GP School Newsletter - South West Peninsula Deanery

N H S S O U T H O F E N G L A N D
GP School Newsletter
Issue 2
21st March 2012
Peninsula Deanery GPST4 Projects update
Following on from the item in the previous
issue we thought it would be
interesting to detail the specific projects
undertaken by our current
GPST4s. We have asked them to provide
an overview for inclusion with this
Issue outlining their Project focus
area:
Primary Care Workforce
Data and Planning
Project undertaken by Ben Titford
( based at Dartmouth Medical Practice).
A significant part of the Deanery's role
is in recruiting and training the GP
workforce. Historically throughout the
UK medical workforce planning has
been poor. Trainee numbers across
specialties have often been driven by
the need to fulfil secondary care service
commitments at trainee level.
There are many examples of career
bottle-necks, doctors re-training at a
late stage in their careers and conversely
of areas of significant workforce
shortages.
I am trying to improve the intelligence
with which we inform our regional
training and recruitment numbers and
strategy. I hope this may be of interest
outside the region.
My main focus is on numbers – I am
looking at the current primary care
workforce in terms of demographics,
work patterns and expected career
and retirement plans. For this I am
using existing data from a variety of
sources and conducting my own surveys
where detail is lacking.
From this work I hope to be able to:
1)Make recommendations to guide the
Deanery's primary care recruitment
numbers and training program.
2)Facilitate organisational changes
towards more intelligent and continuous
medical workforce planning, by
providing further illustration with regards
to the 'why' and 'how' – demonstrating
both the need and the means
to deliver this need.
3)Provide information to trainees on
likely career possibilities, pathways
and opportunities prospects in primary
care in Devon and Cornwall.
4)Provide some thoughts on how to
ensure General Practice remains an
attractive career choice, particularly
those components of General Practice
that are often less well thought of (GP
locum work, Out of Hours work).
Medically unexplained
symptoms.
Project undertaken by
Isobel Moncaster (based at
Ivybridge Health Centre).
The aim of my work this year is to
raise awareness, recognition and
management of patients with medically
unexplained symptoms by the
healthcare professionals in the local
area. This should improve patient care
quality, encourage appropriate NHS
resource use, and hence both increase
quality and reduce cost of
management of this key patient group.
The project involves many different
strands including work with the symptom
management clinic in GP practices
in the South Devon area, involvement
with the South Devon map of
medicine pathway planning group,
pilot studies run at Ivybridge Health
Centre, surveying of GP attitudes in
the South Hams and West Devon
area, and education sessions given to
GP trainees and newly qualified GPs.
Dates for your diary
Inside this issue:
GPST4 Projects update
cont’d
New TPDs/GP Recruitment
2012 update
LTFTT assessment change 3
GPST Maternity benefits 4
2
3
New Trainers Course - 25 & 26 April and 20 & 21
June 2012 Ilsington, Devon
Advanced Trainers Course 10 & 11 May 2012,
Dartington Hall, Devon
Finishers Day—15 June 2012, Exeter Racecourse.
UKCEA Conf , Durham, 19th and 20th September
2012

GP Newsletter March 2012 Issue 2.
Peninsula Deanery GPST4 Projects update cont’d
‘Teen Bodies’ Project
Project undertaken by Grace Butler,
ST4 (based at Wheal Northey,
St Austell).
My ST4 Project aim is to reduce
teenage pregnancy and promote
healthy living for young people in
Cornwall. I propose to run a pilot
project in the St Austell area where I
will be performing final year health
checks accompanied by a careers
advice interview in the four secondary
schools.
Statistics from the Teenage Pregnancy
Strategy Report 2011 indicate
that under 18 conception rates in
Cornwall are on the increase with a
predicted rate of approximately 34
per 1000 / 320 conceptions per
year. The majority of teenage pregnancies
are unplanned and this is
reflected in the fact that approximately
half result in termination.
Teenage pregnancy is a cause of
both health inequality and child poverty.
It is well recognised that teenage
pregnancy is linked to risk taking
behaviours and poor aspirations.
An holistic approach is needed to
look globally at teenage health issues
encompassing their physical,
psychological and emotional wellbeing;
along with advice regarding
future aspirations and life goals. An
individual health check is an opportunity
for targeted intervention. Topics
to be addressed include sexual
health and contraception; smoking,
alcohol and drug taking; mood and
emotional well-being; BMI. The service
will aim to signpost and educate
in order to raise awareness of local
‘young people friendly’ services and
hopefully break down some of the
barriers to teenagers accessing
health care. The final school year is
the last opportunity to gather all
young people together in an institutionalised
setting and offer them
advice and guidance on positive life
choices.
The success of the project will be
measured by a pre and post questionnaire
relating to awareness and
use of local services. If the outcome
is favourable, I propose the service
is commissioned by School Nurses
to be carried out across Cornwall.
Dementia
Project undertaken by Paula Marrett,
ST4 (based at Fowey River
Practice).
The focus of my ST4 year is Dementia.
This chronic progressive
neurodegenerative disease is increasingly
becoming a major health
problem. At this time of great
change in general practice I can be
a part of designing the services of
the future which is allowing me to
develop specialist skills in dementia,
organization and leadership.
I have been lucky enough to join a
fantastic team in Cornwall – we
have been working towards establishing
an innovative way to support
dementia patients, firmly seated in
primary care. We are piloting an
Advanced Care Plan for those patients
who have lost capacity for End
of Life decisions. The aim is to provide
the primary care team with a
toolkit that assists and supports the
legal framework for decision making
in patients who are unable to make
these decisions for themselves. Not
only being good practice but we
have seen a 55% reduction in admissions
to the acute setting from
the Nursing homes in the pilot.
I have also begun to hold practice
based dementia seminars. The
seminars are centred around the
National Dementia Strategy encouraging
a good quality early diagnosis
and interventions for all. I hope to
improve the diagnosis rate in Cornwall.
Strategic Level Integration Project undertaken by Jim Forrer, ST4 (based at Claremont Medical Practice,
Exmouth).
As the population of older diabetic, obese, demented patients increases it seems reasonable to infer that the provision
of adequate to excellent health care will become a more complex effort. An intuitively appealing strategy for tackling this
challenge is to improve the way the health and social realms interact at the level of individual providers with the support
of strategy level integration. This has been lauded for many years and 'core groups' or 'complex care teams' are a
manifestation of this idea.
Please can you let me have any items for September’s GP Newsletter by
mid August 2012 (latest )
trish.trim@southwest.nhs.uk
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G P S CHOOL NEWS LE TT ER M AR 20 1 2

New TPDs appointed for Exeter and North Devon patches
The Deanery has recently appointed new Training Programme Directors for both the Exeter and North Devon schemes.
We would like to welcome Nicola Relph and Stuart Perrin to North Devon VTS and John Fox to Exeter VTS.
GP Recruitment 2012 update
99 candidates at the recent South West Peninsula Deanery Selection Assessment Centre demonstrated competencies
that gave them eligibility to be offered a GP Training Scheme in the UK. Of the 86 vacancies across the schemes in the
SWP Deanery area 84 have accepted a place on a scheme, with the 2 remaining candidates currently holding their offer
. The remainder of the ‘Demonstrated’ candidates will go into Round One clearing for any outstanding vacancies
around the UK.. Thank you to all those Trainers who participated in the Selection process.
Less Than Fulltime Trainees are permitted fewer assessments
per calendar year
Less than full time (LTFT) trainees will no longer have to complete the same number of workplace based assessments a
year for their annual review of competency progression as their full time colleagues, the General Medical Council has
announced.
The GMC has published interim guidance stating that LTFT trainees will be able to collect evidence for their educational
reviews on a pro rata rather than an annual basis.
At present LTFT trainees have to complete the same amount of workplace based assessments over a 12 month period
as their full time peers to demonstrate progress at an annual review of competency progression. This scenario places an
unreasonable burden on LTFT trainees and could lead to assessment taking up a disproportionate amount of the
learning time available, the GMC has said.
The new approach means that LTFT trainees will continue to collect the same amount of evidence as full time trainees
but over a longer period of time proportionate to the time they spend in training. For example, a LTFT trainee working at
50% of whole time in a three year training programme would have their workplace based assessments spread over six
years.
LTFT trainees will continue to have educational reviews at least once a year but will be judged on their global
performance. Workplace based assessments will be used for a “gateway” annual review to confirm progression into
another year of training once enough assessments have been accumulated to support progression.
The Royal College of General Practitioners has welcomed the ruling, which it says is a fairer approach for LTFT trainees.
The GP School and particularly the GP Dean, Dr Julia Oxenbury, have
been actively working together with Devon Docs to have the
Educational Supervisors payments for supervision of GP Trainees
undertaking OOH sessions reinstated since they were withdrawn in
2011. We are happy to announce that NHS Devon has now agreed to
reinstate the payments with immediate effect.
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GP S CHOOL NEWS LE TT ER M AR 20 1 2

Maternity Benefits available to GPSTs and the new Pay2 form
A brief overview
If a trainee becomes pregnant during
their training and requires maternity
leave they could be entitled to
Occupational Maternity Pay plus
Statutory Maternity Pay or Maternity
Allowance. Specific entitlements
are subject to criteria being met and
will differ slightly from person to person.
Whilst in a hospital post a GP
trainee will be employed by an NHS
trust and this usually, though not
always, makes maternity entitlements
rather more straightforward.
The situation is different if a
trainee is in a GP training practice.
Whilst employed by a GP training
practice GPSTs are not employed
by the NHS but employed by a contractor
with the NHS.
Statutory Maternity
Pay (SMP)
A trainee can get SMP for up to 39
weeks during maternity leave. To
qualify a GP trainee must have been
employed by the same employer
continuously for at least 26 weeks
into the 15th week before the week
of the estimated date of delivery
(EDD). The same employer is the
same hospital trust or GP training
practice. If a GP trainee moves hospital
trust, or to a new training practice
they will lose the right to SMP,
but could still qualify for Maternity
Allowance instead.
Maternity Allowance
To qualify for maternity allowance a
trainee must have been employed
(any employer) in at least 26 weeks
out of the 66 week period running
into the week before the EDD.
Occupational
Maternity Pay
A GP Trainee employer will pay
“occupational maternity” pay for a
number of months during maternity
leave as indicated by the contract.
The income from any SMP
and maternity allowance is deducted
from any occupational maternity pay
but as occupational maternity pay
reduces over a number of months
ISS U E 2
the income from SMP or MA will be
more important. To qualify for occupational
pay the GP Trainee must
have been employed in the NHS
continuously for 12 months AND
must reach the 11th week before
EDD with that employer. General
practice posts now qualify as NHS
posts for the purposes of qualifying
for occupational maternity pay. But
this may not apply after training as a
salaried GP. Useful link:
http://www.bma.org.uk/images/
maternityleaveguidance2011_tcm41-204992.pdf
(N.B. see paragraph 2.9.3 specifically)
Keeping in touch
During maternity leave it is often
helpful to keep in touch with your
employer and the employer is entitled
to make reasonable contact with
trainees during Statutory Maternity
Leave. This might be for e.g. trainees
to meet with their educational
supervisor.
Up to ten days can be worked during
Statutory Maternity Leave without
losing Statutory Maternity Pay,
Maternity Allowance or ending maternity
leave. These are called keeping
in touch days - and may only be
worked if both the trainee and the
employer agree. Trainees cannot
work during compulsory maternity
leave which is the two weeks immediately
after the child is
born. Although particularly useful for
things such as training or team
events, keeping in touch days may
be used for any form of work. They
should make it easier for the trainee
to return to work after maternity
leave. Trainees will need to agree
with their employer what work is to
be done on keeping in touch days
and how much pay they will receive.
Introduction of new
Pay2 Form
We have recently introduced a new
Pay2 form, to be used in conjunction
with the Appointment form (Pay1) . If
a GPST experiences a change in
circumstance that requires them to
take time out of the programme
whilst in a GP Practice placement
for e.g. Maternity or Paternity Leave,
the trainee, Practice Manager and
Educational Supervisor complete a
Pay2 form stating the dates that the
Trainee will be absent from the
Practice. The form is then authorised
by the Deanery and sent to the
relevant PSSA/PCSA for their notification.
It is hoped that this will ensure
that all parties that need this
information are kept informed effectively
when there is a such change
in circumstance .
IDT Dates for
transfer Feb 2013
Just a reminder that the dates for
the next Inter Deanery Transfer window—February
2013 are as follows;
2012
Friday 20th July: Deadline for outgoing
deanery to receive IDT applications
from their trainees.
23rd July—3rd August: Outgoing
Deanery Panel held.
6th—10th August: Transferring
Deanery informs the receiving
Deaneries of applications that are
supported.
13th—24th August: Appeals window
for those trainees wishing to
appeal their Deanery’s decision.
27th Aug–10th Sept: PG Dean
considers Appeals.
10 Sept: Confirm outcome of appeal
to trainees (supported/not supported)
and potential receiving
Deaneries (if appeal upheld) .
11– 24 Sept: IDT IN Panel window.
25 – 28 Sept: Inform transferring
Deaneries of outcome.
24 – 28 Sept: notify trainees re
status of request to transfer in.
1 –12 Oct: Appeals process for
trainees who may wish to appeal
against Panel decision.
15-26 Oct: PG Dean to consider
Appeals received.
31 Oct: Appeal trainees and transferring
Deaneries informed of PG
Dean’s decision.
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