Your GP & Hospital Posts - how to make the most of them

Hospital posts

Hospital posts You will gain useful clinical knowledge But how else can you make your experience useful for your future in GP? What could you reflect on and put in your e portfolio?

Generic aspects of hospital practice useful for your future as a GP Medical teamwork Safe prescribing Multidisciplinary teamwork Communication skills How families behave Significant event analysis Ethical issues The hospital-GP interface

Medical teamwork Support for colleagues Allocation of work Effective handover of important information – essential in hospital shift system, especially useful in GP if you work LTFT

Safe prescribing Hospital ‘zero tolerance’ policy for prescribing in allergic patients Easier in GP when prescribing on computer

Multidisciplinary teamworking Understanding the roles of team members Especially other health professionals Respect for their skills and contribution to patient care Effective communication with other team members

Communication skills With patients With relatives With colleagues With other team members

How families behave Many family interactions in A/E, Paeds and Medicine for the Elderly In GP they’re in the background but in hospital they’re often there for you to observe

Significant Event Analysis Looking at what’s happened when something went wrong or nearly did so Looking at the feelings of everyone involved Reviewing the organisational systems involved Working out how to prevent a recurrence

Ethical issues Capacity to consent Informed consent Confidentiality End of life issues Reproductive health issues (in O&G)

The GP-secondary care interface Understanding what secondary care has to offer Communication between GPs and hospital doctors Understanding referral pathways, and what you’ll be referring patients for, when you’re a GP

GP posts

GP posts Rotations all have 18m of GP GP posts are 12m in ST3; remaining 6m may be in ST1 or 2, usually in a different practice

What’s different in GP? Practice is a business contracted to provide primary medical care for the NHS - you are a practice employee Your trainer More personal relationship than with consultants Many roles – teacher, employer, mentor, assessor, possibly friend Practice staff – be relaxed but respectful Practice manager – a key person to get to know Give-and-take - practices may be more flexible employers than hospital, if you are seen as helpful and conscientious and flexible

Work in GP posts You won’t be thrown in at the deep end – will have an induction period Appt interval long at start, aim to reduce to 10 mins Timetable - 7 surgeries/wk, educational time with trainer, HDR, study ½-day Friendly environment but actual work may feel quite isolated Good personal organisation needed – follow through, not handover Long days, possibly 8.30 – 6.30 ish Visits by agreement, not to scary places Out of hours – see next slide

Out of Hours work You are required (ideally) to do 6 hours per month in GP posts Rota organised by our administrator Most sessions with Local Care Direct (LCD) seeing patients at OOH centre or visiting them, with a trainer or other experienced GP supervising you Also triage session with NHS Direct who handle the phone calls. Induction session with them first Other kinds of OOH experience may count Record on form from Y&H website, upload to EP

Education in GP posts Support during surgeries and OOH sessions, and debriefing afterwards Teaching with trainer according to your educational needs Assessments by trainer Possibly teaching and/or assessments by other practice members

A few expectations of you Transport to get yourself to visits and educational sessions Reliable attendance at OOH sessions No ‘moonlighting’ without discussion with your trainer (preferably none at all)

Variation between practices Geographical position Inner city/urban/semirural Size Demography of patients Building Number of sites Doctors’ interests – clinical, medicopolitical, other teaching, non-NHS work Demography of team Systems, IT Management style Ethos/values/priorities Later today you’ll be asked to give your preferences for GP posts in relation to these variables