Out of Hours OOH Module 2 OOH Competences

Out of Hours - OOH Module 2

OOH Competences • Ability to manage common medical, surgical and psychiatric emergencies. • Understanding the organisational aspects of NHS out of hours care, nationally and at local level. • The ability to make appropriate referral to hospitals and other professionals. • The demonstration of communication and consultation skills required for out of hours care. • Individual personal time and stress management. • Personal & other staff security/ safety. @NHS_Health. Ed. Eng

• First GP post (generally ST 1); • GP Trainees will not usually undertake any OOH work • Instead they should be prepared for later work in this field by: – Experience gathered through educational interventions which could include telephone triage, consulting skills in hours – Observation of urgent / unscheduled care provision within hours – In Hours experiential work in the practice

Induction Before trainees are able to undertake Out of Hours sessions they must attend an Induction. They also require accounts to be created, to enable them to access the provider’s IT system. The following documentation must be supplied by trainees: • BLS/AED/ALS with dates as per Traffic Light Form • GMC Certificate • Safeguarding children certificate • Medical Indemnity • Performers list inclusion • Signed computer policy acceptance form @NHS_Health. Ed. Eng

• At least 1 educational session on delivering unscheduled care delivered in house by the in-hours GP trainer and one day should be spent delivering such care under close supervision • During OOH training trainees are supervised either by a Trainer, or by a GP who has been trained and approved by the School of Primary Care to act as a Clinical Supervisor • Trainees’ competence for remote supervision is confirmed by the trainer using the OOH 3 and OOH 4 forms (see below). The traffic light system is used i. e.

• Red = Not ready for own OOH caseload (OOH 5) • Amber = Can manage own shift, with supervisor present (OOH 3) • Green = Can manage own shift with remote supervision (supervisor on the phone, actively supervising and available to attend centre if needed) (OOH 4) Green shifts might be solo (at quiet more rural centres) or alongside a non-supervising doctor in a more urban centre (with the supervisor typically at home or nearby). All green and amber shifts should have protected time for feedback.

In reality… • Amber = Can manage own shift, with supervisor present (OOH 3) • Green = Can manage own shift with remote supervision (supervisor on the phone, actively supervising and available to attend centre if needed) (OOH 4) Green shifts might be solo (at quiet more rural centres) or alongside a non-supervising doctor in a more urban centre (with the supervisor typically at home or nearby). All green and amber shifts should have protected time for feedback.

• Once certified amber or above by the trainer, the trainee will undertake 4 -6 sessions (4 in Cumbria, 6 elsewhere) of OOH work in each 6 m post with local provider; - working within their normal shift pattern where possible - no overnight shifts - time will be deducted from in-house clinical sessions.

GP Trainer with direct responsibility for the day to day work of the training must: • Ensure that the trainee's hours are EWTD compliant … Payback/Clawback • Allow attendance at OOH induction • The trainee is responsible for giving the form to the Provider. • Inform the trainee’s Educational Supervisor and the OOH Provider about any concerns with regard to the trainee's performance and competence @NHS_Health. Ed. Eng

How to record on e. Portfolio • A separate log entry for each session • Title of log entry to include type of session, traffic light, duration, running total • Feedback form from OOH supervisor to be attached • Linked to OOH in learning log @NHS_Health. Ed. Eng

Final ARCP Panel • ES to complete ‘overview’ form • Trainee to complete a log entry and attach this form • ES can signoff OOH as long as there are no more than 2 (booked) sessions outstanding at the time of ESR completion. @NHS_Health. Ed. Eng

Organisation It is the responsibility of the TRAINEE to arrange their Out Of Hours Sessions. The Programme will forward to each provider a list of those trainees accessing their service. @NHS_Health. Ed. Eng

Integrated Training Posts A trainee is still required to complete OOH sessions during these posts unless doing on call for the hospital part of the post @NHS_Health. Ed. Eng

Caution A trainee who has done all of their shifts within a short time frame may be asked to undertake additional sessions to demonstrate that they have maintained their competencies. @NHS_Health. Ed. Eng

Remember… Give adequate notice if unable to attend. Late notice of non-attendance puts patient safety at risk. Non-attendance without notice will be regarded as a negative probity indicator and may result in referral to the GMC. Providers should inform CS and Programme of this. @NHS_Health. Ed. Eng