ST1&2: Training Pathway

Mid-Wessex GP Education is a Patch Office for the Health Education England – Wessex, looking after Primary Care training for doctors and allied health professionals in Basingstoke, Salisbury and Winchester areas.

ST1 & ST2

The ST1 and ST2 years generally consist of 4 six month posts (3 in hospital, 1 in GP for GP Trainees who started training before Aug 2021).

Hospital posts are approved for general practice training by the PGMETB. Quality standards are maintained by the contract between the relevant NHS Trust and the Postgraduate Dean, and are managed by the GP VTS Programme Directors.

FROM AUGUST 2021, new Trainees starting GP training will undertake a 24/12 programme. The aim is for trainees to undertake 2 six month hospital posts and 2 six month GP posts in the first two years ST1&2, then 12m in ST3 GP. We will do our best to provide this, but we cannot guarantee this for all new trainees. Please be aware some trainees may be allocated 6 months in GP and 18 months in hospital as capacity is tight and there may not be adequate space in GP practices.

In February 2021 we created 4 standalone Integrated Training Posts (ITP) in Winchester whereby trainees undertake 12m in ST1 in both a hospital post and GP post, spending half the week in each placement.

ST3

The GP vocational training is delivered by Programme Directors and GP trainers under the management of our Associate Dean of Postgraduate GP Education.

The ST3 year is spent in general practice with one half day per week during term time spent at the Mid-Wessex Day Release Course at the University of Winchester.

E-portfolio and Workplace Based Assessments

All GP trainees are required to complete the e-portfolio as it makes up one third of what is required for your CCT.

Please see RCGP website for more information about the GP curriculum and WPBA:

RCGP curriculum

RCGP Workplace Based Assessments

Timings for ESRs and ARCPs - useful document written by Wessex ARCP Associate Deans Dr McGee & Dr Rial

Timings for ESRs and ARCPs for Trainees April 2022

Links to ARCP website on Health Education Wessex - Form R, Reflection on work outside of training forms etc:

ARCP information on HEW website

Any trainee thinking of undertaking regular locum shifts should first discuss this with their Educational Supervisor to check it is acceptable within a GP training scheme. Trainees must declare and list all locum shifts (dates times where) on their Form R where relevant annually before every ARCP. They also must complete a Reflection of Work Outside training form – Form R and Reflection on Work Outside of training form are available from the HEW ARCP website. Trainees then need to attach completed signed form onto a 'Supporting Documentation type' log entry on Portfolio - clearly titled "Reflection on locum work". This needs to be in place at the time of every ARCP.

Assessments

Trainees are required to pass the RCA (Recorded Consultation Assessment) and AKT (Applied Knowledge Test) through the RCGP.

Out Of Hours/UUC

Please note new guidance on Out of Hours as provided by Health Education Wessex for August 2019 onwards:-

RCGP have also put a new document on the website that maps UUC to the curriculum capabilities:

RCGP link

UUC mapping to RCGP curriculum capabilities

UUC FAQ Wessex

UUC Observational session record

UUC session record

UUC session record completed

UUC Evidence for ARCP

UUC Evidence for ARCP Example ST12

Health Education Wessex GP OOH Training Resources:

OOH information Wessex Deanery

OOH Information for Military Defence Trainees

OOH guidance Defence Trainees

OOH guidance WTR Defence Trainees

Less Than Full Time Training

Guidance on eligibility criteria and how to apply for LTFTT is available on the Health Education England (Wessex) website.

Please note that Trainees are encouraged to apply as far as possible in advance of wishing to undertake Less Than Full Time Training, but no later than 16 weeks before the anticipated start date of your LTFT training.

LTFT information HEW

Trainees who are already LTFTT but wish to change % also need to refer to the guidance on the HEW website and apply to change percentage.

Please note that as of March 2022, LTFT posts for GP trainees will only be offered at 60 or 80% in the majority of cases unless exceptional circumstances apply such as an occupational health assessment, when consideration will be made on a case by case basis. Please see guidance on HEW website GP Training

Additional information for Trainees provided by AiT SubCommittee (updated July 2021)

Please note that this information has been provided to the Patch office by Wessex AiT Sub-committee – information is subject to change and will be updated at regular intervals to keep it up to date for trainees.

Rotas

Work Schedule: Prior to each placement you should receive a work schedule. This is a document that sets out the scheduled duties of the doctor and distribution of hours for which the doctor is contracted. A doctor’s pay is calculated using their work schedule. A generic work schedule must be provided to a doctor at least 8 weeks prior to them starting a placement. A personalised work schedule must be agreed before or within four weeks after the commencement of the placement during scheduled hours of work.

Statutory and mandatory training: must be sent to doctors alongside their generic work schedule and the then be arranged within a doctor’s rostered hours of work.

Exception reporting: used to inform the employer when a doctor’s day-to-day work varies from the agreed work schedule. For example, missed breaks or educational sessions and staying late. Reports should be sent as soon as possible after the exception takes place but must be sent within 14 days. Sending reports help build up a picture of training and can trigger a work schedule review for an individual or department.

For more information:

NHS Employers rota rules factsheet: NHS Employers rota rules

NHS Employers Work Schedule information: NHS Employers Work schedule information

Work Schedule whilst in a GP placement

A full-time week is 40 hours (on average), notionally split into 10 sessions of four hours in length and including ‘out of hours’ work to be scheduled across the year. Your working pattern is arranged across a weekly rota cycle. A week includes, on average:

7 clinical sessions: including (but not limited to) booked and emergency surgeries, house visits including travelling, telephone consultations and ‘out of hours’ work.

You must have a named and accessible GP supervisor for every session.
Trainees should have one hour of admin time for each three hours of clinical time.
Appropriate debriefing time with the supervising GP must be built into each session. The amount of time will be dependent on the trainee, their training level and supervisor.
The booking of appointments will allow for this admin and debriefing to take place within the session.

2 structured educational sessions: including (but not limited to) release to local structured teaching programme, tutorials, practice educational meetings, educational supervisor meetings, activities relating to WPBAs, e-portfolio entries and other engagement with the ARCP process.

1 independent educational session: for independent study and revision.

This can occasionally be used as extra clinic time, for example in the run up to an exam to allow for adequate practice, but this should not be the norm and should be agreed beforehand between trainer and trainee.

Annual Leave

On first appointment to the NHS: 27 days
After five years’ completed NHS service: 32 days
Check employer-specific guidance about annual leave request policies.

LTFT

Rotas: The Junior Doctor Contract states that “each LTFT doctor must have a bespoke work schedule built for them to ensure they are working the correct pro rata proportion of hours and shift types, for their LTFT percentage and working arrangements, and are being paid correctly. The facilitation of bespoke work schedules is the responsibility of both the employer (or host organisation as locally agreed) and the doctor”. Getting this right can be complicated, but the NHS Employers website has helpful information and template examples (see the useful links section).

Annual leave: calculated on a pro-rata basis. For example, a less than full-time trainee working 60% of a full-time rota should receive 60% of the entitlement to annual leave and 60% of the entitlement to public holidays. If you work on a bank holiday, you are entitled to a day-in-lieu.

Study leave: pro-rata according to your percentage.