Medical Performers List

Important Information Regarding the Medical Performers List MPL and CRB Checks

Please note the following guidance re current application and for inclusion on to the PCT’s Medical Performers List.

The MPL regulations state that from commencement in a GP Training post that a 2 month window is allowed to process applications to be included on the PCT MPL with conditions “in a supervised training post”.

  • This applies to all current ST1,2 GP posts and ST3/GPStR posts which commenced on Wednesday 4th August 2010.
  • This 2 month period is therefore from 4th August to the 3rd of October 2010.
  • The rate limiting step, is the eCRB check (which usually takes 6-8 weeks to come back to the PCT) and they will not be notified until the 9th week from application if there is a problem.
  • Due to changes in the CRB requirements (the addition and then subsequent withdrawal of the ISA requirement) the CRB offices delayed processing all applications in the summer for 1 month (!) and there is now a back-log at the office.
  • Provided the application to the PCT MPL was submitted before Wednesday 4th August 2010 then the trainee may continue to train but it must be under “direct clinical supervision” at all times and they should not do unaccompanied home visits.  A visit will be permitted however when a suitable clinical supervisor is present (i.e. another partner or District Nurse).
  • If the application was received by the PCT on or after the 4th August 2010 this will require individual review by the Deanery.
  • Please can I ask that pending receipt of “confirmation of approval by the PCT onto the MPL with supervision conditions” that surgeries do not arrange any “booked surgeries” after the 3rd of October.
  • Please do not contact the PCT with enquires re the eCRB check as they cannot do anything that will speed up the process, however the trainee themselves may approach the CRB office directly at 9 weeks (from date of the application) to check process and request a higher prioritisation of the eCRB check, no one else can.  They should explain their situation and that they may not be permitted to continue work/training in their current post.
  • Some trainee’s may not be permitted to continue clinical training in which case a alternative programme designed to meet other training needs must be arranged, please discuss this with the Patch associate Dean should this arise.
  • Delays in dealing with an eCRB check are usually a result of frequent changes of address (esp. in London), working overseas (including Jersey), or incomplete paperwork or details.

 

Please be patient with the process as the PCT cannot intervene at the CRB Offices, but they will notify the practice ASAP of approval.

Richard Weaver

GP Trainee Applications for Inclusion onto the PCT Medical Performers List

All GP Trainees must apply to be registered on the Medical Performers’ list (MPL) of a PCT to train and work in General Practice.  The Regulations state that the application process requires the PCT to take up Professional references, the Trainee to hold a current Enhanced Criminal Record Bureau Check (eCRB) and from July 2010, the Trainee will need to be registered with the Independent Safeguard Authority (ISA).

ISA (Independent Safeguarding Authority)

(http://www.isa-gov.org.uk/).

All doctors can apply to be registered with ISA from July 2010 and from November 2010, it will be illegal to take up a post without being registered. Application for registration with ISA will be included on a new CRB form and registration will be for life.

The Dean of the Wessex Deanery is the Responsible Officer for all Doctors in Training including GP Trainees on the MPL.

GP Trainees may only work on a PCT MPL within the conditions set out in the guidance for GP Registrars to be placed in supervised Training programmes of the Wessex Deanery.

(http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4138602.pdf)

  • The GP Trainee is permitted to start without full registration on the MPL and work for up to 2 months under normal training supervision (including OOHs and external practice clinical activities and attachments) pending receipt of satisfactory references and completion of an enhanced CRB check.
  • Foundation Year 2 GP Trainee placements who are employed by a Secondary Care trust are exempt from the requirements to apply and be on the MPL.
  • Application to the appropriate PCT’s MPL by Wessex Trainees should be made immediately upon acceptance of the offer of a 3 year training scheme with the Deanery regardless of the order of posts and prior to commencement of the first post on a Training Scheme.
  • The Deanery will send a copy of the trainee’s GP Recruitment application form and references to the PCT at the time of acceptance of a rotation by the trainee.
  • The Deanery will send a letter informing trainees that it is their responsibility to apply for the MPL and setting a deadline for application.
  • It is the responsibility of the Trainee to contact their practice placement Practice Manager to complete and submit the paperwork within the stated time frame to the PCT.  The trainee may not at this stage know their future practice placements but the Deanery/Patch Offices will inform the PCT in adequate time prior to commencement in post of Trainee GP placements.
  • The Deanery will arrange for all Trainees to have an Occupational Health Check prior to commencement in post with a “patch employer” or if this is not possible through the Deanery Occupational Health Service in Winchester.
  • The Trainee will also be required to submit documentation in person to the PCT for completion of the application process.  The Trainee will be informed in writing as to when and how this may be done for each PCT.
  • The Trainee will be placed on the MPL with normal Training and Supervision conditions until satisfactory completion of their full GP Training Programme and final training Certification.
  • Trainees who have failed to comply with the application process (i.e. completed and submitted the application prior to starting in post in August) may be suspended from their training programmes at the end of the 2 month grace period.
  • It needs to be noted that previous overseas placements/work (including Jersey) or frequent changes of address may delay completion of the eCRB check. If the trainee is aware that this may be a problem they should inform the Deanery and the PCT at the time of application.
  • Trainees have a review with their Educational Supervisor every 6 months and a formal ARCP panel review each year to ensure they are progressing satisfactorily. The Deanery is required to inform the PCT of any performance issues and will identify any additional training needs with the Training practice.

Two problems may arise during application to the PCT MPL:

  1. Unsatisfactory References.
  2. Unsatisfactory or failure to receive an eCRB check and ISA registration.

References

GP Trainees provide references as part of the application process (3 are required) during GP Recruitment. These are normally requested and must be provided in March/April.

The Deanery, as required by recruitment practice, does not action “reference screening” until after the Recruitment Assessment process has been undertaken and offers made are subject to satisfactory statements in the references.   Copies of these references will be forwarded to the PCT as part of the MPL application process.

If a reference is identified during screening as highlighting an issue or problem this is reviewed by a Senior Recruitment Lead to determine the course of action required and if necessary referred to the Deanery Responsible Officer.

Unsatisfactory References

When the PCT receives a reference as part of the MPL application process for a GP Registrar Trainee which indicates that the referee(s) have some concerns the following actions are advised:

On receipt of a reference indicating a cause for concern in one or more areas, the PCT should notify the Deanery office and write to the GP Head of School. Following review, the Head of School will make the following recommendations for continuation of training:

A. Normal conditional inclusion on to the MPL as a supervised trainee with the following actions:

  • The GP Trainer is informed of the concerns raised in the references and reviews them with Deanery GP Educators and Trainee.
  • The highlighted concerns or issue are addressed and developed in the training programme throughout ongoing training, as part of routine regular training.
  • On occasion additional remedial support may be required with external input or advice from the Deanery.
  • The PCT is advised that the training programme will address the issues and that supervised inclusion on to the MPL may continue.
  • At the completion of the training programme the final ARCP panel reviews the e-portfolio and confirms satisfactory completion of all training to include the resolution of concerns.
  • Satisfactory completion of training and the issuing of the CCT will lead to full inclusion on to the MPL by the PCT without further conditions.

B. Non-inclusion onto the MPL, until the matters are resolved by the Deanery before inclusion on to the list as above (A) which will include referral to the Deanery Responsible Officer:

  • Unsatisfactory or failure to receive an eCRB check and or ISA Registration

GP Trainees are required to hold a current and satisfactory eCRB check and ISA Registration in order to be included on the PCT MPL in a supervised Training placement.  The NHS regulations state that the Trainee must apply for inclusion onto the MPL list prior to commencing in a GP post and that 2 months is allowed for the completion of the eCRB check.

Only one eCRB/ISA check is required for the whole of the three year GP training scheme though the PCT may contact the Trainee directly should the need arise for any further routine eCRB checks as required by the regulations.

The PCT should review with the GP Head of School of the Wessex Deanery the GP Trainee’s status and role in a GP Trainers practice if:

  1. An unsatisfactory eCRB/ISA check is received by the PCT.
  2. The eCRB/ISA check has not been completed by 2 months after commencement in a GP training post following an application by the Trainee in the appropriate time frame. The trainee’s status will be reviewed by a PCT panel and a recent eCRB check in last 12 months can be taken into consideration.
  3. The eCRB check has not been completed by 2 months after commencement in a GP training post due to a late application by the Trainee.

With the agreement of the PCT and Deanery one or more of the following decisions will be advised:

  1. Normal progression of supervised GP Training will continue with no restrictions on role or responsibilities.
  2. The GP Trainee may continue to train but only under “Enhanced Direct Training Supervision” at all times and may not see and treat patients independently.
  3. The Deanery will invite the Trainee to meet with a Senior Deanery Educator to review the reasons for the unsatisfactory or delayed eCRB/ISA.
  4. Where appropriate the GP Trainee may receive a formal disciplinary warning concerning their performance and professionalism.
  5. The Trainee may be referred to the Deanery Responsible Officer for review and advice.
  6. The GP Trainee may be suspended from the Training Programme until the issue is resolved.
  7. The GP Trainee may be placed in a Remedial Training Placement and referred to the Deanery PSU.
  8. The GP Trainee may be dismissed from the Training programme and if appropriate be referred to the GMC or other organisation as required.
  9. The PCT, Training Practice and GP Trainee will be notified of the decision immediately and this will be confirmed in writing.

For delayed eCRB/ISA checks: once the eCRB/ISA check has been satisfactorily completed the PCT and the Deanery will agree to remove any Training restrictions and this will be confirmed in writing.

Trainees who have failed to comply with the requirements of application to the MPL may receive an unsatisfactory Annual Review of Competence and Progression outcome at their subsequence ARCP panel.

The Deanery (and/or Trainer) will inform the PCT of any significant performance concerns or disciplinary matters that arise during training including those during hospital placements.

The Deanery will inform the PCTs of any unsatisfactory ARCP outcomes where an extension to training is required at the end of each year of training. They will also inform the PCTs of the outcome of the final ARCP to allow the trainee to apply for full inclusion without training conditions on to the MPL.

The Trainee will be placed on the MPL with Training and Supervision conditions until satisfactory completion of their full GP Training Programme.

Inter- and Intra-Deanery Transfers

Inter Deanery Transfers (IDT) normally move at ST2 or ST3 from one Deanery to another. Trainee’s are not required to provide the Deanery with references for the IDT process but must provide their latest ARCP certificate.

Trainees who transfer will have to apply to join the new PCT MPL.  The PCT will review the MPL status of the Trainee with their previous PCT and may require the Trainee to provide recent references to the PCT and undergo a new eCRB check.  The PCT will refer any concerns to the Deanery.

The same procedure will be followed for Intra Deanery Transfers involving a change of PCT within the same Deanery.

Only one eCRB/ISA check is required from the beginning for the whole of the three year training scheme. If a trainee transfers to another Deanery or within the Deanery to a different PCT, then a further eCRB/ISA check may be required.   It is the Trainee’s responsibility to check with the new PCT that they have complied with all their requirements in full.

Deanery policy is that a trainee must transfer to their local MPL if they move. They cannot however withdraw or be removed from the MPL if there is an ongoing performance issue and in this case, the practice move may not be possible.

FW/RDW Feb 2010 
PCT Contact details for Medical Performers’ Lists
  • Hampshire and Isle of Wight PPSA (Hampshire PCT, Portsmouth City PCT, Southampton City PCT, Isle of Wight PCT): Suzy Palmer (01962 876601).
  • Dorset FHSA (Dorset PCT, Bournemouth & Poole PCT): Merita Theobald (01202 851291).
  • Wiltshire PCT: Sally Collier (01380 733813).

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