Out-of-Hours (OOH) Guidelines
Covering out of hours (OOH) remains an important part of GP training and is a challenging part of general practice.
All GP ST3 trainees are required to have completed at least 72 hours experience by the end of their 12 month GP attachment (pro-rata for different time periods and in Less Than Full Time Training posts). This should be a balanced programme across the range of the acute GP Out of Hours services and should include, Telephone Triage (additional specialised training/courses in this are essential), Emergency Clinics, Walk in Centres and Home visiting. There should be a minimum of at least 12 documented sessions in the e-portfolio. In ST3, up to 20 of the 72 hours could be completed in other OOH settings (as in ST1/ST2). Up to 12 hours could be completed in an extended access setting, provided that patients are being seen with acute unscheduled care complaints. Taking these additional options into account, a minimum of 48 hours must still be completed in the full ST3 type OOH service setting.
All GP ST1 and GP ST2 trainees are required to have completed at least 36 hours experience by the end of their 6 month GP attachment (pro-rata for different time periods and in Less Than Full Time Training posts). Trainees are required to undertake at least one session every month and to have completed a minimum of 6 sessions in a range of different services during their GP ST1/2 Post.
Sessions length for the purposes of learning should normally be 4 – 8 hours. This may not always be possible in some attachments (i.e. on an Ambulance shift) and should be clearly explained in the Learning Log Entry. Where a session is longer than 8 hours in length this time will not normally be accepted towards “educational credit” without clear evidence in the Learning Log entry as to what additional learning has occurred. (i.e. up to 12 hours in exceptional circumstances such as an ambulance shift or overnight shift.)
GPSTs must complete a work sheet which should be signed by their Out of Hours Educational Supervisor at the end of their Out of Hours shift. This should be uploaded onto the ePortfolio and subsequently checked by the GP Trainer. The OOH record form this becomes the legal record and log of hours worked and will be subjected to probity checks. Failure to fully document these sessions may lead to referral to the NHS Counter Fraud service.
The GPST must complete a Registration Form prior to commencing any OOH sessions which is to be forwarded to both their Clinical Supervisor and OOH provider, and scanned to their ePortfolio.
These forms are included below. For further information visit the Health Education Wessex Website Out Of Hours Page.
For a general overview of OOH requirements in GP training, please see this document:
ST3 Specific Documents:
- OOH Registration Form (for GP ST3)
- Out of Hours Training in ST3 2014
- Out Of Hours Summary Log for ST3 (complete this summary sheet for final ARCP)
- ST3 OOH log and learning record 2015 (complete one per session and scan to ePortfolio)
All GPST trainees are required to complete an Out Of Hours Summary Log for their OOH sessions.
The ARC panel requires the GPST to complete a summary log listing all OOHs sessions worked for each post. This log must be scanned into the e-portfolio and attached to “Summary OOHs” in the e-portfolio. Failure to do so may result in an unsatisfactory ARCP outcome or a delay in obtaining the CCT.
How much OOH do I need to do?
Currently, you are required to gain 72 hours OOH experience during GPST3 and 36 hours during GPST1/2. This is not difficult but you will need to work steadily at it during your GP placement. Demand for sessions can be high, so plan ahead.
What does it consist of?
GPST1/2 trainees are encouraged to gain out-of-hours experience in a variety of settings. This can include working with twilight district nursing services, paramedics, community mental health crisis teams, community palliative care teams and duty social workers. Other options include following an undertaker, police officers, prison staff or members of the RNLI crew in out-of-hours sessions. A maximum of one session (outside of usual weekday working hours, 0800 – 1830) can be spent working in a walk-in centre.
GPST3 trainees must spend their (minimum) 72 hours of training with the GP Out-of-Hours service. This will include sessions in local OOH Treatment Centres, sessions in the visiting cars and telephone triage. These sessions can be spent at the Weymouth Urgent Care Centre (outside of usual weekday working hours, 0800 – 1830). A maximum of on session can be spent in a walk-in centre (outside of usual weekday working hours, 0800 – 1830).
ST3 trainees may undertake up to two sessions in the A&E GP Project at Royal Bournemouth Hospital – this is a new initiative supplying primary care for out-of-hours acute problems in the emergency department. Sessions can be arranged by contacting Dr Ravin Ramtohal.
How do I arrange it?
If your trainer or another GP in your practice does OOH work, they will often be able to supervise your sessions. If not, then you will need to contact another accredited OOH supervisor to arrange supervised sessions. A list of supervisors is found in the document below. This file is password protected and the password may be obtained by emailing the Dorset GP Centre (firstname.lastname@example.org).
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Urgent Care Service
- UCS Introduction – explains the philosophy and context of the Urgent Care Service locally.
- UCS Honorary Contract – this contract must be completed before work with the UCS is started.
In Dorset, the trainee will need to contact Ellenor Peaty at SW Ambulance Service who will co-ordinate your OOH sessions with the Urgent Care Service. Email or phone 01202 851332 (Monday to Thursday 8.30am – 5pm), in Ellenor’s absence contact Pat Hyde on the same number.
Arranging Out Of Hours Work at ST1 and ST2
- ST1/2 Specific Documents:
OOH options for ST1/2 trainees:
- OOH – Ambulance Service: Please contact Tonia Meakin at SW Ambulance Service who will co-ordinate your OOH sessions with the Ambulance Service. You will need to complete and return the attached form, which can be electronically signed from and NHS account or will need to be hand signed from a personal account.
- 111 Observational shift with the Integrated Urgent care Services: Please contact Christine Bott
- Boscombe & Springbourne Health Centre: Please contact Dr Mufeed Ni’man at Providence Surgery on 01202 395195 or 07719 676464
- Twilight Nursing Team: Please email Clare Head or phone 07789 271903.
- Psychiatry Crisis Team in Bournemouth: Please complete the attached form and return it to Odette Chandler when arranging your session. You will need to take along with you to the session some photo ID (passport or driving licence) and your Trust ID badge.
- Psychiatry Crisis Team in Yeovil: contact Holly Court unit on 01935 411605.
- Acute Paediatric Assessment Ward Poole Hospital: Contact Dr Sumit Bokhandi via his secretary, Wendy Edwards, on 01202 442177.
- OOH Social Services – Dorset wide: phone 01202 657279 (Mon-Thur after 5pm or Fri after 4pm).
- Dorset Police Force – join the Police in Dorset as an observer for a day. Apply via their website here: Dorset Police Lay Observation Scheme
Booking Paid (Post CCT) Shifts Whilst Still an ST3
ST3 trainees are allowed to book OOH sessions following the rules as set out below:
- ST3 contacts Ellenor Peaty or the rota admin team requesting permission to book shifts.
- They are able to do this but not under their own name, rota admin team will book the shifts under “DoctorDoctor” but making a note of the ST3 who has booked the shift.
- The ST3 fills out an application form, having got all their paperwork together, including their final certificate.
- When this is approved, they can then have the shift put into their own name as a sessional GP.
They are not paid to do any shifts whilst they are still in training. For further information please contact Ellenor Peaty.
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Last Minute Sickness
In the event that a GP clinical supervisor goes off sick at the last minute:
- OOHs service identifies this at the earliest stage and endeavours to contact the trainee concerned preferably before they arrive at the treatment centre
- A senior manager/supervisor discusses the options with the trainee namely: cancel their shift and go home, go to an alternative treatment centre where there is a GP clinical supervisor, work remotely with a clinical supervisor on the telephone, spend a shadow shift with another UCS employee
- If the trainee wishes to stay on for the shift then a GP clinical supervisor is identified
- Reassure the trainee that we are a large multidisciplinary organisation with paramedics, emergency care practitioners, nurse practitioners and GPs who they can contact at any time to seek advice or hands or face-to-face assistance
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