The Advanced Trainers' Network exists for those educational supervisors who have an interest in supporting GPs who have identified Performance difficulties. The group meets twice a year with a programme of developmental activity to share and learn from each other’s experiences. The Deanery supports the professional development of this group by paying Locum Backfill for those trainers attending.

Membership of the group is dependent on numbers attending. There is an expectation that where opportunities arise for accepting training placements of doctors experiencing performance difficulty, then those placements would be made to trainers who have used the group formatively to develop their own competences in training doctors with additional needs.

Reporting and Training activity

The level of training undertaken will vary in each case, but will be based on an initial diagnostic assessment. This may have been carried out by the GMC or NCAS prior to referral, or in examples where lower levels of concern have been expressed, the Advanced Training Network itself is able to carry out a Workplace-Based Assessment. Outcomes from this assessment will be linked to the RCGP Competency Framework and will use evidence gathered from standard tutorial techniques such as Case Based Discussion and Clinical Observation, Multi-Sourced Feedback from colleagues, and a Patient Satisfaction survey. Where it is felt helpful to have an objective test of knowledge base, the doctor in difficulty may also be asked to undertake a multiple choice questionnaire.

Competence assessment of doctors with Performance problems requires careful recording of information and the ATN is recommended to use a common recording tool  Structured Trainers Report for Competency Assessment

The following tools may be useful for recording more detailed aspectrs of tutorials and consultation analysis (with thanks to Damian Kenny for his adaptation)

Contractual arrangements

Supporting doctors in difficulty is time consuming and expensive work, and involves a high level of professional responsibility on the part of the trainer. The Deanery's experience is that detailed, watertight contracts need to exist between

  • the Referring Agency
  • the Doctor in Difficulty 
  • the Advanced Trainer.
  • Each contract will vary, but a generic example is available to inspect.

Sometimes a Doctor in Difficulty may work within their own practice, sometimes within the host trainers practice. In order that total clarity exists that the work being undertaken by the Doctor in Difficluty is educational, the doctor will be asked to sign a "Memorandum of Understanding" that the placement carries no financial remuneration.

Thoughts on a Remedial Journey 

This is a series of notes hopefully of potential use and encouragement to others who end up helping remediate colleagues back into GP.