GP Trainer Reapproval
transforming reapproval into a good learning experience
path: TRAINER REAPPROVAL
- reapproval in scotland – old.doc
- reapproval in yorkshire – old.doc
- reapproval visit – the interviews.docx
- reapproval visit – what to ask the trainer.doc
- reapproval visit preparation – oxford.doc
- trainer competencies (west midlands group).pdf
- trainer reapproval seminar YH deanery – trainer pack.pdf
- trainer reapproval seminar YH deanery – tutor pack.pdf
- Aims, Objectives and Intended Learning Outcomes (ILOs)
- Clinical Supervision
- Communication Skills – teaching
- Communication Skills – the microskills
- Educational Theory – the basics
- Educational Theory – everything
- Evaluation of Teaching & Education (& feedback forms)
- Evidence — what makes a good teacher or teaching?
- Facilitation Skills & Small Group Working Skills
- Games in Education
- GP Training Map
- GP Trainers Toolkit
- How to Teach (according to research)
- Induction Programme for GP Trainees
- Learning Environments
- Learning Needs
- Learning & Personality Styles
- MRCGP pages
- Presentations & Workshops — doing & running
- Random Case Analysis & Reviews
- Teaching for Beginners
- Teaching & Lesson Plans
- Tutorial Theory & Tutorial Suggestions
What I have outline below is how GP Trainer reapproval works in the Yorkshire & Humber region. I hope that it provides something for other regions; perhaps there is overlap with what your region requires from you? It also gives other regions something to compare themselves to and hopefully a stimulus for improving things without becoming too reductionistic.
Even in our own region, many of our trainers find the new electronic forms a little too over-inclusive, especially as some items have already been checked by CQC – so the natural question emerges, why check again at the trainer reapproval panel? Yes, our systems are not perfect! So, if other schemes have a better or alternative way of doing things, please leave a comment at the bottom of the page to help us all learn from each other and fine tune these sorts of things. And under the ‘Downloads’ section, you will find what others do in their regions. Again, if you have an updated version of what you do in your region, let me have it. firstname.lastname@example.org
Even if you are not from The Yorkshire & the Humber region, I am sure much of the material presented below will still be relevant for your own reapproval and thus will aid and simply it for you. There’s also guidance for GP Reapproval Leads and Tutors – see the “DOWNLOADS” section above. Ultimately, this page furnishes you with a headache and stress-free approach to GP trainer reapproval – for GP trainers, reapproval leads, reapproval tutors and more!
How Reapproval works in the Yorkshire & the Humber region
Basically, a GP Trainer is re-approved every 5 years. So, at the end of that 5 years, the trainer will submit documents to show that they and their practice continue to be fit for GP training. To do this, they need to provide the following specific pieces of evidence…
The GP trainer will have attended a GP Trainer Quality Assessment seminar within those 5 years
- This seminar is usually a 2 day course.
- Trainers are asked to bring videos to show how they teach the consultation, and example of how they do COT, how they do CBDs and how they give feedback.
- In addition, they are asked to bring their last Educational Supervisor’s Report.
- All these are checked for quality assurance.
- More on the Trainers’ Quality Assurance (TQA) seminars below.
Submit electronic documents about you, the GP Trainer
- Provide information to demostrate that you have had training and are regularly using the ePortfolio
- Your Educational Activities/Other Educational Experiences
- Your Educational PDP
Submit electronic documents about your GP training practice
- Practice Premises
- QoF and CQC
- QoF & CQC reflection
- List of types of meetings at the practice
- List of attendees at 2 practice meetings
- How your practice participates in Audit
- Trainee & Trainer Timetables
- Description of timetable alterations depending on trainee need
- Induction timetable
- The doctor’s bag – details of what is in it and and how it is checked
Submit or declare the following practice policies are in place
- child safeguarding,
- adult safeguarding,
- chronic disease management,
- prescribing (repeats & acutes),
- equality & diversity policy,
- complaints protocol,
- bullying & harrassment policy,
- signficant event meetings
Reports from others about you
- From your Training Programme Directors about you
- From your Local Appraisal Team (LAT form) to ensure you are in good standing
- Simply download each declaration proforma and sign it off digitally.
- I provided a digital signature and it was ok.
Delegate a lot of it to your PM
You do not need to do it all yourself. I got my Practice Manager to do a lot of it and then I simply tidied it up a little. GP Trainer re-approval in Yorkshire & the Humber necessitates the need to download and fill in specific templates. So, just download them from the re-approval site and email them one by one to your PM with some of the advice below. If your Deanery/HEE GP School doesn’t have a proforma to fill in, ask the PM to simply write
- something in Microsoft Word
- not too lengthy
- given them the examples on this page or just refer them to this page.
Things I wrote on my last re-approval that might help you
I have come across so many GP Trainers with anxieties of exactly how much to write in each of the boxes of the online reapproval form for the Yorkshire & the Humber Deanery. I’ve included what I wrote on my own last GP trainer approval in the hope that this helps you. If you have any ideas for improvement – let me know. I love hearing from people. email@example.com
Submit electronic documents about you, the GP Trainer
As an established trainer up for re-approval, I found this a difficult question to answer. I’m not sure how good a response this is but it is all I could think of. May be there are one or two points you can use too. It’s much easier to answer if you’ve been on a Trainer’s Workshop or Seminar on the ePortfolio. And I don’t think you need to be as exhaustive as I have been here.
- I have run Educational Supervision workshop sessions on using the ePortfolio with the Deanery’s Summer and Autumn Schools – last one being in 2019.
- I have run WPBA workshops using the ePortfolio at the Deanery Summer and Autumn schools – last one being in 2020.
- I have written extensively about the ePortfolio and its use in Educational Supervision, Clinical Supervision and the ARCP process on my website: www.bradfordvts.co.uk
- I co-authored the guide ‘ePortfolio pearls’.
- I declare that I am very familiar with the ePortfolio and that I am using it on a regular basis. My last “Feedback for Educational Supervisors” said: “Really good Educational Supervisor’s Report. Helped us a lot at the ARCP panel. Thank you for the specifics and the effort you have gone to with this trainee to develop her reflection skills as is evident by her learning log entries.”
I simply logged into my e-appraisal toolkit and simply ‘cut and pasted’ all the courses I’ve attended (especially those relating to teaching) into a separate word file and then uploaded that. Don’t forget to include things like local scheme workshops, your schemes yearly trainers’ conference, and deanery/HEE provided educational courses, any other courses related to education and training. Don’t just include the one’s you have attended, but include ones you have facilitated. Even include HDR sessions and group tutorials you have facilitated. Here’s a few examples…
- 21.03.18 Trainers’ Workshop – WPBA revisited
- 20.08.18 Trainers’ Workshop – giving feedback
- 28.9.18 Deanery workshop – Making Decisions
- 21.10.18 Tutorial for GP Trainees on Managing COPD
- 22/23.11.18 Trainers’ 2 day Residential Conference
- 21.12.18 Trainers’ Workshop – trainees in difficulty
- 11.03.19 Trainers’ Workshop – Educational Supervision Update
- 21.05.19 Trainers’ Workshop – Trainer issues
- 28.6.19 Scaling the Heights conference for GP educators
- 21.8.19 Tutorial for GP Trainees on End of Life Care
- 29.9.19 Trainer’s Workshop – Professional Capabilities
- 7.10.19 Half Day Release facilitator – Problem Based Learning session 1
- 14.10.19 Half Day Release facilitator – Problem Based Learning session 2
- 21.10.19 Half Day Release facilitator – Problem Based Learning session 3
- 23/24.11.19 Trainers’ 2 day Residential Conference
- 5.12.19 Half Day Release: Mock CSA course
Provide a brief description of the educational bits of your PDP that you formulated in your last appraisal.
- I would like to attend a Motivational Interviewing course not only to help patients but to help motivate trainees without resistance.
- I would also like to attend a course in Compassionate Communication (Non-Violent Communication), as I feel it will help with giving feedback to others in a way that reduces the chances of resistance and hesitation.
- It’s been a while since I helped out at Half Day Release and I think I’m going to volunteer for 8 weeks to help build up my Educational Skills (and hopefully learn a lot of clinical knowledge from others too in the process).
- And finally, I plan to go on a GP Update course to improve my knowledge of Women’s Health.
Submit electronic documents about your GP training practice
We operate from a purpose built surgery built in 2008 providing large clinical rooms which are compliant with the standards set by The Disability Discrimination Act (DDA) and GP Training. Each GP trainee has their own room which is big enough for video recording and ‘sit and swap’ surgeries’. We have a well-equipped library (providing online access, books and a quiet space for study). We have a separate conference room (providing access to projector, online access and again a quiet space for study. This space is often used by a group of GP trainees practicing for their CSA. There is a small common room downstairs and a large common room upstairs providing a space not only for tea and coffee but also ‘bump zones’ to aid networking with others.
Get your PM to do both .
- Statement of QOF achievement.
- Summary of the CQC inspection.
In Yorkshire & the Humber, it is mandatory you use the template provided.
Attach a short written reflection relating to your practice QOF and CQC achievements. Clinical and organisational factors should be discussed here, and trends/patterns or specific areas for change or improvement within your practice as a training practice should be highlighted in what you write any areas of concern highlighted by QOF and CQC processes should be included.
Trends and Patterns
- See our latest QoF achievements here: http://qof.hscic.gov.uk/search/index.asp ; type in BD10 into the search box and select Ashcroft Surgery, Bradford.
- There has been yearly increases in requests for appointments and work diverted from secondary care. The practice has the same list size but the workload has increased dramatically since last re-approval. Despite this, QoF, DES and LES targets have all been delivered well. This has been through collaborative team work which encourages GP trainees to actively participate.
- From the current set of paperwork, we have achieved 518 points from a maximum of 545.
- Specific areas for change or improvement within your practice as a training practice
- The main clinical area we need to improve on is diabetic care (mainly foot checks and retinopathy screening). We scored 64 from a total available pot of 86 points. We have a new diabetic lead within the practice. No doubt this area will improve over the coming year.
All our protocols and policies are available here: www.ashcroftsurgery.co.uk/protocols
Any areas of concern highlighted by QOF or CQC
- None highlighted in QoF.
- CQC – discussed improving our diabetic care and uptake of chlamydia testing in teenagers.
Trends and Patterns
a) Records and information
- The practice has up to date clinical summaries for over 80% of the patients.
- The practice has a system for summarising new patient records within 8w of registration.
- The practice has a system for acting on information received about patients.
- The practice has a robust system for transferring information to other doctors/organisations (e.g. OOH)
b) Information for patients
- The practice supports patients with appropriate health literature (stopping smoking for example) from a variety of sources (physical/electronic leaflets and online material).
c) Education and training
- All practice members receive annual training in Basic Life Support, Info. Governance & Fire Safety.
- All doctors maintain a record of up to date Child and Adult Safeguarding training.
- All GPs and nurses participate in peer appraisal.
- The practice maintains a register of who is up to date and who is not.
- The practice has a system for handling patient complaints and sharing learning points from discussions.
- The practice has a system for reviewing Significant Events and highlighting points for learning and change. In addition, the practice regularly reviews deaths, patients on the terminal care register, child and adult protection cases.
d) Practice Management
- The practice has clear and accessible pathways for Adult and Child protection.
- The practice offers a range of appointments to patients – online, in person, telephone, face-to-face, video consultations and e-consultations.
- The practice has a system to ensure regular inspection, calibration & maintenance of medical equipment.
- The practice has policies which include a staff manual, employment policies, equal opportunities, bullying & harassment and sickness absence – to which staff have access.
e) Medicines Management
- The practice possesses equipment and in-date drugs appropriate to emergency care in general practice. In addition, there is a system in place for checking the expiry dates of emergency drugs on an annual basis.
- The number of hours from requesting a prescription to availability for collection is 48 hours.
- The practice meets a prescribing advisor at least annually to review and improve prescribing.
- The practice has a medication review process for patients who are on repeats (which is recorded in the medical notes).
Specific areas for change or improvement within your practice as a training practice
- We re-profiled our nursing team last year, to increase HCA time and nursing skills. We created a new admin role specifically for the nurses to help with nursing admin work which is on the increase.
- Looking to increase the skill mix and develop our doctor team with introduction of an employed in-house pharmacist, and Advanced Nurse Practitioner.
Any areas of concern highlighted by QOF or CQC
- None highlighted by QoF.
- CQC – none
Attach a list of the meetings that run regularly in the practice (for example, in a typical 3-month period). Within this please highlight those meetings which trainees are free and encouraged to attend.
The practice holds a number of meetings and GP trainees are expected and encouraged to attend. These are….
- Doctor weekly meeting: discussing various hot topics, messages from various organisations (eg CCG updates) and practice issues – in attendance are Doctors, Nurses, GP trainees, Practice Manager and Assistant PM – others by invitation.
- Protected Learning Time: every Thursday afternoon – Doctors, GP trainees, Nurses, and admin as required
- Significant Event Meetings : 1 per month. All practice members attend including GP trainees.
- Palliative and End of Life care meetings: 1 per month. All clinical staff along with District Nursing Team.
- Children at risk & update meetings: 1 per month: All clinical staff along with Health Visitors.
- Mortality review meetings: 1 per month. All clinical staff.
- Prescribing review meetings: 2 per year on average. All clinical staff with in house pharmacist.
- Ashcroft Nursing Home Weekly Ward Round: a nominated GP goes. GP trainee occasionally invited to join to learn.
- CCG/CCF meeting: 1 per month – GP & PM – GP trainee invited if they show interest.
- Committee of Reps meetings: 1 per quarter – GP & PM – GP trainee invited if they show interest.
GP Trainees are also released to….
- 2 in-house tutorials per week each lasting 1.5h.
- weekly Wednesday 1.5h tutorial focused on clinical topics, devised by the scheme.
- Half Day Release every Tuesday pm.
- Attach details of 2 such meetings held in the past 3 months. Declare that minutes of meetings are dated, with names and roles of those attending.
- Regular meetings should be clearly structured with agendas, objectives, clear descriptions of topic, list attendees etc.
Our practice identifies areas worth analysing via audit through
- Significant Events (practice and personal)
- Prescribing Review meetings in liaison with our in-house pharmacist
- Items on QoF that we are underachieving
- Through items on Local and Direct Enhanced Services
- When we (as a practice) feel or know there is a clinical area that we may be neglecting
- From clinical ideas as a result of attending courses like GP Update
- Be specific about where debriefs happen.
- Highlight tutorials and other educational (e.g HDR) activities.
- State how trainee gets OOH/UUC experience.
- Who supervises when Trainer is away?
- Does trainer timetable include 1h per week for educational preparation time (e.g. for tutorial preparation, ePortfolio reading etc.)?
- In Yorkshire & the Humber, you must use the timetable proforma they give you and not your own.
Ask PM to write a brief account about how this timetable might alter depending on the particular needs and level of each trainee (i.e. appropriate adjustment of appointment length, GP trainee involvement with telephone triage, home visits, insurance and other paperwork, tasks etc.).
We recognise that all trainees are different and that they learning and develop in varying ways. Therefore, we modify GP training at this practice in the following ways to help construct a smoother progression and development for the trainee.
- The number of sessions in the GP trainee’s timetable is dependent on whether they are full-time or part-time.
- If they are part-time, we try to ensure as much overlap as possible between the trainer and the trainee (at least 50%). Attendance at the Scheme’s HDR is scheduled in.
- We then make fine adjustments to the timetable if there are particular trainee needs. The trainer approves these finer adjustments.
- For example, surgeries might start later or finish earlier if there are child care issues.
- If a trainee is struggling or has acute social/home issues, we may temporarily put in some appointment blocks to make surgeries feel less pressured.
- If the trainee needs to be away on certain days (e.g. academic GP trainee), we will provide for that.
- If the trainee is nearing their AKT exam, some of the tutorials may be put in with other GPs to increase knowledge levels.
- If the trainee is nearing their CSA exam, some tutorials are changed to CSA mock practice with the Trainer, with more “sit and swap” surgeries.
- GP ST1’s usually start on half-hour appointments and we gradually work them down to 15 minute appoints.
- GP ST3’s usually start on 20 min appointments and we gradually work them down to 10 minute appointments.
- How quick this happens depends on the trainee and is done only after liaising with the GP trainer and the trainee.
Increasing Clinical Exposure:
- In order to get GP trainees trained up to real world General Practice, we involve them in the following (but only when the time is right)
- Home visits
- Various Reports
- Death Certification
- Clinical Tasks
- Projects to help us reach targets
- In Yorkshire & the Humber, there is no proforma for this.
- Ask your PM to give you the last time table they used.
- The induction timetable should cover at least 2w.
- It should show things like tutorials, sitting in with various staff, tour of premises, etc.
There are minimum requirements that some Deaneries/HEE GP schools stipulate that should be included in your Induction Pack. Here are the minimum requirements…
- Introduction to the work of all members of primary health care team.
- Trainee knowing and understanding the ways in which they can also communicate with members of the practice team including admin staff/managers, and clinicians, Doctors, nurses, HCAs and other attached clinical staff such as counsellors, midwives, health visitors etc.
- Trainee understanding how they can contact you, their GP trainer for help/advice throughout the day.
- Trainee is shown how to use equipment and facilities.
- Audiovisual equipment for recording and reviewing of consultations for WPBA. Discussion about their personal responsibility for protecting media which holds patient information including camcorders, etc. Keep under lock and key when not in use. Never leave recording equipment alone in an empty room.
- Basic training in how to navigate the practice computer system and also any practice intranet / desktop / library facilities.
- Child and Adult protection protocols/policies. Must be a discussion re: recognising protection issues and the multidisciplinary aspects of putting protection into place.
- Trainees own personal safety issues – i.e. panic alarms, room layout, keeping doors locked etc.
- Trainee understanding how to raise concerns during the placement.
- Information about how to access counselling or occupational health advice.
- Details of how trainee applies for study and annual leave.
Submit or declare the following practice policies are in place
These are policies from my surgery – Ashcroft Surgery in Bradford. Feel free to adapt and use. Click a blue link to take you there.
Reports from others about you
For Yorkshire & the Humber GP Trainers – please be aware there are two other forms that need to go off to other people who need to send them back to you for you to then upload. DO THIS AS EARLY AS POSSIBLE. These forms are
- A TPD report on you – download the proforma and email it across to your friendly neighbourhood TPD.
- A LAT request form – which you send to the appraisals team who will sign it off saying if there are any GMC/Investigation concerns about you. You have to email this to
- firstname.lastname@example.org West Yorkshire Area Team (this is the one for Bradford)
- email@example.com North Yorkshire and the Humber Area Team
- firstname.lastname@example.org South Yorkshire Area Team
Training the Trainer Videos
Here are 14 videos grouped into 3 modules for you to work through. Don’t watch them all in one go – bit by bit and gradual is the key. Let it soak in so that you can mull it over and build it into your own mental schema. These videos are not specifically designed for the GP Trainer in mind, but the key messages and principles are the same. And they may well help trigger insights and thoughts before your GP trainer re-approval.
Oh, and good luck. I hope you get lots out of your Reapproval Teaching Quality Assurance Workshop and that it is fun. I also hope this page has helped you in some little or big way.
Your apprehension about the GP Trainer’s Reapproval Interview is understandable. In fact, all interviews create anxiety within all of us. At the end of the day, the Trainer Reapproval process is all about ensuring that both the Trainer and their Training Practice (i) are still skilled up clinically and educationally (according to GMC standards), (ii) they are maintaining these skills, (iii) they still have that passion for GP training and (iv) their training is trainee-centred with protected time. The truth of the matter is that if your Deanery or GP School truly understands this philosophy behind re-approval, then they will also understand that the purpose of the GP Trainer’s Reapproval interview is NOT to grill you but to make it an opportunity for you to showcase you and your practice’s training programme and thus worthiness of being reapproved for another 5 years. There are some GP training practices, who don’t maintain their educational skills, rest on their former achievements in years gone by, and over time have become rusty. Do you think it is right for an enthusiastic dynamic GP trainee who will be a GP of our future to be placed there? And the interview process helps recognise these practices that need further input, thus helping decided if they want to continue with GP trainee and what they need to do to get there.
The interview panel will probably want you to furnish them with good evidence for the things below. You cant just “talk the talk” – they will want real examples or real practical suggestions to show that you have thought about it and competent to deal with it. They just want to make sure that….
- you are a committed GP trainer and that you are doing it for the right reasons.
- you are maintaining your educational skills. This includes basic educational theory. You have attended courses run by Deanery, local schemes and other educational establishments. Perhaps you have helped out at HDR. Nearly everyone says how wonderful the GP School/Deanery led trainers’ courses are – so, do make sure you go!
- you are up to date with GP training in general and its individual components.
- you have a structured and holistic approach for “the trainee in difficulty”
- GP training in your practice is practice based activity and not solely delivered by the GP Trainer. In other words, they will want to know how you use other members in the practice to help with training. Using the strengths of others.
- on a practical level, they will probably want to review and perhaps quiz you about your
- induction programme & timetable
- weekly timetable for the trainee – (i) ensuring it does not break the 40h/week rule, (ii) clearly shows debriefs, (iii) clearly shows who the clinical supervisor for each day, (iv) shows protected time for tutorials and admin/personal time.
- you have a system in place for adjusting the weekly hours if a trainee does an OOH session
- that provision is in place for tutorials when you are away on leave
- how will you introduce OOH training to the trainee
On the Bradford VTS pages for New and Intending Trainers, there are some examples of the types of questions they are asked during their interview (see the “DOWNLOADS” section). Some of these are the type of questions they will ask you. Click here to go to the BVTS pages for New and Intending Trainers.
Every GP trainer has an educational philosophy – they just don’t realise that they have one! And educational philosophy is basically a statement about your teaching beliefs; your core values and beliefs about teaching upon which your teaching practice is based. You may not have ever thought about your educational philosophy in a structured or deeper way, but that’s not to say you don’t have one.
For instance, do you strongly believe that trainees should be respected as equal adults to you and your colleagues? Do you believe in treating them as adult learners rather than spoon feeding them? Every time you have a new trainee, do you just do the same thing again and again or do you tailor it to the trainee, their specific needs and difficulties? If so, did you know that you’re believe in being trainee-centred. All of these things form the basis of what is your educational philosophy.
The term “educational philosophy” sounds intellectual and some may even think a bit “snobbish”. But can you see the need for everyone to have an educational philosophy just like the way you have a philosophy for living the life the way you do?
Good & McCaslin (1992) wrote some key principles about teaching worth sharing with you. I like being reminded of these principles which form the basis of what I try to do as a GP Trainer/Educator.
- As a teacher your aim is to develop your trainee’s expertise within an application context, understanding of knowledge, and self regulated application of skills.
- Your teaching content should be organised around a few powerful ideas (basic understandings and principles). Try not to be too exhaustive.
- The teacher’s role is not just to present information but also to scaffold and respond to trainee’s learning efforts.
- The trainee’s role is not just to absorb or copy new information but also to actively make sense and construct meaning. Get them involved!
- Construct educational activities that call for problem-solving or critical thinking, not just memory or reproduction;
- Higher order thinking skills are developed in the process of teaching subject matter knowledge with application contexts that call for trainees to relate knowledge to their lives outside the classroom by thinking critically or creatively about it or by using knowledge to solve problems or make decisions.
If you have any to share, be brave and post them down below in the comments box.