AUGUST 2013 - New Zealand Doctor

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RNZCGP Review of the delivery of general practice vocational training August 2013BackgroundProject scopeThe College is the New Zealand training and education body for general practice and providesspecialist medical training and education programmes enabling vocational registration with theMCNZ as a GP.Training is provided by medical educators, teachers and practices under contract to the College.Training delivery is funded by the Crown through a contract to HWNZ, an agency of the Ministry ofHealth. The College and HWNZ are constantly managing the balance between operational efficiencyand vocational efficacy.GP training schemes began in New Zealand in the 1960s in Southland and Lower Hutt, and theCollege has delivered general practice training and assessment since the formal inception ofa national training programme in 1974. Since then there have been many changes including aminimum formal patient contact level set in 1982, a 36 day ‘day release’ scheme in 1984 and majorfunding cuts in the 1990s.Since 2004, registrar training has been encapsulated within GPEP which is the standard pathway toFellowship of the College and vocational registration as a GP in New Zealand.In July 2012, the College provided HWNZ with a Proposal for the management of employment and/or provision of administration services related to the employment of GPEP Year 1 registrars. TheCollege initiated the TDR as part of this agreement in order to ensure there was a vocational trainingprogramme for general practitioners, delivered in a sustainable way, that would meet the futureneeds of trainees and the profession as a whole.To that extent, the TDR is the next step in the evolution of GP training delivery in New Zealand.The project scope was documented in a Terms of Reference which determined three keydeliverables:• Review of the training delivery model and operations of the College;• Identify future state options for training delivery and operations; and• Agree options and make a recommendation to the College Board.The project scope excluded any review of the College curriculum, regulations or strategy.Three key themes1. There is a requirement for greater equity across all facets of training delivery and funding.Training delivery should be more equitably spread across all three years and utilise a bettercombination of the various methods of education delivery. Costs of training should be moreequitably spread across the stakeholders - those who provide training, those who receive trainingand those who are potentially advantaged by having registrars.2. There is a growing need for more, and closer, relationships between health care educationproviders, including medical schools, DHBs, primary health organisations (PHOs), othercommunity-based vocational scope trainers and the College.3. Some of the consultation options could potentially move straight to implementation, howevermany are more complex and require detailed feasibility and design work to be done priorto implementation. Funding is required for subsequent phases of work which may be bestapproached within the framework of an implementation project.8
RNZCGP Review of the delivery of general practice vocational training August 2013Project principlesParameters• Having a focus on 2025, including the future of (primary) health care needs and delivery, andensuring that training is congruent with future trends.• Researching how other programmes evaluated themselves, noting measures of effectiveness andefficiency.• Recognising the growing mobility of the workforce.• Recognising the need for more collaboration with partners.• Recognising that training begins at PGY1, not PGY3+.• Ensuring sustainability of general practice.• Recognising “best practice”.• Ensuring accountability of GPs in terms of their professional obligations to patients, to the sectorand to funders.The TDR set out to look at:• how the College’s training delivery measured up against similar programmes;• the use of technology in delivering educational programmes;• the best way to meet learning requirements of GP registrars; and• deliver a programme that met the future needs of vocational general practice.The review was undertaken by a project team comprising College staff and key stakeholders andincluded a stakeholder engagement programme to ensure the views of all sections of generalpractice that had an interest in training delivery were consulted.Project objectives• Review the effectiveness and efficiency of programme delivery against similar programmes.• Investigate innovative delivery models, including better use of information and communicationtechnology (ICT) and approaches used in other sectors.• Ensure that the College business model, management and methods for delivering training areoperationally cost effective and efficient.• Recommend innovations that will improve service delivery and/or reduce costs.• Ensure the model and/or recommendations for change acknowledge the needs of the vocationalpathway, education standards and learning requirements of GP registrars.• Ensure the needs and expectations of the various stakeholders of GP training are being met orareas for improvement are identified.9
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AUGUST 2013 - New Zealand Doctor

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