ARCP
Annual Review of Competency Progression
DOWNLOADS
path: ARCP HELP FILES
Intro
Most of the information on this page is for ARCP panel members. However, if you’re a trainee who has stumbled across these pages, please don’t run off. There’s some information about ARCP panels for you too (towards the end of the page). And of course, you might find it helpful to see what the panel members will be doing when they come to look at your ePortfolio – and the types of things they look for. You can then tweak your ePortfolio to make sure it hits the right notes.
Most of the information on this page is for ARCP panel members. However, if you’re a trainee who has stumbled across these pages, please don’t run off. There’s some information about ARCP panels for you too (towards the end of the page). And of course, you might find it helpful to see what the panel members will be doing when they come to look at your ePortfolio – and the types of things they look for. You can then tweak your ePortfolio to make sure it hits the right notes.
If you’re an intending ARCP panel member, TPD or a scheme administrator, this page will prove invaluable reading. Following the scheme below will help you develop an ARCP process that easily enables you to identify the struggling trainee but is light touch for the trainee who is progressing well. There are two ARCP assessment forms available from the downloads box above – a detailed one and a brief one. Inexperience panel members should use the detailed (10 steps…) one whilst the more experience should refer to the brief one (5 steps…). However, even if you’re experienced, you may wish to revert back to using the detailed one – especially for those trainees who are not progressing well – because it may help you define the problem area.
The ultimate purpose of ARCP panels is to determine whether trainees are progressing well towards competence. We’re not asking you to look for excellence. All we’re asking you is to determine whether there is ‘good enough’ evidence of satisfactory progression. Don’t lose sight of this.
It is often difficult to make a general picture of a trainee when looking at their individual assessments alone (like COTs and CBDs). That is why it is important to look at other reports (i.e. both Clinical and Educational Supervisor’s), as well as the MSF and PSQ. These things will provide different windows from which you can look at the trainee and help ‘glue’ everything together into a whole.
What are ARCP panels all about?
The ARCP stands for Annual Review of Competency Progression. In other words, the ARCP panel meets yearly to review how each trainee is progressing in terms of the 13 Professional Competences defined by the RCGP. They do this by comprehensively reviewing their ePortfolio in a structured way. It does not involve a face-to-face review of the trainee. That is why maintaining the ePortfolio is so incredibly important – a trainee is judged via their ePortfolio, and not face-to-face. Their ePortfolio is what represents them. A bad ePortfolio will be interpreted as a bad trainee!
However, if a trainee is deemed to be doing well, they can then be signed off to go onto the next ST year (or be given their Certificated of Completion of Training – CCT – if they are in their final year). For the ARCP panel to be able to sign the trainee off, on top of having the right number of Work-Place Based Assessments and log entries, they have to have their Educational and Clinical Supervisor’s reports uploaded.
Local vs Central ARCP panels
LOCAL ARCP PANELS | CENTRAL ARCP PANELS |
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All ARCP panels – local or central – are a formal deanery sub-school of General Practice. In any round of ARCP panels, each trainee who is due a panel has one panel with one outcome. Most trainees will be assessed by their local ARCP panel run by their local GP Training Scheme. If a scheme is concerned about a trainee who is making unsatisfactory progress, they will not award a grade but instead refer them to a CENTRAL panel who will decide how bad the level of unsatisfactory progress is and whether an extension is granted or in very bad performance, the trainee be released from training. In all referrals to the central panel, the trainee will be told they will have a central panel and they have the opportunity to submit evidence of mitigating circumstances prior to the panel. The decision for a face-to-face or ePortfolio review is made on a case by case basis. The dates of central panels to be advertised in advance and trainees informed that they must make themselves available if required.
BEFORE the ARCP panel meeting
- You need to sort out some dates and venues for the panel meetings.
- For each ARCP panel, there needs to be a minimum of 3 people – a panel chair (a TPD), and 2 trainers. It is desirable to have a fourth lay panel member and you, as the administrator needs to be there too. So, please send an email around to recruit trainers and lay panel members. Let them know of the rates of pay for doing this work.
- Once you have recruited, send the Template Letters below. These letters detail what is expected of their role and points them to the Bradford VTS pages to help guide them.
- Then allocate trainees to each panel member.
- Allocate only to doctor panel members. The lay panel should not be allocated any. If there is not an equal number to go around, give the TPD the lesser amount – because they have the job of coordinating the session too.
- When allocating, PLEASE make sure the trainee has not been under the direct Clinical or Educational Supervision of any of the panel members: this is incredibly important. Please be mindful of this if you are using Practice Managers as lay panel members, this is going to make allocations significantly more difficult.
- Please note down whether a trainee is due for CCT. ST3s due for CCT are the hardest ones to do. ST1s and 2s are generally easier. So make sure the panel members who are assessing have roughly similar number of ST1s, 2s and 3s.
- Finally, add ‘(SUI)‘ if a trainee has been involved in a ‘serious untoward incident’ that the panel member needs to review.
- Add LTFTT is the trainee is part-time
- eg Jack Johnson ST2 LTFTT
- eg Sue Salaman ST3 FT CCT
- eg Mo Akhtar ST1 LTFTT FT
Don’t forget about organising food for these ARCP dates. Just needs to cater for 3-4 people. Perhaps something basic and not too costly?
Please send an email to trainees at the beginning of May, something along the lines of…
Dear trainees, Most of you will be undergoing an ARCP panel review next month. In order to facilitate this process, please can you make sure you do the following as soon as possible. Hopefully, for most of you, it will all have been done in preparation for the Educational Supervision meeting that you will have done recently.
- Please ensure there is a completed “ESR Workbook” which has been upload it to your learning log under the section “Professional Conversation” with the title “The ES Workbook”. Available here: www.bradfordvts.co.uk/edsupervision
- Upload your Form R – and detail any serious complaints and incidents.
- Make sure your ePortfolio learning log entries look good – good numbers & good levels of reflection.
- Complete any missing/outstanding items from your ES meeting e.g. WPBA, PDPs, OOH etc.
- There is a useful document called ‘arcp check list for gp trainees”. Read it and follow it. Available here: www.bradfordvts.co.uk/edsupervision/arcp
Dear Panel member…
Many thanks for helping us with the ARCP panels. It is important that all panel members know what they are doing and that we are all singing from the same hymn sheet. Hopefully, you’ve have been to some sort of “ARCP Training”, but if you haven’t – please contact your GP Scheme Administrator or TPD Lead for ARCPs. The ARCP process that we’re going use encourages a ‘light touch’ approach for those trainees that are clearly doing well and a more heavier detailed one for those who are not. Please visit the Bradford VTS pages on ARCP Training – they will provide you with everything you ever wanted to know about ARCP panels. There’s a lot there so don’t do it just on one day – perhaps a bit every few days would be better.
- For the Bradford VTS help files and guidance…
www.bradfordvts.co.uk/edsupervision/arcp - For an introduction to ARCP…
www.rcgp.org.uk/training-exams/training/mrcgp-workplace-based-assessment-wpba/arcp-for-workplace-based-assessment.aspx
Essential Reading List
This checklist will help add structure to your ‘ARCP assessment’ of the trainee. It will also make the process more time-efficient. And the whole process is a lot easier if you think the Educational Supervisor’s Report (ESR) is reliable. The problem comes when there is a poor ESR – where you end up having to do a mini-ES process yourself. Some people don’t like using forms, BUT this ARCP checklist form will make your life a lot easier. It provides the necessary structure and guidance that inexperienced panel members need to help align them to the more experienced ones. For the experienced, it provides a comprehensive structure so that you don’t miss anything. So, please use them and in time, as you become familiar with the whole thing, the forms become even easier to use. A unified approach will lead to a more reliable, valid and easier to determine ARCP outcome.
How to Review each Trainee
By now, you should have received a list of panels and their allocated trainees. If not, email the GP Scheme administrator. Please take a look and see which trainees have been allocated for YOU to specifically review BEFORE the panel meeting. You need to review each trainee’s ePortfolio in some considerable depth – this takes time, so please don’t leave this til the day before the meeting! From previous panels, most assessors like to do this during the week or weekend preceding the panel date. In that way, the assessment stays fresh in their minds too!
For each trainee, use the ARCP checklist form – you may be asked for specifics about each trainee on the day. And the checklist will help you with that. When you have finished assessing your trainee, give them a global colour score.
- GREEN if they are clearly okay.
- RED if the are clearly not okay and definately need referring to a deanery panel.
- And finally AMBER if you’re not quite sure and would like to seek the opinion of the rest of the panel.
- It’s the AMBER trainees that will mostly absorb panel time. Panels should be able to whizz through those in the GREEN and to a lesser extent, those in the RED.
Transition ARCPs, Progress ARCPs & SUIs
On the allocations list, you may see the following annotations next to one or more of your trainees:
- (SUI) – this means that a trainee has been involved in a ‘serious untoward incident’ that the panel member needs to review to ensure it has been adequately approached and resolved.
- (LTFTT – annual progress review) – this indicates that the trainee is part-time and needs an annual review to make sure they are PROGRESSING well.
- (LTFTT – ST transition review)‘ – this indicates that the trainee is part-time and needs an ARCP ST transition review – which is a full and detailed than a progress review and is basically answering the question “should the trainee be allowed to move up an ST year?”.
Finally, we need three sets of feedback from you.
One on each trainee, one on each Educational Supervisor and one on the ARCP panel process. How can we improve on next year’s quality of ePortfolios, ES reports and the ARCP process if we don’t provide feedback now to help them better themselves? This in turn will make life easier for everyone (including future ARCP panels). After discussing the trainee at the panel, the panel chair will ask you for specific feedback to give to the trainee and Educational Supervisor. Therefore, will all panel members do this. In terms of the feedback for the ES and trainee…
- Pick one or two things that you specifically liked about their respective ES report and ePortfolio that you would like them to carry one doing.
- Likewise, but only if you feel it is warranted, please write one or two things they could do to improve it for the next time around.
AND remember to be specific (in other words, don’t just say something was good, say what was good about it), balanced (i.e. a balance of positive and negative feedback) and gentle (remember, our Ed Supervisors are people with feelings). Re-read the feedback you have given to make sure it comes across as helpful advice rather than something punitive.
As for feedback on the ARCP process itself: we will ask you to do this after the actual panel session. This will help us make the process even more efficient and generally better the next time around.
Thank you once again for helping us and we look forward to meeting you. Don’t forget to bring your assessment sheets with you. Please do not hesitate to get in touch with the GP Training Scheme Administrator if you have any queries.
Yours….
- But please feel reassured that the rest of us are here to listen to you.
- You offer a different perspective: sometimes, the rest of us can be blind to what you can so easily see.
- Therefore, your opinion matters – so please feel comfortable to voice it.
Hopefully, you will have been to an “ARCP training” workshop. If not, please contact the GP training scheme administrator. If you would like to learn more about the ARCP process, please visit these two pages
- For an introduction to ARCP:
www.rcgp.org.uk/training-exams/training/mrcgp-workplace-based-assessment-wpba/arcp-for-workplace-based-assessment.aspx - For some help files and guidance:
www.bradfordvts.co.uk/edsupervision/arcp
Please do not hesitate to get in touch with the GP Training Scheme Administrator if you have any queries.
Yours sincerely,
DURING the ARCP panel meeting
Different panel chairs can decide to run their panel sessions in different ways but the following gives you some idea of one that works very well. The idea behind this set up is to ensure the panel does not run out of time, especially for the difficult ones.
At the start of the session, once everyone has arrived, introduce yourselves.
Go through the Introductory PowerPoint below
- Make sure all panel members are all on the same wavelength
- Lay down some ground rules
- Outline how the chair plans to ‘run the show’ (and to forgive the chair for moving people on)
- Explain how the chair expects them to present (so that it is concise yet comprehensive enough)
On the table there will be 3 sheets of paper labelled GREEN, AMBER and RED
Before we start talking about any trainee, ask panel members to categorise each of their allocated trainees to one of the three colours.
- GREEN = they’re clearly okay.
- AMBER = they’re not sure but would like an opinion from the rest of the panel.
- RED = they’re clearly NOT okay and definitely need referring to deanery panel.
Demonstrate how to present a case
It’s important to demonstrate how you want each trainee to be presented. Otherwise, there will be those that present concisely and others that waffle on and on which absorbs time unnecessarily. So, start the discussions by presenting one of your straight-forward (GREEN) trainees. The purpose of the chair starting is to
- Demonstrate how to present in a smooth and time-efficient way,
- Allow panel members to ask questions to clarify and
- Get one ‘in the bag’.
Go through the Amber cases first
Now go through the AMBER trainees first. These are the ones most likely to need and absorb time – therefore, it is important the panel gives them their due. After the AMBERs move onto REDs and then the GREENs – who should be much easier to get through. If a trainee is bad enough to warrant a ‘RED’, then there really isn’t much to say other than they fail the panel process – there is no need to talk for hours. By following this order AMBER-RED-GREEN, should you run out of time, then at least the panel will have devoted their attention to where it was needed the most – with the ambers.
Don’t forget to Chair & Facilitate as the ARCP Chair person
It is important for you to chair and facilitate the session if the panel meeting is to finish on time. We also don’t want open-ended ruminating discussions – because that is not helpful!. So, in your role as chair…
- If a panel member is being a bit vague and waffly – ask them be specific and descriptive
- If a panel member is going on and on about something that is quite clearly evident – push them to move on. No point talking at length about the good things.
- If the panel group end up ruminating and veering off at a tangent – cut the discussion short. “Would you mind if we get come back to focus so that we can review this trainee and get home on time?”
Formulate Feedback
After the panel has decided what outcome to give each trainee, the panel (especially the chair & the panel member who assessed the ePortfolio) will formulate feedback to give back to the trainee – usually consisting of a mixture of specific things liked about their ePortfolio that they should carry on doing and things which will help them improve it for the next time around. The GP scheme administrator will be at the panel meeting writing down what is being said. If you decide the refer a trainee to the second tier or central panel, please collate ‘additional notes for the second panel‘ to help them with their review.
After this, the panel chair & ARCP panel member should spend a few minutes gathering feedback for the Educational Supervisor – making sure that it is worded in a way that will most likely result in it being accepted (and not making the ES feel dejected and dispirited).
When the ARCP panel session discussions are over, the administrator will hand out feedback forms so that panel members can comment on the ARCP panel process itself.
I hope you all think this is a reasonable way forwards. Any other suggestions – email me on rameshmehay@googlemail.com
Ramesh Mehay
Collate the Feedback
- During the ARCP panel process, you will need to collate feedback to give to the trainee. Although the panel chair will facilitate this, please listen carefully to capture the final positive and negative points for each trainee. If you are unclear about what to write – ask for clarification from the Panel Chair.
- After that, the panel chair will also facilitate the feedback to be given to the Educational Supervisor. They may decide to type this up themselves or ask you to do it. If you are unclear about what to write – ask for clarification from the Panel Chair.
- When the ARCP panel is over, we need you to hand out feedback forms so that panel members can comment on the ARCP panel process itself.
Timetable
For a 9-5pm session, 4 panel members, each given 4 trainees to look at
- 0900-0915 Arrival, Coffee
- 0915-0930 Welcome, Introductions & The presentation
- 930-0945 Chair presents a trainee – to illustrate the process, get one done, allow others to ask questions (1 trainee done)
- 0945-1045 More trainees (3 trainees done @ 20 mins per trainee)
- 1045-1100 15 min comfort break
- 1100-1200 More trainees (3 trainees)
- 1200-1300 Lunch
- 1300-14.00 More trainees (3 trainees)
- 1400-1415 Tea Break
- 1415-1515 More trainees (3 trainees)
- 1515-1530 Tea Break
- 1530-1630 More trainees (3 trainees)
- 1630-1700 Feedback on ARCP process, thank you & depart
On the desk there should be three blank A4 sheets
- On the GREEN form – add names of trainees who are clearly OKAY.
- AMBER form – add names of your trainees with whom you have a few concerns or are unsure about
- RED form – add names of trainees you have SIGNIFICANT CONCERNS that are clearly NOT OKAY and need referral to a central Deanery panel.
Before we start talking about any trainee, ask panel members to categorise each of their allocated trainees to one of these three colours. The panel will go through the AMBER trainees first. These are the ones most likely to need and absorb time – therefore, it is important the panel gives them their due. After the AMBERs the panel will go onto discuss the REDs and then the GREENs – who should be much easier to get through. If a trainee is bad enough to warrant a ‘RED’, then there really isn’t much to say other than they fail the panel process – there is no need to talk for hours. By following this order AMBER-RED-GREEN, should the panel run out of time, then at least they will have devoted their attention to where it was needed the most – with the ambers.
- 10 mins for panel assessor to present – use your form.
- 5 mins for other panel members to ask questions
- 5 mins to help the administrator what to write
- Longer if trainee is of concern (steal time from other trainees who are clearly okay, just like in a GP consultation where you”steal” time from the straight-forward easy patients for those who require more need.
How to Present the Trainee
- We need to be swift yet thorough.
- We’ll present your electronic form on the projector
- You talk us through the different areas of the ARCP checklist form
- But don’t be unnecessarily verbose. If it’s okay, just say it’s okay and you are satisfied.
- Talk more about those areas you have concerns. Define the concern (with examples).
- Panel to ask questions to clarify concerns.
- Decide recommendation.
- Help the administrator: what to write
- Then move on… (Remember: light touch for the GREENs and REDs but more thorough for the AMBERs)
Please allow the ARCP chair person to facilitate and chair – if you wanna get home on time. This means that they might:
- Ask you to be specific and descriptive where needs be
- Push you to move on – esp. if the evidence is clear (we need to stick to time)
- Cut a discussion short if it is veering off at a tangent
In the ARCP free text boxes, please provide a clear explanation of the outcome awarded. If they are satisfactory, you needn’t add much more – keep it short and sweet. However, it is imperative that you add additional information if they are failing. You will need to be quite specific. In particular…
- Identify the specific problem – don’t beat about the bush.
- Write down the evidence for the outcome.
- Specific follow-up action – milestones to achieve.
Don’t forget to ‘cut and paste’ the ARCP outcome and the feedback for the trainee into the Educator’s Notes section of their ePortfolio. In that way, the trainee, the Clinical Supervisor and the Educational Supervisor are well informed and can make plans for the future.
GREEN = doing okay AMBER = more work needed BLUE = unable to comment RED = bad, give extension or release from training |
There are only 4 outcomes LOCAL panels can give… |
(A) Satisfactory
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(B) Mostly satisfactory with some minor issues (e.g. some missing evidence) but no additional training time required.
The panel chair gives feedback to the GP trainee and a timescale to remedy the issues. The panel chair then reviews the ePortfolio after such time has passed and gives a satisfactory outcome and completes and submits the outcome or, if the issues have not been remedied, refers the GP trainee toa central panel (see under Unsatisfactory below). |
(C) Out of Programme
The trainee is Out Of Programme. The out of programme outcome is given and the date of the next panel is carefully chosen so that the returning GP trainee has time to acquire the evidence for satisfactory progression. |
(D) Unsatisfactory The ePortfolio is thought to be unsatisfactory. The panel chair coordinates the information on the ARCP form. The panel chair sends a written report to the central panel detailing the reasons why the local panel was unable to give a satisfactory outcome. It is then the central panel which decides which of the following outcomes to give. It should be made clear that it is NOT the gift of the local panel to offer additional training detailed below; that decision rests with the CENTRAL PANEL and the Director of Postgraduate GP Education.
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AFTER the ARCP panel meeting
When the panel is over…
- The GP Scheme Administrator will email you the trainee feedback – so that you can read and tweak it. Do the same for the feedback to the ES. Send finalised versions back to the administrator to send.
- The GP Scheme Administrator will also email you when it is permissible for you to log in and ‘sign off’ the trainees that were deemed satisfactory on your panel. This step is incredibly important and must be done in an expedient way. This is especially important for the ST3s, as the sign-off triggers the CCT process. The sign off can only be done through you panel chair log in (not your usual log in code).
- Send the chair (via email) the two lists of feedback for tweaking – Trainee feedback & Educational Supervisor feedback. They will make them more receptive by removing harsh comments and through rewording. They will then send the two finalised lists back to you.
- Please ‘cut and paste’ the ARCP outcome and the feedback for the trainee into the Educator’s Notes section of their ePortfolio. In that way, the trainee, the Clinical Supervisor and the Educational Supervisor are well informed and can make plans for the future. Also send a copy to the trainee’s email.
- Then send each Educational Supervisor their own specific ES feedback (but don’t include their trainee).
- Let all panel chairs know when it is okay to log in as chair and sign off their ‘GREEN’ trainees off as satisfactory.
- And of course, send out claim forms to the panel members along with the expected rates of pay.
Trainees - some things about ARCP for you
For the ARCP panel to be able to sign you off, they have to have your Educational Supervisor’s Report uploaded. Because the ARCP panel meet every Jan and June of each year, this means that you must get the Educational Supervision meeting preceding that ARCP panel done before the end of Dec and May respectively.
So, for most full-time trainees, we recommend:
- For Feb – Aug period: ES meeting in the month of May
- For Aug – Feb period: ES meeting in the month of Dec.
For those that are Less-Than-Full-Time-Trainees (LFTTT) or Out-Of-Sync for whatever reason (e.g. extended leave), please read this page:
Here are some things trainees MUST do if they want their ARCP to go smoothly. Remember, ARCP panels are a big deal. If you have not performed satisfactorily, you will be called to a central GP School panel to explain yourself. In some instances, GP Training is terminated early!
The only information available to the panel is what is on the ePortfolio and visible using the administrator log in. This means that items in the learning log that are not marked as ‘shared’ will not be seen, nor will items saved in the ‘personal library’ section. It is the trainee’s responsibility to make sure that all their work is uploaded appropriately. For full guidance on how to make sure your ePortfolio is impressive and how to make it ARCP-ready, please read these two documents:
Otherwise, follow everything on this checklist. It is the same sort of checklist the ARCP panel will use on you.
Some quick tips…
- Make sure you have had a recent ES meeting. If so, hopefully all the things below will have been done.
- Complete any missing/outstanding items from your ES meeting e.g. WPBA, PDPs, OOH etc.
- Upload your Form R – and detail any serious complaints and incidents.
- Get a CSR done for each post
- Please ensure there is a completed “ESR Workbook” which has been upload it to your learning log under the section “Professional Conversation” with the title “The ES Workbook”. Available here: www.bradfordvts.co.uk/edsupervision
- Make sure you have MORE than the minimum number of CBDs, COTs/Mini-CEXs. The assessments should also show competence levels appropriate to your stage of training and demonstrate progression and improvement over time.
- Make sure you are making good progress with your CEPS.
- Make sure you have a good number of log entries for them to look at. Also be certain to make sure that there is a variety of entries (like clinical encounters, professional conversations, audit/projects, significant events etc). Your entries need to show a good depth of reflection and analysis- like focusing on your own attitudes, ethics and core values as well as the knowledge and skills domains. And get your trainer or Clinical Supervisor (e.g. hospital consultant) is reading them AND that you’re mapping them to the curriculum statement headings and that they’re mapping them to the professional competency domains.
- Make sure you are using your PDP – and making the most of it. This should list identified learning needs, realistic ways to meet them, and show that some of them have been met.
If you want to be confident of a smooth progression through the panel process you should aim to have more than the bare minimum of entries in your portfolio. This additional material may be from additional assessments if they are appropriate, or it may be things that demonstrate thoughtful consideration of your learning needs and appropriate measures to meet them. Remember, a lack of evidence means ONLY YOU MISS OUT and the panel may ask you to repeat your last 6 months!
The GP HEE school (formerly known as Deaneries) need to complete their panel processes for their ST3 trainees 6 weeks before your end training date so that CCTs can be issued on time at the completion date. If you are completing your training programme at this time it is essential that you protect this month in your diaries in the event of an invitation to a panel review. Failure to do this may lead to a delay in your application for a CCT and compromise future employment. In other words, DO NOT BOOK A HOLIDAY DURING THIS TIME
FAQs
You will have been given a ‘panel’ log in code and password via email from your GP Training Scheme administrator. If not, please contact him or her.
- To access a trainee’s ePortfolio, go to https://eportfolio.rcgp.org.uk/login.asp
- Enter you log in code and password and click ‘Login Securely’.
- Then select the trainee you wish to look at.
- Once you are in a trainee’s ePortfolio, the navigation system on the left will guide you through the various bits of that ePortfolio.
Panel Assessor…
Mandatory evidence is mandatory! And the numbers stipulated for things like CBDs and COTs are MINIMUM numbers – in other words, trainees should be aiming to do a lot more. Therefore, if a trainee is not achieving the minimum number, even if it is one, you have to flag this up in your ARCP report and let your Panel know – and let them decide. The panel may still decide to approve – but put a strong proviso that the trainee has to do the missed assessment things in the remaining time. If they do this, then it is the responsibility for checking that they have fulfilled this before the end of the GP training programme falls to the GP Training Scheme’s administror + TPD.
Panels, to help you decide…
We need to weigh up the deficient item in light of all the other evidence that is there. Does any of the other evidence make up for it? Ultimately, we’re going to weigh up the WHOLE evidence to see if the portfolio is evidence deficient for any of the 13 Professional Competencies (esp for ST3s).
The panel has a responsibility to assess performance in OOH work. There are 6 competencies relating to the skills needed for OOH care. In the ES Workbook, there is a section devoted to OOH where the trainee lists their OOH sessions which provide evidence for each of the 6 OOH competencies.
The 6 OOH competencies are…. (mnemonic T-SCORE)
- Individual personal Time and stress management.
- Maintenance of personal Security and awareness and management of the security risks to others
- The demonstration of Communication and consultation skills required for out of hours care.
- Understanding the Organisational aspects of NHS out of hours care (nationally & locally)
- The ability to make appropriate Referral to hospitals and other professionals.
- Ability to manage common medical, surgical and psychiatric Emergencies.
The Panel will expect evidence of the educational quality of the OOH experience. Therefore, the trainee needs to make sure that each session is supported by a log entry clearly indicating what they have learned and which of the 6 OOH competences have been demonstrated. It used to be that all GP trainees needed to 48-72 hours per year (which equated to ONE 4-6 hour OOH session per month). The numbers are less important now. What’s important is that the trainee is engaging in regular OOH work and that towards the end of training that all 6 OOH competences are demonstrated. Look at The ES Workbook – it has a section on OOH and asks trainees to say which OOH competency has been demonstrated where.
To read more about Out Of Hours: www.bradfordvts.co.uk/mrcgp/ooh
- At the CCT point doctors should be revalidated and start the 5 year revalidation cycle. The normal GMC policy is to set the revalidation for approximately 3m post CCT date so that there is time for admin systems to line up post final ARCP / CCT with GMC revalidation systems.
- That said, there have been some issues where this has not occurred and trainees have found themselves INCORRECTLY having to be revalidated within 12-24 months of CCT.
- The typical reason for the system failing is where there has been a change in CCT date because the GP trainee has extended training for whatever reason. For this reason, it is really important the ePortfolio is updated to accurately reflect the new CCT date as this is what the GMC base their revalidation date on.
- Sometimes though, it seems the GMC just gets it wrong and sets an inappropriate revalidation date.
- So, if an educator or a trainee thinks the revalidation date is wrong (there shouldn’t be many), PLEASE flag this to the revalidation lead for you GP School – contact your GP Training Scheme Administrator, (s)he will advise. It is important to do this whilst still in training, before CCT as – once CCT is past there is a little the GP Training School’s revalidation team can do as responsibility for revalidation passes to the Local Area Team.
If a trainee has had an SUI in any of the posts that they have been in during that ST year, this must be reviewed and discussed by the ARCP panel. The bottom line is that SUIs can be handled locally and if we are happy, we can sign off ARCP locally, but there needs to be an explicit statement in reference to this in the ARCP sign off. Just so we are all clear from an administrative perspective: please ensure that the ARCP forms on the day state clearly and categorically that these SUIs have both been discussed and noted.
The following gives some idea of what is considered a satisfactory reflection on SUI events. First of all, the trainee must be encouraged to write up the SUI in their ePortfolio contemporaneously – either using the embedded SEA section or using one of the many SUI templates around. The trainee should record a good reflective account of the incident and their learning from it. They should not be defensive or blame others. They should accept their role in the organisational issues that led to the incident. The write up should show some understanding of the theory behind Significant Events (e.g. the Swiss Cheese Model) to indicate a higher level of understanding of SUIs in a medical context.
A complaint or an SUI is not a reason for halting ST progression nor withholding CCT acquisition – even if it is still not resolved or undergoing investigation by the time of the panel. If it is of a serious nature and referred to the GMC, then it is the GMC who will decide whether a doctor’s license is to be removed/suspended; we (the panel) continue to approve (if everything else is okay).
In summary:
- Panels must look at complaints and SUIs for each trainee (if they exist).
- The panel needs to discuss to see whether the SUI/complaint is settled. It’s not just to raise awareness – need to know is settled or ongoing.
- For and ST3, a CCT can still be awarded on the basis of the evidence available. If an investigation is ongoing at the time of the final ST3 ARCP panel, a recommendation for CCT can still be awarded because one is still innocent until proven guilty. The GMC will decide what to do nearer the time of closure.
