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Scotland Deanery

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Quality Management

Quality Management of GP Specialty Training in Scotland

Educational Supervisor and Training Practice Approval Process

 

August 2015

 

Background: This is an update of the policy that was approved at the December 2012 GP Directors meeting and represents the output of ‘Project 10: GP QM-QI refresh’ of the Quality workstream’s Change Management Programme.

 

Principles: 

 

1. QM-QI of GPST in Scotland forms a part of the QM-QI activity of the Medical Directorate and is managed through the annual quality cycle of the specialty grouping that includes GP, Public Health and Occupational Medicine. This includes the annual Quality Review Panel (QRP)and the two-monthly specialty Quality Management Group (sQMG).

2. QM-QI of GPST programmes relate to GP trainees’ experience in departments that host them, usually with other trainees (foundation, specialty). GP trainees’ experience will form part of the global quality assessment through the QRP process. However, GP Trainees  also are hosted within general practices, which are in effect ‘mini-LEPs’ with individual Training Practice Agreements covering training arrangements. The nature of these arrangements require a bespoke QM-QI approach, including the requirement for approval by the regulator of both the training environment (the training practice) and the educational supervisor (ES).

3. Approval and re-approval of ESs and Training Practices (TPs) therefore forms a significant part of the QM-QI of GPST and will be delivered regionally with oversight and approval through the sQMG.

4. QM-QI of training practices and ESs in General Practice is ‘visit-light’ and informed by triangulated data from a variety of sources rather than an over-reliance on the historical routine ‘practice visit’.

5. The QM process and all decisions taken as part of it are guided by:

a. The Trainee Doctor www.gmc-uk.org/Trainee_Doctor.pdf_39274940.pdf, being superseded from January 2016 by Promoting Excellence: Standards for Medical Training and Education www.gmc-uk.org/education/standards

b. The evolving GMC policy relating to the recognition and approval of trainers www.gmc-uk.org/education/10264.asp

c. RCGP guidance on the standards for training www.rcgp.org.uk/training-exams/~/media/Files/GP-training-and-exams/Information-for-deaneries-trainers-supervisors/Guidance-for-deaneries-on-standards-for-GP-training-Jan-2014

d. COGPED/ COPMED guidance on the principles of GP training and education www.cogped.org.uk/archive/principles-of-gp-training.html

e. COGPED guidance on  GP Trainer status where the GMC is taking action through fitness to practice procedures www.northerndeanery.nhs.uk/NorthernDeanery/primary-care/gp-specialist-training/information-for-trainers-and-tpds/Trainer%20status%20in%20cases%20of%20GMC%20action.pdf

f. Any other relevant guidance that may arise from the GMC, COGPED/ COPMED or the RCGP

 

Policy: 

 

The process for approval of GP ESs and Training Practices is described in the flow chart in Annex 1. The following notes give further detail of the various steps in the process.

 

1. Notwithstanding the ‘visit-light’ policy, visits are undertaken for new training practices and when triggered by concerns, significant changes in the practice or at the discretion of the regional GP QM Group.

2. The regional GP QM Group normally meets at least twice per year.

3. The regional GP QM Group comes to a decision on whether the practice requires a visit. If no visit is required, the regional QM Group undertakes a ‘virtual visit’ and makes recommendations to the sQMG in relation to length and conditions of approval.

4. In coming to these decisions and recommendations the material for the ‘virtual visit’ will include the Educational Supervisor’s self-assessment documentation triangulated with trainee performance data, trainee feedback, ES performance (e.g. quality of Educational Supervisor Reports, engagement with faculty development activities), TPD input and any other available intelligence.

5. If a visit is required, a visiting team with a minimum of two people visit the practice. The team is led by an experienced member of the deanery’s GP team supported by another member of the team or an ES. Where possible a lay member will be included. The West of Scotland has modelled good practice of including a trained Practice Manager in addition to this described core visiting team.

6. The resulting visit report then becomes part of the data considered by the regional GP QM Group in making its recommendations to the sQMG.

7. A single agreed set of documentation supports this process, including:

i. Process 

§ Scotland Deanery SPESC Eligibility Process

§ Scottish GP Educational Supervisor First Approval Process

§ Scottish GP Training Practice First Approval Process 

ii. Application Forms

§ Scottish GP Educational Supervisor Accreditation Application

§ Scottish GP Training Practice Accreditation Application 

iii. Reports

§ Scottish GP ES & TP Accreditation Application Virtual Visit Report

§ Scottish GP ES & TP Accreditation Application Visit Report 

8. Re-approval of ESs is for a maximum of three years but may be for a shorter duration dependent on the recommendations that are made.

9. Approval of a new ES in a new training practice involves a visit and is for a maximum of two years. 

10. A re-approval visit is the norm for a new ES in a new training practice within two years of first approval. Assuming that there are no conditions arising from this first re-approval, the period of re-approval is for three years. The process for subsequent re-approval is as described in paragraphs 1-6 above.

11. Approval of a new ES in an existing training practice involves a meeting or a visit and is for a maximum of two years. The process for subsequent re-approval is as described in paragraphs 1-6 above.

12. For all new ESs (in new or pre-existing training practices) the deanery provides interim support mechanisms that include revisit, allocation of a mentor or a TPD interview, which feed into the re-approval process. 

13. The process for an ES to appeal against a decision made with respect to approval/ re-approval is described in Annex 2. 

 

Conclusion: 

 

This paper describes a refresh of the single national process for GP ES and Training Practice approval, agreed in December 2012.


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