A GP is an expert generalist post-certificate of completion of training doctor who provides direct patient care to people presenting to primary medical services. There are additional responsibilities GPs may agree to undertake in the course of their careers, including the supervision of other roles, training or as a contract holder, to name just a few.

With the expansion of ARRS (additional roles reimbursement scheme) roles (including MAPs [medical associate professionals]) in primary care in England, and the diversification of the workforce, GPs have seen a dramatic increase in supervision responsibilities expected of them.

This guidance from the sessional GPs committee outlines BMA advice to sessional GPs regarding the supervision of MDT (multidisciplinary team)/ARRS roles.

• Provision of supervision for MDT/ARRS roles is the responsibility of the employer. With the personal liabilities and the potential risks to a GP’s professional licence that come with such responsibilities the clinical supervision of MDT/ARRS roles remains the responsibility of the employer. Supervision should not be included as part of a salaried GP’s job plan/locum agreement unless expressly and mutually agreed
• Sessional GPs should not be expected to request investigations, make referrals or sign prescriptions based solely on the clinical assessments made by MDT/ARRS roles. If such interventions are deemed required after initial assessment by MDT/ARRS roles, patients should be allowed the opportunity to consult a qualified GP and GPs given the time and opportunity to make their own full and proper assessment of the patient’s healthcare needs
• Should a sessional GP agree to supervise MDT/ARRS roles as part of their agreed job plan, they must be allocated sufficient time to safely perform this role. To enable GPs to safely undertake such clinical supervision it is important they have full knowledge of the qualifications, previous primary care experience, clinical limitations and the regulation of those they are supervising. It must be clearly outlined within the mutually agreed GP’s job plan: which roles they agree to supervise; the number of MDT/ARRS staff members they will be expected supervise on any given day; and what time within their workday will be allocated per supervisee to ensure safe and achievable supervision
• There should be robust systems and protocols in place to ensure MDT/ARRS roles requiring supervision are working within their scope of practice. More information and support on scope of practice and supervision can be found here
• Additional agreed supervision responsibilities should be adequately remunerated. The additional workload which comes with providing supervision of MDTs or ARRS staff should be remunerated with supplementary pay.

Mark Steggles is chair of the sessional GPs committee