Posts on Bradford VTS

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Posts on Bradford VTS

• - how to make the most of them

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Structure of rotations

• Rotations all have 18m 2y of GP
• GP posts are 12m in ST3 remaining 6-12m may be
  in ST1 or 2, in a different practice
• Innovative GP posts part of week in GP, part
  in a specialty e g Womens Health, Child Health,
  Musculoskeletal. Youre responsible for some of
  the planning, with TPDs, GP trainer and hospital
  consultants/GPs with special interest

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But first.

• Nearly all of you are going into hospital posts
  first
• You should gain some useful clinical knowledge
• But how else can you make your experience useful
  for your future in GP?
• What could you reflect on and put in your e
  portfolio?

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Issues from hospital practice for your EP

• Medical teamwork
• Multidisciplinary teamwork
• Communication skills
• How families behave
• Significant event analysis
• Ethical issues
• The hospital-GP interface

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Medical teamwork

• Support for colleagues
• Allocation of work
• Effective handover of important information

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Multidisciplinary teamworking

• Understanding the roles of team members
• Especially other health professionals
• Respect for their skills and contribution to
  patient care
• Effective communication with other team members

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Communication skills

• With patients
• With relatives
• With colleagues
• With other team members

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How families behave

• Many family interactions in A/E, Paeds and
  Medicine for the Elderly
• In GP theyre in the background but in hospital
  theyre often there for you to observe

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Significant Event Analysis

• Looking at whats happened when something went
  wrong or nearly did so
• Looking at the feelings of everyone involved
• Reviewing the organisational systems involved
• Working out how to prevent a recurrence

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Ethical issues

• Capacity to consent
• Informed consent
• Confidentiality
• End of life issues

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The GP-secondary care interface

• Understanding what secondary care has to offer
• Communication between GPs and hospital doctors
• Understanding what youll be referring patients
  for, when youre a GP

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Whats different in GP?

• Practice is a business contracted to provide
  primary medical care for the NHS - you are a
  practice employee
• Your trainer
• More personal relationship than with consultants
• Many roles teacher, employer, mentor, assessor,
  possibly friend
• Practice staff be relaxed but respectful
• Practice manager a key person to get to know
• Give-and-take - practices may be more flexible
  employers than hospital, if you are seen as
  helpful and conscientious and flexible

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Work in GP posts

• You wont be thrown in at the deep end will
  have an induction period
• Appt interval long at start, aim to reduce to 10
  mins
• 7 surgeries/wk, educational time with trainer,
  HDR, study ½-day
• Friendly environment but actual work may feel
  quite isolated
• Good personal organisation needed follow
  through, not handover
• Long days, possibly 8.30 6.30 ish
• Visits by agreement, not to scary places
• Out of hours usually 8 sessions in 6m

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Education in GP posts

• Support during surgeries and debriefing
  afterwards
• Teaching with trainer according to your
  educational needs
• Assessments by trainer
• Possibly teaching and/or assessments by other
  practice members
• Wednesday group tutorials at Ashcroft Surgery, 1
  2.30 pm

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A few expectations of you

• Transport to get yourself to visits and
  educational sessions
• Reliable attendance at OOH sessions
• No moonlighting without discussion with your
  trainer (preferably none at all)

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Variation between practices

• Geographical position
• Inner city/urban/semirural
• Size
• Demography of patients
• Building
• Number of sites

• Doctors interests clinical, medicopolitical,
  other teaching, non-NHS work
• Demography of team
• Systems, IT
• Management style
• Ethos/values/priorities