ARCP

 DATES FOR FIRST AND SECOND TIER LOCAL PANELS IN BRADFORD 2014

  • 4 June – Chair: Lucy Clarke; Lay asessor: Chris Rushton
    Tong Medical Practice, Bradford
  • 5 June – Chair: Maggie Eisner; Lay assessor: Chris Brennan
    Shipley Medical Practice, Shipley
  • 10 June – Chair: Ramesh Mehay; Lay assessor: Phil Bromage
    Ashcroft Surgery, Bradford
  • 11 June – Chair: Nick Price; Lay assessor: Chris Rushton
    at Nick’s house, Oxenhope BD22 9ST
  • 19 June – Chair: Clare Connolly; Lay assessor: Adrian Roebuck
    Horton Park Surgery, Bradford
IF YOU HAVE NOT BEEN EMAILED A COPY OF THE ALLOCATIONS LIST, PLEASE CONTACT SOFYA

INTRODUCTION

Most of the information on this page is for ARCP panel members.  HOWEVER, if you’re a trainee, please don’t run off.  There’s some information about ARCP panels specifically for you at the end of this page.    And of course, you are more than welcome to look around and see what the panel members will be doing when they come to look at your ePortfolio.  Doing this might help you tweak your ePortfolio to make sure it hits the right notes.

As for those of you who are intending panel members, please read on.  In Bradford, we’re trying to develop an ARCP process that enables us to easily identify the struggling trainee but is light touch for the trainee who is progressing well.  There are two ARCP assessment forms available from the downloads box above.   We suggest experienced panel members use the brief one (5 steps..) whilst inexperienced members use the more detailed one (10 steps…) for the first couple of trainees.   However, some of you may wish to revert back to using the detailed one for those trainees who are not progressing well because it may help you identify and define the problem area.

The ultimate purpose of ARCP panels is to determine whether trainees are progressing well towards competence. We’re not asking you to look for excellence. All we’re asking you is to determine whether there is ‘good enough’ evidence of satisfactory progression. Don’t lose sight of this.

It is often difficult to make a general picture of a trainee when looking at their individual assessments alone (like COTs and CBDs). That is why it is important to look at other reports (i.e. both Clinical and Educational Supervisor’s), as well as the MSF and PSQ.  These things will provide different windows from which you can look at the trainee and help ‘glue’ everything together into a whole.

INFO FOR PANEL MEMBERS

DEAR PANEL MEMBER

Dear Panel member…

Many thanks for helping us with the ARCP panels.  It is important that your read through this section carefully because it will guide you through the ARCP process.    Please go through all the documents in the blue downloads box above.  Then go through the content on the rest of this webpage.  Do this in order and bit by bit (say over several days) – you will feel overloaded and exhausted if you attempt to do these all at the eleventh hour.

The documents under ARCP Process and Organisation simply summarise the ARCP process in Bradford. The purpose of these documents is to ensure we all understand how the system works in Bradford and what is expected from each of us. You can read these documents at any time before your ARCP panel date – the earlier, the better.

Next are some ARCP help files which will be particularly helpful to those of you who are new to doing ARCP panels. All new ARCP lay panel members are expected to do the ‘ARCP training package for Lay Assessors’.  Again, please make some protected time to do this and don’t leave it til the last minute – it’s quite a detailed training package that will take a bit of time to complete.

The most important documents are those listed under ARCP forms. These checklists will help add structure to your ‘ARCP assessment’ of the trainee. One of them is brief and the other detailed. If you think the Educational Supervisor’s Report (ESR) is reliable, then use the brief ARCP assessment form. If it’s not, then you’ll have to do a mini-ES process yourself and that’s when the second more detailed form will come in handy. Those who are completely new to doing ARCP panels, I would recommend that you use the detailed one for your first and second allocated trainees (to help you get your bearings right), and the brief one for the ones thereafter.   I know some of you don’t like using forms, BUT these forms will make your lives a lot easier. They provide the necessary structure and guidance that inexperienced panel members need to help align them to the more experienced ones. So, please use them and in time, as you become familiar with the whole thing, you’ll be glad that you did!  A unified approach will lead to a more reliable, valid and easier to determine ARCP outcome.

By now, you should have received a list of panels and their allocated trainees.  If not, email our administrator (Sofya) on admin.GP@bthft.nhs.uk.  Please take a look and see which trainees have been allocated for YOU to specifically review BEFORE the panel meeting.     You need to review each trainee’s ePortfolio in some considerable depth – this takes time, so please don’t leave  this til the last minute either!     From previous panels, most assessors like to do this during the week or weekend preceding the panel date.  In that way, the assessment stays fresh in their minds too!

All ARCP panel members must use one of the two ARCP checklist forms for each of their trainees (available in the Downloads box above). It’s important that we’re all approaching the ARCP process in the same way (singing from the same hymn sheet).  A unified approach will hopefully lead to a more reliable, valid and easier to determine ARCP outcome.  You may be asked for specifics on each trainee on the day.  

  • When you have finished assessing your trainee, give them a global colour score.
    • GREEN if they are clearly okay.
    • RED if the are clearly not okay and definately need referring to a deanery panel.
    • And finally AMBER if you’re not quite sure and would like to seek the opinion of the rest of the panel.
  • It’s the AMBER trainees that will mostly absorb panel time. Panels should be able to whizz through those in the GREEN and to a lesser extent, those in the RED.

Finally, we need three sets of feedback from you.  One on each trainee, one on each Educational Supervisor and one on the ARCP panel process.   How can we improve on next year’s quality of ePortfolios, ES reports and the ARCP process if we don’t provide feedback now to help them better themselves?    This in turn will make life easier for everyone (including future ARCP panels).  After discussing the trainee at the panel, the panel chair will ask you for specific feedback to give to the trainee and Educational Supervisor.  Therefore, will all panel members do this.  In terms of the feedback for the ES and trainee…

  • Pick one or two things that you specifically liked about their respective ES report and ePortfolio that you would like them to carry one doing.
  • Likewise, but only if you feel it is warranted, please write one or two things they could do to improve it for the next time around.

 AND remember to be

  • specific (in other words, don’t just say something was good, say what was good about it)
  • balanced (i.e. a balance of positive and negative feedback) and
  • gentle (remember, our Ed Supervisors are people with feelings)
  • Re-read the feedback you have given to make sure it comes across as helpful advice rather than something punitive.

As for feedback on the ARCP process itself: we will ask you to do this after the actual panel session. This will help us make the process even more efficient and generally better the next time around.

One final thing… on the allocations list, you may see the following annotations next to one or more of your trainees:

  • (SUI) – this means that a trainee has been involved in a ‘serious untoward incident’ that the panel member needs to review to ensure it has been adequately approached and resolved.
  • (LTFTT – annual review) – this indicates that the trainee is part-time and needs an annual review  but not an ST progression ARCP review.
  • (LTFTT – ST change, ARCP review)‘ – this indicates that the trainee is part-time and needs an ARCP ST progression review.
  • There is more about what to do for each of these below.

And for those of you who are lay panel members – we know from previous experience that most of you will feel apprehensive and will wonder what value you can give to panels.   The truth is that you bring with you a different and invaluable perspective that is difficult to capture with a panel full of doctors.   And there’s no need to feel apprehensive – all the panel chairs are approachable and friendly people.  Please don’t be afraid to email or phone your local friendly panel chair if there is anything you do not understand.

Thank you once again for helping us and we look forward to meeting you.   Don’t forget to bring your assessment sheets with you.

Ramesh Mehay

TPD with lead responsibility for ARCP panels

DEAR PANEL CHAIR...

Different panel chairs can decide to run their panel sessions in different ways but the following gives you some idea of how I plan to run mine. It worked very well for me the last time and this ‘formula’ may make things easier for you too. The idea behind this set up is to ensure we don’t run out of time, especially for the difficult ones.

At the start of the session, once everyone has arrived, we will introduce ourselves.

I will then go through a PowerPoint to

  1. Basically make sure my panel members are all on the same wavelength
  2. Lay down some ground rules
  3. Outline how I plan to ‘run the show’ (and to forgive me for moving people on)
  4. Explain how I expect them to present (so that it is concise yet comprehensive enough)

On the table there will be 3 sheets of A4 labelled GREEN, AMBER and RED. Before we start talking about any trainee, I will ask panel members to categorise each of their allocated trainees to one of the three colours.

  • GREEN = they’re clearly okay.
  • AMBER = they’re not sure but would like an opinion from the rest of the panel.
  • RED = they’re clearly NOT okay and definitely need referring to deanery panel.

Then, I will start the discussions by presenting one of my straight forward (GREEN) trainees. The purpose of me starting is to

  • Demonstrate how to present in a smooth and time-efficient way,
  • Allow panel members to ask questions to clarify and
  • Get one ‘in the bag’.

After that first one, we will then go through the AMBER trainees first. These are the ones most likely to need and absorb time – therefore, it is important we give them their due. After the AMBERs we’ll move onto REDs and then GREENs – who should be much easier to get through  (if a trainee is bad  enough to warrant a ‘RED’, then there really isn’t much to say other than they fail the panel process – there is no need to talk for hours).  In this way, should we run out of time, then at least we will have devoted our attention to where it was needed the most – with the ambers.

After the panel has decided what outcome to give each trainee, the panel (especially the chair & the panel member who assessed the ePortfolio) will formulate feedback to give back to the trainee – usually consisting of a mixture of specific things we liked about their ePortfolio that we would like them to carry on doing and things which will help them improve it for the next time around.  (Sofya will usually collate and transcribe).  If you decide the refer a trainee to the second tier or Deanery panel, please collate ‘additional notes for the second panel‘ to help them with their review.

After this, the panel chair should spend a few minutes gathering feedback from the assessor for the Educational Supervisor – making sure that it is worded in the most receptive and effective way (I usually type it up because Sofya will be busy typing the trainee feedback).

When the ARCP panel session discussions are over, the administrator will hand out feedback forms so that panel members can comment on the ARCP panel process itself.

When the panel is over…

  • Sofya will email you the trainee feedback that she has collected so that you can read and tweak it.    After that, please read and tweak the feedback stuff you wrote for the Educational Supervisors.  Send both tweaked finalised lists back to Sofya to send.
  • Sofya will also email you when it is permissible for you to log in and ‘sign off’ the trainees that were deemed satisfactory on your panel.  This step is incredibly important  and must be done in an expedient way.   This is especially important for the ST3s, as the sign-off triggers the CCT process.  The sign off can only be done through you panel chair log in (not your usual log in code).  If you can’t find your panel chair log in – then search your email for ravine – should bring it up unless you have deleted it (Mike Ravine sent the email).  By the way, the RCGP are touchy about sharing login details so I don’’t recommend sharing them.

I hope you all think this is a reasonable way forwards.   Any other suggestions – email me on rameshmehay@googlemail.com

Ramesh Mehay

DEAR ARCP ADMINISTRATOR...

In Bradford, there are now going to be two panel tiers. The first tier panels will look at all the trainees and sieve out which trainees are clearly okay and which need further discussion. Those that are not clearly okay will be sent to the second panel tier whose job will be to decide whether the trainees need a referral to the deanery panel or whether things can be sorted out locally.

BEFORE THE PANEL SESSION

  • We need you to sort out some dates and venues – for both first tier panels (of which there will be several) and a final second tier panel.
  • For each first tier panel, there needs to be 3 people – a panel chair (a TPD), a trainer and a lay person.
    • We need you to recruit one lay panel member (? a Practice Manager) for each first tier ARCP panel:
    • Please can you recruit a trainer for each of our panels.
    • Let them know of the rates of pay for doing this session.
    • Send them an email to ask them to read and become familiar with this Bradford ARCP webpage.
  • The section above on ‘DEAR PANEL CHAIR’ describes how I (Ram) plan to run my ARCP session.  Please liaise with other panel chairs to understand how they plan to run their ARCP session.
  • Then allocate trainees to each panel.    The ones who need an ARCP panel are those that are moving up an ST grade (i.e. moving from ST1 to ST2 or ST2 to ST3) or are due for CCT (i.e. are ST3s who will be leaving our scheme).
    • Please remember: Use the ARCP panel-trainee allocation form in the downloads box above and then upload it onto this website as well as circulating it.
    • Please allocate them evenly amongst the first tier groups – we should have roughly the same work load. This doesn’t just mean making sure we all have the same numbers. It also means that we all have roughly the same number of ST1s, ST2s and ST3s.
    • Within each first tier group, allocate the trainees evenly to the three panel members. It’s particularly important to allocate those who are due for CCT evenly as these can take a bit more time to assess than the rest.
    • When allocating, PLEASE make sure the trainee has not been under the direct Clinical or Educational Supervision of any of the three panel members: this is incredibly important. With us using Practice Managers as lay panel members, this is going to make allocations significantly more difficult.
    • Finally, add ‘(SUI)‘ if a trainee has been involved in a ‘serious untoward incident’ that the panel member needs to review.   Add ‘(LTFTT – annual review)’ if the trainee is part-time and needs an annual review  but not an ST progression ARCP review.   Add ‘(LTFTT – ST change, ARCP review)‘ if they need an an ARCP ST progression review.
  • Organise the date, people and venue  for the second tier panel (who should be TPDs, lay person and trainer again).  Liaise with Clare Connolly if you are unsure.
  • Then send all details and e-paperwork to all panel members.
  • Double check: have you asked all panel members to read and familiarise themselves with the information on this webpage?
  • If you have any issues with allocating a trainee, please liaise with Nick Price or Ramesh Mehay.

Please send an email to trainees at the beginning of May, something along the lines of…
Dear trainees, Most of you will be undergoing an ARCP panel review next month. In order to facilitate this process, please can you make sure you do the following as soon as possible (it’s incredibly important because it will determine whether you go onto the next ST stage):

  • All of the forms mentioned below can be found on the Bradford VTS pages on Educational Supervision: www.bradfordvts.co.uk/educational-supervision   Please upload these forms to your learning log under the section ‘Professional Conversation‘.
  • Upload your COT, CEX and COT mapping forms.   Use an appropriate title like ‘COT mapping form’, ‘CBD mapping form’ or ‘CEX mapping form’ so that they can be easily found or identified.
  • Upload your Statement of Leave form.  Use the title ‘Statement of Leave form’.
  • Upload the Complaints and Incidents form, using the title ‘Complaints and Incidents form’.
  • Upload your OOH log of hours form – with title ‘OOH log of hours form’
  • Upload your HDR  and Weds tutorial (if appropriate) attendance – with the title ‘HDR attendance’ or ‘Weds tutorial attendance’ respectively.   There are no forms for these, but you will have received information about your attendance rates from Sofya – the email with percentage figures in it!   Please make sure you upload these percentages rather than a list of HDR/Weds sessions attended.  
  • Make sure you tidy up and complete anything that needs sorting in your e-portfolios – especially your PDPs.
  • There is a useful document called ‘ES preparation checklist” You can find it under the downloads section of the Educational Supervision section of Bradford VTS website.
Yours Sincerely…

DURING THE PANEL SESSION
Collate the Feedback

  1. During the ARCP panel process, you will need to collate feedback to give to the trainee.  Although the panel chair will facilitate this, please listen carefully to capture the final positive and negative points for each trainee.
  2. After that, the panel chair will also facilitate the feedback to be given to the Educational Supervisor.  They may decide to type this up themselves or ask you to do it.
  3. When the ARCP panel is over, we need you to hand out feedback forms so that panel members can comment on the ARCP panel process itself.

AFTER THE PANEL SESSION

  • Send the chair (via email) the two lists of feedback for tweaking (Trainee feedback & Educational Supervisor feedback).  They will make them more receptive by removing harsh comments and through rewording.   They will then send the two finalised lists back to you.
  • Please ‘cut and paste’ the ARCP outcome and the feedback for the trainee into the Educator’s Notes section of their ePortfolio.  In that way, the trainee, the Clinical Supervisor and the Educational Supervisor are well informed and can make plans for the future.
  • Please DO NOT ‘cut and paste’ feedback for trainees that have been referred to the second tier panel. Wait to see the outcome of the second tier panel and get them to amend the feedback formulated in the first ARCP session before pasting it into the Educator’s Notes.
  • Then send each Educational Supervisor their own specific ES feedback (but don’t include their trainee).  Don’t forget to add your personal touch to these emails.
  • For the second tier ARCP panel session:  a) Only provide information for trainees who have been referred to them and b) include  the feedback derived from the first panel AND any ‘additional notes to the second panel’.
  • Let all panel chairs know when it is okay to log in as chair and sign off their ‘GREEN’ trainees off as satisfactory.
  • And of course, send out claim forms to the panel members along with the expected rates of pay.

Other things

Don’t forget about organising the food for these ARCP dates. Just needs to cater for 3-4 people. Perhaps something basic and not too costly? I hope this will make life and things a lot easier this year with respect to organising ARCP panels.

IT'S MY FIRST TIME ON AN ARCP PANEL. IS THERE TRAINING AVAILABLE? (click to open me)

Yes there is.   The deanery runs an ARCP preparation course.  Please contact our administrator, Sofya, on admin.GP@bthft.nhs.uk who will furnish you with relevant details and how to book on.   If you are new to doing ARCP panels, you MUST book to go on. This course is for both lay and doctor assessors.

There’s also a training package for lay assessors available from the downloadable resources section above.  However, this is no substitute for going on the course (which is better because it is hands on).  

HOW DO I LOG INTO THE EPORTFOLIO?

You will have been given a ‘panel’ log in code and password via email from our administrator, Sofya.   If not, please contact her on admin.GP@bthft.nhs.uk .

  • To access a trainee’s ePortfolio, go to https://eportfolio.rcgp.org.uk/login.asp
  • Enter you log in code and password and click ‘Login Securely’.
  • Then select the trainee you wish to look at.
  • Once you are in a trainee’s ePortfolio, the navigation system on the left will guide you through the various bits of that ePortfolio.

ARCP OUTCOMES IN A NUTSHELL

No additional training:

  • Outcome 1 – satisfactory (for those not awaiting CCT)
  • Outcome 6 – completed training. Award CCT
  • Outcome 2 – specific competencies required – additional training time not reqd (basically a WARNING: ‘get your act together’ sort of message)

Additional training:

  • Outcome 5 – incomplete evidence presented – additional training time reqd
  • Outcome 3 – inadequate progress – additional training time required (you don’t have to give the extension straightaway – ARCP panel decides when it starts).

Release from Training

  • Outcome 4 – released from training (resigns or chucked out) – with or without specified competencies
  • Outcome 8 -OOP (8i.OOP-Experience; 8ii.OOPR-Research; 8iii. OOPC-Career Break (incl. MATERNITY)
  • Outcome 9. Top-up training (outcome should be indicated in one of the areas above)

FILLING OUT THE ARCP SECTION IN THE E-PORTFOLIO

In the ARCP free text boxes, please provide a clear explanation of the outcome awarded.    If they are satisfactory, you needn’t add much more – keep it short and sweet.  However, it is imperative that you add additional information if they are failing.  You will need to be quite specific.  In particular…

  1. Identify the specific problem – don’t beat about the bush.
  2. Write down the evidence for the outcome.
  3. Specific follow-up action – milestones to achieve.

Don’t forget to ‘cut and paste’ the ARCP outcome and the feedback for the trainee into the Educator’s Notes section of their ePortfolio. In that way, the trainee, the Clinical Supervisor and the Educational Supervisor are well informed and can make plans for the future.

CUT AND PASTE THE ARCP OUTCOME & TRAINEE FEEDBACK INTO THE EDUCATOR'S NOTES

Please ‘cut and paste’ the ARCP outcome and the feedback for the trainee into the Educator’s Notes section of their ePortfolio. In that way, the trainee, the Clinical Supervisor and the Educational Supervisor are well informed and can make plans for the future.

However, DO NOT ‘cut and paste’ feedback for trainees that have been referred to the second tier panel. Wait to see the outcome of the second tier panel and get them to amend the feedback formulated in the first ARCP session before pasting it into the Educator’s Notes.

WORKING OUT THE NEXT ARCP DATE

A trainee needs a panel…

  1. Every 12 months – whether you are full time or not.
  2. Every time you move from one ST year to the next.
  3. If they transfer from one Deanery to another (they should have one just before, or just after)
  4. If they decide to go Out of Programme for a while, like on maternity, or seeking experience abroad (in which case they should have one just before or just after).

Full time trainees only need one ARCP panel per year because 1. and 2. above will coincide.   However, these become out of synch if they go part time for any reason.    The best way of telling when their next panel will be is simply by working out 12 months from their last panel  and then working out their next ST transition date – and then going for the one that is sooner.

REMIND ME ABOUT OOH SESSIONS AND NUMBERS

NUMBERS

The indicative benchmark is at least one session (of at least 4 hours) every   month for a full timer, adjusted for part-time trainees on a pro rata basis.  Sessions usually last between 4-6 hours depending on the OOH provider but in   some areas, it’s not as simple as ‘one session every month’.

  • The minimum is 4 hours per month = 48 hours per year
  • The ideal is 6 hours per month = 72 hours per year

In Bradford, for example, sessions do not last 4 hours, and hence a Bradford GP Trainee needs  to do more; a full timer would need to do around 2 per   month (where one session usually lasts 3 hours).  Remember, this isn’t much compared to what they do in hospital posts (Paeds for instance).  Failure to complete the requisite number of sessions will lead to a   face-to-face deanery ARCP panel review.

TYPES OF SESSION

OOH sessions may include an appropriate mixture of

  • OOH as provided by the local deanery approved provider,
  • ambulance sessions,
  • psychiatric service sessions,
  • social service sessions and so on.

Because the availability of traditional sessions will be different from scheme to scheme the scheme, guidance on what non-traditional services will be accepted should be included as a log entry in the e-P if there is a lack of normal GP OOH so that the ARCP panels can review what has been approved locally.  The skills needed for OOH can be acquired to some extent in these other situations and so where there are for organisational reasons difficulties in completing the expected total of 76 hours it is important for the trainee to complete other evidence to demonstrate the competencies which would normally be acquired in the OOH setting.

CONTENT

The panel has a responsibility to assess 2 areas in relation to OOH.

  • The competencies relating to the skills needed for OOH care – as defined in the RCGP curriculum.
  • Completion of the contractual responsibilities for OOH provision (COGPED define as a minimum of 1 session per calendar month of 4-6 hours on average and BMA standard trainee contract defines as 76 hours per 12 months)

The Panel will expect evidence of the educational quality of the OOH experience.  Therefore, the trainee needs to make sure that each session is supported by a log entry clearly indicating what they have learned. Ideally they should make clear how this relates specifically to the OOH setting (as opposed to what they might have learned from the same case in a routine setting).  They can maximise the chances of their OOH experience being accepted if they write an extra OOH log entry which summarises the evidence in their EP supporting the ‘OOH competencies’ – see the 4 points below.

  1. Can consult effectively on the telephone
  2. Recognise and manage acute illness in the OOH setting
  3. Refer acute illness appropriately in the OOH setting
  4. Understand the organisational aspects of OOH care

By the way, if the trainee is progressing well and there and no concerns other than the fact they have a couple of outstanding OOH sessions that are due to be completed AFTER the ARCP panel, then get the ESR or scheme administrator to ensure that these are done.  Prior to the final ST3 panels GPRs should be encouraged to include a log entry detailing the evidence contained within the eP which demonstrates competency in OOH care.

To read more about Out Of Hours, click here.

A NOTE ABOUT EXTENDED HOURS – which is not OOH work!

Extended hours is not classed as OOH work.  Trainees are to be encouraged to do some Extended Hours but this is not compulsory.

CAN OOH SESSIONS BE DEFFERED?

A trainee needs to do 18 sessions of OOH by the time they get to CCT.  OOH is done whilst they’re in a GP post (they do hospital on-call when in hospital posts).   A trainee spends 18 months of their training in General Practice; so this basically equates to 1 session per month in GP posts.

But there are many requirements in GP training and it can be hard to ‘get everything in’ – especially with the added complexities of life.  Although we say a trainee must have done 18 sessions of OOH by the time of the panel that approves their CCT, it is okay for trainees to defer a MAXIMUM of 2 OOH sessions until after the ARCP date.   The panel needs to make sure that these deferred sessions are indeed booked in and that someone (TPD/ES/Scheme adminstrator?) will check their completion.

SPECIAL CASES

THE GOOD TRAINEE WHO IS ONLY MISSING ONE PIECE OF MANDATORY EVIDENCE

Mandatory evidence is mandatory!   And the numbers stipulated for things like CBDs and COTs are MINIMUM numbers – in other words, they should be aiming to do a lot more.  Therefore, if a trainee is not achieving the minimum number, even if it is one, you have to mark the ES report as unsatisfactory and let your Training Programme Director know.

ARCP PANELS FOR TRAINEES WHO ARE PART-TIME (LTFT) AND/OR OUT-OF-SYNCH

As you may know, all trainees have to have an annual Panel review, which for the majority is in June. For most trainees, this corresponds to their transition between ST years, so the aim of the review is to determine whether they may progress to the next ST year or to CCT.

However, if a trainee is LTFT and/or out of synch (for example if they have taken maternity or other leave), their annual review may not coincide with their ST transition. In this case, the aim of the Panel review, and the ES report which precedes it, is to determine whether they are generally ‘on track’ – in other words, whether

  1. they are engaging with the e portfolio
  2. they are doing COTs, CBDs, DOPs etc at a rate which suggests that by their ST transition date, they will have done the required number
  3. there are no significant concerns about them

This means that as an Educational Supervisor or a Panel member you are doing a slightly different job for the LTFT and/or out of synch trainees. You can work out whether this applies to your trainee by looking at the Profile page of their EP and checking the dates of their posts. The RCGP guidance on Less than Full Time Trainees and WPBA can be accessed from a yellow box at the top of the page. To help you check whether they are doing a reasonable number of assessments, go to the Evidence page, make sure the drop down Review menu is set to their current ST year (it should be, by default) and set the drop down Review menu to ‘All Reviews’, so you can see the total number of assessments they’ve done in their current ST year.

THE TRAINEE WHO IS OUT-OF-PROGRAMME OR ON MATERNITY

Before the trainee leaves:

  • Arrange an ES meeting with a view to doing an ES report just before they leave. In this meeting…
    • Review the evidence – is it satisfactory for where they are at?
    • Make plans for the future (PDP) – for their return to the programme.
  • The (local) ARCP panel needs to give an Outcome 8
  • Email Deanery so that they can record the exact dates the trainee is away. Esme Ross: esme.ross@yh.hee.nhs.uk

When the trainee comes back (within 2 months of returning)

  • Get a Clinical Supervisor’s Report done
  • Get another ES meeting arranged (an ES report will be needed for an ARCP panel; also formulate a PDP)
  • Arrange for a central Deanery ARCP panel (email Grace Coggill – grace.coggill@yh.hee.nhs.uk )
  • All this needs to be done within 2 months of returning
  • If the trainee is Out of Programme for more than 12 months, they need to have their competencies reassessed when they come back.

Remember: ARCP panels will need a ES report and a CS report. Make sure the trainee gets the latter from the current post they are in.

A special case: If the trainee is coming back from maternity with just a few weeks before their CCT – they will need two ESRs and two ARCPs. The first (penultimate) set will be done before they leave – to basically say they are fully competent and that you are happy to recommend for CCT once the remainder of their time is completed. Keep in touch with them and then do the final ESR when they come back (but no more than 2 months before the final ARCP) and inform the Training Programme Directors to sort out an ARCP in timely way so they can be quickly signed off. Otherwise, their CCT will be delayed.

THE TRAINEE WHO HAS HAD A SIGNIFICANT UNTOWARD INCIDENT (SUI)

If a trainee has had an SUI in any of the posts that they have been in during that ST year, this must be reviewed and discussed by the ARCP panel.   The bottom line is that SUIs can be handled locally and if we are happy, we can sign off ARCP locally, but there needs to be an explicit statement in reference to this in the ARCP sign off.  Just so we are all clear from an administrative perspective:  please ensure that the ARCP forms on the day state clearly and categorically that these SUIs have both been discussed and noted.

The following gives some idea of what is considered a satisfactory reflection on SUI events.   First of all, the trainee must be encouraged to write up the SUI in their ePortfolio contemporaneously – either using the embedded SEA section or using one of the many SUI templates around.   The trainee should record a good reflective account of the incident and their learning from it. They should not be defensive or blame others. They should accept their role in the organisational issues that led to the incident.  The write up should show some understanding of the theory behind Signficant Events (e.g. the swiss cheese model) to indicate a higher level of understanding of SUIs in a medical context.

A complaint or an SUI is not a reason for halting ST progression nor withholding CCT acquisition – even if it is still not resolved or undergoing investigation by the time of the panel. If it is of a serious nature and referred to the GMC, then it is the GMC who will decide whether a doctor’s license is to be removed/suspended; we (the panel) continue to approve (if everything else is okay).

In summary:

  • Panels must look at complaints and SUIs for each trainee (if they exist).
  • The panel needs to discuss to see whether the SUI/comlplaint is settled.  It’s not just to raise awareness – need to know is settled or ongoing.
  • For and ST3, a CCT can still be awarded on the basis of the evidence available. If an investigation is ongoing at the time of the final ST3 ARCP panel, a recommendation for CCT can still be awarded because one is still innocent until proven guilty.  The GMC will decide what to do nearer the time of closure.

INFO FOR GP TRAINEES (also good for new panel members)

WHAT IS THE ARCP PANEL & HOW DOES IT FIT IN WITH TRAINING? (click to open me)

The ARCP (Annual Review of Competency Progression) panel meets every June to review the trainees progress and hopefully sign them off so that they can go on to the next ST stage or, if they’re in their final year, get their certificate of completed training (CCT).  The ARCP panel is a formal deanery sub-school of General Practice.  In any round of ARCP panels, each trainee who is due a panel has one panel with one outcome.   For the ARCP panel to be able to sign the trainee off, they have to have their Educational and Clinical Supervisor’s reports uploaded.

WHAT ARE LOCAL PANELS?

The panel is a two stage process, beginning with a local (scheme) panel and concluding with a central (deanery) panel which takes place a couple of weeks after the round of local panels has concluded. Each of the three areas (Leeds, NEYNL and Sheffield) hold central panels in their respective offices. Trainees who are given a satisfactory panel outcome by the local panel, or are out of programme, do not need to be further considered by the deanery panel.Local panels will be chaired by Training Programme Directors with the rest of the panel made up in accordance with the Gold Guide (usually a GP Trainer and a lay panel member).  Deanery input is offered to local panels for as long as local panels wish it (different schemes are at different levels of readiness to run local panels and deanery input is to offer support, advice and consistency as necessary).

  • Local panels review the trainees’ ePortfolios; face to face meetings do not happen at local panels.
  • There are four possible conclusions a local panel can come to with four different actions:
    1. Satisfactory (either for progression or CCT). The panel awards the outcome and the panel chair completes and submits the outcome.
    2. Mainly satisfactory with some minor issues (eg some missing evidence). The panel chair gives feedback to the GP trainee and a timescale to remedy the issues. The panel chair then reviews the ePortfolio after such time has passed and gives a satisfactory outcome and completes and submits the outcome or, if the issues have not been remedied, refers the GP trainee to the second stage of the panel, ie: the central (Deanery) panel (see bullet 4 below).
    3. The trainee is Out Of Programme. The out of programme outcome is given and the date of the next panel is carefully chosen so that the returning GP trainee has time to acquire the evidence for satisfactory progression.
    4. The ePortfolio is thought to be unsatisfactory. The panel chair coordinates the information on the ARCP form. The panel chair sends a written report to their central (Deanery) panel detailing the reasons why the local panel was unable to give a satisfactory outcome.

AND THE DEANERY PANELS?

All GP trainees where there is any doubt about the outcome are reviewed at the second stage central deanery panel. The trainee is told they will have a central panel and they have the opportunity to submit evidence of mitigating circumstances prior to the panel. The decision for a face-to-face or ePortfolio review is made on a case by case basis. The dates of central panels to be advertised in advance and trainees informed that they must make themselves available if required.

  • It is envisaged that some unsatisfactory ePortfolios will become satisfactory by the time of the central panel. If so, then a satisfactory outcome may be awarded, but there should be consideration of entering an Educator’s Note about why the local panel was unable to award a satisfactory outcome.
  • Most unsatisfactory ePortfolios will remain unsatisfactory because of incomplete evidence (either quantitative or qualitative) or the need to develop specific competences, and if so they should be given the appropriate outcome and the reasons detailed on the ARCP form. Neither of these outcomes requires extension of training, although it is a possible future option if the issues aren’t resolved.
  • If an ePortfolio is so flawed, or the trainee is in such difficulty, that they will not complete WPBA within the time (usually 3 years) then the trainee should be given an outcome of inadequate progress and additional training required, or released from training. It should be made clear that it is not the gift of the panel to offer such additional training; that decision rests with the deanery and the Director of Postgraduate GP Education.

The deanery panel sets the date of the next ARCP panel and this goes back to local panels as described above.

WHY HAVE I GOT TWO PANELS WITHIN THE SAME YEAR?

You need an ARCP panel…

  1. Every 12 months – whether you are full time or not.
  2. Every time you move from one ST year to the next.
  3. If you transfer from one Deanery to another (you should have one just before, or just after)
  4. If you decide to go Out of Programme for a while, like on maternity, or seeking experience abroad (in which case you should have one just before or just after).

Full time trainees only need one ARCP panel per year because 1. and 2. above will coincide.   However, these become out of synch if you go part time for any reason.    The best way of telling when your next panel will be is simply by working out 12 months from your last panel and then working out your next ST transition date, and going for the one that is sooner.

WHAT WILL THE PANEL BE LOOKING FOR?

The only information available to the panel is what is on the ePortfolio and visible using the administrator log in. This means that items in the learning log that are not marked as ‘shared’ will not be seen, nor will items saved in the ‘personal library’ section. It is the trainee’s responsibility to make sure that all their work is uploaded appropriately.  For full guidance on how to make sure your ePortfolio is impressive, please read this document:  ePortfolio Pearls – making it work for you.  If you’re a trainee and have got a panel meeting coming up, here are some tips…

  • Make sure all your Educational Supervisor’s reports are upload
  • Make sure all your Clinical Supervisor’s reports are uploaded.
  • Make sure you have MORE than the minimum number of CBDs, COTs/Mini-CEXs. The assessments should also show competence levels appropriate to your stage of training and demonstrate progression and improvement over time.
  • Make sure you are making good progress with your DOPS
  • Make sure you have a good number of log entries for them to look at.  Also be certain to make sure that there is a variety of entries (like clinical encounters, professional conversations, audit/projects, significant events etc).   Your entries need to show a good depth of reflection and analysis- like focusing on your own attitudes, ethics and core values as well as the knowledge and skills domains.   And get your trainer or Clinical Supervisor (e.g. hospital consultant) is reading them AND that you’re mapping them to the curriculum statement headings and that they’re mapping them to the professional competency domains.
  • Make sure you are using your PDP – and making the most of it. This should list identified learning needs, realistic ways to meet them, and show that some of them have been met.
  • Make sure you’ve filled in a trainee self-rating scale on the 12 professional competencies. In the comments box that accompanies each competency, write down the evidence behind your rating score (e.g. for Practising Holistically  you might write: 6 of my last 8 CBDs are marked as competent in this area). Put as much evidence for each competency (CBDs, COTs, MSFs, PSQs, CSRs and so on).
  • Email your Educational Supervisor and ask them if they have ‘Completed and Submitted’ their report (they’ll know what that means). Also make sure that they filled in a competency rating scale for you too.
  • Make sure you’ve done an MSF and PSQ if you need to.

If you want to be confident of a smooth progression through the panel process you should aim to have more than the bare minimum of entries in your portfolio. This additional material may be from additional assessments if they are appropriate, or it may be things that demonstrate thoughtful consideration of your learning needs and appropriate measures to meet them.  Remember, a lack of evidence means ONLY YOU MISS OUT and the panel may ask you to repeat your last 6 months!

SOME NOTES FROM A RECENT ARCP PANEL

Here are some important points we felt it might be worth passing on after having been to a recent ARCP panel meeting:

What the curriculum headings mean:

  • Teaching, mentoring and clinical supervision means the teaching etc which the trainee has done, NOT the educational etc experiences which they have received
  • Management in General Practice means organisational management, NOT clinical management of patients

DOPS

  • There’s no point recording previous experience which hasn’t been directly observed.
  • Also, the procedure has to be on a patient and not, for example, in a skills lab.
  • It’s essential to get the e portfolio entries for the compulsory DOPS put in by whoever observed the procedure. If this isn’t done, you will not get your CCT when you come to the end of ST3.

CSA preparation

  • The RCGP representative who was at the panel strongly recommended that some COTs are done not on video but with directly observed consultations, i.e. the trainer sits in with the trainee. This will help trainees get used to consulting with someone watching. Also, it means that a range of normal consultations are observed by the trainer, not just the good ones which trainees tend to select for COTs

OOH

  • The educational reason for OOH is for trainees to acquire the relevant competencies. Simply recording the number of sessions worked doesn’t provide evidence of this. Trainees should make sure that they write a summary of patients seen and pick one or two to write in more detail with the purpose of providing some evidence for professional competencies.

Quality Assurance

  • A small percentage of trainees will be invited to a panel for quality assurance purposes. This is a RCGP requirement. These trainees will be informed that this is the case and not that their portfolio gives cause for concern.

WHEN SHOULD MY ES MEETING HAPPEN IN RELATION TO ARCP PANELS?

For the ARCP panel to be able to sign you off, they have to have your educational supervisor’s reports uploaded.   Because the ARCP panel meet every June of each year, this means that you must get the Educational Supervision meeting of each post done before the end of May respectively.  For most full-time trainees, we recommend:

  • For Feb – Aug period: ES meeting before the end of May
  • For Aug – Feb period: ES meeting before the end Dec.

HOW MANY OOH SESSIONS DO I NEED TO DO IN A GP POST?

The indicative benchmark is at least one session (of at least 4 hours) every   month for a full timer, adjusted for part-time trainees on a pro rata basis.  Sessions usually last between 4-6 hours depending on the OOH provider but in   some areas, it’s not as simple as ‘one session every month’.

  • The minimum is 4 hours per month = 48 hours per year
  • The ideal is 6 hours per month = 72 hours per year

In Bradford, for example, sessions do not last 4 hours, and hence you need   to do more; a full time Bradford trainee would therefore need to do around 2 per   month (where one session usually lasts 3 hours).  Remember, this isn’t much if you reflect back and think of how many times   you had to do on call in your hospital posts (Paeds for iinstance).  Failure to complete the requisite number of sessions will lead to a   face-to-face deanery ARCP panel review.

Remember: as well as the number of sessions you’ve done, the Panel will expect evidence of the educational quality of your OOH experience – so make sure that each session is supported by a log entry clearly indicating what you’ve learned. Ideally you should make clear how this relates specifically to the OOH setting (as opposed to what you might have learned from the same case in a routine setting).

You can maximise the chances of your OOH experience being accepted if you write an extra OOH log entry which summarises the evidence in your EP supporting the ‘OOH competencies’ (e g the 4 points below), and explains why you were unable to complete 18 sessions. Your ES and the ARCP panel need to be convinced that you

  • Can consult effectively on the telephone
  • Recognise and manage acute illness in the OOH setting
  • Refer acute illness appropriately in the OOH setting
  • Understand the organisational aspects of OOH care

To read more about Out Of Hours, click here.

ADDITIONAL INFORMATION FOR ST3s APPLYING FOR THEIR CCT

The Deaneries need to complete their panel processes for their ST3 trainees 6 weeks before the end of the training programme so that CCTs can be issued on time at the completion date.  The deanery will start to examine portfolios in the first week of June and invite any trainees whose portfolios indicate any concerns to a face to face review in the second week of June.  If you are completing your training programme at this time it is essential that you protect this week in your diaries in the event of an invitation to a panel review. Failure to do this may lead to a delay in your application for a CCT and compromise future employment. In other words, DO NOT BOOK A HOLIDAY DURING THIS TIME.