Springboard Training

The structure of GP training in Staffordshire and Shropshire is changing from August 2017 to a scheme known as Springboard Training.

This involves 4 month attachments in the first and second years rather than 6 months attachments. There will be a 4 month GP attachment in both the first and second years.

The advantages are:

1. More GP experience (4m in ST1 and 4m in ST2, 8 months in total compared to usual 6 months in ST2)

2. Early GP experience (This will improve GP registrars understanding of General Practice as well as helping them get more from the hospital attachments in ST1 by having a primary care exposure).

3. More variety (There are now four hospital attachments of 4 months rather than 3 attachments of 6 months. This allows a wider experience of hospital posts so hopefully will enable more GP trainees experience Paediatrics, Psychiatry, Obstetrics and Gynaecology as part of their rotations.

4. Shorter posts will allow a better focus on training as well as reducing the “toil” of attachments with a heavier workload.  

It is hoped that the GP registrar will be placed at the same practice in ST1 and ST2 if this is at all possible. The registrar will then move to the final training practice for 12 months in ST3.

Throughout the three years of the Training Programme they will be supported by the Training Programme Directors and their own personal Educational Supervisor.

In ST1 and ST2, the GP registrar is supported by Clinical Supervisors in every post whether based in hospital or General Practice. They should all be familiar with the workplace based assessments and with the GP curriculum.

In ST3, the GP registrar will usually join the training practice where his Educational Supervisor is based.

Here the GP registrar is immersed into the GP team and should experience a large number of clinical encounters, facing clinical/psychological and social dilemmas. The GP registrar will be supported by the GPs within the practice.

There are four excellent schemes in this area located in:

  • Shropshire - including Telford and Shrewsbury
  • North Staffordshire - including Stoke-on-Trent.
  • South Staffordshire - including Stafford, Cannock, Rugeley and Womborne/Seisdon area
  • East Staffordshire - including Burton, Lichfield and Tamworth

GP recruitment has been sustained at the highest levels ever with Round 1 recruitment filling the available spaces for the third year running. There are around 350 GP trainees across the two counties; 260 in Staffordshire and 90 in Shropshire.
Geographically, Staffordshire and Shropshire GP Training is the largest training area spreading across 40% of the West Midlands and trains 25% of all the GP trainees in the West Midlands, more than any of the other areas in the West Midlands.

Brief attractions of living and working in the area

The area covers 44% of the West Midlands Region with a population of around 1.5 million and has traditionally been a blend of history, innovation and culture set in a remarkable landscape.
Easy access to wonderful countryside, such as the Shropshire Hills, Cannock Chase, the Staffordshire Peak District and even Mid-Wales a short drive away. Many festivals and events take place during the summer. Traditional crafts such as the pottery and tile industry as well as the brewing industry around Burton still flourish amongst modern developments.

Provincial Theatres are based in Wolverhampton, Telford, Shrewsbury, Stafford and Stoke and show local and West End Shows, comedy, ballet and music events throughout the year at a fraction of Birmingham and London prices.

The area is family friendly with castles, historical houses, walks and theme parks. Skiing is available all year at the Tamworth Snowdome and there are plenty more sporting activities with many football, cricket, hockey and rugby teams ready to welcome you. There is also a fantastic canal network and plenty of cycling and walking routes.

Leek and parts of North Staffordshire are within commuting distance of Manchester. For those wishing to settle, housing for rent or purchase is readily available and affordable. Furthermore, school standards are generally very good at both primary and secondary level.

Key Contacts

Dr David Palmer - Area Director Staffordshire and Shropshire david.palmer@hee.nhs.uk

The Teaching Programme

GP Training is a three year development programme developing doctors from a foundation level of knowledge and competence and giving them the experiences and guidance to allow them to graduate with MRCGP and the skills to cope in the increasingly demanding and complex profession of General Practice.

The Learning Environments within Staffordshire and Shropshire

Area Study Days

There is a programme of Area Study Days looking at important or topical areas in GP Development. There is also an Exit Day for ST3 who are approaching the end of their training.

Programme approach 

There are at least 24 study half-days usually on a Thursday where the programme group of GP trainees get together and discuss issues relevant to General Practice. This is an opportunity to learn from your peers and also take a lead in discussions.

Cluster learning

Outside the VTS sessions there are smaller learner led cluster sessions which are usually organised geographically. These provide an opportunity to cover aspects of the curriculum in more depth, improve knowledge for the AKT examination and to role play consultations in preparation for the CSA examination.

Training Practice

This provides a quality assured environment for experiencing General Practice whilst still having the safety net of an experienced GP available for support. Exposure to patients leads to clinical confidence and improved decision making. The supervising GP is available for guidance and assistance in order to ensure patient and doctor safety is maintained.

Staffordshire and Shropshire Training Practices face similar demands to all General Practices. Some practices are very much “inner city” with a large number of patients with socio-economic problems. Other practices face the problems of rural isolation often being located away from major towns and hospitals. Each practice has its own challenges but all will provide a worthwhile experience for potential GPs.

Hospital and Community Attachments

There are some innovative community posts such as sexual health clinics, hospice attachments and public health posts. Others are based at acute, community and mental health hospitals. Each post will have a clinical supervisor who is familiar with the GP Curriculum. They should also help with the Work-Base Place Assessments needed for MRCGP.

Local support for MRCGP assessments

The trainers have a positive attitude towards providing the necessary support for GP registrars to pass the CSA and AKT. Each VTS has a lead TPD who will provide additional support and advice for registrars who may have communication or language problems. Newly qualified GPs who have recently been through the process, as well as experienced trainers also provide additional advice.

Each programme area organises training days looking at the CSA, giving feedback of communication skills and discussing management of complex problems. Ideally potential problems should be identified early and action taken to improve the situation for the GP registrar.

Opportunities within each Training Programme

  • Four GP training packages based at Burton, Stafford, Stoke-on-Trent and Shrewsbury/Telford
  • Well-established network of experienced trainers across the areas
  • Good standard of Educational Reviews and trainee support through-out
  • University Hospital of North Staffordshire Royal Stoke Hospital acts as a tertiary centre
  • District General Hospitals based at Burton, Stafford, Telford and Shrewsbury delivering training focussed on GP curriculum and GP requirements

Shropshire Programme

A large scheme with 70 trainees spread across Shropshire but also includes Welshpool and Montgomery which are in Powys, Wales but both are only 40 minutes from Shrewsbury.  Secondary care jobs are delivered at two hospital centres at the county town of Shrewsbury as well as Telford. Both these hospitals are working closely with the TPDs to deliver GP focussed training.

GP trainers are well motivated and provide superb support for trainees who are accepted into the practice team. Practices can be town or rural based. The out-of-hours provider ShropDoc provides well-supported OOHs training for the GP trainees.

The GP cluster Quality Assurance Visit organised by Health Education England highlighted the following notable achievements in 2013:

  • Enthusiastic TPD’s, trainees and trainers
  • Supervision and support good with trainees
  • Shropdoc (Out of Hours) is good, supervision excellent with trainer involvement
  • Foundation experience form used in ST1 to allocate ST2 posts
  • C.S.A. training involving trainers is good
  • Trainer workshops highly appreciated.
  • Good JEST/GMC Survey results.

East Staffordshire Programme (Burton)

Hospital jobs based at Queens Hospital, Burton-on-Trent where there is a good working relationship between consultants and the training programme directors and local GPs.

GP training is based along the Trent corridor at Tamworth, Lichfield and Burton in well- established training practices. There is a high standard of educational support and feedback for trainees.

Around 40 trainees in the scheme and in 2012-2013 no trainees failed CSA.

The scheme has developed a well-received ethics day and also organises a muscular skeletal medicine day at St Georges Park.

Health Education England Quality Assurance Visit in September 2013 said;

  • There is high quality training experiences - all the trainees are happy
  • Half day release includes well organised, Balint Group learning in which all trainee participate and which is effective and valued by all trainees.
  • Motivated, creative and enthusiastic trainers who network and communicate well; a group who act collectively, responsibly dealing with issues of governance, probity and significant event audits

North Staffordshire Programme

The North Staffordshire Training Programme is a large scheme with an intake of around 28 each year. The Acute Hospital attachments are based at Royal Stoke Hospital, one of the busiest and forward thinking hospitals in the country.

GP attachments can be based in inner city environments or in more rural or remote practices in the Staffordshire moorlands.

The Health Education England Quality Assurance Visit in 2014 said:

  • An established Training Programme on an upward trajectory in terms of reported satisfaction levels amongst Trainees, with a strong academic ethos
  • Trainees praised the well-structured teaching programme and Half Day Release (HDR) sessions that adopted a variety of educational concepts and methodologies, and covered both specialist and holistic aspects of General Practice (GP) training.
  • After qualification there are many opportunities for employment locally as either salaried GP or as partners in the area. Parts of Stoke-on-Trent are some of the most deprived in the West Midlands and so there are high levels of job satisfaction and also patient appreciation.
  • Acclaimed academic and research centre based at the Medical School at Keele provides additional opportunities for involvement in research and medical student education.

South Staffordshire Programme(Stafford and Cannock)

The programme has focussed on delivering patient centred and compassionate training. The hospital delivers high quality medical education. The Hospital has become a part of the University Hospital of the North Midlands working alongside the Royal Stoke Hospital. Paediatrics, Obstetrics/Gynaecology and ENT are based at the Royal Stoke Hospital. There are Rheumatology and Elderly Care attachments based at Cannock Hospital which is part of the Royal Wolverhampton Trust.

The programme provides support and education for about 40 trainees. Uniquely, the Foundation Year 2 trainees in general practice are also invited to attend as this helps develop their skills and competences whether or not they later opt for general practice.

Health Education England Quality Assurance GP cluster visit in 2011 said;

  • Trainees reported that they have good clinical exposure and practices ensure appropriate exposure is obtained when experience is lacking, which is appreciated by trainees.
  • Trainees reported that all Educational Supervisors are very supportive and approachable.
  • Trainees commended the excellent communication of the Educational Supervisors and they appreciate the pastoral support provided.

The recent 2016 Quality Assurance visit stated;

  • The panel commended the Training Programme Director (TPD) team’s engagement with whole day regional ‘masterclasses’.
  • Trainees had high praise for County Hospital, which was considered very friendly and an enjoyable place to work. 

Targeted Enhanced Recruitment

Targeted Enhanced Recruitment Scheme provides a salary enhancement (which is taxable) for a select number of GP trainee applicants for certain specified rounds of recruitment in Staffordshire and Shropshire (as well as other areas with recruitment challenges in England). 

There are 18 TERS placements available for Round 1 Recruitment with a view to start in August 2020. This is a fraction of the posts available for each training programme and these are focussed on attracting GP trainees to rural, isolated practices in the area. These trainees will need to develop the additional skills needed to manage patients in rural communities and hopefully as newly qualified GPs will then continue to practise in these areas.

Recruits to Staffordshire and Shropshire should declare an interest by applying for the TERS scheme as well as their choice of VTS area. The successful applicants will be allocated by VTS scheme according to their ranking. As a result many applicants will be disappointed not to be awarded the TERS enhancement ; they will then default to their alternative training programme. 

The placement is determined by the location of the ST3 general practice where the Educational Supervisor is based. There must be a commitment to engage with the ES throughout the whole of GP training and to go to the practice for 12 months in ST3 (wte). 

The purpose of the placement is to encourage and stimulate GP training in rural hard-to-recruit practices which are usually some distance away from the VTS training centre. The successful applicants should be willing to be followed up by NHS England to see if this rural experience does lead to a future career in the area.

The TERS schemes are allocated as follows from the list of rural practices according to their capacity and availability for 2 years’ time (2021-22):

Shropshire (7 out of usually 28 ST1):

North Staffs (7 out of usually 28 ST1):

South Staffs (2 out of usually 15 ST1):

East Staffs (2 out of usually 15 ST1):

Shropshire:

North Shropshire: 

Oswestry:        Plas Ffynnon,

                        Caxton Surgery

Other;              Wem and Prees

          Knockin

          Bridgewater Surgery, Whitchurch

South Shropshire:

Ludlow:          Portcullis, 

         Station Road Surgery

Other;              Baschurch 

         Church Stretton 

         Pontesbury

         Bridgnorth 

North Staffordshire:

Leek;               Moorland Medical Centre

         Leek Health Centre

         Park Health Centre 

Cheadle;         Well Street Surgery

         Allen Street Surgery

Other;             Waterhouses 

         Kidsgrove 

         Tean

         Biddulph

South Staffordshire:

Womborne 

Perton

Brewood 

Armitage (Rugeley)

East Staffordshire:

Dove River (branches at Tutbury and Sudbury) 

Tutbury Practice 

Alrewas 

Barton-under-Needwood

Highlighted practices are the practices selected for this round of TERS placement but these could alter due to a change of circumstances at the practice.

Please note: there is no incentive available for trainees attending these practices in ST1 or ST2 or placed outside the TERS scheme such as at other recruitment windows. 

Any deviation away from the accepted scheme will lead to the successful applicant having to return the Salary Enhancement. The Enhancement is usually paid at the start of the GP training scheme after an agreement or understanding has been signed by both parties.

Travel and Commute Arrangements:

Each of the 4 programmes across Staffordshire and Shropshire cover a huge area. It is extremely difficult to manage any of the programmes without the ability to drive to the practices. Public transport is often not reliable or frequent.

Because of the distances involved in commuting from home to a practice, it is common to come across a commute of 60 minutes or 50 miles. Bear in mind that a commute of 60 minutes in a major city like Birmingham may only be 10 miles at rush hour. Please also note that if commuting from Birmingham up the M6 or A38, the traffic going towards Birmingham is usually considerably heavier.

Having a long commute is not a justifiable reason for a transfer to another Training Area although it undoubtedly does add to the degree of stress.

If you don’t drive you need to let the Programme Team know as soon as you are made an offer. You will also need to let them know where you are likely to be living. The Team will do their best to make reasonable changes to the rotation to allow the training to be possible.

Non-drivers should be prepared to either organise taxis to go to visits as stated within the Recruitment process. Often practices may be flexible to ensure visits are to local or walkable addresses.

Academic GP Training

Academic Trainees can apply for training rotations once accepted onto GP Training and at any stage during the training (ie at ST1-2-3). The Academic Scheme is very competitive as it provides a unique opportunity for GP Registrars. It has the following benefits:

  • An extra 12 months of funded training - usually the 25% protected academic time is taken as 50% when in ST3 and ST4 –
  • Opportunity to complete research in Platform Science in parallel with clinical training. Research involves using large primary care databases to answer research questions of your choice - supported by academic supervisors
  • NIHR funded salary - member of NIHR Academy and access to their meetings and support
  • £1k annual bursary for conferences and courses
  • Masters level training.

Please contact Prof Jo Protheroe Professor of General Practice, Keele Medical School on j.protheroe@keele.ac.uk

Opportunities are usually found through NHS jobs. Current advert is

https://www.jobs.nhs.uk/xi/vacancy/?vac_ref=915816948 – GP

Research Opportunities

For those interested in research, but not wanting to extend GP training then there are opportunities with the Staffordshire Primary Care Research Network. This will help trainees develop leadership potential.

Tier 2 Certificate of Sponsorship

Applications to GP training from doctors who require Tier 2 sponsorship to work in the UK are welcome and will be considered alongside all other applications. Later on during training, the Staffordshire Team at NHS England will assist Tier 2 Visa holders to complete a further application before the visa expires when training is completed.

 

Following Completion of GP Training

First 5 Groups

After attaining MRCGP and completing training, the first few years can be challenging both clinically as well as administratively. The First 5 Groups in each area are invaluable in providing peer support for newly qualified GPs. They can also provide a useful network for young doctors to keep them informed about opportunities and vacancies as well as keeping them up to date with local CCG and structural changes.

The Educational Hubs have recently been able to obtain additional funding to support the First-5 Groups. In addition, for GPs completing this year (and hopefully subsequent years), there will be additional support available for these new-to-practice GPs in Staffordshire and Shropshire. This will be through a mentorship programme and additional leadership or educational opportunities through the educational hubs for those seeking additional challenge.

There is a Facebook Page which is a wall for practices to advertise vacancies and other opportunities. It has also been used by newly qualified GPs to make practices aware of their availability. You can search on Facebook for Staffordshire and Shropshire General Practice Exchange for job opportunities or Staffs & Shropshire GP training for training opportunities.
Follow local education and training news on Twitter @GPStaffsShrops.

Career prospects as a GP

There are plenty of salaried and partnership opportunities. For those looking for additional excitement and development, the area offers many innovative posts during training and also rolling on after completion of the training period.

Fellowships are being developed to cultivate interest in global health, education and training, and leadership. There are opportunities for both trainees and newly qualified GPs to work alongside colleagues from the Clinical Commissioning Groups (CCG) focussing on Clinical Improvement.

In addition the Staffordshire Primary Care Research Unit is keen to develop leadership potential for trainees interested in research.

Portfolio careers are supported by the local CCGs, local Federations, Education Hubs and OOH organisations. As in previous times, innovative ideas are flourishing. The North Staffordshire Federation established an online “Locum Agency” advertising local GPs and local jobs. Training for Physician Associates and Urgent Care Practitioners have all been developed locally. New models of care with a multi-professional workforce are being developed locally to ensure that 21st century general practice is safe, sustainable and satisfying.

Want to find out more?                                      

Contact Dr David Palmer david.palmer@hee.nhs.uk  who will put you in contact with the appropriate person whether it be a current GP registrar, a newly qualified GP or TPD.

We also have a Staffordshire and Shropshire GP Training page on Facebook.

If you are applying to GP training and are looking for great hospital experience aimed at your needs as a GP trainee, followed by apprentice style training from urban/rural practices with experienced and quality approved trainers, then you should consider Staffordshire and Shropshire.

You will also have very good prospects of innovative and flexible employment as a salaried doctor, portfolio GP or partner in some of the most pleasant areas of Britain.