Practice Managers play an incredibly important role in GP training. To ensure training goes smoothly within the practice, it is important for practice managers to get a good understanding of the implications of committing to GP training.

The documents above will help you in this respect and may answer some of your uncertainties or other questions that til now remain unresolved for you. If you have any other suggestions on how to improve this page for you or other Practice Managers, please let me know on rameshmehay@googlemail.com

If you have any other queries, please contact one of the Programme Directors (click 'contact us' in the submenu box above).

Maggie Eisner is our lead Course Organiser for looking after intending/new trainers and their practice managers. She runs a workshop specifically for practice managers on an annual basis. Please contact Maggie if you wish to attend: maggie.eisner@me.com

To make the organisational aspect of training easier, please take a look at:

• The Training Map - for trainers and practice managers

Hot Issues

These hot issues were recently discussed at a practice managers' training workshop:

1. The trainer tells you that they’ve had a conversation with the Programme Directors who complain that your trainee is always about 20 mins late for both Half Day Release and Wednesday tutorials.  What might be causing this, what could the practice do about it, what could the scheme do about it?
   
   Suggestion of a ‘late arrivals register’ separate from the normal attendance register, so that trainees can record what time they arrive and the reason for late arrival.  This would be a research project, not a way of making trainees feel bad!
   
   
2. A trainee with a history of moderately severe asthma goes on a routine visit.  The patient has Chronic Obstructive Pulmonary Disease and is still a heavy smoker.   The trainee has quite a bad asthma attack.  What is the practice’s Health and Safety responsibility?  What should be done?  How can this be avoided?
   
   Legally, Health and Safety procedures suggest that the patient could be asked to stop smoking, and open all the windows, for 4 hours before the doctor’s visit.  However I’m sure you can think of many practical difficulties in implementing such a policy.
   
   
3. A trainee who has been in hospital posts for several years before starting GP is on the ‘grade 3’ scale.  In their last hospital job he/she had 6 weeks’ annual leave per year.  He/she has done 6 months in a practice which allowed him/her 3 weeks’ holiday, although their usual trainee contract only allowed 5 weeks per year.   Your contract says 5 weeks and you would prefer to keep it that way – the trainer agrees, feeling that the service/education balance for trainees is often too heavily weighted towards education.  How do you explain this to the trainee?  How do you stop him/her developing a resentful attitude?
   
   An experienced trainee on ‘grade 3’ employment scale entitled to 6w annual leave when in hospital, but to a practice contract if in GP.  The consensus from the discussion is in the new policy document.
   
   

4. The trainee seems generally resentful and you don’t really know why.  The staff say the trainee is never spontaneously helpful, doesn’t smile much, etc.  Do you feel that the manager has a role to play in this situation?  What if it turns out to be something about their conditions of work?  Can a practice manager help to prevent this sort of situation developing?

   
   It was agreed that the most useful thing would be a discussion between the trainee and the trainer rather than the PM, but that once the practice knew why the trainee felt resentful, there might be things which could be done (e g family-friendly working hours).  However, it is important for trainees to understand that there will inevitably be variability between the exact working conditions in different practices, which are autonomous organisations.
   
   
5. Maternity leave – a trainee who has been working for the NHS for some time is told by WYCSA that she is only entitled to the statutory minimum (6 weeks at 90% and then 33 weeks at £117.84) but reads on the BMA website that GPSTRs are entitled to the NHS scheme which consists of 8 weeks at full pay, 18 weeks at 1/2 pay etc.   How can the practice manager get this sort of thing sorted out without wasting loads of their valuable time?
   
   This was because when WYCSA referred to ‘the statutory minimum’ they meant ‘the usual amount in an NHS contract’ - not the same as the national statutory minimum.
   
   
6. The trainer says he/she feels that training has a low profile in the practice because it doesn’t make as much money as other activities.  This makes him/her feel less valued than partners who bring in GPwSI income.  How can the practice manager support the trainer (and the concept of the practice as a teaching and learning organisation)?
   
   Many suggestions including meetings at which all practice members are reminded of the benefits of being a training practice.
   
   
7. The trainee keeps ringing in sick at the last minute, e g at 8.30 when their surgery starts at 9.  It’s mostly minor ailments of the trainee, though sometimes it’s that their child is sick.  What can the practice, practice manager and/or trainer do about it?
   
   Many suggestions – a) Important to be clear who in the practice the trainee should ring.  b) PM should implement the normal practice sickness policy (e g a back-to-work conversation after every episode of sick leave;  a formal interview if there are 3 episodes in 6 months;  could refer to Occupational Health).  c) Trainer should discuss the educational implications and possible need for and additional training period at the end of the scheme.  d) VTS should create a continuing sickness and holiday record for each trainee, with continuity from post to post.