Search the website

GP Trainees and Registrar News

February 2007

• About the subcommittee
• Attention GP trainers - GP trainers network
• Contributions to the newsletter - we want to hear from you
• Doctors and Dentists Review Body (DDRB)
• Maternity leave
• Need advice?
• Out of hours (OOH) training
• PMETB proposes another increase in fees
• The GPs To Be Conference 2006: 'Growing into General Practice'
• The GPs To Be Conference 2007
• We need your details
• Welcome

Welcome
Welcome to the latest edition of the GP registrars newsletter and I wish you a very happy and healthy 2007. This newsletter aims to help keep you up to date with the issues that have been concerning those training for general practice and the work that the subcommittee has been doing in these areas.

The GP registrars subcommittee exists to represent any doctor in training for general practice within the UK, whether currently in a hospital placement or in their GP registrar component of training, and works with and is supported by the UK General Practitioners Committee.

Membership of the subcommittee relies on a trainee from every deanery sitting on the committee in order to share the views of their fellow trainees within their region. In an intense period of training the thought of volunteering to represent your colleagues can seem daunting at first, but it can be very rewarding. Full details of the membership of the subcommittee can be found at the end of this newsletter along with details of how you can become involved.

There are many issues facing general practice training at the moment, making this a busy time for the subcommittee. Many of the issues are to be welcomed such as the approval of the new GP training curriculum by the Postgraduate Medical Education Training Board (PMETB) and the gradual implementation of the new MRCGP examination. There are, however, specific issues that continue to be of concern for GP registrars. These include a consultation from PMETB on further dramatic increases to certification fees coming not long after their last increase in fees. There have been some improvements in the speed and reliability of certification, especially for the August cohort of trainees completing their vocational training schemes; however there continue to be too many examples of trainees who do not receive the level of service that should be expected.

I also recently attended the annual oral evidence day for the Doctors and Dentists Review Board (DDRB) and had the opportunity to present further evidence as to why the level of GPR supplement should not be reduced in following years, as has been suggested by NHS Employers.

We hope you enjoy reading this edition of the newsletter. We also produce an electronic update, the e-bulletin several times per year. If you are not receiving this, please let us know and we will make sure that we have your contact details / email address so that you can receive future editions.

I am always keen to hear your views and would welcome your comments and suggestions on issues that are affecting you or that you feel we should be dealing with.

Andrew Thomson
Chairman, GPC GP registrars subcommittee

PMETB proposes another increase in fees
In October 2006, the PMETB released their latest fees consultation, announcing plans for yet another massive hike in certification fees, as well as introduction of fees for Quality Assurance work.

The GP registrars subcommittee, along with the Education, Training and Workforce subcommittee of the GPC, and working closely with the BMA’s Junior Doctor’s Committee (JDC), took the lead to produce the BMA response to this consultation, which outlined a number of our concerns as detailed below.

Certification
Under the PMETB’s proposals, the cost of a Certification of Completion of Training (CCT) will increase by a staggering 50% in April 2007, to £750. The cost of applying for a Statement of Eligibility for Registration (SER) will be increased by 32%, to £1,250.

The BMA is firmly opposed to these unfair increases in certification fees, which we believe are unjustified and unfair. We do not believe it is acceptable for the PMETB to introduce two large increases in the level of fees within the space of 12 months, giving just a few months notice on each occasion. Additionally, we are particularly disappointed that the PMETB have reneged on their undertaking to phase in further certification fee increases over a number of years.

Quality Assurance
The consultation also outlined the PMETB’s plans to charge Deaneries for Quality Assurance visits. The BMA does not believe this to be the most appropriate way to fund quality assurance, as we feel it contradicts the PMETB’s principle of beneficiary pays. The public are the main beneficiaries of the PMETB’s Quality Assurance work and we have therefore suggested to the PMETB that they should seek funding from the Department of Health.

We recognise that the PMETB has to ensure that it receives enough funding to undertake Quality Assurance visits, but are appalled at their suggestion that, if deaneries were late in paying, trainees may be expected to meet any shortfall.

Links:
PMETB consultation

PMETB/GMC Quality Assurance Consultation
The PMETB recently released a joint consultation, documenting their proposals for the Quality Assurance of Foundation Programmes. The GP registrars subcommittee contributed to the BMA’s response, which broadly welcomed the proposals, while making suggestions for further improvements. We feel that they are a positive starting point for the development of a robust system of Quality Assurance, and hope that they will form the basis of a consistent approach to Quality Assurance throughout medical training, from Foundation Schools to Specialty Training.

Out of Hours (OOH) training
The GP registrars subcommittee have been made aware that GP registrars in Scotland and parts of the Northern Deanery are required to undertake a benchmark of 20 OOH sessions during the course of their year’s training.

The Committee of General Practice Education Directions (COGPED) position paper on OOH, which has now been formally incorporated into the Royal College of General Practitioner's (RCGP’s) GP Curriculum for August 2007, confirms that GP registrars should undertake a benchmark of 12 OOH sessions. There are a number of circumstances where it may be appropriate for GP registrars to undertake more than 12 OOH sessions, but this should only be where a greater amount of exposure to OOH is required in order to meet educational competencies, and must be agreed individually between GP trainer and GP registrar. GP registrars should not be expected to undertake 20 OOH sessions as a matter of course.

The GP registrars subcommittee will continue to press for a resolution to this matter, and have requested that the Deaneries involved confirm why registrars in their region require a greater level of OOH training than GP registrars in other parts of the UK.

Links:
COGPED position paper on OOH .

Doctors and Dentists Review Body (DDRB)
The past year has seen a dramatic increase in the level of training related expenses – for example certification fees - that GP registrars are required to fund themselves.

Therefore, the BMA’s evidence to the DDRB on GP registrars this year focussed heavily on the expenses that GP registrars have to meet during the course of their training. We called for an uplift in basic salary of 4% for GP registrars, and for the GP registrar supplement to be retained at 65%.

The Department of Health and NHS employers also submitted evidence to the DDRB. Under increasing pressure from the Treasury to contain public sector pay rises, they have called for any uplift in basic salary to be limited to the rate of inflation (which they expect to be approximately 2%) and have called for a reduction in the GP registrar supplement to 65% to 55%.

Links:

• BMA evidence .
• NHSE evidence .
• DH evidence .

Who are the DDRB?
Officially called the Review Body on Doctors’ and Dentists’ Remuneration, the DDRB is one of a number of independent bodies which makes recommendations on salary and remuneration levels to the Prime Minister and to Secretaries of State. Similar bodies exist for professions such as Nurses, Teachers, Police and the Armed Forces.

The BMA – along with the Department of Health, NHS Employers, and a number of other organisations – submit evidence to the DDRB each September. Each organisation is permitted to submit supplementary evidence in order to respond to the evidence of others and to bring up any new and relevant information to the attention of the DDRB. The DDRB then carefully weigh this evidence, conducting further research of their own where necessary, before releasing their recommendations the following spring.

Although under no obligation to do so, the government usually accepts the DDRB’s recommendation.

More information about the DDRB can be found on the Office of Manpower Economics’ website .

The GPs To Be Conference 2006: ‘Growing into General Practice’ report by Dr Martin Beastall, GP registrar subcommittee representative, Trent region
It was with some anticipation that I waited for the printer to produce the application form for this annual BMA two-day conference, held in 2006 in the cosmopolitan metropolis that is modern day Leeds. The conference is organised by the BMA’s GP registrar subcommittee, which operates at a national level, and is a subsidiary of the full General Practitioners Committee.

As a GP registrar entering my final year of training in Doncaster, South Yorkshire, I felt certain that this was a conference designed for me, by people just like me. Early signs were encouraging: the conference was held at the Queen’s Hotel, one of Leeds’ oldest and most respected establishments. It certainly provided a fitting backdrop to the two ‘big guns’ of the General Practice world who took the stage following the introductory preamble. Hamish Meldrum (Chairman, BMA GP Committee) engagingly set forth his vision of the future working environment destined for General Practice. This was followed seamlessly by Mayur Lakhani (Chairman of Council, RCGP) who ably demonstrated his considerable skills of oratory with a stirringly inspirational description of ‘The Future GP’.

Feeling proud to be part of the profession, I took the opportunity to glance down at the list of conference delegates. Flicking through the pages, I was surprised by the backgrounds of many of the attendees. There was a bewildering mix of doctors – some on Foundation Schemes, others hoping to make the switch from the muddle that is hospital practice at present and even some from very keen doctors who had flown in from overseas!

What was their motivation, I wondered, as I was directed to the first of four parallel small group sessions. Such is the clamour to leave hospital practice in the current confusion over future training (I am a former Surgical trainee myself), I can only assume that these delegates are attending any event with the words ‘General Practice’ in the title, hoping to improve their chances of securing a place on the increasingly competitive Vocational Training Schemes.

The parallel sessions, designed to introduce an element of choice into the busy timetable, were for me the highlight of the conference. With a broad range of subjects, ranging from financial management to flexible career planning, these small group discussions were exactly what I had been hoping for – practical advice from practicing GPs with plenty of time available to ask questions. Other topics covered included preventing burnout, revalidation, academic work and advice regarding the new GP contract.

Although many of these sessions were designed with the needs of existing GP Trainees in mind, there was much for the aspiring Vocational Training Scheme (VTS) applicant to benefit from. As Modernising Medical Careers (MMC) increasingly forces trainees into making hugely important decisions about their future job plans very early on in their careers, the chance to hear what life is really like as a GP and to network with those already in training is invaluable.

The best networking opportunity presented itself at the evening dinner event between the two days of the conference. The hotel proved to be an excellent venue for such an event, and the quality of the food and service meant the evening easily justified the extra expense involved to attend this optional part of the conference proceedings.

After more worthy parallel sessions on the morning of the second day of the conference, the final ‘big name’ from the world of general practice took to the stage to deliver an in-depth dissection of the MRCGP examination. Roger Neighbour is undoubtedly a legend in the world of primary care, and securing his services was certainly a coup on the part of the conference organisers. As the MRCGP examination is due to change radically in 2007, his experience and insider knowledge of the skills and attributes required to achieve exam success were both timely and welcomed by the assembled delegates.

So, should you attend this conference? Yes, but choose your parallel sessions carefully to ensure the information you receive is relevant to your needs. Be prepared to have your faith in the medical profession and the BMA revived – opportunities to celebrate the privilege of a career in Medicine and to meet so many of your present and future colleagues are few and far between.

The GPs To Be Conference 2007
Thursday 12 & Friday 13 July 2007, Renaissance Hotel, Solihull
There’s something for all doctors in training at the GPs to be Conference, whether you’re a Foundation Doctor considering a career in General Practice, mid-way through a GP VTS, or you are already in a GP registrar post and looking for hints and tips on how to get the best out of your training.

The packed two day programme includes:
High profile keynote speeches from prominent GPs
Practical workshops and Q&A sessions covering a wide range of topics, including:

• Salaried GPs and Partnerships
• Locum and Flexible Working
• Contracting for General Practice
• nMRCGP and planning your GPR year

Once the conference programme and details are finalised, further information will be posted onto the BMA website.

Maternity Leave
In our last newsletter, we noted that agreement had been reached with NHS Employers that maternity leave for GP registrars would be increased to 8 weeks of full pay and 18 weeks of half pay, in line with hospital doctors’ terms and conditions.

We had hoped that these new arrangements would apply from 1 April 2006. However, we now understand that the Department of Health now plans to introduce them later this year.
Attention GP trainers - GP trainers network
The GPC is currently setting up a GP Trainers Network, which will provide a forum for GP trainer representatives from across the UK to discuss issues relating to GP trainers’ pay and conditions.

We are currently trying to obtain contact details for as many GP trainers as possible, so that we can keep them informed of Network’s development, and involved in its work. We have already collected the contact details of hundreds of GP trainers, but if you have not already submitted your contact details, please could you send your name, address and email address to: jgoodway@bma.org.uk

About the subcommittee
The GP registrars subcommittee is a subcommittee of the General Practitioners Committee (GPC). The subcommittee has a remit to look after the interests of all doctors in training for General Practice, from the moment they enter a Vocational Training Scheme to the moment they receive their certificate from the PMETB.

The subcommittee is made up of representatives from every region of England, plus three from Scotland and one each from Wales and Northern Ireland, who are elected annually by regional GP registrar committees. The subcommittee also draws on the expertise of representatives from other BMA committees, such as GPC and the Junior Doctors Committee, and is supported by a small secretariat.

The subcommittee has close links with a number of external organisations, particularly the Royal College of GPs, and also has a voice in wider BMA policy making through its seats on the GPC, and the representatives it sends to the BMA’s Annual Representatives Meeting.

If you would like to know more about the GP registrars subcommittee, including information on how to become an elected member, and how to contact your local representative, please visit our website or email Angela Button – abutton@bma.org.uk.

The subcommittee’s work
Probably the largest policy area covered by the subcommittee is GP registrar pay, and terms and conditions, and we regularly negotiate with NHS Employers and the Department of Health. Currently we are discussing the following key issues:

• revised maternity provisions to bring maternity leave into line with that of junior hospital doctors
• review of the allocation of motor vehicle allowance
• ongoing reviews of the GP Registrar Directions

We also present evidence each year to the Doctors and Dentists Review Body.

The subcommittee also represents GP registrars’ interests in other areas, either via direct negotiations, the development of guidance, or by responding to consultations. Some of the areas that we have been working on recently include:

• specialist training schemes for general practice
• employment arrangements for GP registrars
• the future of assessment for general practice
• GP certification
• quality assurance of GP training

Subcommittee vacancies
We currently have vacancies for representatives in the following regions: South West, London (NE), Oxford, Mersey, Scotland (SE), Scotland (N, NE & E).

If you are on a GP VTS in one of these regions (whether you a GP registrar or in a hospital post) and are interested in becoming a member of the subcommittee, please contact either your local registrars committee for further information, or email abutton@bma.org.uk

Local representation
Some regions have a regional GP registrar committee, which is supported either by the BMA regional office or the deanery office. We would encourage you to attend these meetings, as they are an excellent way to ensure that your voice is heard, to influence GPC policy via the subcommittee’s regional representative, and to meet with other GP registrars in your area. For further information, or if no regional committee exists, and you want support in setting one up, please contact your regional subcommittee representative or regional BMA centre.

We need your details
Whether or not you are a BMA member, please ensure that your details held in the BMA’s records are up to date, so that relevant documents can be sent to you. To update your contact details, please telephone the BMA’s membership and professional records department on 020 7383 6595.

Need advice?
Contract problems and ambiguities, such as those involving maternity provision, are best resolved before employment commences, so we recommend that you carefully consider the implications of your contract before signing.

The subcommittee’s website contains guidance on a wide range of issues, from detailed information about the Framework Contract to guidance on how to choose the right trainer for you .

If the information you require isn’t available on our website, askBMA are able to advise members directly on their individual contractual and employment issues. Contact askBMA on 0870 60 60 828 or visit their website .

Contributions to the newsletter – we want to hear from you
If you have any issues that you would like to see included in future editions of this newsletter, or suggestions for the website, please contact Angela Button at abutton@bma.org.uk

Any correspondence for the subcommittee should be sent to Angela Button, GPC Secretariat, British Medical Association, BMA House, Tavistock Square, London, WC1H 9JP, or email: abutton@bma.org.uk