Our aim is to provide you with an overview of 12 areas of training for practice staff and help you to stay on top of training demands.
Mandatory and statutory training for clinical staff
In some cases, what is described as mandatory or statutory training may not actually be the case. To help practices identify what training is required the following information should help.
It is good practice to ensure that practices are aware of guidance on training in cervical smear taking. CCGs may wish to monitor the quality of cytology services and take action if this reveals evidence of any shortcomings in quality.
There are, however, no contractual grounds for requiring GPs to undertake update training, unless this is expressly agreed as part of local PMS or APMS contractual arrangements.
The NHS cervical screening programme recommends that all practitioners taking cervical smear samples should undertake a minimum of a half day training programme every three years to ensure they are up to date with both the programme and the method of smear taking.
There are no mandatory requirements for performing spirometry.
Some practitioners who perform or interpret diagnostic spirometry in general practice may choose to be on the National Register.
This demonstrates they have achieved the standard of practice set out by the Association for Respiratory Technology and Physiology (ARTP).
CQC expects practices to be able to demonstrate that all staff who perform spirometry tests or interpret results are competent.
They can demonstrate this if the relevant staff members are on the National Register, but may choose to present other evidence.
Practices could be asked by CQC to demonstrate training for clinical staff linked to their specific clinical responsibilities.
For nursing staff, for example, this could be taking samples for the cervical screening programme, administering vaccines and for extended roles in treating minor illness and long-term conditions.
It is for the practice to determine how they demonstrate that their staff have the necessary skills to perform the activities asked of them.
Minor surgery is defined in the GP contract as 'curettage and cautery and, in relation to warts, verrucae and other skin lesions, cryocautery'.
There are no mandatory training requirements for performing minor surgery. It is up to the practice to determine the training required to meet the needs of their patients.
RCGPLearning provides minor surgery courses and the RCGP minor surgery page has links to NICE and NHS published guidance for the management of skin cancer and for the different levels of skills required.
Safeguarding vulnerable children
Safeguarding vulnerable adults
Mental capacity act and deprivation of liberty safeguards
Basic life support
All staff should understand their role as part of the team response to resuscitation. The CQC does not have explicit guidance around emergency equipment but has produced agreed principles and encourages practices to have defibrillators.
Who should do it?
All staff, including non-clinical, should undergo regular training in adult and child resuscitation appropriate to their position.
How and when it should be completed
Basic Life Support training encompasses knowledge and practical skills. Annual updates are encouraged, although not mandatory. A variety of methods can be arranged to plan and deliver these flexibly, in line with the needs of clinical staff and practices.
Clinical staff should be able to:
- recognise cardio-respiratory arrest
- call for help and start CPR with defibrillation as appropriate
- receive regular training updates at an appropriate frequency to maintain their competency
- retain documentary evidence of completed and approved CPR training.
Infection control
All GP practices are required to assess the risk of, and prevent, detect and control the spread of infections.
Following the code of practice on prevention and control of healthcare associated infection, issued by the Department of Health, the law says that the CQC must take the code into account when making decisions about registration.
By following the code, practices will be able to show how they are meeting their requirements. However, you may be able to demonstrate in a different way (equivalent or better) from that described in the code.
Who should do it?
Clinical staff and all relevant staff whose normal duties are directly or indirectly concerned with providing care.
How it should be completed
Face to face or e-learning.
Fire safety
In most healthcare premises, written instructions should be provided to your staff who have been nominated to carry out a designed safety task, such as calling the fire and rescue service or checking that exit doors are available for use at the start of each shift.
Fire action notices where used should be posted in prominent locations.
Who should do it?
All staff should complete fire safety training and be given instructions and information as soon as possible after they are appointed and regularly after that. It’s important to include staff who work outside of normal working hours, such as contract cleaners or maintenance staff. See more guidance from the Health and Safety Executive.
How it should be completed
Face to face combined with e-learning. E-learning on its own is not sufficient as it won’t take into account individual circumstances.
Information and instructions should be given in a form that can be used and understood. They should take account of those with disabilities such as hearing or sight impairment, those with learning difficulties or those who do not use English as their first language.
Practice staff should be able to:
- know what to do if there is a fire
- understand the measures that have been put in place to reduce the risk of fire
- identify the people who have been nominated with responsibilities for fire safety
- understand what the fire protection arrangements are including: the designated escape routes, location and operation of the fire-warning system and any fire-safety equipment required.
Health and safety
The Health and Safety at Work Act 1974 requires you to provide whatever information, instruction and training and supervision necessary to ensure, so far is reasonably practicable, the health and safety of your employees at work.
Who should do it?
All staff.
How it should be completed
Face to face or e-learning combined with face to face. E-learning alone will not cover local arrangements.
Manual handling
Employers have a legal obligation under the Manual Handling Operations Regulations 1992 to make a suitable and sufficient assessment of the risk to employees from manual handling.
Who should do it?
This is dependent on the tasks undertaken by staff.
How it should be completed
Face to face or e-learning.
First aid
The training and experience of a GMC registered and licensed doctor, or a NMC registered nurse, qualifies them to administer first aid in the workplace.
This means there is no need for other staff to hold a First Aid at Work / Emergency First Aid at Work, or equivalent qualification.
Training for employed and self-employed GPs
When training should be carried out and fees
- Training which practices / employers insist is compulsory should always be carried out within paid work time should always be carried out within paid work time.
- For employed GPs this should occur within their contracted hours and should not come from their CPD allowance.
- GPs who have their rates set by the organisation under zero hours contracts, for example doing urgent care or out-of-hour work, should insist on being paid for each hour of “mandatory” training that is specific to that role.
- Where mandatory training requirements are changed and GPs have used their paid training allowance, sufficient time must be allowed for them to accrue further paid time for training or additional paid time must be given to them.
Avoiding training duplication and recognising training from other platforms
- Practices and other primary care services that contract sessional GPs should ensure that they are not putting GPs under pressure to duplicate training.
- While an employer may offer their free training through a particular training platform, a GP may have covered the content of a training module and be certified via another platform, particularly if they work in more than one service. Employers should maintain an up-to-date list of training providers or platforms which provide certification that is equivalent to their own training platform.
- Employers should also take into consideration that new training platforms are frequently being developed and that GPs may have carried out appropriate training on a platform that is yet to be added to their list. In this scenario, GPs may be able to demonstrate that they are already compliant, and the practice / employer should update their platform list accordingly.
Professional responsibility and avoiding excessive mandatory training
- When a practice or other employer is considering adding to their list of training for practice staff and contractors, it is important that they consult with their GPs to sense check the proposals and ensure the training is both necessary and relevant to their roles. Keep in mind that unnecessary training can be a factor in poor workforce retention.
- GPs have a professional responsibility to follow and remain compliant with the practice / employer’s policies and processes, regardless of any training that an employer has in place. GPs are also obliged to keep abreast of broader developments in the NHS, their specialty, and the college.
- Instead of initiating a new mandatory training programme, it may be more appropriate and less time-consuming to ask GPs to sign a statement of responsibility to follow practice / employer procedures. Providing access to guidance and standard operating procedures is often an effective alternative to training. For example, a statement of agreement to follow infection and control procedures, or to follow policies on non-discrimination, could serve the same organisational purpose as recording time spent on e-learning training.
- The practice / employer should operate a process for GPs to appeal against the imposition of mandatory training.
CQC and GMC viewpoints
CQC
- The CQC does not have a list of mandatory training for members of the GP practice team.
- Advises that the exact training requirements is dependent on the role and specific responsibilities of each practice and the needs of the people using the service.
- Advises that ultimately the practice is responsible for determining what training staff need to meet the needs of their patients.
- Practice must have sufficient numbers of suitably qualified, competent, skilled and experienced staff to meet the needs of the people using the service at all times.
What do the CQC look at when carrying out an inspection?
- Whether staff have the right qualifications, skills and knowledge and experience to do their job.
- How the practice identifies the learning needs of staff.
- Whether they have appropriate training to meet the learning needs of staff and to cover the scope of their work.
- Read more in CQC guidance on staffing.
GMC
The GMC’s Good Medical Practice sets out the following:
- places a duty on doctors to keep their knowledge and skills up to date by regularly taking part in activities that maintain and develop their competence and performance
- the GMC does not tell doctors what continuing professional development (CPD), or how much CPD, is right for them
- doctors will need to judge how best to apply the principles of the GMC’s guidance to their own practice and professional development
- doctors must consider their CPD needs across the whole of their professional practice. This includes both the clinical and the non-clinical aspects of practice, and any management, research, and teaching or training responsibilities they have.