Foundation Training and GP in the Northwestern Deanery

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Foundation Training and GP in the Northwestern
Deanery

• Dr Andrew Craven
• Associate GP Director

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Introduction

• The key has been all the different parts of the
  organisation working together

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Organisations involved

• The Strategic Health Authority
• The Dean and hospital Associates
• Hospital trusts and consultants
• The Foundation Programme Directors
• The GP team
• Learning environments
• Supervisors

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Strategic Health Authority

• Worked closely with the Deanery
• Workforce issues
• Funding agreed on top of the DOH 55
• Premises development weighted depending on need

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The Deanery

• GP Dean
• A Vision to place all F2s in GP
• General Professional training pilot pre F2
• The Associate Deans and GPs all sat on the trust
  foundation boards
• Deanery development group

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Horus

• Portfolio used by medical students re designed to
  form a Foundation Portfolio.
• This works well for GP environments

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Hospital Consultants and FPDs

• Very enthusiastic FPDs appointed
• Development course leadership, negotiation,
  team development etc
• This led to supportive consultants and trusts
• Stimulated by very positive experience and
  feedback

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The GP Team

• We firmly believed that time in GP would improve
  doctors training
• We clearly signalled that spare capacity could be
  used for F2
• Set a challenge to the trainers
• Gave clear guidance and regular communication

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Learning environments

• Initially all F2s in an approved training
  practice
• Moved away from the training practice to the
  environment
• Premises development
• Multiple learners in the practice
• One supervisor for each learner

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The supervisors

• Many trainers to start
• Retired trainers less hoops
• Associate trainers
• Teaching medicine in GP not teaching general
  practice
• Enjoy the continuum Undergrad to F2

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Recent ideas

• More associate trainers
• Some in a non training practice but an approved
  environment and mentored by a trainer
• Nurse practitioner supervisors
• Using ISTC during the programme

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Preparation of the supervisors

• Basic Trainers Course
• Generic course Nuts and Bolts
• Best delivered by GP educators
• Support of the supervisors
• Local supervisor groups

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How to maintain learner enthusiasm

• GP can cover wide areas of the curriculum
• They need a role and to provide a service
• We can bias the work a little to keep the learner
  engaged
• Many innovative ideas

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Trainees and Outcomes

• Most are told they will have primary care in the
  track
• Some of them complain but generally very positive
  feedback
• High Proportion of GP ST applicants from the NW
  foundation school

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Trainees and Outcomes 2

• Good background knowledge and awareness of
  competencies at GP selection
• Anecdotal evidence of better performance with
  simulated patients
• We have supported a research project looking at
  career choice relating to F2

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Where are we now?

• There are tensions with the ST programmes
• Most of the trainers really enjoy it but there is
  fatigue
• More people to train in GP

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Where are we now?

• 155 tracks (465 trainees)
• 140 tracks have GP placement (90)
• 10 have a community placement
• 97 have community placement
• Still aiming for 100!

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To be continued....

• The key has been all the different parts of the
  organisation working together