1. Overview of GP recruitment and retention
Sessional, Retainer and I&R GPs Workshop Sessional doctor workshop
Overview of GP recruitment and retention
Mary Rose Shears
Associate Dean, East Sussex, Induction and Refresher lead, HEE working across KSS

2. Objectives
Update you about National and local initiatives regarding GP recruitment and retention
Provide the context regarding current workforce issues
Understand what matters to you about GP retention?
Anything else?

3. How many currently involved in KSS
I&R Scheme -  5 GPs in Placement
- 15 in Assessments
- 6 completed assessments waiting for NPL/Placement
- 7 completed scheme since May
Retention Scheme - 46 in placement
- 1 completed in the last year (5 year scheme)
Sessional doctors – ?? (only aware of those on groups)

4. I&R Programmes The GP Refresher Programme (April 2015)
The GP Induction Programme (April 2015)
The GP Refresher Programme (April 2015)
The International Recruitment Programme (announced August 2017)
The Learning Needs Assessment Route
The Portfolio Route for returners with previous UK experience working in equivalent roles

5. On line MCQ learning Resources

6. Overview of the International I&R Scheme
Entry Steps
- Stage 1 – recruitment agency selection criteria - undertaken, web-based, overseas
- Stage 2 - UK based assessment of doctors’ skills and interviews with GP practices in UK
Pre-induction phase – observerships in practice, preparing for the assessments, following the curriculum
MCQ, Sim surgery
Induction and Refresher phase – working as GPs under supervision (on National Performers’ list with conditions)
Networks, mentoring and support - To support ongoing retention of international GPs

7. Example candidate journey
Month 1
Month 2
Month 3
Month 4
Month 5
Month 6
Month 7
Month 8
Month 9
Month
Candidate approached by recruitment supplier responds to marketing
National and local prospectuses provided by supplier
Pre-screening checks and interviews / assessments completed by supplier
Initial Skype interview in home country
If successful:
Start GMC registration
Nominates/ matched to an STP area if more than one recruiting in region
Invited to 2nd interview
Attends face to face weekend and 2nd interview in area
Receives offer letter
Receives contract from practice
Receives welcome pack to area including nominated contact details
Starts relocation process supported by supplier and local contact
Start date agreed with practice clinical supervisor
Arrives in England
Introduced to GP practice and clinical supervisor
Starts observer placement in practice
Undertakes training including language, consultation skills and top-up training based on ongoing individual learning needs assessments
Is assessed as ready to undertake I&R assessments i.e. MCQ and Sim Surgery
If successfully passes I&R assessments Responsible Officer signs candidate onto NPL with conditions
Able to undertake patient consultations under supervision
I and R placement
Expression of interest
First interview
Induction weekend
Relocation
Observer Placement
Networking, Mentoring, Support and Retention by Educator Network -.

8. Progress on the Scheme
Pre-induction phase: make use of information from stage 1 and 2 interviews, learning needs reviewed against curriculum, learning opportunities – learner set, HEE regional days, external educational supervisor, preparation for assessments
Induction phase: make use of information from MCQ and Simulated Surgery performance
Work place Based Assessments
Regular reviews (most placements three reviews)
Structured Placement Report
Final Structured Placement Report

9. Cultural/diversity
Creating a working culture which recognises, respects and harnesses difference.
Conflicts of UK medical culture with home medical culture
Families have been uprooted
Mandatory training
Professor Geert Hofstede conducted one of the most comprehensive studies of how values in the workplace are influenced by culture. He defines culture as “the collective programming of the mind distinguishing the members of one group or category of people from others”. The six dimensions of national culture are based on extensive research

10. Dimensions of National Culture
Power Distance Index (PDI)
 Individualism versus Collectivism (IDV)
 Masculinity versus Femininity (MAS)
 Uncertainty Avoidance Index (UAI)
 Long Term Orientation versus Short Term Normative Orientation (LTO)*
 Indulgence versus Restraint (IND)

11. Networking
Do you have relevant experience? Coming from a different medical culture?
Welcome these doctors to your learner sets?
Relevant educational resources?

12. GP Retention Scheme 2017
Doctors must hold full registration and a license to practice with the GMC and be on the National Medical Performers List.
doctors who are seriously considering leaving or have left general practice due to personal reasons (caring responsibilities or personal illness) and approaching retirement
offering greater flexibility and educational support

13. Scheme continued
This scheme enables a doctor to remain in clinical practice for a maximum of four clinical sessions (16 hours 40 minutes) per week sessions per year, which includes protected time for continuing professional development and with educational support.
Annual review each year to ensure that the doctor remains in need of the scheme and that the practice is meeting its obligations.
Retained GPs may be on the scheme for a maximum of five years

14. Financial Benefits
Practices will receive £76.92 per session. This allowance supports the provision of mentoring and educational support and flexibility of employment provided to the RGP. Monies will be paid during any leave where the Retainer continues to be paid by the practice.
Retainer doctors will receive a bursary dependent on the number of sessions worked, approximately £1000/year for working 1 session/week, pro-rata up to the maximum number of 4 session/week
Further details, application forms available at retainers

15. Additional retention activities
Sessional Doctor Learning Sets and KSS- wide days 2x/year
HEE KSS Resilience Service (for GPs / Practice Nurses / Practice Managers)
Post CCT Fellowships for recently trained GPs based on Urgent Care / Frailty / Cancer programme
Career Plus Scheme – ESBT Pilot site
Local retention plans
Ensure you have an NHS address to receive information from your CCG, (Any locum GP who does not have an NHS can ask any practice with whom they regularly work to set up such an address.  However, locum GPs can also apply to the Local Organisation Administrator [LOA] within the CCG where they undertake most work)  

16. Workforce concerns Numbers of GPs >55y
Numbers of practice nurses >55y
Numbers of patients >75y
Multimorbidity of patients

17. HEE addressing workforce issues
Five year forward view – better integration between professions, services and different sectors
New roles – physician associates, pharmacists, paramedics, nurse associates, apprenticeships
Increasing numbers of graduates
Encouraging medical graduates to choose GP as a career
Recruitment from overseas
Increasing retention

18. Retention What is important to you?
Are you discussing these aspects with your employers, teams, educational networks?
How can we help?

19. Retention Valuing staff Organisational culture Developing resilience
Educational and training opportunities
Pay
What else?