.
Generally, one credit is produced by one hour of learning but it is important to remember that learning often continues outside the classroom or lecture hall and you will be encouraged to record learning by reading and through professional discussions too.
Often you will be able to develop new ways of working following a learning programme, perhaps introducing a new protocol into your GP practice, and the RCGP does allow recognition of this additional work ( you may double your credit score in these circumstances but this additional ‘impact’ must have clear reflections on how it has improved patient care).
As you plan your CPD throughout each year you might like to consider the following ‘5 P Model’ as it opens up your thinking to additional learning opportunities and needs: -
Personal:what do I need to learn to further my career?
Patient:what do I need to learn to provide good care for my patients?
Practice:what do I need to learn to help my practice develop?
Population:what do I need to learn to reflect the needs of my CCG population?
Political:what do I need to learn to reflect the needs of the NHS?
GPs are used to using reflective tools such as ‘PUNS’ and ‘DENS’ to identify their personal learning needs as they consider their patients, but will increasingly need to consider the needs of their practices and their local population (defined by their membership of a Clinical Commissioning Group) as well. Wider decisions, across KSS and nationally will further affect each doctor’s learning requirements as improvements in patient care outcomes and difficult decisions about limited resources are made over the next few years.
Our GP Tutors are a common link for CPD and will champion this new model as they meet grassroots GPs, appraisers and commissioners, and our Development Centres will promote understanding of this model amongst the appraisers you will meet whilst they develop the skills required to deliver strengthened appraisal within a collaborative clinical commissioning paradigm.More on GP Tutors later in this pack!
More on NHS Appraisal
What make a good appraisal portfolio: 10 Top Tips
- Keep up to date with your CPD log…like your current learning log it is much easier to make entries regularly rather than leave this to just before your appraisal
- Remember to record learning from all sources, including reading, e-learning, professional conversations etc.
- Once beyond 50 credits decide which items are most relevant to the improvement of patient care, directly or indirectly, and ensure you mark these as included for appraisal….less ‘impactful’ material does not need to be shared with your appraiser if you already have 50 credits.
- Join a Sessional Doctor Learning Set as soon as you can. This will help you accumulate learning credits on a regular basis and will offer many additional advantages (more later).
- Remember you do not need to do everything, every year! Some components have to be included annually to show you keep up to date but others are only required once in a revalidation cycle of five years. You can discuss the best timing of these components with your NHS Appraiser when you first meet.
- Remember that your appraiser would rather see a short piece of reflection than a certificate
- Remember that reflection should encourage consideration of some sort of action: perhaps a change in how you or the practice delivers care to a group of patients
- These actions/changes may be very small but worth recording
- Ensure you share your portfolio with your appraiser in good time (a minimum of two weeks before your appraisal meeting). Appraisers can then advise if something needs tweaking!
- Be proud of your portfolio…it is an expression of your worth as a GP!
What will your NHS appraiser actually do?
Your NHS Appraiser behaves like your previous educational supervisor and has a dual role of support and assessment. Appraisers do not decide whether you are fit to practice but do prepare statements using their professional judgement that inform the Responsible Officer’s team. It will be the Responsible Officer who recommends your future Revalidation to the GMC.
Your appraisal will prepare for your appraisal meeting by reading through your portfolio in advance. They may approach you if they believe material is missing or needs clarification. At the meeting they will go through the portfolio with you before making a summary of the appraisal discussion. They will be curious about you, your work and your workplace. They will explore all aspects of your clinical work and they will confirm that components required for revalidation have been completed. They will go through your previous PDP and will help you formulate a new PDP for the year ahead.