GP Registrars,
West Midlands Deanery.
Shropshire VTS

OUT OF HOURS RECOMMENDATIONS

ALL GP registrars need to do a minimum amount of our of hours work, even if their trainers have opted out of this under the new GMS contract.

This will be 72 hours over the three years of training.

• No out of hours to be done in the first 2 months of GP training
• A maximum of 50% of OOH can be done in ST2 and ideally about a third (24 hours)
• Ideally the OOH should be spread through the year (do not leave it till the last minute)
• All out of hours sessions should be recorded in the e-portfolio

This is part of the GP Registrar’s normal contract of employment.

The GP Registrar must have adequate supervision and adequate time for a debrief after each session.

The supervisor needs to have relevant competencies, but need not be a trainer or even a doctor as long as they have the necessary skills & competencies.

The number of hours worked per week will take the European Working Time Directive into account

“Red eye” overnight OOH will not take place on the night before any educational activity. A GPR working the whole night should have the next day off

The sessions need not be worked as one per month and could for example be worked as two separate weeks in each six month period.

GP Registrar competencies to be acquired during OOH sessions:

1. Ability to manage common medical surgical and psychiatric emergencies in the OOH setting
2. Understanding of the organizational aspects of NHS OOH care
3. Ability to make appropriate referrals to hospitals and other professionals in the OOH setting
4. Demonstration of communication skills required for OOH care
5. Individual personal time and stress management

Shropshire VTS Out of Hours System

Shropdoc are providing Out of Hours Training with accredited Trainers and other Doctors who have attended a specific OOH Training Course. It is the registrar’s responsibility to arrange the 72 hours of training stipulated. This can be arranged via Shropdoc (Tel 01743 285600)

Shropdoc operates a traffic light system such that registrars initially start doing out of hours shift directly supervised (red) where the supervisor is present when consulting to being closely supervised (amber), whereby the supervisor is in the same building but the registrar consults alone. Finally the registrar will consult independently from the supervisor who is available by phone (green)

When a registrar has achieved the status of green they will gain associate membership of Shropdoc. This allows them to do Shropdoc shifts after they have completed their training.

The principles of this system are:

• Registrars can do shifts usually of 4-8hrs.
• Registrars will not be expected to do shifts over Christmas or New Year
• The registrar supervisor will generally be a doctor who is a trainer, or who has experience of working in a training practice, or who has attended an OOH Training Course.
• IT training will be provided by the Shropdoc at the end of the ST1 year
• It is the responsibility of the registrar to contact Shropdoc to arrange shifts
• If Registrar’s experience any problems they should approach either their Trainer or Programme Director.