Over the last year, the BMA GP registrars committee has been working closely with COGPED, the committee of general practice education directors, to update our joint guide to a session document that was published in 2012.
We are pleased to announce that we have agreed an updated document with tangible, positive changes to GP training.
What is included in the updated training week guidance
Flexible working patterns
This update recognises flexible working patterns, with allowance for timetables based on either sessions or hours, depending on the employment contract applicable in the nation that the GP registrar is working in, with any agreement on an adjusted timetable constructed on agreement between the trainer and registrar, whilst meeting the terms as set out within the terms and conditions of employment.. The standard working week remains 8 hours or 2 sessions per day over 5 days during core general practice hours, but condensed timetables may be followed when there is agreement between trainer and GP registrar.
Clearer guidance on appointment times
GP registrar appointment times will vary in length depending on the stage of training, the individual educational needs of the registrar as well as the modality and complexity of the consultation. In line with the RCGP’s Fit for the Future report as well as BMA Safe Working Guidance, GP registrars are advised to build towards a minimum appointment length of 15 minutes for face-to-face consultations by the end of training, recognising the increasing complexity of GP consultations and changing patient needs.
Clearer guidance on self-directed learning
Full-time GP registrars should be rostered for 4 hours of self-directed learning per week, in line with the RCGP curriculum. All less-than-full-time GP registrars have a prorated entitlement. The structure and location of self-directed educational time is at the discretion of the GP registrar in order to best suit their individual learning needs.
Induction
All GP registrars should be provided with an induction appropriate for their stage of training when starting at a practice or after any long-term leave. During this time, training must be provided on all local IT systems required for day-to-day work and logins and building access provided prior to starting clinics.
Home visits
Home visit allocation should be made in conjunction with the GP registrar and must be appropriate for their educational needs. The update reinforces that travel time and documentation are clinical time, and should not detract from contractual breaks. Lone-working risk assessments should be undertaken by the hosting practice and appropriate measures put in place to protect the health and personal safety of the GP registrar. Where possible, a device such as a laptop should be provided to registrars on home visits to enable contemporaneous documentation.
Duty doctor sessions
GP registrars may undertake duty doctor sessions in general practice posts. Such work involves a higher degree of clinical risk and intensity, and therefore may be expected to be undertaken by registrars at later stages of training who are able to practise more independently. A high degree of supervision and support is expected from a supervising GP.
Reasonable adjustments
GP registrars have specific educational needs which vary on an individual basis and training should be tailored in order to meet these needs. These may be pre-existent at the start of training or relate to a diagnosis made during the course of training. Where a registrar has been diagnosed with a disability or a long-term condition, employers and hosts have a legal duty to provide reasonable adjustments. Reasonable adjustments may require changing a registrar’s work environment and/or work schedule to facilitate their development according to their individual needs.