Case study 9 - North-East Employed & Locum GPs

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You can download our case study North-East Employed & Locum GPs (pdf).

Introduction

North-East Employed & Locum GPs Group (NELG) is a non-profit support group for sessional GPs. The group disseminates information and provides sessional GPs in the North-East of England with the tools they need to stay connected and progress professionally. As a result it’s playing a vital role in helping sessional GPs to prepare for revalidation.

Challenges

NELG has found that a significant challenge in supporting its members with revalidation has been that, because of the nature of their role, many sessional GPs are isolated professionally. It’s been important they offer opportunities for networking, and ensure information about appraisal and professional development reaches its member network.

Dr Paula Wright, Chair of NELG, explains: ‘Information from NHS organisations is currently cascaded via practice managers, which often only reaches those that have a permanent base in a practice.’ NELG’s challenge has been to ensure its members are not ‘out of the loop’ on key communications.

A further challenge has been assisting those sessional GPs who are new to the area, or newly qualified, as they are often unsure who their appraiser should be or how to go about arranging appraisals. Often, sessional GPs are appraised by partners who don’t always understand the challenges faced by sessional GPs.

Collecting supporting information can also prove demanding, as Dr Wright testifies: ‘A sessional GP who moves from practice to practice cannot do a traditional audit which is about improving systems within a practice. It is important for them to be able to focus on collecting appropriate information that is meaningful for them as individual GPs.’

Action

In response to these challenges, NELG has played a key role in providing sessional GPs in the North-East with up to date information and guidance on revalidation, and supporting their members to access additional support and initiatives.

Simple yet effective measures include email alerts and an all-member email facility, while the members’ website has also been a vital tool, housing the latest information and guidance from the GMC and a detailed appraisal pack specific to the region, designed by Dr Di Jelley, the clinical appraisal lead for the region’s 2,500 GPs.

This pack has been carefully tailored to cater for the needs of both partners and sessional GPs. An informal mentoring system also offers additional support for sessional GPs and helps them to improve their knowledge of processes within the region.

Close ties to the local deanery have been crucial in providing up to date information, and NELG now holds its meetings immediately before a deanery education lecture. This provides members with two incentives to attend meetings – networking and professional development – helping to overcome the competing effect on the time of busy doctors.

NELG also supports its members to join self-directed learning groups, autonomous groups that meet once a month for professional development and peer support. All doctors will need to demonstrate evidence of continuous professional development as part of the supporting information required for appraisal and revalidation.

The groups are particularly important for sessional GPs who may find it more difficult to collect this evidence than their peers. Anecdotal evidence suggests that 75% of the region’s sessional GPs are currently affiliated to one of these groups.

NELG has also helped to raise awareness of the need for surgeries to be supportive and inclusive towards sessional GPs, in particular alerting members of letters sent to practices to encourage inclusivity. Further examples of this include inviting sessional GPs to practice clinical and educational meetings, and including them in colleague and patient feedback.

Results and benefits

The appraisal rate for locums within the North-East is similar to that for GP partners – between 90% and 95%.

‘I think we are reasonably well prepared for revalidation in our region, because of a variety of factors,’ says Dr Wright. ‘The support provided by NELG is one of several significant factors in this.’ This is a view supported by Dr Roger Bolas, Secretary of the NELG Executive Committee, who estimates that ‘less than a dozen’ GPs in the North-East are unaware of revalidation and what it means to them.

Dr Hasan Omran is a newly qualified GP who has recently moved from Essex to the North-East. He currently works both in a fixed position and in a salaried role at a walk-in centre, and is a NELG member.

Having just received his first appraisal he is positive about the role revalidation will play in his professional development and the wider benefits it offers sessional GPs: ‘From my perspective, I think sessional GPs in the region are ready for revalidation. In many ways how much doctors take from appraisals and revalidation is down to how keen they are to progress, improve their clinical knowledge and develop their specialty.’

Dr Wright believes that the appraisal process has in fact helped many partners who work as appraisers to gain a greater understanding of the role sessional GPs play within the region, while the implementation of revalidation will offer further benefits: ‘While this region is relatively well developed, in certain other areas there’s no doubt that revalidation will be a driver to ensure that sessional GPs are better supported.’

More than anything, though, NELG’s leaders believe that revalidation will incentivise doctors to strive for greater professional development. ‘It is about identifying areas that worry doctors and having a system in place to put that right,’ says Dr Bolas. ‘General practice is not what it was – doctors need to stand back, take stock and step up to the mark.

It is about being professional in the modern NHS. You cannot make assumptions about strengths and weaknesses, but going through the process can give you reassurance that you are fit to do the job.’

‘Regular appraisal and the revalidation process will benefit all doctors as they will have to show that their knowledge is to a certain standard,’ says Dr Omran. ‘It will be especially helpful in supporting and developing GPs and will benefit patients too, in terms of them knowing that every doctor they see is accountable. For me, the process is essential – it’s vital for the future of the profession.’

Key findings

• Professional networks with strong communication and easy access to peer support are one of the ways that locum doctors can be supported with appraisal and revalidation. Autonomous learning support groups can also help locum doctors to collect important evidence of their continuing professional development.
• Organisations and practices that use locum doctors can help them with their appraisal and revalidation by making sure they are included in clinical and education meetings.
• Some doctors experience professional isolation because of the way they have chosen to practise, so it’s important that information about appraisal, revalidation and professional development opportunities reaches them. NELG’s website and events have helped sessional GPs in the region stay up to date with the latest information about revalidation.