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Local Out of Hours Training Regulations

by Andy Punton — last modified 15-03-2012 10:49

Out of hours regulations for ECGPTP and WLGPTP in conjunction with Cumbria Health on Call (CHOC)

From February 2007, all GPRs must ensure that they complete at least the GMC minimum requirement for OOH work. This is a minimum of 6 sessions per 6 months in general practice attachments (including ITP posts) pro rata.

A total of at least 72hrs in on call duties must be documented before the final educational supervisor interview at 34 months.

It is expected that a GPR will undertake one out of hours session per month while working in general practice.

The pattern of OOH work is defined as follows:

All GPRs will complete all modules of the OOH training course.
GPRs are responsible for arranging their shifts with a clinical supervisor, who may be their trainer. Cumbria Health on Call (CHOC) circulate free OOH shifts to GPRs before they are released to other GPs, and GPRs must act quickly to secure the appropriate shifts. Scheme offices will forward these free shifts to GPRs who will be entering or returning to general practice by email
OOH shifts must be spread evenly throughout the general practice component of the GPRs training scheme.
Each GPR is expected to undertake around 4 fully supervised shifts, though the exact number of supervised shifts depends on the trainer's assessment of competency (when moving to an ITP post, the trainer may wish to begin with a supervised shift, before moving to distant supervision). If GPRs require more supervision than this, the trainer will normally discuss the educational needs of the GPR with the training programme director.
When the trainer has assessed that the GPR is competent to perform shifts with distant (telephone) supervision, the trainer will complete the “Confirmation by the trainer that the GPR is competent to work with telephone supervision” document and forward this to CHOC.
The GPR is expected to perform a minimum of one OOH session per month during their GP attachments (including ITP posts), and a total of one “solo” night shift per 3 months of employment in GP over the duration of their time on the scheme. Each GPR will therefore complete at least 4 overnight “solo” shifts (ie with telephone supervision).
GPRs must gain experience in different types of shift during their OOH experience.
The exact balance of types of shift and number of OOH sessions worked is decided by the trainer on the basis of the competencies exhibited and proved by the GP registrar. The Schemes will fully support the trainers assessment of GPR competency in OOH work.

Competency in OOH work

It is a defined component of certification that all GPRs must be proved competent at OOH work. This competency must be agreed by the trainer and a ‘Satisfactory Completion of OOH Training' document provided, before certification of completion of training can be applied for. Thus, it is expected that some GPRs may need to perform more than the minimum GMC requirement to prove their competency.

Competency in OOH work is based on the GPRs performance in emergency work in primary care.

GPRs must present documentation of the clinical supervisors assessment to the trainer for each OOH session performed to the trainer for discussion (unless the clinical supervisor is the GPRs own trainer).
GPRs must present documentation of the work they have done on the OOH shift to the trainer for discussion.
GPRs must record each OOH session in the learning log of the eportfolio, including the number of hours worked in that shift.

The trainer will then discuss the session with the GPR using the competency framework defined by the GP curriculum and recorded in the nMRCGP workplace based assessment e-portfolio. If the OOH documentation is not available, the trainer will not be able to assess competencies, and therefore the OOH shift will not count towards the GMC minimum requirement. It is fully the GPRs responsibility to collect and ensure appropriate completion of this documentation.

Cumbria Health on Call (CHOC) GPR out of hours training scheme

Recording Clinical Experience
An important part of the OOH Training programme is recording clinical experience gained while working CHOC shifts. The log sheets issued allow a brief record to be kept but a valuable educational resource is case discussion with your trainer following a shift.

In order to allow this to happen you will need to have a mechanism for keeping copies of your clinical notes about patients you have seen or given telephone advice to. This brief guide explains ways in which you can currently save a record.

ADASTRA:
During your shifts you will be writing your clinical records using the ADASTRA software. After completing the details in the Consultation screen (for either a telephone advice call or a face to face consultation) DON'T CLICK ON THE "FORWARD" or "FINISH" BUTTON BEFORE PRINTING OFF A HARD COPY.

Once you have finished entering your data, CLICK ON "FILE" then CLICK ON "PRINT"

Then finish the episode by clicking on "Forward" or "Finish"

The Printer will then print off a copy of your record (NB The printer will not activate until you have clicked on Forward or Finish).

For notes that were written during a home visit on ADASTRA Remote you can search ADASTRA for "My Work" when you return to base and print case reports from here. If you are unsure how to do this the drivers or admin staff should be able to show you.

OOH shift feedback from GPR to trainer

Shifts which GPRs should avoid

Solo Working in all areas

not Saturday am or pm car shifts
not Sunday am or pm car shifts
not treatment centre shifts
not Bank Holiday am or pm car shifts or treatment centre
GPRs will be able to pick up all evening shifts and nights

Accompanied by trainer in all areas

GPRs can work any shift accompanied by their Trainer with the understanding that at peak times they may be only able to observe due to high fluctuation in patients’ demand.

CHOC REQUIREMENTS FOR GPRS BEFORE UNDERTAKING SHIFTS:

ADASTRA training

All new GPRs need to be Adastra trained prior to commencing their first Out-of-Hours shift with CHoC. The training takes approximately one hour and can be delivered from various points across North Cumbria, i.e. Carlisle, Whitehaven, Wigton or Penrith. Please e-mail Jon Rayson on Jonathan.Rayson@choc.nhs.uk or ring the office directly on 01228 608200 to request to speak with either Jon to organise Adastra training.

It is important that Registrars are issued with their log-in details and understand how Adastra works prior to undertaking an Out-of-Hours shift.

BADGES

You will also need to have a CHoC badge before undertaking OOH shifts. To arrange a badge, at least two weeks before you are due to start your first shift e-mail a passport size photograph to:
estates-helpdesk@cumbria.nhs.uk
Tel: 01228 603131 Fax: 01228 512214