scholarly journals Overseas GP recruitment: comparing international GP training with the UK and ensuring that registration standards and patient safety are maintained

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen18X101640 ◽  
Author(s):  
Emily Fletcher ◽  
Anna Sansom ◽  
Emma Pitchforth ◽  
Gerens Curnow ◽  
Adrian Freeman ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Safety ◽  
Data Collection ◽  
Continuing Professional Development ◽  
Test Case ◽  
European Economic Area ◽  
Overseas Country ◽  
The Uk ◽  
Gp Training

BackgroundAmbitious overseas recruitment targets have been set by the UK government to help alleviate the current GP shortage. European Economic Area (EEA) doctors can join the UK’s GP register under European law. Non-EEA doctors must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained doctors. CEGPR applications can be time-consuming and burdensome. To meet overseas recruitment targets, it is important to facilitate the most efficient route into UK general practice while maintaining registration standards and patient safety.AimTo develop a methodology to map postgraduate GP training and healthcare contextual data from an overseas country to the UK.Design & settingDesk-based research and stakeholder interviews.MethodFour stages were undertaken: 1) developing a data collection template; 2) conducting a case study (using Australia as a test case); 3) refining the data collection template; and 4) creating a mapping framework. The case study used the 2016 curricula for the UK and Australia.ResultsFive ‘domains’ were identified: healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation. The final data collection template comprised 49 mapping items across the domains. The methodology incorporated the application of a red, amber, or green (RAG) rating to indicate similarity of data across the five domains. Australia was rated ‘green’ for training pathway, curriculum, and assessment, and ‘amber’ for healthcare context and CPD and revalidation. The overall rating was ‘green’.ConclusionImplementing this systematic methodology for mapping GP training between countries may support the UK’s ambitions to recruit more GPs, and alleviate current GP workforce pressures.

scholarly journals Comparing international postgraduate training and healthcare context with the UK to streamline overseas GP recruitment: four case studies

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101034
Author(s):  
Emily Fletcher ◽  
John Campbell ◽  
Emma Pitchforth ◽  
Adrian Freeman ◽  
Leon Poltawski ◽  
...  
Keyword(s):  
South Africa ◽  
General Practice ◽  
New Zealand ◽  
Continuing Professional Development ◽  
General Medical Council ◽  
Rapid Review ◽  
Medical Council ◽  
European Economic Area ◽  
The Uk ◽  
Gp Training

BackgroundThere are ambitious overseas recruitment targets to alleviate current GP shortages in the UK. GP training in European Economic Area (EEA) countries is recognised by the General Medical Council (GMC) as equivalent UK training; non-EEA GPs must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained GPs. The CEGPR may be a barrier to recruiting GPs from non-EEA countries. It is important to facilitate the most streamlined route into UK general practice while maintaining registration standards and patient safety.AimTo apply a previously published mapping methodology to four non-EEA countries: South Africa, US, Canada, and New Zealand.Design & settingDesk-based research was undertaken. This was supplemented with stakeholder interviews.MethodThe method consisted of: (1) a rapid review of 13 non-EEA countries using a structured mapping framework, and publicly available website content and country-based informant interviews; (2) mapping of five ‘domains’ of comparison between four overseas countries and the UK (healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation). Mapping of the domains involved desk-based research. A red, amber, or green (RAG) rating was applied to indicate the degree of alignment with the UK.ResultsAll four countries were rated ‘green’. Areas of differences that should be considered by regulatory authorities when designing streamlined CEGPR processes for these countries include: healthcare context (South Africa and US), CPD and revalidation (US, Canada, and South Africa), and assessments (New Zealand).ConclusionMapping these four non-EEA countries to the UK provides evidence of utility of the systematic method for comparing GP training between countries, and may support the UK’s ambitions to recruit more GPs to alleviate UK GP workforce pressures.

scholarly journals Assessing patient satisfaction with a microsuction service in general practice: a comparative study

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen19X101649 ◽  
Author(s):  
Ruairi Hasson ◽  
Eoin McDermott ◽  
Karena Hanley ◽  
Camilla Carroll ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Data Collection ◽  
Comparative Study ◽  
Usual Care ◽  
Intervention Group ◽  
Hospital Setting ◽  
Patient Acceptability ◽  
Prospective Comparative Study ◽  
The Uk

BackgroundIn the UK, about 2.3 million people each year require intervention for wax impaction, while otitis externa accounts for just over 1% of general practice consultations. Aural microsuction of debris from the ear canal is a commonly performed procedure within the ear, nose, and throat (ENT) outpatient clinic. This article examines the patient acceptability of an aural microsuction service delivered in general practice.AimTo determine patient satisfaction following the introduction of a new microsuction service in general practice compared with a hospital-delivered service.Design & settingThis is a prospective comparative study in two rural general practices in Ireland and the emergency department (ED) of the Royal Victoria Eye and Ear Hospital (RVEEH), Dublin.MethodA 3-month period of data collection on usual care of 56 patients in general practice was followed by a 3-month period of GP-intervention data collection on 67 patients. Comparative data were collected on 37 patients who attended the RVEEH for the same intervention procedure. Patients completed a validated patient satisfaction questionnaire (PSQ-18).ResultsBoth general practice groups scored significantly higher in all seven aspects of medical care than the RVEEH cohort. Patients in the GP-intervention group scored significantly higher in terms of satisfaction with procedure technique compared with the usual care GP group.ConclusionThe provision of microsuction as a service in general practice confers as much or more patient satisfaction as the provision of the service in a hospital setting.

scholarly journals Medical students’ perceptions of a career in general practice

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702773
Author(s):  
Kimberley Banner ◽  
Hugh Alberti ◽  
Jane Stewart
Keyword(s):  
General Practice ◽  
Longitudinal Study ◽  
Medical Students ◽  
Family Life ◽  
Personal Narratives ◽  
Career Intentions ◽  
Form Part ◽  
Training Programmes ◽  
The Uk ◽  
Gp Training

BackgroundRecruitment into general practice is falling and many training programmes in the UK have unfilled training posts. In 2016 NHS England pledged to increase the number of graduates entering GP training to 50%. However in 2017 only 15.3% of foundation year 2 doctors commenced general practice.AimThis work aims to understand medical students’ perceptions of a career in general practice, and how this may affect their career intentions.MethodAs part of a larger, longitudinal study at four UK universities. First and fourth year students were invited to a focus group to discuss their perceptions of a career in general practice. The recordings were transcribed and content analysis was performed.ResultsThe perceptions discussed could be broadly grouped into three categories. ‘The GP’ highlighted students’ ideas of the GP as someone who was dedicated, could create rapport, and wanted a family life. The ‘Job of the GP’ indicated students were positive about the continuity of care the job offered, but felt the work was isolating and paperwork heavy. Finally, external factors such as denigration and the ‘GP land’ concept also had an impact on students’ perceptions.ConclusionFurther work is needed to understand how these perceptions develop, how this may impact students career intentions, and how this research could be used to improve GP recruitment. This data will form part of a wider longitudinal study, the results of which will be analysed for themes and personal narratives of the students.

scholarly journals A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

2019 ◽  
Vol 8 (2) ◽  
pp. e000538
Author(s):  
Edward Croft ◽  
Maria Tighe Clark ◽  
Nikolaos Efstathiou ◽  
Caroline Bradbury-Jones
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Patient Safety ◽  
A Priori ◽  
The European Union ◽  
Medical Practitioners ◽  
The Public ◽  
Factors Associated ◽  
Mapping Review ◽  
The Uk

BackgroundMedical misconduct is an international problem. It is judged according to whether a doctor has endangered the health of the public. Little is known about the risk factors associated with medical misconduct. To inform patient safety, we undertook a focused mapping review and synthesis (FMRS) of tribunal reports retrieved from the Medical Practitioners Tribunal Service (MPTS).MethodsA four-phase FMRS was undertaken: (1) identification and retrieval of 1-year tribunal transcripts from the MPTS (focus), (2) analysis of transcripts to identify patterns mapped to ‘a priori’ risk factors (mapping), (3) peer review of the data (calibration) and (4) creation of a risk profile (synthesis).ResultsOut of the 351 investigative tribunals, 249 (70.94%) resulted in a guilty verdict. 82.73% of all guilty verdicts led to the removal of the doctor from practice. Through the identification of four a priori risk factors, we developed a model of risk associated with medical misconduct: (1) being male, (2) primary medical qualification (PMQ) outside of the UK, (3) working within general practice and surgical specialties, and (4) having passed PMQ more than 20 years ago. Notable ‘unconfirmed’ factors, such as locum work, PMQ achieved outside of the European Union, increasing age and lack of clinical guidance are also relevant to what is deemed professional behaviour and what is not.ConclusionsThe findings can inform debates about patient safety and lay the groundwork for further research into medical misconduct. Prospective studies should focus on confirming the contributory factors and relationship between these four a priori risk factors for medical misconduct: being male, PMQ outside of the UK, increasing age and working in general practice or surgical settings.

scholarly journals The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England

2019 ◽  
Vol 69 (685) ◽  
pp. e578-e585 ◽  
Author(s):  
Sharon Spooner ◽  
Louise Laverty ◽  
Kath Checkland
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Focus Groups ◽  
Early Career ◽  
Situational Analysis ◽  
Career Intentions ◽  
Training Programmes ◽  
The Uk ◽  
Gp Training

BackgroundThe capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.AimThis article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.Design and settingA qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).MethodParticipants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.ResultsFifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.ConclusionStrategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.

scholarly journals Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care

2020 ◽  
Vol 17 (20) ◽  
pp. 7614
Author(s):  
Michael Toze ◽  
Julie Fish ◽  
Trish Hafford-Letchfield ◽  
Kathryn Almack
Keyword(s):  
Data Collection ◽  
Population Level ◽  
Good Health ◽  
Capabilities Approach ◽  
Individual Level ◽  
The Uk ◽  
Multiple Domains ◽  
Lgbt Populations

Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the case study of the UK, where there are proposals to improve government and health data collection on LGBT populations, but also a degree of apparent uncertainty over the purpose and relevance of information about LGBT status in healthcare. This paper applies a health capabilities framework, arguing that the value of health information about LGBT status should be assessed according to whether it improves LGBT people’s capability to achieve good health. We draw upon 36 older LGBT people’s qualitative accounts of disclosing LGBT status within UK general practice healthcare. Participants’ accounts of the benefits and risks of disclosure could be mapped against multiple domains of capability, including those that closely align with biomedical accounts (e.g., longevity and physical health), but also more holistic considerations (e.g., emotion and affiliation). However, across all domains, individuals tend to assess capabilities at an individual level, with relatively little reference to population-level impact of disclosure. Clearer articulation of the benefits of disclosure and data collection for the collective capabilities of LGBT populations may be a beneficial strategy for improving the quality of information on LGBT populations.

scholarly journals Functionality and Usability Requirements for a Crowdsourcing Task Interface that Supports Rich Data Collection and Volunteer Participation: A Case Study: The New Zealand Reading Experience Database

2021 ◽  
Author(s):  
◽  
Donelle McKinley
Keyword(s):  
Data Collection ◽  
Data Entry ◽  
Future Research ◽  
Reading Experience ◽  
The Social ◽  
Volunteer Participation ◽  
Usability Requirements ◽  
Rich Data ◽  
The Uk

<p>Research problem: The New Zealand Reading Experience Database (NZ-RED) is a crowdsourced history of reading project based on the UK-RED launched in 1996. The purpose of this study is to produce high-level functionality and usability requirements for a NZ-RED task interface that supports volunteer participation and rich data collection, and to determine the extent to which the UK-RED task interface meets these requirements.  Methodology: The case study takes a mixed-methods approach informed by grounded theory. Data was collected from RED project documentation and research, a usability inspection of the UK-RED task interface using evidence-based heuristics developed by Petrie & Power (2012), an online questionnaire of 112 current and potential RED contributors, an examination of recent crowdsourcing projects, and literature on crowdsourcing and human-computer interaction.   Results: This study established seven functionality and usability requirements for a NZ-RED task interface that supports volunteer participation and rich data collection: minimize user effort; support integration of the task with research processes; enable new visitors and contributors to understand what the task involves quickly and easily; support accurate and controlled data entry; be easy to use for people reasonably confident with the Web; support flexible, structured data entry; and support bilingual data entry. The UK-RED task interface partially meets four of the seven requirements.  Implications: Evidence-based requirements that inform project development and evaluation contribute to the social sustainability of crowdsourcing projects driven by academic and cultural heritage institutions. Future research could review the requirements produced by this study and consider their impact on the social sustainability of the NZ-RED and, potentially, World-RED partners. An increase in published requirements documentation could help to inform the requirements activity of other crowdsourcing projects, thereby reducing the time and expertise required. Future research could also investigate the value of studies like this one for other crowdsourcing projects.</p>

scholarly journals Exposure of undergraduates to authentic GP teaching and subsequent entry to GP training: a quantitative study of UK medical schools

2017 ◽  
Vol 67 (657) ◽  
pp. e248-e252 ◽  
Author(s):  
Hugh Alberti ◽  
Hannah L Randles ◽  
Alex Harding ◽  
Robert K McKinley
Keyword(s):  
General Practice ◽  
Medical School ◽  
Quantitative Study ◽  
Medical Schools ◽  
Training Programme ◽  
Foundation Programme ◽  
Practice Teaching ◽  
The Uk ◽  
General Practice Training ◽  
Gp Training

BackgroundIt has been suggested that the quantity of exposure to general practice teaching at medical school is associated with future choice of a career as a GP.Aim To examine the relationship between general practice exposure at medical school and the percentage of each school’s graduates appointed to a general practice training programme after foundation training (postgraduate years 1 and 2).Design and setting A quantitative study of 29 UK medical schools.MethodThe UK Foundation Programme Office (UKFPO) destination surveys of 2014 and 2015 were used to determine the percentage of graduates of each UK medical school who were appointed to a GP training programme after foundation year 2. The Spearman rank correlation was used to examine the correlation between these data and the number of sessions spent in placements in general practice at each medical school.ResultsA statistically significant association was demonstrated between the quantity of authentic general practice teaching at each medical school and the percentage of its graduates who entered GP training after foundation programme year 2 in both 2014 (correlation coefficient [r] 0.41, P = 0.027) and 2015 (r 0.3, P = 0.044). Authentic general practice teaching here is described as teaching in a practice with patient contact, in contrast to non-clinical sessions such as group tutorials in the medical school.DiscussionThe authors have demonstrated, for the first time in the UK, an association between the quantity of clinical GP teaching at medical school and entry to general practice training. This study suggests that an increased use of, and investment in, undergraduate general practice placements would help to ensure that the UK meets its target of 50% of medical graduates entering general practice.

Mentoring and coaching in education practitioners’ professional learning

2015 ◽  
Vol 4 (4) ◽  
pp. 293-302 ◽  
Author(s):  
Marion Jones
Keyword(s):  
Professional Learning ◽  
Workplace Learning ◽  
Continuing Professional Development ◽  
Research Impact ◽  
Policy And Practice ◽  
High Quality Research ◽  
Content Type ◽  
Education Professionals ◽  
The Uk

Purpose – Mentoring and coaching are key strategies employed in workplace learning and are perceived as effective ways to provide learner support. However, there is a paucity of evidence of how research outcomes may have influenced these practices and to what extent they have benefited those involved in this process. The purpose of this paper is to demonstrate that research on mentoring and coaching can in fact result in beneficial impacts on education professionals’ learning and development. Design/methodology/approach – The paper critically reflects on the process of developing an impact case study submitted to the UK Research Excellence Framework 2014. It seeks to make explicit the close relationship that exists between research and professional practice and how evidence of any resulting impact of research on user communities can be identified, collected and verified. Findings – In describing the process of developing such an impact case study the article focuses on three key aspects: identifying a suitable case; meeting the criteria of high quality research; and evidencing impact. It highlights the importance of a collective, cross-professional approach and draws attention to the nexus that needs to be established between user and research communities, between academics and professional practitioners, in order to generate evidence of research impact in the field. Originality/value – This paper brings to light the benefits research in mentoring and coaching can have on policy and practice, specifically in terms of education professionals’ workplace learning and continuing professional development in a local and international context.

scholarly journals Advancing an understanding of access as ‘human fit’: A qualitative participatory case study in general practice

2021 ◽  
pp. BJGP.2021.0375
Author(s):  
Jennifer Voorhees ◽  
Simon Bailey ◽  
Heather Waterman ◽  
Katherine Checkland
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Conceptual Framework ◽  
Care Access ◽  
Healthcare Workforce ◽  
Equal Importance ◽  
Access To Primary Care ◽  
Definition Of ◽  
The Uk

Background: Good access to primary care is an important determinant of population health. Whilst the academic literature on access to care emphasises its complexity, policies aimed at improving access to general practice in the UK have tended to focus on measurable aspects, such as timeliness or number of appointments. Aim: To fill the gap between the complex understanding of primary care access in the literature and the narrow definition of access assumed in UK policies. Design and Setting: Qualitative, community-based participatory case study within the geographic footprint of a Clinical Commissioning Group in northwest England. Method: We applied Levesque et al.’s conceptual framework of patient-centred access and used multiple qualitative methods (interviews, focus groups, observation). Analysis was ongoing, iterative, inductive, and abductive with the theory. Results: The comprehensiveness of Levesque et al.’s access theory resonated with diverse participant experiences. However, while a strength of Levesque et al. was to highlight the importance of people’s abilities to access care, our data suggest equal importance of healthcare workforce abilities to make care accessible. Thus, we present a definition of access as the ‘human fit’ between the needs and abilities of people in the population and the abilities and capacity of people in the healthcare workforce, and provide a modified conceptual framework reflecting these insights. Conclusion: An understanding of access as ‘human fit’ has the potential to address longstanding problems of access within general practice, focusing attention on the need for staff training and support, and emphasising the importance of continuity of care.

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