Practice Managers Handbook

The Practice Managers Handbook contains a variety of important information which you need to consider when there are trainees based in the practice.

This is regularly updated ready for the new intake of trainees so please check to ensure you have the most up to date version.

If you think there is anything missing from the handbook which you would find useful please email Jemma Waugh

 

Peninsula Postgraduate Medical Education

Information Pack for General Practice Training Practice Managers

May 2017

General Terms and Conditions for GP Specialty Trainee Registrars 
Contracts, Terms and Conditions 
Sickness, Maternity and Paternity Leave 
Absence from Training 
Study Leave 
Getting Started 
National Training Number (NTN) 
Medical Indemnity Provision for Trainees 
Notification of Change in Circumstances 
Revalidation for Trainees 
Trainer Approval and Re-approval Visits 
The Purpose of the Visit 
Who Attends the Visit 
Preparation for the Visit 
The Visit 
Outcomes of the Visit 
Trainees in Difficulty 
Resources Available
Who to Contact
Delivering the Curriculum 
The Educational Supervisor (ES) 
Training Programme Directors (TPDs) 
Useful Information – Guidelines, Policies and Procedures 
Website 
Swaps in Training Placements 
A Guide to Training – The Gold Guide 
Shared Business Services (SBS)
Payments
Staff Contact Details
Office Contacts
Senior Education Team
Local Education Team
South West Peninsula GP Team Structure
Other Useful Contacts
Lead Employer
MDDUS – Medical Indemnity
General Medical Council (GMC)
Royal College of General Practitioners (RCGP)
The British Medical Association (BMA)

General Terms and Conditions for GP Specialty Trainee Registrars

Contracts, Terms and Conditions

Doctors on rotations in their Specialty Training (ST) 1 or ST2 year will have a 6 month attachment to a training practice. In the ST3 year the practice placement will be 12 months. From 01.04.2017 all new trainee placements will hold their employment contracts with the Peninsula Post Graduate Medical Education, School of Primary Care’s Lead Employer.  Details and contact information can be found under 'other useful contacts' in this handbook.

In all other circumstances the contract will continue with the GP Practice. If that is the case - terms and conditions of service of a General Practice Specialty Trainee (GPST) regarding such things as reimbursement of expenses, sickness leave, maternity leave and paternity leave etc. can be found in the Schedules Concerning General Practice Registrars (2003) with annual amendments available from the NHS Employers website: NHS Employers

Payments to trainers in respect of trainees on maternity leave and other reimbursements to trainers employing a GPST can also be found in the Schedules Concerning General Practice Registrars (2003) with annual amendments available from the NHS Employers website.


Sickness, Maternity and Paternity Leave

The trainee should notify their Lead Employer of any change in circumstances using the GP Trainee Change of Circumstance form.  On completion the form should be sent to their local Programme Administrator as detailed on the form.

For trainees who are returning from a prolonged period of absence, for example due to sick leave or maternity leave, and are near the end of their training the following points need to be considered:

  • All doctors returning to training from a prolonged period of absence greater than 12 months (exactly 12 months is acceptable) in total and wanting to apply for their CCT would be expected to have a minimum period in clinical practice to allow adequate time for the Educational Supervisor (ES) to assess the doctors competencies before a recommendation for a Certificate of Completion of Training (CCT) will be made.
  • This period might usually be of three months duration. In certain circumstances the School of Primary Care may be required to provide additional funding for an extension.
  • Trainees must be reminded that annual leave accrued during sickness or maternity leave (for which they get paid) may put their absence from training over the maximum 12 month period away from Clinical Practice and require them to have an extension before a recommendation for a CCT will be made.
  • For any absence periods of 12 months or less, if the Annual Review of Competency Progression (ARCP) panel decides that there is sufficient evidence to confirm that the trainee has gained all the required competences for the completion of training (which includes their own review of the trainees ePortfolio as well as the results of the ES report) and all other Membership of the Royal College of General Practitioners (MRCGP) components have been passed, then a successful completion of training has been achieved.

Absence from Training

The following policy should be referred to when a trainee has been absent from training due to sickness, jury service, maternity leave or paternity leave and is a continuation of guidance that was previously in place:

  • The Royal College of General Practitioners (RCGP) will allow time off from the training programme for sickness absence, jury service, maternity leave or paternity leave. However, the sum of these absences must not exceed two weeks over one calendar year. Any leave taken in excess of this must be made up in full, but not necessarily in the specialty or post where the absence occurred. 
  • Managing compliance with absence from training is a function of the School of Primary Care. Trainees must advise the Primary Care Programme Co-ordinator if they are going to be taking maternity/paternity leave and if they have to attend jury service. Trainees must also inform the Primary Care Programme Co-ordinator of any absence due to sickness. 
  • Trainees should confirm with the RCGP and the School of Primary Care that their plans to make up lost time will mean that their programme of training conforms, on completion, with regulatory requirements. 
  • Trainees that have been on sick leave and have returned to training on reduced hours because of an occupational health recommendation should meet with their Associate Postgraduate Dean to ensure that they will be completing the required three years of training.
  • It is RCGP and General Medical Council (GMC) guidance that training periods of less than three months in duration will not normally count towards CCT. However, in cases where a GP in training has to make up time lost through sickness, jury service and/or maternity/paternity leave the RCGP may be able to request that the GMC accept training periods of less than three months towards a CCT as long as a full three year training programme is completed. The final decision regarding this lies with the GMC.

The Practice Manager is asked to inform the relevant Lead Employer, on a monthly basis, of all GPSTs periods of absence including annual leave/study leave.

Study Leave

Full details of study leave and appropriate forms can be found on the website under Study Leave and Travel Expenses

Key points are:

  • Whilst in a GP surgery approval for study leave time is given by the practice, for trainees in hospital this approval is given by the Trust.
  • Expense claims are made via the School of Primary Care and forms for this are available on the link above. 
  • GPSTs have a nominal £300 per training year for learning needs not already provided.
  • Study leave payments cannot be made retrospectively once a trainee has changed years.
  • The account will be held centrally by the School of Primary Care.
  • Study leave can be used flexibly, within reason.
  • Each separate use of study leave needs approval.
  • Travel and subsistence costs can be reimbursed under this scheme but will be deducted from the nominal £300 per trainee.

Guidelines for study leave approval are:

  • Activity linked with individual’s Personal Development Plan (PDP) and/or an identified learning need.
  • Activity relevant to GP training.

Each of the five locality centres will run a series of day release meetings in ST1 and ST2 years. In ST3 the meetings are more regular and in the form of half day release. GPSTs are expected to attend these meetings. The local Training Programme Directors (TPDs) plan and deliver this programme. It is an opportunity to study areas of the curriculum most appropriate to group learning.

In addition there is a series of ‘Peninsula Days’ across the three year training programme. GPSTs should also attend these events. These days are designed to meet areas of the curriculum that are most appropriately delivered to big groups and offer opportunities to work with colleagues across the region. 

For more information about who you should contact regarding study leave allocation for trainees in the practice please see the Practice Managers section of the website.

Getting Started

National Training Number (NTN)

Before commencing their ST1 year, trainees will be requested by the School of Primary Care to complete the Enhanced Form R. The Form R in this instance triggers the School of Primary Care to allocate a unique NTN to the trainee which is required in order to register for the RCGP ePortfolio. This number stays the same throughout the training years.

Medical Indemnity Provision for Trainees

Peninsula Postgraduate Medical Education trainees can benefit from full cover from MDDUS, an experienced and established medical indemnity provider, for the whole three-year training programme. This is arranged and paid for automatically. GP trainees in hospital posts will benefit from enhanced medico-legal assistance from MDDUS on top of the standard NHS cover that they receive when in hospital posts (the standard NHS cover will continue to be arranged through the placement hospital trust). Trainees in practice posts will receive full cover, arranged by MDDUS, for the time they are in practice. Trainees will, of course, have the option of arranging cover for themselves if they would prefer.

If you have any queries, contact details can be found under 'other useful contacts' in this handbook

Notification of Change in Circumstances

It is important that the School of Primary Care have accurate information about trainees. The trainee should inform the local patch administrator and the Lead Employer of any change of circumstances that would affect the records we keep. This would include:

  • Change of name
  • Change of address
  • Change of email 
  • Change of telephone number
  • Maternity Leave
  • Change of post start or end date
  • Change to percentage of working

The trainee should notify any change in circumstances to the Lead Employer using the GP Trainee Change of Circumstance form.  On completion the form should be sent to their local Programme Administrator as detailed on the form.

Revalidation for Trainees

Revalidation is the GMC’s way of regulating licensed doctors. The aim is to support doctors in their professional development, helping to improve quality, patient safety and public confidence in the profession.

Licensed doctors, including those in Foundation Year two and Specialty Training will have to revalidate very five years, they will also be revalidated when they receive their CCT. However, if their training is less than five years, as with GP training, the first revalidation will be at the point of their CCT.

The employing practice will be asked, every six months, if their trainee/s have been involved in any formal Serious Untoward Incidents (SUIs) or Significant Event Investigations (SEIs) and whether these have been resolved or not. Practices will also be asked whether trainees have been involved in any conduct or capability investigations or complaints.

All trainees will have to complete an Enhanced Form R annually, prior to their ARCP. This is a mandatory form that requires them to answer questions about whether they have been involved in any complaints or investigated incidents over the last year.

The information provided by the practice and the trainee will be made available to the trainees' ARCP panel who will complete a section on the ARCP form as to whether there are any current unresolved causes of concern. In turn these pieces of information will be given to the Revalidation Manager who will be able to advise the Responsible Officer whether this trainee can be recommended for Revalidation to the GMC, or if further investigation needs to take place.

More information regarding Revalidation can be found on the following websites:

http://primarycare.peninsuladeanery.nhs.uk/about-us/gp-specialty-trainees/performers-list-after-training/

http://www.gmc-uk.org/doctors/revalidation.asp

 

Performers List

All GP Specialty Registrars working in a practice placement are required to be registered on the NHS England National Medical Performers List (NPL), which is overseen by NHS England.

a)         If they are already on NHS England National Medical Performers List, they will need to transfer between NHS England Regions. They would need to fill in and email the NPL2 form to the new area team and the area team they are leaving. The form can be found on the following link: https://www.england.nhs.uk/joint/ and the contacts for the relevant Area Team can be found at https://www.performer.england.nhs.uk/AT/SearchByPostcode. Please note this only applies to trainees transferring between NHS England Teams. If they are transferring from Wales or Scotland, they will need to let us know as soon as possible so we can liaise with NHS England to start the application process.

They would also need to let their current area team know they are leaving.

b)        If the trainee is not on NHS England National Medical Performers List, they no longer need to submit the NPL1 application form and undertake a face to face identity check. Instead, are required to inform us as soon as possible so we can liaise with NHS England to start the application process.

It is the GP registrar’s legal responsibility to maintain appropriate indemnity cover at all times within their training programme

It is also the responsibility of GP registrars to inform the Performers List of any changes to their circumstances such as:

  • Resignation / removal from training
  • Dismissal
  • Failure to achieve CCT or
  • Referral to GMC
  • Moving into a hospital post

 

Trainer Approval and Re-approval Visits

The Purpose of the Visit

Before a practice can commence training a GPST a practice approval visit needs to take place in order to assess the practice’s suitability for training. This is a statutory obligation from the GMC. The purpose of the visit is to ensure quality standards for training and to help and support the development of individual trainers. After a successful visit new training practices will be approved for a year in the first instance and established practices for four years. If the visit takes place too late NHS Shared Business Services (NHS SBS) will not pay the trainer’s grant.

Who Attends the Visit

The local Associate Postgraduate Dean, one of the local TPDs and a third member who may be another trainer, aspiring trainer or a member of the School of Primary Care administration team.

Preparation for the Visit

The practice/trainer should complete the approval paperwork which is available from the GP Trainers page on the website.

This should be submitted (electronically) to the local Postgraduate Medical Education office at the hospital. For Plymouth this is situated in the Peninsula offices in Plymouth Science Park. The practice would liaise directly with the centre administrator in order to agree a date for the approval or re-approval visit to take place. If the visit is in relation to a re-approval of trainers the centre administrator will contact you as a reminder of the date the visit is due.

The Visit

The visit will normally last a morning or afternoon. A tour of the practice and its facilities should take place and a room will be required for the trainer, trainee (if there is one in the practice at the time), Practice Manager and visiting team to meet. The room should ideally have IT facilities. Documentary evidence of how the practice is meeting (will meet) the training criteria standards should be available. There will be a brief discussion with the trainer and the visiting team will sign a confidentiality agreement. If a re-approval visit is taking place, the GPST should be present to meet the team and discuss their experience of the practice. After the visit there will be an opportunity for the team to feedback their findings and the practice will be informed of the approval/re-approval decision.

Outcomes of the Visit

The visit will ensure the quality of the training practice; it will provide the evidence of the structure of the practice and training programme; it will support the trainer and provide advice and guidance; development of the trainer/practice will be considered over the next one/four year/s.

The visiting team will compile a report and official approval/re-approval will be given. The approval paperwork will be sent to the local centre. This will activate the grants which the trainer is entitled to. These grants are (at time of writing):

  • £750 CPD grant
  • £7,908 per trainee, per annum whilst in practice 
  • £42 per month, per trainee whilst providing ES support in ST year 1 and 2

Please see the Finance page for more infomation

Trainees in Difficulty

Resources Available

There are various resources available for when a trainee is experiencing difficulties and needing support during their training.

Who to Contact

The first point of contact when it becomes apparent that a trainee is experiencing difficulties in practice should include:

  • The trainer at the surgery
  • The ES
  • The local TPDs
  • The local APD
  • The School of Primary Care administration team

Following the liaison and advice from the above it may be decided to explore the following for the trainee who is experiencing difficulty:

  • Occupational Health service for GPSTs, contactable through the Lead Employer
  • For support for doctors, getting the work/life balance right, handling pressure, dealing with career/health/financial issues Support4Doctors aims to put doctors and their families in touch with a range of organisations who can help. Their website is: www.support4doctors.org/default.asp
  • The Doctors Support Line is staffed by volunteer doctors to provide peer support for doctors and medical students and is an independent, confidential and anonymous service. You can call 0870 765 0001.
  • The Doctors Support Network is a self-help group for doctors with mental health concerns. They can be contacted on 0870 321 0642.
  • The Sick Doctors Trust are for doctors who are addicted to drink or drugs and can be contacted on 0870 444 5163.
  • The Peninsula Postgraduate Medical Education’s mentoring programme is open to all trainees who would like a mentor. For more information can be found on the following website page: Mentoring.
  • Peninsula Postgraduate Medical Education provides a freely available independent short-term counseling service for all doctors within the South West Peninsula. This service is designed to offer independent support and more information can be found on our Counselling page.
  • Career Guidance can be offered with one to one career support. This support takes the form of impartial and confidential meetings with a qualified career guidance practitioner. If your trainee is considering leaving medicine and would like to discuss career planning and career opportunities, information is available on the Career Planning Services page.

Delivering the Curriculum

The Educational Supervisor (ES)

Supervising and supporting GPSTs throughout the three year programme is a role of the trainee's ES and they will have an overview of progress throughout the training programme. The ES will contact the trainee at the start of their three year programme to arrange a face to face meeting. This meeting must take place within six weeks of the trainee starting on the programme. Whilst the trainee is in hospital placements, the ES will meet with them in January and June ready for their six month reviews and ARCP panels. The ES generally remains with the trainee for their first two years in training before they move practice, and ES, for their final third year.

Training Programme Directors (TPDs)

The TPDs' role over the three years is to facilitate small groups and learning activities appropriate to a small group setting. These small groups will be based in the local Postgraduate Centres within the hospital. The TPDs also help arrange the trainees’ placements and are a first point of call for trainees if they have any issues.

Useful Information – Guidelines, Policies and Procedures

Website

The website (www.peninsuladeanery.nhs.uk) is full of useful information and links. We are very pleased to have recently introduced a Practice Managers page. It is regularly updated so please use it as a first resource if you have any questions. The School of Primary Care administration staff will be happy to help you if you cannot find what you need on the site, constructive feedback is also welcomed.

Swaps in Training Placements

It is the policy of the School of Primary Care that the doctor accepts their allocated rotations and that no swaps will be authorised unless there are serious extenuating circumstances.

A Guide to Training – The Gold Guide

The Gold Guide explains arrangement for Specialty Training programmes within the United Kingdom. You can access it via this website if you would like more information.

Shared Business Services (SBS)

Payments

The payments made to the practice are as follows in accordance with Schedule Directions to GP Registrars (2003) with 2011 Amendments (21 April 2011):

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270927/Directions_to_HEE__GP_Registrars__Amendment_Directions_2013_FINAL__2014____.pdf

  • GP trainers allowance
  • Educational Supervisor payments

Staff Contact Details


Office Contacts

Health Education England - South West
Peninsula Postgraduate Medical Education
Raleigh Building
Plymouth Science Park
Derriford
Plymouth
PL6 8BY

Office hours are 9am to 5pm Monday to Thursday and 9am to 4pm on Fridays.

Please note that the office is closed between Christmas and New Year. Please do not submit anything one week prior to this.

The contact details for the administration staff are as follows:

  • Education Team Manager – Amber Worley / 01752 676153
  • Education Programme Officer - Jemma Waugh / 01752 676155
  • Education Programme Co-ordinator  – Gemma Sams / 01752 676127
  • Education Programme Administrator - Sarah Anderson / 01752 676168

Senior Education Team

The contact details for the medical workforce within the School of Primary Care are as follows:

Local Education Team

Each area within the Peninsula has a number of GPs (the TPDs) who lead on the training delivery and education, these are as follows:

Peninsula School of Primary Care Team Structure

 

Other Useful Contacts

Lead Employer

With effect from 1st April 2017 the Lead Employer of GP Trainees will be the relevant Acute Hospital Trust for the VTS Scheme they are attending. Click here for contact information.

MDDUS – Medical Indemnity

MDDUS
Macintosh House
120 Blythswood Street
Glasgow
G2 4EA
Contact Email: gainslie@mddus.com
Contact number: 0141 2281272

General Medical Council (GMC)

The GMC is the body responsible for postgraduate medical education and training. The website is full of useful information for GPSTs:

Royal College of General Practitioners (RCGP)

The RCGP leads on all aspects of GP training across the UK through providing guidance and running the GP assessments. They can provide information on the assessments a GPST is required to complete during their training and can also help with any problems with the ePortfolio.

The British Medical Association (BMA)

The BMA can provide guidance on a number of issues regarding trainees, such as contract etc.

  • Main telephone – 020 7387 4499

For BMA members who require new employment advice and information queries, there are a number of other contact details: