Out of Hours
The sections below provide information on Out of Hours (OOH) requirements and how these are met during your GP placements.
OOH is defined as work undertaken between 18.30-08.00 and all day at weekends and on public holidays. OOH is also taken to mean the type and style of working that takes place in this time. Ideally a mix of sessions should be experienced - evenings, weekends, overnights and Bank Holidays.
Note that extended hours working when patients attend on pre-booked appointments is not counted as OOH.
If a practice has a Saturday morning extended hours surgery, a limited number of these sessions may count towards OOH provided patients are attending purely on a 'drop in' basis, ie there are no pre-booked appointments. If there is a mix of 'drop in' and pre-booked appointments, this cannot count towards OOH.
For those practices opting-in to provision of OOH care, the trainer remains responsible for providing experience in OOH care. For those who have opted-out, this responsibility falls to the local OOH provider. In all cases, the trainer remains responsible for ensuring that there is sufficient evidence that the trainee has met the competency requirements.
Trainees must complete the equivalent of one OOH shift for each month of full time training in a GP post - this is considered the minimum requirement to achieve competency, however a GP trainer may determine that more shifts are required to demonstrate adequate competence.
Shifts must be evenly split between GP placements, ie minimum 6 shifts in a 6 months ST1 placement and minimum 12 shifts in a 12 months ST3 placement. Any shortfall in the ST1 GP placement must be made up in the ST3 GP placement.
The requirement for Less than Full Time (LTFT) Trainees is pro rata.
If you wish to - and the shifts are available - you can attend more than one shift in a month, you are not limited to doing a shift every calendar month.
The requirement in terms of hours is that on average over the duration of a GP placement, you must complete at least 4 hours of OOH per month - so at least 48 hours in a 12 month post and at least 24 hours in a 6 months post. As shifts with the Sheffield GP Collaborative vary in length, you must ensure that you select shifts which will enable you to achieve this and the administrators at the Collaborative will bear this in mind when reviewing your shift selection.
Please note that it is highly likely you will complete more than the 4 hours per minimum number as the requirement to complete one shift per month in GP is the priority.
Please also note that only shifts completed with OOH providers count towards your OOH requirement.
Induction sessions with OOH providers do not count towards your OOH total.
One shift in 6 months can be done at SCH ED with your trainer as alternative experience provided the session is after 6pm in the week or at weekends. It cannot be more than this. The usual feedback form will need to be completed by the supervisor. Please check with your MDO that any OOH shifts you complete at the SCH are covered.
After attending the induction session, trainees are provided with login details to access the online booking system and select OOH shifts. Selections have to be authorised by the Collaborative administrators who will e-mail to confirm whether or not the selected shifts have been approved. When selecting shifts, please refer to the Minimum Number of Shifts Required section above and the Levels of Competence section below.
Sheffield GP Collaborative
All practices in Sheffield use the Sheffield GP Collaborative for OOH.
Shifts range from 3 and 7 hours duration.
General Points
Please remember to contact the Collaborative by phone if you are unable to attend an allocated shift due to sick leave.
It is your responsibility to ensure that sufficient shifts have been booked to enable adequate evidence of competency.
Before you are able to attend OOH shifts with the Sheffield GP Collaborative you are required to provide evidence that you have completed Safeguarding Children training, Mental Capacity Act training, Basic Life Support and have a Hepatitis B Certificate. (Note - Safeguarding Children and Mental Capacity Act training may be covered in Sheffield GPSTP teaching sessions for trainees in hospital posts and attendance at these sessions is acceptable to the Collaborative). Alternatively, online training is available and you will be provided with details of these by the GPSTP office.
The evidence should be sent to the Collaborative at:
The GP Centre - Heli Pad Building next to A&E
Northern General Hospital
Herries Road
Sheffield
S5 7AU
or by e-mail to:
Induction Session
Bulk induction sessions will be arranged by the GPSTP Office early in your GP placement and you will be allocated to one of these. Note you cannot attend OOH sessions until you have attended an induction session and met the requirements outlined above.
Please note that when you return to GP for your ST3 year, you will be required to provide the evidence outlined above and also attend a refresher induction session prior to undertaking any OOH sessions. The induction session will be arranged for you by the GPSTP Office. You will resume OOH at the level acquired at the end of your first GP placement, unless advised otherwise by the scheme.
Weekend and Bank Holiday Shifts
Trainees in their first GP placements may only attend weekend/bank holiday shifts if they are accompanied by their own GP trainer - the type of work to be carried out is face to face consultations or home visits only. If you would like to attend a weekend shift with your trainer, please let the Collaborative know. ST1 GP trainees should therefore only select weekday evening shifts.
ST3 trainees need to attend weekend shifts to leave weekday shifts free for ST1 trainees.
Supervision of the GP trainee may be performed by the Trainer, a partner in the trainee´s practice, a trainer from another practice or a trained clinical supervisor.
Trainees will be asked to complete a 'Record of Supervision of Registrars' form with their trainer/supervisor after undertaking a training session at Collaborative. It is important that this form is completed so that the Collaborative obtains feedback on the training provided and also to generate the extra payment made to the trainer/supervisor. Please note the supervisor should not request a copy of this feedback from the trainee - if they do this, please refer them to Liz Eaton, Clinical Manager.
It is the Trainer's responsibility to determine the level of competence demonstrated by the trainee and notify the GPSTP Office if the trainee cannot follow the normal progression through Red, Amber and Green. Shifts allocated by the OOH providers with clinical supervisors other than the trainee's's own trainer will be based on normal progression as defined by the 'traffic light' system below:
- Red Shifts (Direct Supervision)
First 1-2 shifts/4 hours. The GP registrar is supervised directly by the clinical supervisor/trainer and takes no clinical responsibility. - Amber Shifts (Close Supervision)
Remaining ST1 shifts, first 6 months of ST3 shifts. The GP registrar consults independently but with the clinical supervisor close at hand i.e. supervisor to be available in the same building but would accompany the registrar on home visits. - Green Shifts (Remote Supervision)
Final 6 months of training, or earlier if the GP Trainer feels the trainee is able to progress to this level earlier. The GP trainee consults independently and remotely from the trainer/supervisor, who is available by telephone. This will include the GP trainee undertaking home visits independently with the clinical supervisor available for support by telephone.
GP trainees should record details of OOH shifts as a log entry in their ePortfolio and use the Worksheet available in the Downloads section below to record shifts which take place with a supervisor other than their trainer or other GP at the training practice who does not have access to your ePortfolio. This should then be uploaded to your ePortfolio. When adding an OOH shift/worksheet to your ePortfolio, please include the following:
- Date and duration of the shift
- Type of shift - telephone triage, visiting doctor, base doctor, etc.
- Number of patients seen
- A selection of the most interesting patients
- The significant learning points and link these to the Curriculum
Trainees are responsible for keeping a record of their experience, reflection and feedback in the 6 generic competency competencies, embedded within the RCGP Curriculum Statement on `Care of acutely ill people´. The evidence will be formally reviewed by the educational supervisor. The 6 competencies are defined as the:
- Ability to manage common medical, surgical and psychiatric emergencies in the out-of-hours setting.
- Understanding of the organisational aspects of NHS out of hours care.
- Ability to make appropriate referrals to hospitals and other professionals in the out-of-hours setting.
- Demonstration of communication skills required for out-of-hours care.
- Individual personal time and stress management.
- Maintenance of personal security and awareness and management of the security risks to others.
Please use the 'Record of OOH for ePortfolio' in the Downloads section below to keep a record of OOH shifts attended, including a running total of hours and the number of shifts. This document will automatically calculate the total number of hours completed. It should be regularly updated and uploaded to your ePortfolio to allow your trainer and educational supervisor to check your progress with OOH.
Trainees should carry normal medical equipment required for clinical examination.
