HEE SW GP Leadership & Education Extension of Training (LEET)

 

The Programme

The local GP schools of Severn and Peninsula have created the LEET programme (Leadership and Education Extension of Training) to nurture our highest-flying trainees and give them skills to become our future GP leaders. The LEETs are supported to gain experience and skills in leadership and change management as well as improving their clinical skills over a 12-month period.

During the year, trainees will drive forward a major project that should be of publishable quality. In recent years, the focus of these projects has been around health initiatives and important changes to service have been achieved in areas such as Dementia Care and Troubled Families. This year’s LEETs have all been working towards workforce projects based on the 10-point plan to boost GP numbers.

Purpose

Both Severn & Peninsula GP schools are committed to developing excellence, and the LEET programme is vital towards this aim. It will strengthen and develop leadership and management skills in our newly qualified GP cohorts. Overall, we hope that the LEETs will be our GP leaders of the future, and also that their skills and knowledge will be passed on to our grassroots trainees in the process.

This programme is politically expedient given the challenges facing GP recruitment and workforce development, particularly in the area of leadership. It also helps us to meet HEE’s mandated priorities from Government, and the NHS 10-point plan for boosting GP workforce.

Programme Aims

  • To develop self-motivated newly qualified General Practitioners with higher-level management and leadership skills and the networks to support them.
  • To create a cohort of highly able NQGP who are able to implement significant improvement to the NHS locally, regionally and nationally.

Structure

Six GP LEET trainees will be recruited across the region for a year-long extension of training after completion of ST3. Three will be hosted in within the Severn School of Primary Care, with an identical model in the Peninsula GP School.  

There is an expectation that trainees will remain in their current patch, however we will not recruit more than one LEET per patch unless there are extenuating circumstances. Furthermore, the major project may be based in a different patch to the clinical base of the trainee and will be determined by the appropriate APD. There is likely to be travel over the footprints of each school to work in areas of leadership need.

Work Balance

LEET trainees work 50% GP at their host practice doing clinical and practice work and 50% on the Education and Leadership work stream with a dedicated mentor (40 hours total FTE, excluding OOH). The mentors and LEET host practices are selected by the local patch APDs. As some of the work will be based in locations other than their host practice, LEET trainees will require access to appropriate transport.

Less than full time trainees work pro-rata accordingly, as per the deanery’s LTFT guidance.

Recruitment

Details of 2019/20 recruitment will be published in due course.

Posts will be advertised to current Severn/ Peninsula ST3s as a one-year extension as a GP LEET. Recruitment will be based on structured criteria, designed to reward excellence.

All trainees must be on track to complete ST3 and have had nothing other than satisfactory outcomes at previous ARCP. They should ensure that their ES supports their application.

Potential LEET trainees would be expected to have contacted the local Patch APD and TPD in advance of their application, in order to gain their explicit approval for their application, and to sound out local project opportunities.

The Interview

The format will be a panel interview, consisting of TPD’s, APD’s and current LEET’s.

·         The interview will be based on a 5-minute presentation (prepared in advance) 

·         5 minutes of questioning on the  presentation topic. 

·         This will be followed by 5 subsequent questions (approx. 5 minutes each). 

These will test a range of skills and attributes, through a values based recruitment model.

Support

LEET trainees have support from a dedicated GP LEET Training Programme Director (TPD) or Associate post-graduate Dean (APD) in the deanery. They also have the support of their Educational Supervisor (based in their clinical training practice) and a mentor from a wider healthcare organisation.

Both regional GP LEET cohorts (Severn and Peninsula) meet as a small group every 6 weeks to review progress and hurdles. Benchmarking and peer learning will be facilitated by the local TPD or APD responsible for the LEET programme. Alternate meetings are run together with all LEETs across the region.

Expectations

By end of first month:

  • Finalise job plan with ES
  • Finalise job plan with leadership mentor
  • Plan project outline for the 12m duration of the programme
  • Submit all to LEET TPD

By end of month 3:

      Write an interim 3-paragraph review of progress to submit to local LEET APD/ TPD, and to upload to Eportfolio in the learning log:

  1. Achievements and barriers encounters to date
  2. Key Learning so far
  3. Next steps   

By end of month 5: Preparation for first ESR due at 6m

  • LEET to repeat the 3-paragraph review as above
  • Leadership mentor to complete CSR based on leadership work project
  • ES to complete ESR based on the evidence submitted

By end of month 10: Preparation for the Final ESR

  • LEET to repeat the 3-paragraph review as above
  • Leadership mentor writes final CSR
  • ES completes final ESR
  • LEET to have completed 2000 word written project to be submitted on eportfolio and to LEET TPD and APD

10-12 months:

  • Final presentations and posters to be completed for showcase events
  • LEETs to focus on legacy and sustaining their project once they leave

Evaluation and work on supporting incoming LEETs and inspiring Grassroots trainees in ST1/2

The LEETs must be rigorous about how they use and document their additional time:

  • All LEET time project time must be approved in advance by your ES, and recorded so that you can justify what you’ve done and when
  • All LEET project work should be documented in the eportfolio learning log under the title “project work”. This will help the ARCP panel see what additional work you’ve undertake 
  • A clinical supervisor reports (written by your project supervisor) needs to be completed prior to their each ESR
  • LEET write-ups must be completed and uploaded to your ePortfolio (and emailed to your project supervisor and GP school) prior to your final ESR, otherwise you risk passing your final ARCP

Host practice responsibilities:

Host practices receive a reduced (33%) trainer’s grant for hosting a LEET trainee. They need to provide a proposed timetable for the trainee to show how their week would be structured. Clinical work is not expected to be undertaken at less than 10-minute consultations.

Training practices should provide a 1-2 hour CPD session per week. This should include time for face-to-face tutorials and problem case analysis. This time should be aimed at developing the trainee’s PDP, including teaching them higher-level management; setting up a quality improvement project or running of a QoF area or practice team. The practice would also be expected to provide clinical support when required.

ESR should take place as normal.

Mentors can claim backfill to allow support of the LEET (up to 33% of a trainer’s grant).

In conjunction with the LEET, the mentor must produce a timetable of project work and supervision, to be drawn up within the first month of starting the post and submitted to the LEET TPD or APD for approval.

Work based placed assessment and OOH

Eportfolio and WBPA continue in the LEET year. There is an expectation of pro-rata CBD and COTs. There should be 12 CBDs over the year, half on clinical subjects and half on project discussions. There should be 50% of the usual number of COTS a 12m placement (as the clinical commitment is 50% time). There will be naturally occurring evidence for the project work that should be included in regular learning log entries, at least one per week.

The OOH requirement continues at 72h over the year.

Project

The LEET trainees will be expected to deliver a significant project driven by both local NHS and Health Education working across the south west (Severn/ Peninsula) needs.

In 2016, this was aligned with the GP workforce 10-point plan announced to boost training, retention and returning GPs.

The project should be written up, with a minimum 2000 words and fully referenced. It should be worked into a formal presentation to be given to the LEET cohort and their mentors at the end of the year. It can also be given to the local VTS as part of the work to pass on this expertise to the grassroots trainees. LEET trainees should also try to gain publications/ poster presentations, as appropriate.

The Severn SoPC has a dedicated research group who could advise if formal research is being considered as part of the LEET year.

The major project will be determined by the respective APD, based on the current leadership needs in the region. It is possible for it to be based on an area of personal passion as long as it is formally worked up and approved by the local LEET TPD/APD.

In general projects will be drawn from one of the following areas:

  1. Improving the primary/ secondary care interface for patients
  2. Improving GP workforce issues
  3. Working with developing Community Educational Provider Networks (CEPN)
  4. Improving local public health
  5. Working with local commissioning to enhance primary care services for a community
  6. New models of working within GP federations
  7. New models of inter-professional and multi-disciplinary learning

Opportunities

LEET work opportunities outside of their training practice should be roughly split in terms of local and regional/national development projects. There is an expectation for them to develop along multiple lines, but to focus on the major project.

The opportunities listed below give a flavour of what’s available. These should be determined by the LEET trainee in liaison with the LEET TPD, the local patch APD and their local mentor when drawing up project proposals and timetabling of their year.

Roughly speaking, of the 5 sessions per week, 3 would be spent on a single major project activity; 1 on management skills and quality improvement activity within their training practice; and 1 on other bespoke areas of interest across the year.

Local LEET opportunities include:

  • Responsibility for QOF running and development within practices
  • Practice management e.g. HR and team liaison roles
  • Quality improvement projects via local federations - e.g. One Care Consortium/ teaching federations, CEPN
  • CCG links and their projects eg Dementia, Integrated care pilots
  • Improving interface care pathways
  • Developing medical student/ ST teaching at the practice/ cluster level
  • Developing sustainable pathways for training locally
  • CCG priority area development  (admissions avoidance, early supported discharge programmes)
  • Local Medical Committee project work

Regional/ national LEET opportunities include:

  • Developing LEET agenda nationally
  • Trainee harmonisation work with Peninsula
  • RCGP liaison work
  • Deanery interface opportunities - developing educational sharing across specialties
  • Leadership and management course and networking
  • Conference presentations 
  • Developing sustainable pathways for training regionally and nationally
  • Working with regional and national groups (RCGP, Primary Care Organisations) in project work