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IMPORTANT NOTE: AS OF FEB 2013 THE CURRENT OOH SYSTEM IS BEING REVIEWED AND MODIFIED.  THERE MAY BE INACCURACIES ON THIS PAGE RELATING TO INFORMATION SPECIFICALLY FOR TRAINEES IN THE WEST YORKSHIRE REGION.  AS SOON AS WE HAVE A CLEAR PICTURE, WE WILL UPDATE THIS PAGE.

GP trainees in GP  posts should have experience of both face to face care and telephone triage. Trainees will do sessions with NHS Direct at their  Wakefield centre – which will include comprehensive training in telephone triage  as well as an introduction to their systems. Training in telephone triage and NHSD’s  systems will be a useful addition to GP training.

We’ve noticed that a lot of trainees are being referred to ARCP panels for making unsatisfactory progress with respect to OOH training – either not doing the minimum required number of sessions or (more commonly) not writing them up in a way that shows their reflection and learning. PLEASE REMEMBER, YOU ARE PAID TO DO OUT OF HOURS – IT’S INCLUDED IN YOUR SALARY!

It is the trainee’s job to make the job of your educational supervisor and  the ARCP panel easy.   In this case it means do the OOHs, write it up, preferably with  something about what you have learnt and ideally document competencies in  relation to the attached COGPED statement.

The training programme director with lead responsibility for OOH is Nick Price. Please contact him if you have any further queries.

EXAMPLE OF AN OOH REFLECTIVE LOG ENTRY

PLEASE CLICK THE HEADERS BELOW TO SEE MORE

  • Venue: Bradford OOH
  • Date: July 21st
  • Time: 19:00 – 23:00 5 hours
  • Supervisor: Dr Ashraf Khan
  • Type of session: face to face consultations
  • Number of patients seen: 7

  1. LRTI – 64 yr old Asian lady with COPD and CKD seen with daughter interpreting. Presented with symptoms and signs of LRTI, admitted to BRI due to tachypnoea, tachycardia, and dehydration.
  2. Abdo pain – 18 yr old girl with Down’s syndrome, seen with parents, with crampy abdo pain and 3 wks alternating constipation and diarrhoea.
  3. Threatened abortion – 19 yr old lady with partner with threatenred abortion at 6 wks. Scan arranged for 1 week later, patient unhappy with wait.
  4. 2yr old, wheezy and pyrexial from URTI.  Seen with separated parents, much confusion between them abot which inhalers were prescribed. Desperate for something to be done to help child sleep. Advised child was well at present (wheeze and pyrexia settled), and needed to see own GP for further clarification of long term management plan.  Several minor respiratory infections – children and adult,  acute back pain,   probable depression, drug abuser seeking medication, new migraine, emergency   contraception.
  5. Acute back pain – 24y old with acute low back pain for 3d, not settling.  No alarm features.  Analgesia and mobility advice given.  see own GP
  6. Probable depression – 33y old low mood, going on for months but getting worse.   no suicidal ideation.   empthathised, advised to see own GP.
  7. Migraine diagnosis – 45 y old with typical migrainous headache (hemicrania, photophobia, aura etc) – given im sumotryptan

Communication – I found the case of the girl with Down’s syndrome interesting as I presumed I was going to have immense communication and cognitive difficulties with her.  I was also anxious not to miss a serious problem – perhaps she would not be able to accurately present her problems.   But this couldn’t be further from the truth!   The patient was charming and cooperative.  She spoke quite a few words to me and we didn’t really need much input from her parents (although they did contribute, of course).

  1. I must not presume that someone with learning disabilities means the consultation will be more difficult (person centred care and hence practising ethically)
  2. I built rapport in this particular case by introducing myself  and showing interest in her comments about cartoons and toys.  This helped the consultation to ‘flow’. (communication skills)
  3. Of course, there were other things that made this consultation ‘flow’ – such as keeping questions and language as simple as possible. (communication skills, data gathering)
  4. It’s important to engage other people present in the consultation (in this case, the parents) not only to triangulate the information recieved (data gathering & interpretation), but to get a fuller picture (practising holistically) and make them feel involved.
  5. During the examination I was conscious that it was important to keep things as comfortable as possible for her while still completing the necessary exam as I did not want to lose her trust and possibly make her frightened of doctors in the future.  In fact she expressed no pain and giggled throughout her abdo exam.

In the end, I was relieved to exclude an acute abdomen and was pleased that the consultation went well with the invaluable input of the patient’s parents.  I think she had constipation.  She hadn’t been to the toilet for several days, her motions prior to that were round pellet like and the pain was crampy and colicky in nature.   There were no alarm features and the history was fairly acute (making diagnoses/decisions).  I gave her some movicol and suggest she be reviewed by her GP in 2 weeks if no better. (clinical management)

Here are the competencies the Clinical Supervisor awarded…

  1. Communication Skills
  2. Data gathering & interpretation
  3. Practising holistically
  4. Making diagnoses/decisions
  5. Clinical management

Notice how the trainee in this excellent write up indicates (in parentheses) which clinical competencies her statements and learning points relate to.   For a professional competency to be awarded, you must show some reflection on that particular competency resulting in some sort of action to be maintained or pursued in the future.

SETTING THE RECORD STRAIGHT

The General Medical Services contract (GMS) has defined the normal working day for general practice to be between 08.00 and 18.30 on all weekdays except public holidays. Thus, OOH is defined as that work undertaken between 18.30-08.00 and all day at weekends and on public holidays. However, in GP training, OOH is also taken to mean the type and style of working that takes place in this time.  At Deanery level it has been decided that GP trainees in GP posts should have experience of both face-to-face care and telephone triage. Therefore, trainees will do:

  • Sessions with NHS Direct at their Wakefield centre – which will include comprehensive training in telephone triage as well as an introduction to their systems. Training in telephone triage and NHSD systems will be a useful addition to GP training.
  • Sessions with LCD, at Eccleshill – roughly 6 x 6h per 6m full-time equivalent GP post.  If your sessions are less than 6 hours each, then basically you have to do enough sessions to make up a minimum of 24 hours in total within that 6m period.

We’ve noticed that a lot of trainees are being referred to ARCP panels for making unsatisfactory progress with respect to OOH training – either not doing the minimum required number of sessions or (more commonly) not writing them up in a way that shows their reflection and learning.  It’s the trainee’s responsibility to do the OOHs, do the right number of OOHs and write them up in the most reflective and educational way.   Please try to make the job of your Educational Supervisor and ARCP panel easy – they really do want to push you through but cannot do that if you don’t provide the right information or evidence!

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

THE BASICS

  • Who to contact: The Training Programme Director with lead responsibility for OOH in Bradford  is Nick Price. Please contact him or Sofya Loren (our administrator) if you have any queries or problems in relation to OOH.  And do this EARLY.
  • Guidelines on OOH: Basically you need to do on call. In hospital posts, this will be whatever the department has organised. In general practice posts, you will participate in a rota for on call with the Out Of Hours service providers. The rota will have already been worked out in advanced and is available on this website.  Click here to see the rota now.
  • We realise that GP trainees are human and like most doctors are not overcome with a love of on-call. You are paid a significant uplift in your salary for on-call and so cannot opt out. However, you might find it helpful to remember that the Yorkshire-Humber approach is an educational one rather than a punitive or service approach.
  • Yorkshire being so diverse in geography has different on-call systems in different areas. There are a number of organisations involved in the delivery of OOH and unscheduled care services, including GP co-operatives, commercial services, NHS Direct, NHS 24, nurse triage, urgent care centres, minor injury centres, primary care walk-in centres (eg Darzi centres), GPs embedded within A&E departments and some remaining individual practices and practitioners. The model of service provided is out of necessity varied; this also means that one model as an answer does not fit all.  Don’t be surprised if what you are doing differs from a peer on another scheme.

The problem with OOH sessions is that they can appear very unstructured in terms of learning because of its nature (people presenting at random, unpredicatably of what will come in etc). Some trainees feel they dont get much out of OOH sessions whilst others say the opposite. The reality is that trainees who get a lot out of it either have a really good clinical supervisor OR the trainee is so motivated that (s)he maximises the learning potential within the session.  The main thing is that the Trainees get a wide experience in OOH which includes differing timing of shifts and telephone/visits etc. For example, if the Trainee was in the Outer Hebrides then they might need to do more hours but in inner city areas the Trainer/Deanery might feel they have achieved the competencies required in a shorter amount of time.  In a nutshell, you have to engage in OOH so that before we sign you up as qualified GPs, we can be certain that you:

  1. Are able to manage common medical, surgical and psychiatric emergencies in the out-of-hours setting.
  2. Understand  the organisational aspects of NHS out of hours care.
  3. Are able to make appropriate referrals to hospitals and other professionals in the out-of-hours setting.
  4. Can demonstrate the communication skills required for out-of-hours care.
  5. Can manage your own individual personal time and stress.
  6. Are aware and can maintain your personal security and awareness as well as that of others.

The COGPED statement makes it very clear that it is the trainee’s responsibility to present the ARCP panel with sufficient evidence to convince the panel that the appropriate competencies have been gained. Don’t be too worried about whether their OOH sessions have been 4 or 6 hours long and but concern yourselves diligently with demonstration that the Chapter 7 competencies have been acquired.  Satisfying the panels that OOH competencies have been acquired is one of the most frequent problems trainees encounter at ARCP time and at the end of the training programme this is a high stakes issue – so please do not to take this issue lightly. And please if you have any doubts or queries, ask for clarification sooner rather than later.  Encourage the OOH Clinical Supervisor to complete a feedback sheet (they’re meant to do this anyway) – perhaps in relation to the 6 competencies above. Make sure you share with your trainer not only for evidence purposes but to encourage reflection and consolidate learning. Do this at the next available opportunity with your trainer.

SPECIFIC POINTS FOR BRADFORD TRAINEES

To work in Out of Hours in General Practice, you need to have a smart card to give you authorisation to access electronic medical records through a piece of software called SystmOne (why they can’t spell System, I will never know!).

  • It is your  responsibility to ensure you have a smartcard
  • Access to  SystmOne OOH is only available via a smartcard and is a requirment when working  OOH sessions
  • You will need  to contact Susan Webster susan.webster@bradford.nhs.uk or Julie Hayley julie.hayley@lcdwestyorks.nhs.uk with  your name and smartcard number so one of them (sponsor) can arrange  for you to be given access to this particular unit.
  • YOU MUST DO THIS IN GOOD TIME before you are due to work  OOH.

A smartcard can take approximately 2 weeks to set  up.  You have to provide a sponsor with  the completed form and ID so they can then complete part 3.  You then need to go to the PCT to have your  card issued. Adding access to this unit will normally take 1  week.  The sponsor fills out a form and  sends it to the PCT for processing.

VERY IMPORTANT PLEASE READ: DO YOU WANT TO CREATE A CLINICAL RISK?  IF YOUR ANSWER IS “NO” PLEASE ACT NOW!

  • If you use SystmOne in any form you MUST have a working valid Smartcard.
  • If you receive any of the following messages please speak with one of the contacts below:
    • RBAC Verification Mode – “Your Smartcard is not setup to allow you to access to this UNIT
    • RBAC Verification Mode – “There is a discrepancy between your Smartcard and your SystmOne access rights”

Who to contact:

WHO ORGANISES THE OOH ROTA & WHERE CAN I FIND IT?

The Programme Director lead for OOH in Bradford is Nick Price.  Both he and Sofya (our administrator) organise the OOH rota which you can find online.  It’s under the navigation menu tab ‘Our Scheme & Us’.

WHEN DOES OOH HAPPEN?

The  new General Medical Services contract (nGMS) has defined the normal working day  for general practice to be between 08.00 and 18.30 on all weekdays except  public holidays. Thus, OOH is defined as that work undertaken between  18.30-08.00 and all day at weekends and on public holidays. However, in GP training, OOH is also taken to mean the type and style of working  that takes place in this time.

WHERE DOES OOH HAPPEN?

If you are down for a face-to-face or telephone session with patients at the OOH centre, then it will be Eccleshill Hospital.   Eccleshill Hospital is opposite Ashcroft Surgery (where Weds Tutorials are held).    Address: Eccleshill Hospital, Newlands Way, Off Harrogate Rd, Eccleshill, Bradford, BD10 0EP    Phone:01274 623000.   Click here to see Eccleshill Hospital on a map.

If you are down for a mobile session – i.e. where you are driven to patients’ homes in a car, then you will need to report to Westbourne Green Community Hospital.    Address: Westbourne Green Community Hospital 50 Heaton Rd, Bradford BD8 8RA  Phone:01274 322093.  Click here to see Westbourne Green on a map.

WHAT IF I NEED TO CANCEL MY OOH SESSION?

Firstly, you shouldn’t cancel unless it is absolutely necessary. If it is, you should try and swap that session with one of your colleagues; it is your responsibility to do this.

After making changes, YOU MUST INFORM:

  1. the trainer you would have originally been on call with
  2. the new trainer you will be on call with
  3. the co-operative/deputising service (tel: 01484 487272) , and
  4. Dr. Nick Price & Sofya Loren (our administrator)

AM I COVERED TO DO OOH SESSIONS? (INDEMNITY & LIABILITY)

Trainees  in general practice will be subject to the normal processes of clinical  governance, GMC regulations and civil law.  Each  doctor will carry their own professional insurance and medical indemnity  organisations have indicated that a GP trainee’s standard membership will  provide indemnity for work undertaken during OOH training.

In short… YES. But double check with your medical indemnity cover provider (usually MDU or MPS).

WHAT ARE THE GUIDELINES ON OOH COMMITMENT?

Basically you need to do on call. In hospital posts, this will be whatever the department has organised. In general practice posts, you will participate in a rota for on call with the out of hours service providers. The rota will have already been worked out in advanced and is available on this website (go to the bottom section of the home page).

We realise that GP trainees are human and like most doctors are not overcome with a love of on-call. You are paid a  significant uplift in your salary for on-call and so cannot opt out. However, you might find it helpful to remember that the Yorkshire-Humber approach is an educational one rather than a punitive or service approach.

Yorkshire being so diverse in geography has different problems about on-call in different areas.  There are a number of organisations involved in the delivery  of OOH and unscheduled care services, including GP co-operatives, commercial  services, NHS Direct, NHS 24, nurse triage, urgent care centres, minor injury  centres, primary care walk-in centres (eg Darzi centres), GPs embedded within A&E departments  and some remaining individual practices and

OOH EXPECTATIONS

The number and frequency of out of hours sessions to  be completed whilst working in a training practice is defined in Form B for  each post. This is usually, but not always, at least one session of at least 4  hours per month.

As a trainee you need to discuss with your trainer – and  / or educational supervisor how you are going to fulfil your out of hours  commitments during your induction to the training practice. Leaving this until  later might reduce your opportunities to complete a sufficient number of  sessions toward the end of your post and create problems when an ARCP panel  assesses your portfolio.

There needs to be an appropriate balance between  telephone consultations and face to face consultations in your out of hours  experience. You should discuss this with your trainer at induction and review  your progress through the post. Consulting on the telephone is an important  skill and should not be neglected. As a guide it might be considered that  between a third and a half of your out of hours sessions should focus on  telephone consulting. This might vary depending on how much telephone  consulting is experienced in the practice in normal hours and the rate of  competency progression.

A separate but related issue is the development of the  competencies detailed in chapter 7 of the GP curriculum – Care of Acutely Ill  People. These competencies can be developed in a number of settings in primary  and secondary care and within working hours as well as out of hours. Working in  an out of hours setting provides a different and important experience in  managing acutely ill people. When your portfolio is assessed by an ARCP panel  evidence of satisfactory competence progression in a variety of settings will  be required.

Finally you should remember that some out of hours  centres and some sessions tend to be busier than others. It may be the case  that in order to demonstrate all the required competencies you might need to do  more sessions than those specified in form B or more daytime “on  call” activity. You should discuss this with your trainer and educational  supervisor sooner rather than later and not leave it until an ARCP panel  advises that your portfolio does not demonstrate sufficient coverage of the  curriculum in this area.

HOW WILL I BE SUPERVISED?

Depending on what stage you are at in your training and how experienced you are, your clinical supervisor may either oversee your work in detail or take a step back and see how you get on.

  • Direct Supervision – the GP StR is supervised directly by the  clinical supervisor and takes no clinical responsibility.
  • Close supervision – the GP StR consults independently but with  the clinical  supervisor  close at hand e.g. in the same building.
  • Remote  supervision – the GP StR consults independently and  remotely from the   clinical supervisor, who is available by telephone. An    example   of such  a session would include a session ‘in the ‘car’ supervised by another GP ‘at  base’.

WHAT SORTS OF THINGS WILL I BE DOING IN THE GP OOH SESSION?

There needs to be an appropriate balance between telephone consultations and face to face consultations in your out of hours experience. You should discuss this with your trainer at induction and review your progress through the post. Consulting on the telephone is an important skill and should not be neglected. As a guide it might be considered that between a third and a half of your OOH sessions should focus on telephone consulting. This might vary depending on how much telephone consulting is experienced in the practice in normal hours and the rate of competency progression.

A separate but related issue is the development of the competencies detailed in chapter 7 of the GP curriculum – Care of Acutely Ill People. These competencies can be developed in a number of settings in primary and secondary care and within working hours as well as out of hours. Working in an out of hours setting provides a different and important experience in managing acutely ill people. When your portfolio is assessed by an ARCP panel evidence of satisfactory competence progression in a variety of settings will be required.

Finally you should remember that some out of hours centres and some sessions tend to be busier than others. It may be the case that in order to demonstrate all the required competencies you might need to do more sessions than those specified in the Form B or more daytime “on-call” activity. You should discuss this with your trainer and Educational Supervisor sooner rather than later and not leave it until an ARCP panel advises that your ePortfolio does not demonstrate sufficient coverage of the curriculum in this area.

LEARNING THROUGH OOH

The problem with OOH sessions is that they can appear very unstructured in terms of learning because of its nature (people presenting at random, unpredicatably of what will come in etc). Some trainees feel they dont get much out of OOH sessions whilst others say the opposite. The reality is that trainees who get a lot out of it either have a really good clinical supervisor OR the trainee is so motivated that (s)he maximises the learning potential within the session.  The main thing is that the Trainees get a wide experience in  OOH which includes differing timing of shifts and telephone/visits etc.  For example, if the Trainee was in the Outer Hebrides then  they might need to do more hours but in inner city areas the Trainer/Deanery  might feel they have achieved the competencies required in a shorter amount of  time.

And these are the 6 generic  competencies which YOU NEED TO DEMONSTRATE:

  1. Ability to  manage common medical, surgical and psychiatric emergencies in the out-of-hours setting.
  2. Understanding  of the organisational aspects of NHS out of hours care.
  3. Ability to  make appropriate referrals to hospitals and other professionals in the out-of-hours setting.
  4. Demonstration  of communication skills required for out-of-hours care.
  5. Individual  personal time and stress management.
  6. Maintenance of  personal security and awareness and management of the security risks to others.

The  COGPED statement makes it very clear that it is the trainee’s responsibility to  present the ARCP panel with sufficient evidence to convince the panel that the  appropriate competencies have been gained. Don’t be too worried about whether their OOH sessions  have been 4 or 6 hours long and but concern yourselves diligently with  demonstration that the Chapter 7 competencies have been acquired. And remember that chapter 7 competencies  can be acquired in a variety of settings in addition to OOH.  Satisfying  the panels that OOH competencies have been acquired is one of the most frequent  problems trainees encounter at ARCP time  and at the end of the training  programme this is a high stakes issue – so please do not to  take this issue lightly. And  please if you have any doubts or queries, ask for clarification  sooner rather than later.

Encourage the OOH clinical supervisor to complete a session feedback sheet (they’re meant to do this anyway) in relation to the 6 competencies above. Make sure you sshare with your trainer not only for evidence purposes but to encourage reflection and consolidate learning. Do this at the next available opportunity with your trainer.

WHAT IF I DIDN'T SEE THAT MANY PATIENTS IN MY OOH SESSION?

It doesn’t look good if you only saw 2 patients during an OOH session.   The worry is that you may not be getting adequate exposure.  Therefore, you may need to do additional sessions to demonstrate adequate exposure.  You do need to do a minimum of 24h in a 6 month period, but if those OOH sessions are all quiet – then there is little evidence to give you an okay.   If you end up having a quiet time during OOH, please think – how can you make the session more educationally useful?  For instance, how about discussing the structure and organisation of OOH with your Clinical Supervisor?  How about sitting in with reception staff and seeing how they field calls?  How about fielding some calls yourself?  We hope you get the idea.  Remember, panels are assessing what’s in the e-Portfolio (i.e. the content), and not just the number of sessions done.

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

WHAT IF I AM PART-TIME? (LTFTT)

Trainees who are working less than full time in a traditional GP post are not expected to do the same level of on call as a full timer. Their slice of the cake should be pro rata i.e. 60%.

SO IT'S ALL ABOUT THE NUMBERS?

In the beginning when the portfolio was very new the Deanery ARCP panels were asking trainees to log 6    sessions of OOH – then they moved onto specifying number of hours. Now they are   looking for something educationally more appropriate in terms of demonstrating   that trainees have had sufficient experience to satisfy the panels that they   have acquired the competencies specified in chapter 7 of the curriculum – Care   of the Acutely Ill.

Besides being a more meaningful assessment this recognises that OOH sessions   in different places provide different experience, caseload and mix. Panels have   previously found that although trainees had done 6 sessions of OOH in some   sessions they saw so few patients (some have seen no patients at all) that they   could not be given satisfactory outcomes.

So we ask trainees to log sufficient sessions sufficient hours and sufficient   experience And state clearly that simply logging six sessions attended is most   unlikely to be found satisfactory.

COURSE ON THE ACUTELY ILL

Yorkshire-Humber Deanery runs a regularly scheduled Care of the Acutely Ill course. See the Y&H Deanery website for more details.

CRITERIA FOR QUALIFYING AS A OOH CLINICAL SUPERVISOR

All Clinical Supervisors must be able to teach  although they will not necessarily require the educational expertise required  of GP trainers.  The following are considered to be fit:

  • GP Trainers,  GP Associate Directors and GP Programme Directors
  • Holders of postgraduate  certificates, diplomas or degrees in education.
  • GPs who have been on the Deanery’s Clinical Supervisor’s training course.
  • Doctors with  significant teaching experience (postgraduate or undergraduate)  within the last five years, subject to the  approval of the patch Associate GP Director.
  • Non-GP  clinical supervisors:
    • Those recognised  by their own profession as qualified to teach students of the level to which  they will be teaching GP StRs.
    • Those who have  completed a Clinical Supervisor’s training course with the Deanery

WHY DO I NEED TO DO IT IF I DON'T PLAN TO DO OOH WHEN I QUALIFY?

The opinion of the College is that GP StRs  should continue to be trained in OOH work, as this remains a core part of the  GP’s role. However, opinion doesn’t mean anything without justification, so here goes:

1. Some of the skills and  competencies needed for OOH care, for example those exhibited in undertaking  telephone triage, also take place during the normal working day, and therefore is a good opportunity for more practise and consolidating learning

2. You cannot predict your future. Your circumstances might change where you might need extra income and thus engage in OOH. For that reason, isn’t it better to have had some training than none?