Trainees Experiencing Difficulties
All those GPStRs who are identified as having problems or indicators of potential future difficulty will be monitored either at Training Programme level or central School level depending on the level of concern. View the policies section to see the overall Health Education England Working Across Yorkshire and the Humber policy provides the formal framework that is followed. There is however specific guidance for the GP school.
The school policy follows a similar format to the generic Health Education Working Across Yorkshire and the Humber policy on the policies section, for managing performance concerns and falls within that policy, however it has been adapted to be more specific for the different challenges of the GP training programme. If a discrepancy arises, the overall Health Education England Working Across Yorkshire and the Humber policy is the one that should be followed.
For further support you can visit the Support for Doctors page on the Academy of Medical Royal Colleges website.
The School Lead is Dr Karen Bradley (please contact via GPSouth.yh@hee.nhs.uk)
The Locality Leads are:
Dr Elena Pamphilon - South Yorkshire (please contact via GPSouth.yh@hee.nhs.uk)
Dr John Featherstone - East and West Yorkshire (please contact via GPEast.yh@hee.nhs.uk)
Dr Natalie Hodgson - East and West Yorkshire (please contact via GPWest.yh@hee.nhs.uk)
Each Scheme has a nominated Performance Champion.
The GP school has written a short summary of the courses available for those who may benefit from them.
Trainees may have a variety of difficulties including sickness.
There are a range of support systems available within HEE:
These are resources that help identify particular problems with a trainee in difficulty.
One of the tools that most trainers find helpful is the RDM-p model which stands for:
- Relationship
- Diagnostics
- Management
- And professionalism
The RDM-p screening tool can help you identify trainees in difficult and the nature of that difficulty:
This is also the structure that the new Clinical Supervisors Report is based on and can be linked back to the GP trainee competencies that we are all familiar with.
SKIPE - Skills, Knowledge, Internal, Past, External.
Internal would include personality traits, attitudes, health issues.
Past would include previous educational experiences, medical training, upbringing culture.
External includes current stressors, such as family issues, long commutes, work environment.
I-SID (Identify, Share, Involve, Document) is a way of bringing all this information together, please see PowerPoint here.
There is a Supported Return to Training (SuppoRTT) programme for trainees that have had an absence from clinical work of more than three months.
If there are concerns raised that a new ST1 trainee is not performing at the required level, please use the attached flowchart and explanation on how to manage this situation.
Concerns may be raised within a GP practice or from hospital colleagues in a hospital post.
Please raise concerns with TPDs and the performance team.
AKT Revision and Exam Technique Guide
AKT Courses - Various options are available. Please discuss with your Performance TPD in the first instance.
Please see PowerPoints below:
Successful AKT preparation example - Dr Raj Dhaliwal, GP trainee
Click here for the NW England Consultation toolkit overview document and Consultation analysis tool to help you and your Trainer analyse and improve your GP consultation skills. Although these are stand alone pdf documents they contain the same valuable educational activities that are in the 14 Fish toolkit, for you to use as you identify tasks and skills you need to work on.
Global Skills
Structures consultation - red and green criteria and educational activities
Avoids repetition - red and green criteria and educational activities
Progresses through tasks - red and green criteria and educational activities
Finishes data gathering by 6 mins - red and green criteria and educational activities
Uses clear language - red and green criteria and educational activities
Remains responsive to the patient - red and green criteria and educational activities
Tasks
Opens consultation and explores problem - red and green criteria and educational activities
Discovers patient's psycho-social context - red and green criteria and educational activities
Identifies cues - red and green criteria and educational activities
Discovers patient’s ICE - red and green criteria and educational activities
Generates _ tests diagnostic hypotheses - red and green criteria and educational activities
Rules in _ out serious disease - red and green criteria and educational activities
Undertakes appropriate examination and tests - red and green criteria and educational activities
Makes a working diagnosis - red and green criteria and educational activities
Offers a safe patient centred management plan - red and green criteria and educational activities
Provides follow up_safety net - red and green criteria and educational activities
Interpersonal Skills
Generates rapport - red and green criteria and educational activities
Uses open questions appropriately - red and green criteria and educational activities
Clarifies and explores cues offered - red and green criteria and educational activities
Listens and shows curiosity - red and green criteria and educational activities
Uses closed questions appropriately - red and green criteria and educational activities
Verbalises thinking - red and green criteria and educational activities
Seeks informed consent - red and green criteria and educational activities
Verbalises diagnosis and rationale - red and green criteria and educational activities
Shares and uses ICE in plan - red and green criteria and educational activities
Negotiates and uses psycho-social information in plan - red and green criteria and educational activities
Supports in decision making - red and green criteria and educational activities
Please click here to access English Language Support
Please click here to access free neurodiversity screening provided by genius screening.
Here is the link to the Neurodiversity Pathway
Link below for Schools Neurodiversity Screening Policy including the Referral Process flowchart:
Schools Dyslexia Screening Policy
How Neurodiversity can be a hidden disability at work handout
The Academy of Medical Royal Colleges has developed a useful support page for doctors, click here to go to their website.
There is a specifically designed website for Nigerian GPs in the UK, click here.
A useful resource for trainees is our Social Integration page, it explains the ways of finding accommodation, taxes, transport and more, click here.
GP Educators should also hopefully find following documents relating to the identification and management of under performance useful:
RCGP Indicators of Under Performance Framework
RCGP Competence Areas (word pictures)
Occupational Health Referral template letter and additional information
Performance Team PowerPoint Resources (Intending Trainers & Experienced Trainers)
View further information in the Trainee section
