Urgent Unscheduled Care (UUC) – what does that mean?
An essential part of gaining confidence in General Practice
As a GP, you will need to be capable of handling urgent and emergency presentations who present in an unscheduled manner. By unscheduled, we are referring to patients who want to see a doctor acutely (i.e. they did not book into a routine scheduled appointment). There are a variety of settings in which patients present urgently in an UNSCHEDULED manner.
- Duty Doctor for the surgery (i.e. on-call surgeries)
- Out of Hours Emergency GP Centres
- GP centre attached to A&E departments
- GP Extended hours work where the appointments are for acute unscheduled problems and not routine.
- Other primary care emergency/acute services delivered within a secondary care or community care provider.
So, don’t just rely on one of these places for gathering evidence for your engagement in Urgent Unscheduled Care. Your experience (and evidence) should be from a mixture of working with these services.
Currently, the out of hours provider in Mid Sussex is IC24.
When to do UUC
You must start engaging in all posts that are based in General Practice (including GP posts in the ST1 or ST2 stage). You must space them all out and not do them all in one go towards the end.
How many sessions
In the past, GP trainees were expected to do 18 sessions over the 18 months of General Practice. That equated to roughly ONE session per month – each session lasting 4-6 hours.
However, in their latest guidance, the RCGP is moving away from number of sessions. Instead, they want you to do enough sessions to provide adequate evidence of capability in all of the above 5 Professional Capability Areas (or 13 Professional Capabilities).
“Time served” should not be seen as the model against which to define the attainment of Urgent & Unscheduled Care capabilities.
The only exception to this new guidance is if you have a contractual requirement to complete a certain number of OOH sessions – your TPDs will be able to tell you.
The Clinical Supervisor is trained and selected appropriately to be responsible for overseeing a specified trainee’s clinical work and providing constructive feedback during their placement. You should have a clinical supervisor who you can refer to for every clinical session you do – for both urgent and routine work. So, when your doing on-call for your practice, be sure to find out who your clinical supervisor is and make sure you touch base with them.
It might be a different doctor every time you do in-house practice on-call. During OOH sessions, you will be told who your Clinical Supervisor is. They will closely supervise you, unless they feel you are good enough to start working a little more independently. Even then, you should always ensure every clinical session is debriefed with them.
GP trainees undertaking direct, near and remote sessions should have an identified individual who will, (for the duration of that session) have the lead responsibility for ensuring the safety of both the trainee and patients and who has been appropriately trained.
Clinical supervisors should raise concerns where appropriate.For clinical competence concerns,
Even if the trainee fails to attend a session.
They should know who to contact and the appropriate pathways to raise concerns.
How to log UUC Learning
Use the form provided by the RCGP to log your learning with respect to each Urgent Unscheduled Care session you are involved in.
Out of Hours – 40 hours a week
Don’t forget, if you do any shifts at a local Out of Hours centre – this needs to come off the 40 hours maximum working time per week. Your practice will not know when you are doing Out of Hours. So, when you have your dates, please tell your Practice Manager early so that he or she can tweak your rota to ensure your average week working time remains 40 hours and no more. Telling them in advance helps them to do this without disrupting the service provision to patients from their practice.