General Practice Longitudinal Integrated Foundation Training (GP LIFT) - What is LIFT?

The Longitudinal Integrated Foundation Training (LIFT) model aims to improve clinical progress and patient-centred practice, as well as the quality of the educational experience. Instead of receiving one 4-month block of general practice training as Foundation Year 2 trainees, LIFT trainees experience two sessions per week (1 day) in general practice throughout their two years of Foundation training.

This runs alongside 4 days each week in the traditional 4-month hospital block placements, experiencing 6 other placements across the 2-year training programme. The general practitioner supervising the trainee will be the Educational Supervisor for the whole two years of training.

Application Process: 

The LIFT programme now falls under the Foundation Priority Programme (FPP) vacancy. Further information on FPP vacancies and the application process can be found on the UKFPO website, a link to which is available here: https://foundationprogramme.nhs.uk/programmes/2-year-foundation-programme/foundation-priority-programme/. 

What do trainees think?

Our former and current LIFT Representatives have summarised their experiences on the LIFT programme in a few words below: 

 “An unexpected benefit of the programme is that you get to keep your educational supervisor for the whole two years. Working with your mentor for two years is a world away from working with them once, which is what peers on the standard Foundation Programme have sometimes found. Learning in parallel also gives you the opportunity to apply what you’ve learn in GP to the hospital setting and vice versa”.

“The LIFT programme is a fantastic way of experiencing GP whilst not taking away from acute hospital placement. It gives you a fresh perspective on patient care where some of your non GP LIFT colleagues may not appreciate this and allows you to develop yourself as a more independent clinician”.

“The GP LIFT programme has been integral to my training and development as a foundation year doctor.  The integration with general practice has supported me both professionally and personally to develop skills that will be useful for whatever specialty I choose to go in to. The teamwork, support and fun has been invaluable. This has been a true training post and I cannot recommend the experience enough."

What do trainers think?

Supervisors consider LIFT trainees at FY2 to be “more aware of the patient journey” and “the primary and secondary care interface” than their counterparts who are following the traditional training route. They continue to have “surpassed expectations”, possessing superior consultation and communication skills, greater understanding of medical conditions from their early development and treatment by GPs through to acute stages requiring specialist care in the hospital environment, “excellent” clinical knowledge, are more able to treat patients “holistically”, and excel at providing essential referral and hospital discharge information. They are generally “more autonomous than a traditional FY2”. 

“….. [they have] reached a level of independence so to speak, that we would not normally see from our foundation trainees in the old scheme…..” 

LIFT trainees now additionally have a better understanding of the roles of the wider GP practice team than others. They are aware of their colleagues’ “strengths” and when it is useful to involve them in patient care. This can include the nurses, physiotherapists, and health visitors amongst others. The team gives pastoral support as well as their supervisor(s), having now “got to know them well”, developed friendships, and often formed social as well as working relationships with colleagues. 

What are the benefits and challenges of the LIFT programme?

Benefits

• Richer understanding of relationship between primary and secondary care

• Increased number of specialties, a ‘bonus’ rotation giving greater exposure to the healthcare system

• A form of continuity and stability throughout the 2-year programme that non-LIFT trainees do not get in the same way

Challenges

• Rota coordination can be difficult to organise, especially in the early days. Better communication between Trust and Practice is being implemented to help with this issue

• Acute trusts can feel that they are losing manpower in F1 but the rotations chosen allow them to gain manpower in F2

Summary

This is a novel programme aimed at trainees planning a career in general practice. It gives trainees benefits in terms of longitudinal experience in general practice and maintains the other skills gained in Foundation training. For further insight into the structure of the LIFT programme, our 2020-21 LIFT Trainee Representatives have put together an extremely helpful LIFT Trainee Handbook.
The handbook offers advice for future and current LIFT trainees and can be used as a point of reference for how the programme works and how to deal with any issues LIFT trainees may face. The handbook is attached at the bottom of this page.