FAQ | East of England

Academic Trainees

AKT and CSA for Trainees

Community Based Posts

What should the registrar do during their day in GP? Do they need a tutorial?

Trainees should have a morning and afternoon surgery with appropriate debrief time. There is no requirement for a formal tutorial as they should receive this in the hospital based part of the post.

^{_{(TPDs June 2017)}}

How should leave or sickness be recorded, during a community post?

Annual Leave and other kinds of leave (unpaid, compassionate, parental) should be agreed by both the community post and host GP practice.

All leave, including sickness leave, should be reported to the GP practice and the training practice is responsible for recording this, and (for trainees starting from August 2013) forwarding this on to the lead employer i.e. St. Helens and Knowsley NHS Trust.

Trainees would be advised to ensure that their records regarding illness and leave are complete otherwise this can lead to delays at CCT, if it becomes apparent that further training time is required due to more than 2 weeks leave (other than annual leave) arising in a year period.

All leave apart from Annual and Study Leave should be recorded on form R and uploaded to the ePortfolio prior to the trainees ESR.

^{_{(st Jan 2014. updated st hm Nov15. updated TPDs June 2017)}}

Who are the clinical and eudcational supervisor(s) in Community based posts?

Generally the clinical supervisor is allocated by the community side of the posts.

The GP practice should allocated a named trainer or AT for overall clinical supervision whilst in practice and they may contribute to the ePortfolio through educators notes.

Generally the educational supervisor is whoever is educational supervisor prior to the arrival in that post who is usually the ES for all 3 years.

^{_{(st Jan 14. updated st hm Nov15. updated TPDs June 2017)}}

What day of the week should the trainee attend the GP placement?

This is negotiable between the GP practice and the community placement.

Ideally it would not be a Wednesday as this would result in the trainee only being in Practice once a fortnight due to Day Release teaching.

^{_{(st Jan 2014. updated st hm Nov15. updated TPDs June 2017)}}

How do I arrange leave when in community posts

Whilst is community (e.g. Comm Psych, Public Health) posts, GP Practice Placements, the GP practice is the over-arching employer. When you wish to book leave, you will need to ask permission for leave from both the GP practice and either the community post. Even if you will not be absent from the practice, you must keep St Helens and Knowsley, the lead employer, informed so that they may record the amount of annual leave taken, and avoid any potential delays to CCT if there were to be uncertainty about annual leave taken.

_{^{(ST Nov15. Updated TPDs Jul17)}}

ePortfolio for trainees

How often should I make ePortfolio entries?

The RCGP suggest an average of one to two entries/ week are made by GPST.
Quality and quantity are both important.

Remember that at the end of ST3, an independent eye should be able to sit down and look at the eportfolio and determine that there is sufficient evidence of curriculum coverage to deem a trainee competent to move to independent UK general practice.

^{_{(st Oct 13, updated Nov15. Reveiwed TPDs June 17)}}

I am LTFT trainee - how often do I need an ESR?

Trainees should have an ESR every 6 months full time or not.

You should complete pro-rata WPBA in line with other trainees. The ePortfolio doesn't take account of LTFT when counting WPBA, but the trainer will look and make sure that the appropriate minimum of WPBA is being performed.

There will need to be an ESR timed to be 2 months prior to any gateway ARCP.

source:
http://www.rcgp.org.uk/training-exams/mrcgp-workplace-based-assessment-w...

^{_{(ST/HM Nov15. Reviewed TPDs Jun17)}}

What is the role of the PDP?

The PDP is an integral part of the ePortfolio and should have current entries within it at the time of ARCP review.

Your PDP is entirely your responsibility although it should be discussed with your supervisors. It is the place where you record your longer term learning.

It can be derived from learning events, from systems such as PUNs and DENs, from personal reflection, guidance from supervisors or health policy statements.

As you are in training the number of items that you might record will be large so a conversation with your supervisors can help you to know how to prioritise. The PDP is a fundamental part of your NHS appraisal.

PDP entries should be SMART and updated regularly showing that you are engaging with the process.

^{_{(ST & MW June10, Updated TPDs Jun17)}}

ESR and ARCP Timescales

An Educational Supervisors review needs to be undertaken by the end of November and May each year.

Most trainees have a calendar ARCP in June each year.

For most trainees the calendar ARCP is also the 'gateway' ARCP- a review to confirm progress from ST1 to ST2, ST2 to ST3, etc or from training to CCT.

If, e.g. for reasons of mat leave or other OOP, or February starters, the calendar ARCP remains in June, and they may then need a 'gateway' ARCP at another time.. Please approach Hayley who can help with this situation.

As an ST1 you will need to complete the mandatory minimum number of work place based assessments for the first six months by the end of November.

^{_{(ST & HM updated Nov15. Reveiwed TPDs June17)}}

How often do I need to complete a Form R?

A Form R should be completed before each ARCP. When you are emailed an invite to your ARCP panel, a blank form should be sent to you in order for you to complete.

You need to scan/upload a copy of Form R into your learning log under "Courses/Certificates" and share

^{_{(TPDs Jun17)}}

What is a Form R and what to I do with it?

Prior to ARCP a trainee is required to download, fill in and scan/upload a form R to the learning log of their ePortfolio, under 'courses and certificates'. This must then be shared so that it can be seen.

The form R is designed to provide information for the ARCP.

On this form, trainees must declare all ill-health leave or other leave e.g. Jury Service and detail any other posts outside of training which are medically relevant (e.g. locum posts, other medical employment).

There is also a health statement and GMC GMP declaration statement.

There should also be a record of significant events, complaints or investigations as part of the form R, which should also be reflected appropriately in the ePortfolio.

source: HEE website
guide to Enhanced Form R and Form R
https://heeoe.hee.nhs.uk/gp_arcp

^{_{(HM & ST Nov15. Revewied Jun17)}}

Extending training

I am doing extended training after the 3 year period - do I need to do OOH?

The ARCP panel will confirm whether you need to do further OOH shifts. If your ES feels you that you have demonstrated competency in OOH you will not need to do further OOH shifts. However, if your local educators feel that it would form an appropriate part of the learning plan to help you meet he required competencies, then it would be appropriate for you to do so.

Is there a even year limit for completion of GP training?

If you have a lot of time away from training e.g. with pregnancy, sabbatical, OOP experience or illness etc. you will be pleased to hear that there is no longer any time limit for validity for CSA or AKT, nor is there a seven year time limit for completion of training.

It is wise to keep up to date with any shifts in requirements for WPBA and the ePortfolio during this time.

_{^{(ST Jun11, reviewed Nov15. reveiwed TPDs Jun17)}}

I'm an extending trainee offered LTFT - can I do locum work?

Your contract as an extension trainee differs from that of a GPST1-3 and you may undertake locum work. You should consider if locum work is in your best educational interests and discuss with your Ed. supervisor.

_{^{(ST Aug15. Reveiwed TPDs Jun17)}}

I am an extension trainee and am re-sitting exams - do I need to attend day release?

If you are an extension trainee re-sitting CSA then we would expect you to attend, as available, in order-

1: Group E (Extension Group) sessions as these are special sessions for this circumstance
2: Group C (Exam Phase) sessions if there is no Group E session
3: appropriate external CSA or comm skills courses on a day release day
4: any relevant Group Session you choose, if there is no Group C or E session

If there is no Group C or E session and you do not wish to attend another group session, you should discuss in advance suitable activities with the PDs. We may be able to fund actors, etc. There is also the option to work in Practice.

If you are an extension trainee re-sitting AKT only then we would expect you to attend, as available, in order-

1: Group D sessions
2: any relevant Group Session you choose, if there is no Group D session

If there is no Group D session and you do not wish to attend another group session, you should discuss in advance suitable activities with the PDs. We may be able to fund question practice materials, etc. There is also the option to work in Practice instead of attending Day Release.

_{^{(ST Nov15. Reveiwed Jun17)}}

Form filling

GP Placements

To whom should cremation and other fees be paid in GP posts?

1: Any private fees or work performed during working hours (e.g. crem fees, patient medicals, private sicknotes, notifiable diseases etc.) are the property of the employing practice. It is suggested that registrars familiarise themselves with the practice fees and procedures for handling private monies during their induction. It is advisable that registrars, when seeking payment on behalf of the practice, request that monies are paid directly to the practice and preferably via a cheque made out in the practice name.

2: There are a minority of practices that operate a different policy, whereby all such fees are paid to the registrar. Registrars should then be aware that this generates them a personal tax liability which they alone are responsible for reporting and paying to HMRC.

_{^{(ST Oct13. Nov15. TPDs Jul17)}}

How much leave am I entitled to in a GP placement?

The annual leave entitlement for a full-time doctor is as follows, based on a standard working week of five days:
a. On first appointment to the NHS: 27 days

b. After five years’ completed NHS service: 32 days.

These leave entitlements include the two extra-statutory days previously available in England under the 2002 Terms and Conditions of Service.

https://sharedservices.sthk.nhs.uk/lead-employer/policies-and-forms/

_{^{(HM Jan20)}}

What happens to my rota if I take maternity leave during a GP placement?

If you take maternity leave during a GP post, your planned future GP and hospital placement rota will alter. It is best to contact Hayley who will look at the rota and suggest rota possibilities.

HEE is obliged only to offer you appropriate training posts in approved jobs in either hospital or GP to make up a suitable onward rota. Norwich GPSTS aims to find appropriate jobs and GP placements within the Norwich scheme.

Please note that if you require extra time for whatever reason, the next person scheduled to any particular GP or hospital posting is not bumped from, or delayed into that posting.

Trainees are advised to join and remain members of the BMA during their GPST training, as they are a valuable source of advice regarding rights and responsibilities in this area.

_{^{(ST Feb09. updated Oct13. Nov15)}}

What is the National GP Performers list and why do trainees have to be on it?

Medical performers may not perform NHS primary care services in England unless they are included in a national performers list held by NHS England. It is a requirement of your General Practice placement to be registered on the list as a trainee.

What happens if I take time off to care for a sick child or other emergency?

Employers are required to provide clear guidelines on the length of special leave for domestic reasons and whether it should be paid or unpaid. All employees, regardless of service length, have the right to reasonable time off work to deal with emergencies involving a dependant. Payment may be made by local agreement, but the expectation is that relatively short periods of leave for emergencies will be paid.

Circumstances when employees can take time off would normally include:

if a dependant falls ill or has been injured or assaulted

where a partner is having a baby (although this may be covered by paternity leave arrangements)

to make care arrangements for a dependant who is ill or injured

to make funeral arrangements or attend a funeral of a dependant

to deal with an unexpected disruption or breakdown in care arrangements for a dependant, e.g. when a childminder fails to turn up

to deal with an incident involving the employee's child during school hours, eg if a child has been involved in a fight or suspended from school.

It should be noted that such leave is for 'domestic emergencies' and so it would normally be expected to be for a very short period, probably not in excess of three consecutive days. The normal expectation is that other arrangements will be made by the employee after this period (which may include granting request for annual leave at short notice)

** Be aware that if more than 2 weeks absence in addition to annual leave accrues, then this will require an extension to training, and the completion of unscheduled change to training forms etc with the deanery

_{^{(GR Jul17)}}

I don't drive. What are my responsibilities?

During the application process, you will have signed your name against the statement below:

I do not drive. Should it be necessary in the course of my training programme to provide domicilliary care and I have not yet obtained a full driving licence, I agree to provide a car and driver at my own expense so that I may fulfill this requirement.

_{^{(ST Sep10, reviewed Oct13. Nov15. TPDs Jul17)}}

What happens if I would like time off to take a child/relative to a hospital or other non emergency appointment?

There is not entitlement for paid leave for these purposes.

Trainees should negotiate with their host practice, and it would normally be expected that this time is taken as either annual leave, or as unpaid leave. Practices may have their own policies on such leave, details of which are usually contained within the staff handbook isued to trainees at induction.

If you will be away from all/part of a Day Release day, then this must be advised in advance, and it would normally be expected that this time is taken as either annual leave, or as unpaid leave.

(other FAQs cover leave for emergency care for a relative or child and leave for the purposes of attending maternity care)

_{^{(ST Oct13. Nov15. Jul17)}}

I can no longer drive.... what are my responsibilities?

If you have had your licence revoked on health grounds:

under the DDA you will need to negotiate with your practice some mechanism for doing home visits. This could be to take a share of the visits to which you can cycle or walk, or could be that you are allocated a 'ward round' at a residential home, and you are dropped/ collected or can take the bus.

If you have lost your licence for an offence/ totting up of points, etc.

you agree when you sign your contract with the deanery that in such a circumstance you are willing to provide yourself with a car and a driver, and must make an arrangement to that if you are on-call for the practice, or will have visit obligations that this is available to you.

_{^{(ST Jan11. Updated Oct13. Nov15. TPDs Jul17)}}

I have been unwell and absent from work, what certificates should I supply to my employer/trust?

You should supply certificates to Southend as the Lead Employer and details regarding this can be found at

https://heeoe.hee.nhs.uk/gp_lead_employer

If the employing trust declines to accept an SC2 form, and requests you to obtain a private GP statement of illness, please discuss with the programme directors before embarking on this action.

You also need to inform your place of work or the GP Office if it is a teaching day.

_{^{(ST updated Nov15. Update TPDs Jul17)}}

What is the snow policy?

Whether your GP placement is in central Norwich, or in deepest rural Norfolk, you can be affected by the snow.

Half of the Norfolk winters result in driving conditions that are very difficult. When the winter comes you should ponder how you will get to work in such conditions- is your car in good order and appropriately prepared? -have you factored in the extra time to clear your car of snow and ice? If you have a difficult driveway, might you be better parking on the street?

Some practices have a snow policy and you should familiarise yourself with this. If you do not feel confident about driving in the snow, might it be worth having a chat with the practice or your fellow trainees to see if you can get a lift with somebody in a large 4x4 vehicle?

If you are unable to get to work because of the snow, you should advise practices as soon as possible.

As speciality trainees you receive more than the statutory minimum of holiday, so if you are unable to get to work, the practice or hospital can determine that this day is taken as annual leave. The practice may also determine that this is a day of unpaid leave.

If you cannot go to work because you have children and the school is closed, then you should inform the practice or hospital as soon as possible. In law you have the right to short term unpaid leave to make alternative arrangements. If the school closure is prolonged, you would be expected to make arrangements to cover care for children and dependents

_{^{(ST Feb13. Updated Nov15. Reviewed TPDs Jul17)}}

I'd like to move from my current training practice, is this possible?

If you would like to move training practice during a placement, this is our process

1: Can you resolve any issues that have developed in your current training practice? Discuss things with a trainer, practice manager, senior partner or associate trainer if you can.

2: Email Hayley advising of the issues and that you are looking to move practice

3: The programme directors and Hayley will look at the issues and consider meeting with you and/or the practice to see if there are things that can be resolved.

4: We will look at the rota and see if there are any training practices available that meet your needs. Sometimes practices cannot accommodate trainees even if the slot is listed as empty. Sometimes trainees will need trainers with particular skills, or we are aware of particular pressures within a practice that means that your needs can't be met by any given practice.

5: We will then write to the practice and see if they are willing to take you on. Practices do not have to accept any individual trainee to any placement, and may say no without giving any reason.

6: If the practice is willing to take you on, you will need to work your notice period with your current practice as per your contract.

7: If there is no suitable training practice vacancy locally, we are happy to approach the deanery and neighbouring schemes to see if there any GP training vacancies that they have that are suitable. It is sometimes possible to remain with the Norwich scheme in this instance.

8: It is also possible to request time out of programme through the deanery whilst waiting for a new training opportunity, although this is unpaid.

We would ask you to consider very carefully if a move is right for you. Often people following an exam failure feel like only a fresh start will enable them to move forward, but bear in mind that moving practices will mean that you will be spending 2 or 3 weeks familiarising yourself with a new practice and its systems, and this may not be to your advantage.

_{^{(ST Fbe13. Nov15. TPDs Jul17)}}

May I do locum work whilst in a GP or hospital placement?

from the Gold Guide:

6.25 Before a training number is issued trainees will be required to indicate formally that they accept the Conditions of taking up a training post (Appendix 3). In addition, trainees awarded a training number should:

...
not undertake locum activities which compromise their training or make them non-compliant with Working Time Regulations
...

The Norwich Scheme requires you to inform the programme directors if you:
make an agreement with an employer to opt-out of the EWTD
are performing locum sessions in Hospital whilst in a GP placement
are performing locum sessions outside of your current speciality whilst in a hospital placement
are performing any locum sessions if you are a LTFT trainee

_{^{(ST Oct13. TPDs Jul17)}}

Can I take time out from my GP placement to be an examiner at the UEA (or elsewhere)?

We encourage GPST to become assessors and examiners as part of post graduate professional development. You can do this under one of two arrangements;

1) You may take annual leave for this purpose, subject to agreement with your practice and trainer.

2) You may use a private educational study session(s) up to a maximum of two and a half days per year, which is the minimum required by the UEA. This is subject to the agreement of your practice and trainer.

We request that trainers giving authorisation for use of a private educational study or other practice time for this purpose email Hayley so that the scheme may monitor this activity and liase with the university.

_{^{(ST Nov13. Nov15. TPDs Jul17)}}

How do I get intouch with occupational health?

Whether you are working in Hospital, a community post or a GP post, occupational health is now covered by St Helens and Knowsley, the lead employer.

Information about referral, and referral forms are available at

https://heeoe.hee.nhs.uk/gp_lead_employer

_{^{(ST Nov15. TPDs Jul17)}}

Am I entitled to time off got my/my partner's antenatal appointments?

Fathers, partners and civil partners of a pregnant woman are entitled to unpaid time off during working hours to accompany her to 2 ante-natal appointments. This includes the intended parents if they're having a baby through a surrogacy arrangement.

There is no legal right to paid time off for antenatal appointments. However, employers may allow this time off with pay under the terms and conditions of employment, or allow employees to take annual leave, swap shifts or make up time.

Pregnant employees are entitled to reasonable time off with pay for antenatal care made on the advice of a registered medical practitioner.

_{^{(ST Nov15. TPDs Jul17)}}

Who do I tell about sick leave in GP posts?

All leave, including sickness leave, should be reported to the GP practice and the training practice is responsible for recording this, and forwarding this on to the lead employer i.e. St. Helens and Knowsley NHS Trust.

It is also possible and advisable to directly report ill health leave to St H and K through the ESR system.

Trainees would be advised to ensure that their records regarding illness and leave are complete otherwise this can lead to delays at CCT, if it becomes apparent that further training time is required due to more than 2 weeks leave (other than annual leave) arising in a year period.

All leave apart from Annual and Study Leave should be recorded on form R and uploaded to the ePortfolio prior to the trainees ESR.

_{^{(TPDs Feb17)}}

Hospital Posts

Is attendance at GPSTS compulsorary in hospital posts?

Trainees should be released from the hospital rota for fortnightly day release.

It is expected that trainees will attend 70% of all available sessions.

Hospital departments will be expected to facilitate attendance at fortnightly day release in their rota planning.

Only exceptional service demands should prevent attendance.

The programme directors and Director of Medical Education NNUH meet to review and facilitate attendance at day release.

_{^{(ST Nov15. TPDs 2017)}}

What guidance is there about taking parental leave whilst in a hospital post?

Either parent can request parental leave to care for a child. The regulations regarding timing are best explained at:

https://www.gov.uk/parental-leave

The NNUH policy on parental leave reflects this:

http://intranet/depart/Human%20Resources/index.htm

You would then have to apply to the deanery for an extension to your training completion date.

Note that at the NNUH parental leave is unpaid.

_{^{(ST updated Nov15. TPDs Jul17)}}

How much leave am I entitled to in a hospital post?

The annual leave entitlement for a full-time doctor is as follows, based on a standard working week of five days:
a. On first appointment to the NHS: 27 daysb. After five years’ completed NHS service: 32 days.
These leave entitlements include the two extra-statutory days previously available in England under the 2002 Terms and Conditions of Service.

How much leave can I take in any one hospital post?

Often trainees get married during their VTS years, and hope to take an extended period of leave for a nice honeymoon somewhere, hence this question.

Trainees are allowed a set amount of leave, so as long as the total leave in
the year is not exceeded, that shouldn't be a problem.

The only issue I can foresee is that taking 3 or 4 weeks in e.g. a 3 month placement will limit the acquisition of learning and competencies in that post.

This is something you might should discuss early on with your educational supervisor and it would be advisable to write requesting this leave very early on to the department concerned. It would also be advisable to clear this leave with your likely departmental clinical supervisor if you are in a short 3m post.

_{^{(ST Jan10. TPDs Jul17)}}

What happens to my rota if I take maternity leave during a hospital placement?

If you take maternity leave during a hospital or community post, your planned future GP and hospital placement rota will alter. It is best to contact Hayley who will look at the rota and suggest rota possibilities.

HEE is obliged only to offer you appropriate training posts in approved jobs in either hospital or GP to make up a suitable onward rota. Norwich GPSTS works to find appropriate jobs and GP placements within the Norwich scheme.

Please note that if you require extra time for whatever reason, the next person scheduled to any particular hospital posting is not bumped from, or delayed into that posting.

Trainees are advised to join and remain members of the BMA during their GPST training, as they are a valuable source of advice regarding rights and responsibilities in this area.

It is worth emailing Hayley if you are planning maternity leave as she can go through the deanery procedures for extending training with you.

_{^{(ST Feb09. Oct13. Nov15. TPDs 2017)}}

How do I get in touch with occupational health?

Whether you are working in Hospital, a community post or a GP post, occupational health is now covered by the lead employer.

Information about referral, and referral forms are available at

https://heeoe.hee.nhs.uk/gp_lead_employer

_{^{(ST Nov15. TPDs Jul17)}}

Am I entitled to time of for my/my partners antenatal appointments?

Fathers, partners and civil partners of a pregnant woman are entitled to unpaid time off during working hours to accompany her to 2 ante-natal appointments. This includes the intended parents if they're having a baby through a surrogacy arrangement.

There is no legal right to paid time off for antenatal appointments. However, employers may allow this time off with pay under the terms and conditions of employment, or allow employees to take annual leave, swap shifts or make up time.

Pregnant employees are entitled to reasonable time off with pay for antenatal care made on the advice of a registered medical practitioner.

_{^{(ST Nov15. TPDs Jul17)}}

How can I get LTFT training in a hospital post?

The deanery website details the steps in application for LTFT.

https://heeoe.hee.nhs.uk/less_than_full_time_training

Being accepted for LTFT does guarantee that LTFT is available within GPST.

It is very difficult, in practice, to change from full-time training to LTFT whilst in a hospital post. For information regarding LTFT in GP placements, see the appropriate FAQ.

Once a trainee has obtained eligibility for LTFT training from HEEEoE it is possible to arrange LTFT under 3 arrangements

1: as a supernumerary funded trainee.
regrettably, there is no deanery budget for this, except in very occasional cases of illness, for short term durations only, and it is unlikely that the hospital will agree to fund supernumerary LTFT

2: To work LTFT in a full-time slot. This is subject to the workforce needs and requirements of an individual hospital department. Although the hospital can use the post funding to obtain cover for the slot, it is often not practicable or achievable to find (short, medium or long-term) locum cover to enable this.

3: as a job or slot sharer. It is possible to slot share with another training eligible for LTFT training. The scheme are happy to mail Norwich trainees and in the wider deanery to see if anyone would wish to slot share.

Where trainees envisage that they could return to FT training in the medium term, and no satisfactory LTFT solution can be found, it is possible for trainees to apply to HEEoE for time out-of-programme (OOP) with a view to returning to FT or LTFT training at a defined future date

_{^{(ST Feb15. Nov15. TPDs Jul17)}}

Who do I tell about sick leave in Hospital posts?

All leave, including sickness leave, should be reported to the relevant leave coordinator within the hospital department and this person is responsible for recording this, and forwarding this on to the lead employer i.e. St. Helens and Knowsley NHS Trust.

It is also possible and advisable to directly report ill health leave to St H and K through the ESR system.

The leave coordinator in a department is usually a specifically identified department secretary, and your educational supervisor, or any one of the departmental admin team can usually point you to the right person.

Trainees would be advised to ensure that their records regarding illness and leave are complete otherwise this can lead to delays at CCT, if it becomes apparent that further training time is required due to more than 2 weeks leave (other than annual leave) arising in a year period.

All leave apart from Annual and Study Leave should be recorded on form R and uploaded to the ePortfolio prior to the trainees ESR.

_{^{(TPDs Feb17)}}

IDT

Urgent and Unscheduled Care/OOH

Rota Questions

Study Leave

May I take private study leave?

HEE does not encourage the taking of private study leave for any reason during a GP/Community placement. This includes exam preparation, as the best preparation for AKT and CSA is consulting with patients and reflecting on casework. Additionally, whilst in a GP placement, self-directed study time should be used for private study.

Individual host employers should consider 1-2 days of exam leave to allow the trainee to take the exam.

Regarding private study leave in a hopsital placement - Please see the answer above. However, whilst HEE does not generally encourage the taking of private study leave for exam preparation, we recognise that during a hospital post, trainees do not have specific self-directed study time each week in their contract of employment. So, in recognition of that, GP trainees could potentially request a total of 5 days during the total period of time in non-GP/community placements for either private study leave or online courses (please see FAQ below) prior to an exam. We would expect this private study leave to be taken in the month immediately prior to the exam. We recognise that hospital placements will need to consider the ability to deliver a safe service when assessing these study leave requests

Individual host employers should consider 1-2 days of exam leave to allow the trainee to take the exam

How much online study time can I take prior to my exam?

For online courses, up to 5 days of study leave during your time in non-GP placements can be requested for this. This 5 days is a total combined with private study leave, please see above FAQ. In GP/Community posts, self-directed study time should be used for this activity

How many days study leave may I take?

Trainees are entitled to 30 days study leave maximum per year. About 20 of these days are accounted for by STS day release.

This leaves a maximum of 10 days worth of study leave available per year.

_{^{(Updated TPDs June17)}}

Is it possible to have private study leave for CSA or AKT practice instead of attending day release?

Whilst you may apply for formal study leave through the usual mechanism, approaching your educational supervisor and the programme directors for approval to take such study leave, private study leave is rarely granted.

(see the separate FAQ on the topic of private study leave)

We are more than happy if trainees want to set up a CSA morning to practice cases for an entire ST grouping, and would ask that you approach Hayley and Sharon in the first instance with your ideas.

Please note, that whilst STS days may have a particular title, the day itself will have a large component of communication skills training applicable to the CSA and much applied knowledge relevant to the AKT.

_{^{(ST/MW/HM/ Mar10. Updated TPDs Jun17)}}

How do I apply for study leave while in a hospital post?

Firstly, please discuss your study leave intentions with your Educational Supervisor as part of your individual training plan.

It is advised that you complete a study leave form for all GPSTS contact days. This way we can audit reasons for decline and non attendance.

Information for Hospital study leave can be found on the NANIME page https://nanime.nnuh.nhs.uk/induction/

_{^{(ST Oct13. Updated CR Jul17)}}

Do I have to take a days study leave to sit an exam?

Trainees are allowed leave to sit professional exams. This is meant to form part of the study/ professional leave allocation.

Most professional exams are held some distance away, and reasonable leave for the purposes of travelling to, and returning from, an exam should be given. This time is also counted out of the study leave allocation.

Where trainees are sitting a professional exam abroad, e.g. USMLE, MRCP, they are entitled to study leave exactly as above.

It is courteous whilst in both hospital and GP posts to inform the employer well in advance.

If an employer wishes, they may choose to grant an employee additional paid leave for exam purposes, instead of allocating these days against the study leave allocation. Trainees should be aware that they more than 2 weeks absence outside of study leave/ holiday (e.g. illness, compassionate leave, unpaid leave, etc.) entitlement has to be made up at the end of training.

If a trainee has used all of the study leave allocation and wish to sit an examination, then leave would normally be granted, but either as part of annual holiday leave, or if this is all used, then as unpaid leave.

_{^{(ST Sept12. Updated TPDs Jun17)}}

Can I do locums while on study leave?

No.

^{_{(ST Feb14. Updated TPDs Jun17)}}

What is the local process for applying for study leave funding

Please see https://heeoe.hee.nhs.uk/general_practice/norwich/study-leave

Study leave for LTFT

LTFT trainees are entitled to study leave on a pro-rata basis and the to the same study leave funding as full-time trainees.

The study leave allocation for a full time trainee is 30 days per year. LTFT trainees 30 days pro rata. From the total number of days pro rata a trainee must attend 70% of local teaching/day release, we have an average of 20 days teaching per year.

50% = 15 days per year study leave allocation. 10 days teaching. Trainees must attend a minimum of 7 days per year (70%) at local teaching/day release.

60% = 18 days per year study leave allocation. 12 days teaching. Trainees must attend a minimum of 8.4 days per year (70%) at local teaching/day release.

70% = 21 days per year study leave allocation. 14 days teaching. Trainees must attend a minimum of 9.8 days per year (70%) at local teaching/day release.

80% = 24 days per year study leave allocation. 16 days teaching. Trainees must attend a minimum of 11.2 days per year (70%) at local teaching/day release.

The study leave policy can be found https://heeoe.hee.nhs.uk/gp_lead_employer

Trainees are reminded to inform the office if you are not attending teaching and the reason why - work, AL, sick leave, study leave, carers leave etc.

Teaching

Trainee Representatives

WPBA

Requirements with regards to audit as a component of work-place based assessment

There has been no change in the requirements for work place based assessment and East of England Deanery follows the national RCGP guidance.

The position is:

* It is expected that GPs will have a thorough understanding of audit; taking part in audit in practice is currently a requirement for revalidation for the GP register.

* Trainees must be able to deminstrate that they have become familiar with the principles and applicatin of audit and in most cases will have been involved in a full (i.e. 2 cycle) audit during their training.

* It is not an absolute requirement that trainees undertake a full (i.e. 2 cycle audit) but in many cases the easiest way of demonstrating understanding is by including an audit in the learning log.

* Therefore ARCP panels in East of England, as in all Deaneries look for evidence of an audit or clear evidence that the trainee understands the principles of audit such as a turotial on audit or evidence that the trainee understands the need for a second cycle against the original criteria and standards.

From the above it will be clear that some trainees, trainers and educational supervisors may be contacted after panels with regard to ensuring that adequate evidence of undertaking and understanding a full 2 cycle audit is present in a trainees portfolio before final sign off for application for CCT.

_{^{(ST Oct13. Nov15. Updated TPDS Jun17)}}

Is there any guidance as to the required standards for the different CEPS?

DOPS have been replaced by CEPS.

It is recommended that entries are linked to skills assessments to populate the summary board.

It is expected that the essential skills are still assessed but the CEPS gives scope to show wider clinical skills.

^{_{(TPDs Jun17)}}

Can skills assessments performed in F2 rated as 'competent' be transferred across to the eP somehow?

The 8 Mandatory CEPS must be completed by the end of ST3 training. Optional skills are also listed. Foundation skills are also listed. A trainee may wish to demonstrate optional or foundation skills for a skills assessments, and a trainer may ask them to do so.

When it comes to the Mandatory CEPS, these have to be performed and assessed whilst in GP training. It isn't possible to transfer competencies in these skills across from F2. This may seem odd, but skills rated in F2 are assessed and rated at a Foundation level, rather than 'at the level of a competent GP'.

For example; In a hospital clinic setting, patients *may* be prepared for intimate examination by a healthcare assistant or nurse. The purpose and routine of these examinations may have been explained in some detail by them, leaving the doctor to take history and perform examination following brief consent.

It is essential that trainees can demonstrate that they can explain the purpose, routine and consent a patient prior to intimate examination, and perform these examinations at the level of a competent GP.

Guidance as to expected standards for these examinations is listed within the filestore section of the website.

^{_{(ST Jun10. Updated TPDs Jun17)}}

How many COTS do I need to produce and when?

The requirement is for a minimum of six COTs or Mini-CEX in each of ST1 and ST2, (ensuring there are three before each six monthly review), and 12 COTs in ST3 (six before each six monthly review).

The minimum requirements reduced for GPSTR not in full time training.
^{_{(ST Feb13)}}

What kind of consultation should i show in a COT? What cases? What length?

Consultations should be selected across a range of patient contexts and over the entire period of training spent in general practice and should include at least one case from each of the following categories:
Children (a child aged 10 or under)
Older adults (an adult aged more than 75 years old)
Mental health.

You can select the consultations. It is hard not to decide to show what you feel are your very best consultations, particularly when the word 'assessment' is floating around. You tend to get more out of COTs initially if you show consultations that didn't go so well and get the advice from your trainer about what you want to improve on.

The process is about having your consultation skills reviewed and shaped, being given formal feedback, and demonstrating improvement in skills during training, heading towards CSA success.

^{_{(ST Feb10)

(Adapted from A Brief Guide to Workplace Based Assessment in the nMRCGP) http://www.rcgp.org.uk/docs/nMRCGP_WPBA_in_the_nMRCGP_sep07.doc}}

Who can complete MSF Assessments?

The RCGP states that it should be possible to identify, even in small practices 5 clinicians who have sufficient knowledge of the trainee to complete a MSF. Clinicians ≠ doctors. (doctor of any kind, including F2 or fellow registrar, nurse, nurse specialist, nurse practitioner, district nurse, midwife, prescribing pharmacist, ECP, paramedic, HCA, osteopath etc)

http://www.rcgp-curriculum.org.uk/nmrgcp/wpba/multi-source_feedback.aspx

^{_{(STOct13. Nov15. Updated TPDs Jun17)}}

When should I do a patient satisfaction questionnaire?

Once in the first 6m in GP in the ST1 year. Once in the final 12m in GP in the ST3 year.

If you are a LTFT trainee, you need only produce one PSQ during your ST1 training period and one in the ST3 year.

^{_{(ST, amended with LTFT info Feb10 from Deanery Jul08 newsletter. Updated TPDs Jun17)}}

What are the requirements for CPR AED for CCT?

GP trainees must demonstrate competence in CPR and AED.
At the completion of ST3 your ePortfolio must include certificated evidence of current CPR and AED training.
A simple way of doing this is to scan, upload and attach a valid certificate of competence in CPR and AED to a learning log entry in the course/certificate category of your ePortfolio. Your educational supervisor can then validate it.

All couses / certificates must conform with / be authorised by UK Resus Council.

Despite ALS certificates being valid for 4-5 years, the MRCGP guidance requires evidence that is obtained during GP training and within 3 years of CCT.

http://www.rcgp.org.uk/training-exams/mrcgp-workplace-based-assessment-w...

^{_{(ST Nov15. TPDs Jun17)}}

THE FOLLOWING FAQ ARE UNDER REVEIW. PLEASE CONTACT YOUR SCHEME ADMINISTRATORS OR TRAINING PROGRAMME DIRECTOR IF YOU HAVE ANY QUESTIONS.