GP Specialist Trainees (GPSTs) must be competent in the provision of OOH care in order to attain a Certificate of Completion of Training (CCT). The assessment of OOH competence forms an important part of the workplace based assessment component of the MRCGP examination. Educational supervisors must be able to sign off their GPST as being competent in their final educational supervisor review.
The current educational and contractual requirements are that a GPST must have completed 6 hours of OOH training for each month that they are in a GP training post during their training. Thus 18 months of GP training will require a minimum OOH experience of 108 hours. Innovative training posts should include a proportion of OOH training commensurate with the time spent in general practice, e.g. a 4 month innovative placement of which 50% is in practice would require 2x6 hours OOH experience for that placement. The requirement to complete 6 hours per month applies in all contexts including extensions to programmes. Some of the experience can be gained in different contexts, for example walk in centres, A&E services under the supervision of a GP Clinical Supervisor, ambulance services and GP/ Primary care based OOH Palliative care. In the event that the GPStR is attached to these alternate OOH service providers the Trainer of the GPStR takes Clinical and Educational governance responsibilities unless the supervisor in these alternate providers is a HEEoE approved OOH Clinical Supervisor. It is expected that the majority of the trainee’s experience should be gained in a HEEoE approved GP out of hours services. There are two principles:
- Although the contexts are different, the quality of both care and education provided in OOH should be no less than that provided in working hours.
- Extended hours of GP surgery do not count towards OOH training.
This is the system of governance that provides overall assurance of the quality of care provided to patients. Clinical governance is the responsibility of the CCG exercised through the OOH Provider.
This is the system of governance that provides overall assurance of the quality of education and experience provided to GP Specialist Trainees. Educational governance is the responsibility of HEEoE/ LETB exercised through HEEoE/ LETB staff and the GP Trainers as educational supervisors.
Roles and responsibilities
- CCGs are responsible for providing sufficient training capacity in OOH to meet the need.
- CCGs must include this requirement in contracts with their OOH providers
- GP Trainers as the educational supervisor are responsible for assisting GPSTs to obtain adequate experience and for certifying that GP Specialist Trainees have reached competence
- OOH clinical supervisors assure the quality of care and patient safety. They supervise the educational experience of the GPST on behalf of the OOH Provider and will liaise with the GP Trainer
- Health Education East of England/ LETB is responsible for assuring the overall quality of the education and accrediting the clinical supervisor and the OOH provider for this purpose.