All of the OOH work for GPs in Colchester and Tendring is now run by Harmoni. More information about the company is available from their website.
It is a requirement of PMETB that all trainees should be adequately trained in GP Out of hours care. The following guidelines have been drawn up in response to the EoE deaneries statements on OOH.
Every trainee has to do 36 hours in OOH during their 1st 6 month stint in GP. If they have not done this during that 6 months, then it needs to be made up.
Every trainee has to do 72 hours in OOH during their ST3 year, which has to be completed before their final ESR at 34 months. The trainer cannot sign off their OOH without this being completed and hence the trainee cannot get their CCT without this.
All trainees start off with 2 red sessions. A red session involves tailing the trainer and becoming familiar with OOH processes/IT etc
All trainees cannot be signed off without having done 3 green sessions. Green sessions involve more independent practice. Nevertheless, there has to be a clinical supervisor doing a shift at the same time in case of difficulty and who can also do a face to face debrief at the end, discussing any problems.
In between the red and green sessions, the trainee is doing mainly amber sessions. There will always be a debrief with a Clin sup at the end. If this occurs after the shift ends, then the time can be added onto the hours completed. ie a 5 hours shift with 30mins debrief after = 5.5 hrs. With 30 mins debrief done during the session = 5 hours!
When trainees are thought to be ready to move to green sessions, the Clin sup should put a note in the OOH session record to show that they agree. If the trainer also agrees, then the trainer should complete the Harmoni “green session” authorisation form and send it to Harmoni. Trainees will then be given green sessions.
The trainee can do other activities which count. These could include sessions with the ambulance service, at NHS direct, sitting in with a WIC nurse practitioner.
Clinical supervisors can supervise up to 2 trainees at a time. However, no more than 1 red at a time. In other words, 1 red and 1 amber or 2 amber but not 2 red.
Marjorie Gillespie is going to be doing an induction for all the new trainees starting OOH every 6 months.
With 30 trainees in GP, we need to average at least 30 sessions a month or more. At present, clin sups are doing around 30 sessions a month. With 2 trainees per session, that makes around 60 sessions.
Trainees should be strongly encouraged by their trainers to get going with their OOH early in the year and to space out their sessions. If they leave it all to the last few months, they may well not be able to get enough sessions.
Trainees make themselves available for sessions through the Harmoni site. Harmoni then allocate them. If a trainee makes himself available for 6 sessions in desperation in the last month, he may well only get 1 or 2. He will then not get signed off in time for the panel to approve him and, as a consequence, end up unable to work as a GP for a few months after finishing the scheme.