2021 - (Urgent & Unscheduled Care) UUSC
Guidance For Educational Supervisors, Severn School of Primary Care
In previous iterations of the ESR the ES used to tick a box so indicate whether they considered their trainee to be competent in OOH. This box has now disappeared making it harder for ARCP panels to judge whether trainees have achieved this competency at their final ARCP.
Trainees are required to present evidence in their portfolio of their UUSC competency for final ARCP. The SoPC suggest that this is best presented using the UUSC Passport that we developed. The trial involves the ES copying and pasting a sentence from the front page of the UUSC passport onto the Learning Log entry in the portfolio where the passport has been saved to indicate whether they believe their trainee is UUSC competent, and if not, why not.
In the latest version of the eportfolio, there is no longer a separate box to be ticked at the end of the final ESR asking educational supervisors to confirm that “UUSC requirements are met”.
Now that there is no specified number of hours a trainee must work in OOH, feedback has highlighted the difficulties many trainers face in deciding if a trainee is competent in all aspects of UUSC at the end of ST3, particularly if the ES isn’t involved directly in working OOH themselves.
We are therefore piloting a project, to help trainers when deciding if their trainee is competent in UUSC.
1. Do trainees still need to spend time working in OOH as part of their training?
Yes - all trainees still have to gain experience in OOH as part of their training and be able to demonstrate they are competent to work in all settings by the end of ST3.
A trainee who has spent no time working in OOH in ST3 will be unable to CCT.
2. But we've been told it’s not about hours anymore, so how do I know if my trainee is competent ?
Trainees are expected to upload their completed UUSC passport to their eportfolio before their final ESR.
As a minimum, they will be now expected to document 3 pieces of evidence in each of the 6 UUSC competency areas on the passport.
As their trainer, you need to decide if the evidence presented is relevant, and demonstrates that the trainee can safely practice in that aspect of UUSC work (just as you decide for all of the other clinical experience groups). As part of this process of assessment, you might want to ask them about their evidence within a tutorial or supervision meeting which they can then add as supporting information within the learning log.
By saying they are competent, you must be satisfied they are competent to work independently in all UUSC settings (daytime duty doctor in GP and in an OOH setting) specifically in terms of
- Fitness to practice
- Communication and consultation skills
- Clinical management, and
- Managing medical complexity
across all the 6 UUSC competencies
1. Ability to manage common medical, surgical & psychiatric emergencies in all UUSC settings
2. Understanding the organisational aspects of NHS out of hours care, nationally and at local level
3. The ability to make appropriate referral to hospitals and other professionals
4. The demonstration of communication and consultation skills required for UUSC in and out of hours
5. Individual personal time and stress management, and
6. Maintenance of personal security, and awareness and management of security risk to others
3. So I’ve read my trainee’s evidence and discussed it with them and I believe they are competent in UUSC - what do I do next?
If you are satisfied that they have met the UUSC requirements, then add the following comment to the entry in your trainees portfolio where the passport is uploaded:
“I am satisfied that my trainee has met UUSC requirements for CCT”
4. So I’ve read my trainee’s evidence and discussed it with them. I am not sure if they are competent in UUSC - what do I do next?
If the quality / quantity of evidence is such that you are unsure if your trainee is competent, and subsequent discussion with them does not provide additional evidence, then add a comment to the entry in your trainees portfolio which has the passport uploaded:
“I am not satisfied that my trainee has met UUSC requirements for CCT and would like the panel's opinion. The reasons are as follows:”
It would then be helpful to the panel to outline the reasons why you are uncertain that the trainee has met the competencies.
Both these statements have been added to the front page of the UUSC passport and so can be easily cut and pasted.
Jim Bartlett, John Edwards and Andy Eaton
On this page you will find all the information required to complete the Urgent and Unscheduled Care requirements of GP training in Severn PGME. The resources you will need can be downloaded and kept in an easily accessible location.
The FAQs should answer the majority of questions so we would ask you to refer to these in the first instance. If you have any outstanding queries after reading them please do get in touch with the UUSC Fellows Alison Hutchings and Andy Eaton.