Wales Specialty Training School for General Practice

Trainee Performance Management Policy

The GMC requires that there is a robust process for identifying, supporting and managing trainees whose conduct, health, progress or performance is giving rise to concern. The Wales Deanery has a Performance Unit which is led by Dr Sally Davies and managed by Leona Walsh. This document sets out guidelines for the performance management of General Practice Trainees in Wales.

The aim of the performance management policy is to identify trainees at an early stage when problems are developing or have recently been identified. The objective is to assess trainees and to develop a management plan such that they maintain their progress within general practice towards a CCT/CEGPR.

Concerns relating to trainee performance can arise in a number of ways:

  • In the workplace, from the trainee’s Clinical Supervisors (CS), Educational Supervisors (ES) or other colleagues
  • From the trainee themselves
  • From the trainee’s Programme Directors or Local Associate Dean
  • On evaluation of the documentation for ARCPs
  • Patient Complaints
  • Concerns from other agencies, e.g. Health Board’s

Reasons include:

  • Failure to pass required examinations
  • Issues in communication with colleagues and/or patients
  • Issues with attitude and behaviour
  • Issues with team working
  • Involvement in critical incidents
  • Issues with the trainee’s own health
  • ARCP outcome 2, 3, 4 or 5
  • Issues with attendance at work
  • Social factors
  • Training and/or supervision factors

Neither of these lists are exhaustive but they both serve to illustrate the points above.

GP Performance Process

Roles and Responsibilities

Trainee – has the responsibility to inform at the earliest opportunity their clinical and educational supervisors (and if relevant their Programme Directors and/or local Associate Dean) of any factors that may be influencing their performance e.g. health

Clinical Supervisor – they should inform the responsible Programme Directors when they have concerns relating to the performance of the GPStR.

Educational Supervisor – They should inform, at the earliest opportunity, the local Programme Directors (and Clinical Supervisor if appropriate) when they have concerns relating to the performance of the GPStR.

Programme Directors – To respond to any concerns regarding performance of GPStRs on their Scheme. This may include:

  1. Information gathering
  2. Meeting with individuals concerned and making decisions in the light of this information.

Decisions may include:

  1. Local resolution,
  2. Educational action planning
  3. Requesting a further meeting with the local Associate Dean.

Any documentation should be recorded on the GPStR Performance meeting form, see Appendix 1.

Associate Dean – To advise and respond to any requests from Programme Directors regarding individual GPStR performance issues. To attempt to seek local resolution if appropriate or request formal referral to the GPPT by using the GPStR Performance meeting form, Appendix 1.

General Practice Performance Team (GPPT) – To review all referrals made by ADs. Decisions would include:

  1. Referral back for local resolution
  2. To agree and construct a referral to the Deanery Performance Unit.

Other responsibilities include maintaining effective communication with all interested parties after the referral has been made and also acting as a source of advice and information for general enquiries relating to performance issues in GP.

The Process (Please refer to Appendix 2)

  • Trainees with performance issues are likely to be detected by Clinical Supervisors, Educational Supervisors or others working with the GPStR. When concerns arise about the GPStR’s performance the situation should be first be discussed with the responsible Programme Directors.
  • Information gathering and/or a formal meeting can be arranged using the appropriate paperwork (Appendix 1).
  • After due consideration the concerns will either:
  1. Require no further action
  2. May require an educational action plan (with GPStR, ES and/or CS) with an appropriate timescale for re-visiting
  3. Further advice and request for meeting with the local AD.
  • If required the local AD and PD will meet with the GPStR to discuss the relevant performance related issues and document this meeting using Appendix 1. At this point options would include:
  1. Further attempts to locally resolve the issue
  2. Re-visiting the agreed educational action plan
  3. Referral to the GPPT.
  • If required the GPPT will review all information presented to them from previous meetings regarding the GPStR and make a decision in the light of this. Options will include:
  1. Refer back to local AD and PD for local resolution with recommendations
  2. Refer to Deanery Performance Unit with supporting documentation.
  • All meetings should be carefully documented and agreed by all parties involved.
  • The GPPT in collaboration with the Deanery Performance Unit will ensure that all parties involved (with the consent of the GPStR) are fully informed of the progress of the GPStR.
  • All referrals to the Deanery Performance Unit will lead to an automatic notification to the MD of the local LHB.
  • If a Trainee is referred to the GMC for investigation, Stephen Hunter at the Welsh Assembly Government () will need to be informed.

Where there are issues of patient safety the responsible employers’ procedure should be followed. Where there are issues of professional misconduct the Trust Conduct Policy or the relevant section of the BMA GPStR contract of employment must be followed. There is a clear responsibility for those managing training to communicate effectively with those responsible for employing GPStRs and the Deanery.

Contact Details

GP Performance Lead

Dr Martin Sullivan

07779 555498

GP Performance Manager

Nicki Elliott

02920 687507

GP Performance Officer

Ciara Hovey

02920 687508

Deanery Performance Manager

Mrs Leona Walsh

02920 687417

Deanery Performance Officer

Mrs Trish Moore

02920 687411

When concerns are raised … (Appendix 2)

  • Do not wait for the next annual review to raise issues - ‘No surprises’ at (ARCP)