GP Enhanced ST3 Programme 2016

Configuration

The Enhanced GP training Framework was proposed by the RCGP in order to tackle the readiness of the future GP generalist working in a rapidly changing NHS landscape; a landscape where the future of healthcare shifts from reactive disease focused units of care to a broader multi-professional and holistic system of proactive and integrated health and social care. HEE KSS have run a very positively evaluated integrated training programme (ITP) for ST2 trainees based in General practice over the last 7 years which has gone some way towards addressing this agenda. Based on the experience and trainee feedback from that programme, Clinical Leadership in Commissioning, (CLIC), we are now able to offer enhanced training for those trainees in their third year of training who are making the requisite progress towards certification of completion of training, (CCT). This will add 3 months to the training envelope.

The HEE KSS Enhanced ST3,(EST3) programmeprovides 6 days of intensive teaching together with a variety of facilitated learning opportunities over a 6month period. A final 7th day provides the participants with the opportunity to show case their achievements to peers and supervisors. During the course of their placement trainees undertake a Quality Improvement Project within a Primary Care setting such as the CCG, Public Health or within one of the New Care Models. They will be supported by their supervisors (listed below) and will spend one day a week in their project setting.

Roles and responsibilities

  1. Educational supervisor,(ES), also known as GP Trainer – oversees, facilitates development, monitors progress and directly assesses and teaches the trainee throughout the 3 year training envelope and HEE KSS enhanced ST3 programme. Usually in the GP surgery setting the ES is also the clinical supervisor of daily practice
  2. Clinical supervisor, (CS), provides day to day supervision in any placement e.g. hospital setting, primary care, GP surgery
  3. Training Programme Director, (TPD), has the responsibility for the overall quality management of the educational programme and its delivery and development within locality training schemes.
  4. Programme development – this is an evolving curriculum which is supported by a senior TPD and Associate GP Dean. The programme is mapped to the GP RCGP curriculum, Enhanced GP Specialty Training and the NHS Healthcare Leadership Model.

Linkage

This is the process whereby trainees are able to assimilate the curriculum requirements and apply theory in practice. It involves real time experiential active learning, reflection in action and on action, (Schon, D. 1983), as the trainee moves between the different environments of clinical practice and the wider commissioning landscape, working in partnerships across organisations mindful of the central position of patients as individuals and citizens within the constraints of modern health care delivery.

Activity / Objective / Proposed Outcome / Curriculum mapping
  • Areas of RCGP Curriculum
  • NHS Healthcare Leadership Model
  • Public Health Agenda

Action Learning Set (ALS)
~ one hour of small group facilitated discussion is scheduled within every programmed day i.e. once a month for the duration of the enhanced ST3 programme /
  • To provide a forum for reflection, discussion and problem solving.
  • Learning within the ALS is trainee centred
  • TPD can help the trainees to apply the theory of change management, management of self and others to their discussion and learning
/
  • Trainees learn to reflect on action and develop skills to strengthen their ability to reflect in action whilst working within the EST3 programme. A shared problem solving approach promotes a team ethos and supports development of their team roles.
  • The ALS provides a safe forum where trainees can disclose anxieties and concerns
/ GP Curriculum
Capabilities:
  • Knowing self and relating to others
Professional Modules:
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing Professional Knowledge
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
  • 1.4 Acting with personal Integrity
Statement 2 Working with Others
  • 2.1 Developing Networks
  • 2.2 Building and maintaining networks
  • 2.3 Encouraging Contribution
  • 2.4 Working with Teams

Workshops
There are 6 scheduled days of teaching based on a workshop model.
Areas to be addressed support the transition from acquisition of competence to capability; enhanced clinical, generalist and leadership skills and outcomes.
The workshops focus on managing change and development of the necessary skills to lead others through change. /
  • To enable the trainees to develop an understanding of a range of theories which support change management, development of self-awareness and the management of others
/
  • Trainees develop further understanding of communication skills through Transactional. Analysis Workshops. Trainees are encouraged to reflect upon this within their e-portfolio
  • Trainees develop an understanding of team roles and team working: Belbin
  • Trainees participate in a managing change workshop and consider the Kubler Ross Loss Curve reflecting upon their own journey through the rotation and using their e-portfolio to demonstrate personal learning
  • Leadership theory is considered for exampleTransactional and Transformational approaches
  • An introduction to systems-based thinking
/ GP Curriculum
Capabilities:
  • Managing complex and long term care
  • Working well in organisations and systems of care
  • Caring for the whole person in the wider community
Professional Modules
  • 2.02 Patient Safety and Quality of Care
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing professional knowledge
Clinical modules
  • 3.01 Healthy people; promoting health & preventing disease
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
Statement 2 Working with Others
  • 2.1 Developing Networks
  • 2.2 Building and maintaining networks
  • 2.3 Encouraging Contribution
  • 2.4 Working with Teams

Reading Materials and Reflective Journals
Trainees are encouraged to read materials about the areas of leadership which have been identified. The materials are to support understanding and support the reflective journey through the rotation /
  • To demonstrate self-directed learning
  • To develop an academic approach to enhanced knowledge acquisition
/
  • Trainees are expected to fully participate in this activity. This is to support their academic development and final presentation at the end of the rotation
/ GP Curriculum
Capabilities:
  • Knowing self and relating to others
  • Working well in organisations and systems of care
  • Caring for the whole person in the wider community
Professional Modules:
  • 2.04 Enhancing Professional Knowledge
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
Statement 2 Working with Others
  • 2.1 Developing Networks
  • 2.2 Building and maintaining networks

Project work based in a CCG/Public Health setting/New Care model e.g. Vanguard or The Primary Care Home /
  • To understand different leadership styles and their impact
  • To understand the principles of collaborative working
  • Self directed learning
/
  • Implementation of evidence based practice within daily GP activity
  • Contextualise practice commissioning roles and responsibilities
  • Introduction to future roles within the wider remit of commissioning and new care models
  • Understand how multi-professional and inter-professional teams function
/ GP Curriculum
Capabilities:
  • Knowing self and relating to others
  • Applying clinical knowledge and skills
  • Managing complex and long term care
  • Working well in organisations and systems of care
  • Caring for the whole person in the wider community
Professional Modules
  • 2.02 Patient Safety and Quality of Care
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing professional knowledge
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
Statement 2 Working with Others
  • 2.1 Developing Networks
  • 2.2 Building and maintaining networks
  • 2.3 Encouraging Contribution
  • 2.4 Working with Teams

Clinical work /
  • To understand different leadership styles and their impact
  • To understand the principles of multi-professional team working
  • Self directed learning
/
  • Contextualise commissioning within GP daily activity
  • Implement leadership and team working skills within clinical practice
/ GP Curriculum
Capabilities:
  • Knowing self and relating to others
  • Applying clinical knowledge and skills
  • Managing complex and long term care
  • Working well in organisations and systems of care
  • Caring for the whole person in the wider community
Professional Modules
  • 2.01 The GP Consultation in Practice
  • 2.02 Patient Safety and Quality of Care
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing professional knowledge
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
Responsibility to peers and reciprocity of teacher pupil relationship /
  • Share learning
  • Role modelling
/
  • Presentation to peers
  • Life- long professional development of teacher and pupil in tandem
/ GP Curriculum
Capabilities
  • Knowing yourself and relating to others
  • Managing complex and long term care
  • Working well in organisations and systems of care
  • Caring for the whole person in the wider community
Professional Modules
  • 2.02 Patient Safety and Quality of Care
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing professional knowledge
Medical Leadership Framework Competency
Statement 1 Demonstrating Personal Qualities
  • 1.1 Developing self-Awareness
  • 1.2Managing Yourself
  • 1.3Continuing Personal
Development
Activities
Enhanced ST3 trainees are invited to join with the E Kent CLIC ST2 trainees on some specific field (community) activities which have been found to be of particular benefit. These are not compulsory. /
  • Trainees are encouraged to network widely in support of their enhanced learning and project work. This may include visiting other organisations/localities and attending a variety of meetings.
/
  • To develop SMART working practices
  • Establish appropriate networking behaviours
  • Develop more effective and comprehensive understanding of out of hospital health and social care, commissioning agendas and, the delivery of accountable healthcare
/ GP Curriculum
Capabilities:
  • Knowing yourself and relating to others
  • Caring for the whole person in the wider community
Professional Modules
  • 2.02 Patient Safety and Quality of Care
  • 2.03 The GP in the wider professional environment
  • 2.04 Enhancing professional knowledge

Programme Administration

The administrator responsible for this program is Donna McFarlane, .

The programme leads are Jane Arnott (Programme Director and course leader for the CLIC ITP), and Kim Stillman (Associate Dean), .

You will be supported to identify a placement in a CCG or other organisation by your own Programme Directors.

Trainee selection Criteria

Experience with the CLIC ITP highlights the importance of trainee maturity and self-discipline. Trainees are volunteers and have been selected upon eligibility criteria:

  • Applicant must be in their ST3 training year on 1st January 2016
  • Applicant must have passed the AKT with a score of 70% or higher at the time of application
  • Applicant must have had an Outcome 1 at their first and second year ARCP
  • Applicant must have a well-developed reflective e-portfolio learning log
  • Applicant must demonstrate evidence of initiating an audit or service improvement project
  • Applicant must have a stated intention to undertake the CSA no later than the April 2016 diet and a reasonable expectation of success in the exam. (Eligibility to remain on the programme will be confirmed on gaining a pass in the CSA by 30th April 2016).

Trainee Timetable

Trainees will commence the Enhanced ST3 programme on Wed 4th May 2016, whilst remaining under their usual contract until Tuesday 2nd August 2016. They will then commence a 3 month additional period of GP training, during which they will continue to work the expected COGPED weekly timetable for a GPST3:

  • 7 clinical sessions
  • 2 sessions in a placement aimed at fulfilling the QIP project
  • 1 tutorial/educational session in practice

By starting the Enhanced ST3 programme in May, all EST3s will have successfully completed both AKT and CSA exams before they join the EST3 programme.

The Enhanced ST3 year programme includes:

  • An extra 20 days of formal study leave, some of which will be taken for:

- Attendance at a one day introduction to educational theory and clinical supervision

- Attendance at a monthly ‘CLIC’ peer learning set for EST3s

  • A personalised timetable from 3.8.15 to 1.11.16

Within the Enhanced Phase ST3 trainees will work towards their PDP with the provision of the extra 20 study days which should be evenly distributed across the weekly timetable. Trainees will be expected to plan their study days in discussion with their GP Trainer and where appropriate Programme Director.

Study days would usually be undertaken on a regular basis throughout the remaining time in the programme but there may need to be flexibility sufficient for the trainee to meet their intended learning outcomes.

Date / Subject / Facilitator / Venue / Outcome / RCGP / Commissioning Cycle: colour-coded / Notes
12/5/16 / Introduction to
The EST3 programme / Jane Arnott
Kim Stillman / MedwayChristChurchUniversity Campus / Understand the NHS constitution & a values-based approach to Healthcare
Introduction to Clinical commissioning cycle / ET1 relating to others / Strategic Planning:
•Assessing Needs
• Reviewing Service Provision
• Deciding Priorities / Hopes, fears & expectations
8/6/16 / Improving the public’s health?
New Care Models
Social Care & caring / Jane Arnott
Kim Stillman
External experts: / MedwayChristChurchUniversity Campus / Knowledge of Clinical Leadership in commissioning
Understand the Commissioning Cycle
Awareness of the Impact of Organisational Change at the micro and macro level
Understanding research methods and how to undertake a Quality Improvement Project / Enhanced Leadership skills:
3.1, 3.2, 3.3, 3.4
Enhanced Generalist skills:
2.1, 2.2, 2.3, 2.4, 2.5
Enhanced Clinical Skills:
1.1, 1.2, 1.3, 1.4, 1.5
ET1: relating to others / Strategic Planning:
•Reviewing Service Provision
• Deciding Priorities / Big picture thinking
Taking an evidence based approach
7/7/16 / Innovation & the impact of quality / Jane Arnott
Kim Stillman
External experts: / MedwayChristChurchUniversity Campus / Understanding of NHS financial regulation & proposed reforms
How to approach health inequalities
Awareness of organisational demand
Reflection on impact of commissioning decisions / EGS: 2.1, 2.2, 2.3, 2.4, ELS: 3.1, 3.2, 3.3
ET1: relating to others / Strategic Planning:
•Reviewing Service Provision
• Deciding Priorities
17/8/16 / The role of Leadership and implementation of change; a systems based approach / Jane Arnott
Kim Stillman / MedwayChristChurchUniversity Campus / Understand change management, systems based thinking and the role of teams in improving health care outcomes. / ELS: 3.2, 3.3, 3.4
ET1: relating to others
ET4: working in systems of care / Strategic Planning:
•Reviewing Service Provision
• Deciding Priorities / Team roles
Leadership theory
Systems thinking
22/9/16 / Introduction to clinical supervision in the workplace / Glyn Williams
Debbie Taylor / Feedback skills
Clinical supervision skills development / ET1: relating to others / Procuring Services:
•shaping structure of supply
•Planning capacity & managing demand / Education, training and facilitation
28/9/16 / Medicine as Art and Science / Jane Arnott
Kim Stillman
External experts: / MedwayChristChurchUniversity Campus / The knowledge landscape from expert patient to digital technology
Introduction to Health informatics
The impact of the genome project / ET4: working in systems of care / Procuring Services:
•shaping structure of supply
•Planning capacity & managing demand / The future patient & the role of the GP
Clinical mandate/priority areas
19/10/16 / CBDs, Presentationsproject handover report
Programme evaluation / Jane Arnott
Kim Stillman
Trainees invite peers and supervisors / MedwayChristChurchUniversity Campus / Demonstration of trainee personal development
& service improvement
(Kirkpatrick level 4) / ET1: relating to others / Teaching the teachers; student as master

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KS 13/2/16