Somerset Quality Assurance Report (2009)

Somerset Quality Assurance Report (2009) Severn Deanery School of Primary Care Swindon Visit (30th September 2009) Somerset Response

Visitors • Lead visitor: Dr Jon Elliman – Associate Postgraduate Dean (Swindon) • Other visitors: Dr Sarah Hands – GP Educator • Dr Mary Valentine – GP Educator • Dr Tom Gamble – GP Educator • Dr Liz Olden – Educator Scholar • Pam Gates – Lay Visitor • Clare Couchos – Knowledge Transfer Partnership Fellow • Siobhan Tims – GP Administrator

Team available on the day • Doreen Burnell – Administrator • Dr John Edwards - GP Educator/APD Assessment & Performance • Dr Hannah Gales – GPE Fellow • Dr Lisa Horman – GP Educator • Dr Steve Holmes - APD • Dr Ian Kelham – GP Educator/APD recruitment • Dr Martin Minogue – GP Educator • Dr Sue Neville – GP Educator • Dr Sarah Thomas – GPE Scholar • Dr Jill Wilson – GP Educator

Points of commendation • 2 GPE sessions down over the last year • Large geographical area • Strong teamwork • ST3 letter felt to be very useful (induction) • Increase structure in DRC • Impressed by two ST3 residential courses and avoidance of duplication • Rolling programme of curriculum coverage • ST3 Educational scholar has more structured programme

Recommendations

Attendance at DRC • Robust systems to check noted • Suggested to aim for 100% attendance rather than 70% (deanery wide policy) • Somerset happy to change to deanery policy (noting need for holidays and occasional service commitments (on-call) and possible illness at times) • Suggest closer monitoring of “days in practice” • Somerset agree with this and have started to monitor; this will be reported at our two monthly GPE team meetings

Administration • Adminstration support is excellent and systems and processes appear robust and well managed. • The administration support is under resourced for the size of the Somerset scheme and the number of GPEs. ie one full time PA based in Yeovil and the equivalent of 1 day per week admin support in Taunton. The Taunton administrator has a substantial amount of other responsibilities not related to GP • Somerset GPE team realise that we have two bases and the complexities of delivery from two sites with two administrative supports. We are funded proportional to the number of GP ST – however, wonder if budget would be available to support the complexity of bases.

DREEM questionnaire • Noted that the level of response is still just below the numbers required to evaluate reliably (44%) • Somerset will encourage more directly a response this year (and have shown improvement from previous years results). We note the discussion on evaluation overload, hence need to co-ordinate this with other demands on evaluation.

ST 1-3 / CCT programmes • Consider more integration of the ST3 programme with ST1/ST2 and the CCT educational programme (perhaps more integration of the roles within the team) • Somerset GPE Team will aim to continually develop this over the next two years. We have a plan to involve GPE experience throughout the GP ST training cycle.

ST Groups • Consider the value of forming small ST groups with stable membership (we understand that the groups currently have varying membership). This might enable a more supportive self learning environment to develop within each group • Somerset team feel this a useful and achievable aim and will endeavour to deliver this. Some of the variation has been linked to maternity leave / ill health. Consistency we believe would provide benefits. WE will report back on use of groups at our GPE meeting.

Management of psychological issues • We found the concept of signposting possible psychological distress at the beginning of a session interesting and wonder if it may not be more positive to be aware of and follow up distress if it occurs. We would encourage an approach which enables people to feel comfortable to discuss sensitive issues within a small group. • The Somerset GPE aim to forewarn, but would always follow up any psychological distress if identified during a session

Residential Course • Monitor the topics on residentials to ensure that individual GPSTs do not have duplicated topics • Somerset GPE team will continue to do this

GP Appraisal / CPD • Although there is GP input into CPD programme this appears to be uncoordinated and not informed by appraisal outcomes. There also appears to be only a loosely coordinated link between the VTS and topic based events of the education trust. This may be a useful area to explore, ie SGPET as a useful resource to deliver most of the main topic based education allowing the ST teaching to concentrate on other areas of the curriculum that wouldn’t be covered otherwise. • Somerset agree with this statement. We have close links with the GP appraisal lead in Somerset PCT (SPCT) and the Somerset GP Education Trust (SGPET). We will protect some time at our next GPE meeting to discuss and agree actions on the use of SGPET for topic based education. We will support the linking of GP appraisal outcomes to the CPD programme

SGPET quite correctly runs as a fairly independent part of GP education although the STs are automatically members. Administration of SGPET is supported by a dedicated administrator based with the local LMC office. There are some mutually shared admin responsibilities and liaison between the Education Trust and the GP administrators within the hospital trusts. However, there is no financial remuneration from SGPET to the hospital trust for this. • Somerset GPE team will continue to monitor the situation regarding this area of funding. The SGPET has only been established recently and there has been some flexibility in support not only from GPE team but the LMC too

Team Development Plan • We feel that the team might find it useful to look at and formalise their team development needs. • The GPE team will address this at our next meeting and produce a short ongoing document clarifying anticipated development needs. We had previously undertaken this by adaptation (eg departure of one GPE; revalidation implications) but recognise the benefits of a written description of these to clarify thinking.

Conclusions • We were delighted at the positive nature of the report and hope this satisfies the QA requirements of the School Board • We wish to thank the Swindon team for the time and energy the put into our visit. • We are happy to address the recommendations and have developed a reporting system through our GPE team to ensure this occurs.

GPE team meeting checklist • Team development plan • ST group continuity reporting • DRC / day in prac attendance (continue) • ST 1-3 and CCT programme overlap / co-ordination • Avoid duplication on Saunton Residential • Admin and SGPET funding awareness

Somerset Quality Assurance Report (2009)