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

2. Hospital posts

3. 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?

4. 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

5. 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

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

7. 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

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

9. 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

10. 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

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

12. 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

13. GP posts

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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)

20. 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