Once the induction phase has finished, each GP registrar will need to start seeing patients.
The aim of the placement, particularly for ST3’s is to get them to a point (over the year) where they are competent at completing the work of a GP. The transition from GP registrar to being a GP can be quite daunting, so it is about equipping them with enough experience and confidence to be competent with this transition.
A Registrar’s workload needs to build up over time and be a mix of learning opportunities, tutorials and experience. It is useful to have guidelines for registrars to set out key milestones and expectations. This is particularly important when you have more than one registrar in the practice, so each registrar knows that there is an equitable and fair system.
You may want to consider:
- Length of appointments that each registrar starts with and how these will be reduced down to shorter appointments as they become more competent.
- Number of appointments to be completed per week, gradually building this up over time.
- Telephone Calls and Triage – building these up over time.
- On call – starting with shadowing GPs and then running their own GP on call sessions with support from another GP.
- Home Visits – consider when to give registrars home visits
- Tutorial Time – with their own trainer, other GPs, other practice staff
Learning opportunities will come in many forms, not just through clinical consultations and regular tutorials. Videoing consultations (ensure patient consent prior to this) is a very useful tool for improving consultation style. There are also a number of other areas that registrars can be involved with:
- taking part in audits
- feeding back at significant event meetings
- managing complaints
- attending meetings (internal and external)
- involvement in projects with the practice manager.
- Practice management training
GP registrars need to undertake some work with the Urgent & Unscheduled Care – UUSC (previously OOH) team. How much time and how this works has changed and it is no longer counted as a certain number of hours. GPST Doctors in Training (DiTs) now need to keep a UUSC passport to log their UUSC hours and ensure they can demonstrate a number of competencies. Under the Working Time Regulations, you need to monitor and be aware of registrars working times and ensure that they get at least 11 hours break between finishing out of hours and starting back in the surgery.
You should also keep a record of what they have worked and monitor their workload to ensure that they get adequate breaks (20 minutes break during a 6 hour work period) and do not work more than 48 hours per week (this can be averaged out over 17 weeks).
Considerations for Practice Managers:
- Develop a policy for registrars setting out what is expected from them and the key milestones for their development.
- Ensure regular tutorials are set up with relevant staff.
- Identify projects that could be undertaken in conjunction with other staff.
- Set up a system to record and monitor registrars working hours, including out of hours work.