The purpose of this section is to help you to think about the best way of preparing yourself for clinical work in primary care over the next few weeks, and to keep yourself up-to-date and able to deliver your best.
In “Good Medical Practice”, the GMC has set out clear guidance about the professionalism with which doctors should approach their work. Specifically, the “Duties of a doctor” section states:
- You must be competent in all aspects of your work.
- You must keep your professional knowledge and skills up to date.
- You must regularly take part in activities that maintain and develop your competence and performance.
- You should be willing to find and take part in structured support opportunities offered by your employer or contracting body (for example, mentoring). You should do this when you join an organisation and whenever your role changes significantly throughout your career.
- You must recognise and work within the limits of your competence.
This is all about the importance of patients receiving the best care – which is probably the main motivation for your wanting to join and support the primary care workforce at this time. To meet these requirements – and achieve your overall aim of patients receiving the best care – there are several steps that you should now take.
It is important that you clearly understand which tasks you will be doing, so that you can work out which skills, if any, need some updating. We have below listed some educational resources to help you in updating your skills, but this list is not exhaustive. If during the next few weeks your type of work changes, then you should go through this process once again:
- Clarify the type of work you are being asked to do
- Identify the skills and knowledge that you will need
- Work out which of your skills or areas of knowledge need updating
- Identify and use appropriate educational resources or help from colleagues to remedy these areas
You may be unsure about exactly which areas of clinical knowledge you need to refresh. Certainly having a good understanding of the symptoms, signs, progression and treatment of the Covid-19 illness will be important, but it is important to remember that patients you speak to with fever may well have tonsillitis, otitis media, bacterial pneumonia, pyelonephritis, cellulitis, meningitis, encephalitis etc. rather than Covid-19. Obviously if you are working in a setting where you are helping with non-Covid-19 patients, you may need to be familiar with almost any area of primary care – and in this scenario the GMC’s advice about only working within the limits of your competence are that much more pertinent.
You may want to complete the RCGP’s Self-test: this is an open-book on-line test (available free to returning GPs during the Coronavirus crisis) that you can complete at your own pace at home, covering a wide range of GP-relevant topics, and after completing this you will have a report on the areas with lower scores where you should consider focusing your updating.
The RCGP also has other ways of you testing your own knowledge in their Essential Knowledge Challenges (EKC), linked to their Essential Knowledge Updates (EKU) programme.
The E-learning for Health learning platform has a huge range of educational resources for all health professionals; it is best to register with the platform so that any learning you complete can be saved under your own log-in, although in fact you are able to access resources in the Coronavirus section by clicking “continue” when asked to enter your log-in details and password. There are some resources selected specifically for GPs (click on “Resources for Staff Working in Primary Care and Community Setting”).
- NICE produce their excellent Clinical Knowledge Summaries (CKS) which are readily accessible summaries of the current evidence base and practical guidance on best practice for a wide range of primary care topics. You can also find a list of NICE Guidance relating to Covid-19 here.
- RCGP: During this time of national crisis, until 30 June 2020 the RCGP are making their entire eLearning content freely available to support all returning GPs and primary healthcare professionals.
- Fourteen Fish will be known by many as an appraisal portfolio platform, but it has a wide range of educational resources in its GP Library. It is free to register with Fourteen Fish.
- NB Medical and Red Whale are commercial providers of excellent GP learning resources. Although normally only available for a charge, for three months Red Whale are making their resources available free of charge (go to www.GPCPD.com and use the code RWGIFT to redeem this offer).
- If there is any question of your work bringing you into direct contact with patients, you should make sure that you are familiar with the guidance on the use of Personal Protective Equipment (PPE).
For a fuller guide to educational resources for specific topics and areas (produced by Martyn Hughes from Somerset Training Hub) please follow this link (insert link to document)
Ensuring that staff are suitably trained to fulfil their duties safely and competently is an employer responsibility, and this is why employers insist on certain training modules are undertaken and completed successfully by new employees. However, we recommend that before undertaking an on-line mandatory training module, if possible you assess your own learning needs first, by attempting the course assessment. If you pass this, you have demonstrated your knowledge, and can download a certificate to evidence this; if you do not pass, this may have identified a learning need, and it would be appropriate to work through and complete the module.
It may well be a number of years since you were on the receiving end of a supportive mentoring relationship at work, and you might feel that this won’t be necessary, but you will be encouraged to seek mentoring. Having a mentor will help with clinical situations where there are a number of options for management and you want to explore these; but mentoring can be even more useful for helping to process and “sort out” all the other things that affect your ability to do your best work, for example:
- asserting yourself appropriately during difficult encounters with colleagues
- taking on a new role when you weren’t expecting to
- making the most of your strengths
- managing expectations of colleagues and patients when you are working in an unfamiliar field
- coping with professional isolation
- time and task management
- being able to leave work behind and switch off when you finish the day or session
- delegating tasks and referring patients effectively
If you prefer not to have a mentor through your employing organisation, you might be able to source mentoring and peer support from your own professional networks; if you can’t then your local RCGP faculty or Local Medical Committee (LMC) (see links) may be able to help.
- The British Medical Association (BMA) has confidential 24/7 counselling and peer support services open to all doctors and medical students on 0330 123 1245, where there is always someone you can talk to.
- NHS Practitioner Health are running twice daily events by Zoom called “The Doctors Common Room” – they describe this as a positive place to come together, to connect and to establish a safe, containing space in which to think and reflect. People can join the group when they wish and there is no expectation that people will attend every group.