This set outs in broad terms the approach taken by NGPTP when we become aware of a trainer who may be in need of support.
Triggers to the provision of support
These are many and varied. Trainers may simply ask for help but more commonly the trigger relates to something happening:
- The trainer has experienced having a doctor in GP training who has had difficulties (educational, health-wise, or related to their personal life are the most common reasons for this)
- Criticisms in a returned Bristol Online Survey
- Concerns raised to us by a doctor in GP training, practice, trainer, TPD, or HEE
- The trainer has returned from a significant period of absence, e.g. due to illness
Our initial response to this trigger
We may respond at different levels, depending on our assessment of the situation:
- Watchful waiting – if we have a concern that may or may not be valid (for example, if we have been given information but it is not attributable – the doctor in GP training does not want to be identified to the trainer as the source; or the issues identified from the Bristol survey may be ticks in the wrong boxes) we may simply make a note on our files. This means that if corroborating or disproving information comes to light subsequently, we can then resolve the potential concern either way.
Outcomes here are therefore: no further action; keeping note on file for further monitoring; or contact with the trainer (as per what follows).
- Telephone /email contact – if the concern appears to be relatively minor and we are simply lacking certainty that the trainer is aware and planning to address it (for example, if there are mildly negative lime survey comments but no trainer comment to clarify the trainer is even aware of them) then we may simply contact the trainer to seek clarification of this.
Outcomes here are therefore: no further action; keeping note on file for further monitoring; or the offer of a meeting (as per what follows).
- Offer of a meeting – If the level of concern or the degree of support needed is sufficiently high; we will make contact to offer a meeting.
These are arranged with the aim of identifying key issues relating to the trigger(s) for the meeting and then developing a SMART (specific, measurable, achievable, relevant and within a specified time-frame) plan to address those issues. We generally aim to spend 1 – 2 hours with the trainer concerned developing this plan. Following the meeting we will document the plan in an email and share it with the trainer as well as other parties as appropriate (and as agreed)
- Outcomes here are therefore: no further action; keeping note on file for further monitoring; or further contact with the trainer, either via phone, email or a further meeting.
Issues relating to this approach
Not everything works as neatly as above! The following situations require different approaches:
- Serious concerns are raised. An example might be an accusation of major failings in educational provision from a GPR about a trainer of whom there have been previous concerns raised in other contexts. Discussion within NGPTP will take place in such situations.
- Possible outcomes are: the offer of a meeting; or referral to HEE so they may consider handling the situation within their processes.
- The trainer declines a meeting. Sometimes this simply indicates the trainer has adequate support from other quarters. Sometimes it indicates a possible lack of willingness to accept there is a significant problem.
- Possible outcomes are: no further action; keeping note on file for further monitoring; the offer of a deferred meeting; or referral to HEE so they may consider handling the situation within their processes.
Trust and Evidence
We generally take it on trust that a trainer’s perspective is an accurate representation of what actually is the case. Some issues are significant enough, however, that we will wish to seek corroborating evidence to help us confirm this. Examples of the kinds of evidence we might request include:
- A meeting or contact with a doctor in GP training to seek his or her perspective
- A meeting or contact with other relevant parties, e.g. a co-trainer
- Sight of the trainer held record to see how well this reflects the situation
- Review of the doctor in trainings ePortfolio to assess trainee and trainer input to it
- Possible outcomes are: no further action; keeping note on file for further monitoring; the offer of a meeting; or referral to HEE so they may consider handling the situation within their processes.