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Covid 19 Update

Video tutorials to support ST2/3 trainees approaching final exams - The Home Help Series

ARCP - updated 5/5/2020

AKT / CSA and the RCA (CSA temporary replacement) - updated 19th May 2020

Supervision

Support

Visas

Workplace Based Assessment Changes

 


Video tutorials to support ST2/3 trainees approaching final exams - The Home Help Series

Episode 1 -  About the changes afoot

Episode 2 - How to record remote video consultations, gaining consent remotely

Episode 3 - Analysing consultations in preparation for the RCA


ARCP

  • ST2s and ST3s ARCP dates will be 12 months from your last ARCP and should be detailed on your previous ARCP and the portfolio.
  • ST1s may not have been given an official date yet but they are usually in the last week of June and first 2 weeks of July.
  • You need to arrange your ESR not more than 8 weeks prior to your ARCP date. Get planning now with you educational supervisors. Educational supervisors, please ensure that you have created a new review period for your trainee.
  • ESRs are usually done face to face, however during the crisis using video chat is acceptable.
  • Please make a note on the ESR of how the meeting occured.
  • A new guide for ARCP process during covid was reelased on 31/3/2020 'Gold Guide Version 8'
  • The number of assessment required for work place based assessment has been reduced by 50% during the Covid 19 pandemic
  • Allowances will be made to ensure that disruptions to training whilst working flexibly to deliver care during the Covid 19 pandemic will not disadvantage trainees and their progression.
  • End of training is considered to be the single critical progression point in GP
  • Annual ARCP will continue but the panel can be reduced to 2 members (3 members for a 'non standard' outcome)
  • ARCPs will now be held online with a panel chair and 2-3 panel members. There will be no lay representative or observers and no external RCGP asessor
  • Online BLS certfiicates will be accepted during the Covid pandemic period due to lack of availablilty of face to face courses. The online certificate should mention automated external defibrillation (AED) OR the trainee shoujld add a reflective entry demonstrating an understanding of AED.
  • A refelective learning log entry for child level 3 safeguarding is not required during the e Covid 19 pandemic. 
  • Adult safeguarding changes are not being implemented i.e. adult safeguarding certificates and reflective entries will not be required at present.
  • CEPS (Cliinical Examination Procedures) - it may not be possible to demonstrate CEPS at present and therefore alternative evidence may be provided for those about to CCT. Acceptable are a CEPS reflective learning log entry and / or educational supervisor comments regarding competency in mandatory CEPS.
  • Evidence numbers
    • Item ST1 ST2 ST3
      CBD 3 3 6
      COT/miniCEX 3 3 6
      MSF 1 or LLE - 1 or LLE
      PSQ waived waived waived
      CSR 1 per post 1 per post 1 per post
      Logs As work permits As work permits As work permits
      QIP/Audit waived waived waived
      Form R required required required
      BLS Online accepted Online accepted Online accepted
      CEPS Some activity Some activity Mandatory CEPS
      Sig Event 1 for any event on form R 1 for any event on form R 1 for any event on form R
      Safeguarding  Online accepted Online accepted Online accepted
  • If AKT / CSA has not been passed but satisfactory work place based assessment present an outcome 10 will be issued. 'acquisition of some capabilities delayed by impact of Covid 19' There are two types of outcome 10. An Outcome 10.1 is issued for trainees not at the end of training and outcome 10.2 for trainees at end of training unable to CCT. nb if the work place based assessment is not satisfactory the relevant outcome is issued instead of an outcome 10.
  • Supplementry Outcome 10 codes
    • C1 - Trainee at cirtiical traiing progression point but not at CCT
    • C2 - Trainee at critical progression point but not at CCT and derrogation provided for the applicable element (not applicable to GP VTS)
    • C3 - Redployment could not acquire the required experience (trainee could not acquire appropriate curriculum related experience due to service changes)
    • C4 - Prolonged self isolation needed during Covid 19 preventing appropriate curriculum related experience.
    • C5 - Inadequate progress in this training year prior to covid 19. Trainee was not on course to receive an outcome 1 or 6 but given disruption an unsatisfactory outcome cannot be awarded.
    • C6 - Incomplete evidence due to Covid 19. Due to disruption incomplete information has been supplied and is available to the ARCP panel.e.g. trainee unable to obtain supervisor reports.
    • C7 - Foundation trainees
    • C8 - Royal college or faculty exam cancelled with trainee at CCT date. Trainee could not attempt the exam and will need to sit at the next available opportunity. 
    • C9 - Royal college or faculty mandatory training course cancelled with trainee at CCT date
    • C10 - not appliciable to GP trainees
    • C11 - not applicable to GP trainees
    • C12 - Other issue relating to Covid 19 - covers any issues not covered by cods C1-11
  • Additional information on the temporary changes for ARCP and training

  • Panels will be flexible and take into account the restrictions you face. You may find the Workplace Based Guidance during Covid 19
  • Frequently Asked Questions - updated 5/5/2020


AKT / CSA

Updated 19th May 2020

The Recorded Consultation Assessment will replace the CSA until further notice. The RCA will assess your ability to apply clinical, professional, communication and practical skills for general practice. You are being tested on the same competency and curriculum areas as tested by the CSA exam and to the same standard. i.e. can you practice safely and independently.

  • 13 recorded consultations are to be submitted from your current working environment
  • Consultations may be any combination of audio, video or face to face encounter and may include home working
  • Details on the submission process is to be released and trainees closest to date of CCT are being prioritised
  • For trainees sitting RCA before the 30th of September a fail at RCA will not be counted in your 4 allowed exam attempts to allow for the effect of disruption in training.

 

Information as of 28th April - RCGP Statement

The College has no direct control over either the training programme nor entry onto the GP Register, and so most of the decisions that need to be made do not fall within our gift alone. However, we are very involved in discussions and decision-making about this, as the standards of training, and the experience of trainees, are of paramount concern to us and we are keen to find a solution and to be part of managing this difficult situation in a way that supports trainees and protects patients.
 
The College is considering all possible options for managing the assessment of training, including expediting the required assessments, so that they can be delivered as soon as government social distancing restrictions allow, looking at ways that the MRCGP could be modified or adapted in order to reflect the realities of your current situation and the impact it has had on your training, and exploring what flexibility we can apply to the assessment of standards, while continuing to ensure patient safety.
 
We will be presenting these options to the other stakeholder organisations that are responsible for GP training and standards as part of our discussions to find a solution to the current training disruption. We have already made significant changes to Workplace Based Assessment which we hope will make this more manageable in the current climate and we are open to discussions about all possible routes to complete training provided that they maintain patient safety and offer suitable support for trainees. Not only is it our responsibility to consider implications for patient safety, but we also want to make sure that all newly qualified GPs have the skills, knowledge, experience and confidence they need to succeed and thrive as GPs and that the current, temporary disruption does not have any detrimental longer-term career impact.
 
Please be assured that this is a top priority for the College and that we hope to be able to reach a conclusion on these issues shortly, in a way that is as supportive to trainees as possible. We have involved trainee representatives in the discussion and decision-making process so far and will continue to do so, and are very conscious of the need for outcomes that will offer you security and protection for the future, both short and long term. We are joining key stakeholder organisations for a meeting tomorrow to try to find a solution to these complex problems and we hope that we will be able to update you and inform you of some real progress very soon following that meeting.

 


Frequently Asked Questions

 

 


Supervision

  • GP Trainees still need to be supervised at all times while they are working clinically.
  • The supervisor for an individual session will often be the Educational or Clinical Supervisor themselves, but as before, this responsibility can be delegated by the ES/CS to another doctor in the training practice. If the trainee is working on another site, this should ideally be with their usual ES/CS. If this is not possible trainees should at all times be able to access a qualified GP (in person, or via telephone and/or video link) who is a trained clinical supervisor (ES/CS or OOH CS).
  • Depending on the experience of the trainee, supervision can be either direct supervision (in the room), near supervision (in the building) or remote supervision (on the phone).
  • The level of supervision required must be discussed with the trainee and should match their experience of working in that type of session. Trainees who can work under near supervision for face-to-face consulting may need direct supervision as they learn how to consult remotely. This may involve conducting some joint telephone surgeries until the trainee is ready to work under near supervision.
  • Undertaking consultations with remote supervision should normally only be used for more experienced trainees. The trainee should agree that they are ready before moving to working under remote supervision. Trainees should not be lone working as the only doctor on site in a GP surgery, or in any alternative setting.
  • The Covid-19 pandemic is throwing up some new contexts for supervision:
  • Trainees working remotely due to self-isolation or shielding. Trainees undertaking telephone consulting or other remote clinical working (processing patient results, etc) should normally have contact with their supervisors at the beginning of each session (to confirm arrangements and check availability), and at the end for debriefing. A supervisor should be available at all times during the session to help them with queries.
  • Trainees working in Covid-19 hubs will need appropriate induction and training before working in this environment.
  • Trainees working in alternative settings. Sometimes, as a result of local service pressures, trainees will be pulled into working in training environments which are not currently GMC approved training sites. This is acceptable, but please follow the guidance in Appendix A

Appendix A

  • In responding to the Covid-19 pandemic, the local healthcare system may require GPSTs currently based in GP practices to provide care in new and emerging community settings (e.g. Covid Response Hubs) or practices not currently approved as GP Training learning environments.   
      
    The nature of the pandemic and required response means flexibility and pragmatism are key, so such work should be facilitated where the following are taken into account.   
      
    •    Prior to undertaking such work, GPSTs require the support and agreement of their Employer, Clinical and Educational Supervisors, and Primary Care Dean or nominated deputy  
    •    All activities should be subject to the usual risk assessments of the service host including the provision of all necessary recommended equipment  
    •    GPSTs should not work above their contracted hours without their and their employer’s agreement  
    •    GPSTs shouldn’t work more than two sessions per week in this alternative setting, without the approval of the Primary Care Dean  
    •    Wherever possible, trainees should work alongside one of their current supervisors  
    •    There should still be protected time for breaks and rest in line with the Junior Doctors Contract  
    •    Supervision is of vital importance. At all times, trainees should be able to access a qualified GP (in person, or via telephone and/or video link) who is a trained clinical supervisor  
    •    A trained clinical supervisor is someone who is an existing GP or Foundation trainer, OOH GP training supervisor, or who can provide evidence of training in clinical supervision e.g. supervisor on the NHSE/PCN pharmacy programme  
     

Support

  • Formal Tutorial time and HDRC teaching have been suspended during the current pandemic. A full-time trainee can be based in the practice for 10 clinical sessions. Guidance is still in preparation on the current requirements for WPBA.
  • However these 10 sessions should still normally include (inside the usual 40 hour working week) an opportunity for supervision and debriefing after each session with the supervisor for that session. The balance of clinical/admin time in each session should remain at 3:1, as before.
  • Time should also be set aside each week (again, inside the 40 hour working week) for a fuller debriefing on the week with the supervisor. This should include discussion of challenging patients/scenarios and exploring the trainee’s responses to working in new ways and under an increased workload pressure.
  • These 10 sessions should include the time that trainees need to spend in acquiring new knowledge and skills to practise safely during the Covid-19 pandemic, e.g. accessing telephone consulting training material.
  • Local GP Programmes are organising virtual group work, using Skype or similar, usually on Tuesday or Thursday when the HDRC was running. Trainees tell us this is a really valuable opportunity for peer support, so supervisors should make every effort to release trainees for these times when clinical pressures allow.
  • Support is still available to trainees in their local programme via their TPDs. HEE is also recruiting recently-retired GP educators to provide additional support in case TPDs need to devote more time to their clinical work as a result of workload pressures.
  • If a trainee is struggling and needs additional support beyond what is immediately available then contact the programme Associate Dean for advice. The local HEE PSW team are also still available to provide additional support.

 


Visas

  • Because of coronavirus (COVID-19), some NHS workers and their families will have their visas automatically extended for 1 year. To get the extension, you must:work for the NHS as a doctor, nurse or paramedic have a work visa that’s due to expire before 1 October 2020.
  • The extension will apply from the date your visa is due to expire.
  • UK Visas and Immigration (UKVI) will contact your employer to confirm your visa has been extended.

 


Workplace Based Assessment Changes

Guidance on the changes to workplace based assessment are shown here

 

 

 

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