Document Sample
                    1ST September 2005 to 31st August 2006
INTRODUCTION                                          harmonisation and this is expected to
PMETB                                                 continue.
The Postgraduate Medical Education and
Training Board (PMETB) took over from the             Budget
JCPTGP on 1 October 2005. The Royal                   Notifications were again delayed this year
College of GPs now has a Postgraduate                 but the 2005/6 outturn was satisfactory.
Training Committee and a Certification Unit.          Overall deaneries face a 15% efficiency
One of the things that has been lost is the           saving but are relatively protected when it is
facility for getting formal approval for part         considered that only one in four of the
programmes. In the case of applicants for             previous SHA staff will keep their jobs.
an Article 11 Certificate of Eligibility of           The HPE Scheme, the Flexible Career
Registration there is very little experience          Scheme and the Returner Scheme have all
and so advice from deaneries has to be                been casualties of the budget pressures.
very circumspect. Straightforward CCT
applications      are   being    dealt   with
The RCGP has submitted its new                        PERSONNEL
curriculum and assessments to the PMETB               Deputy Director
and although these have been approved in              Following the retirement of Dr Adrian Ball
principle there is a problem about                          st
                                                      on 31 December, Dr Vish Kini has been
resourcing 18 months training in General              appointed Deputy Director.
                                                      Associate Directors
Foundation Programmes                                 Following Dr Kini’s promotion, Dr Mike
In August 2006 the first F2 doctors started           Cranney has been appointed an Associate
in General Practice. There are 46 triplets            Director with responsibility for Vocational
giving 138 doctors experience in GP. All the          Training. Mike, who is a GP in Liverpool,
supervisors have attended the training                has been a trainer and course organiser.
course and at this stage nearly all
placements     are    proceeding     without          Course Organisers
problems. It has, however, been announced                    st
                                                      On 1 April two of the senior Course
that the expected increase in numbers to              Organisers in the deanery retired. Dr Jerry
80% of the current PRHOs undertaking F2               Henry had been a Course Organiser for 24
in GP from August 2007 will not take place            years and made major contributions to
and the proportion will remain at 55% for             educational development. Dr Michael Burke
another year.                                         has been appointed as his successor at the
In anticipation of the new run through                Wirral Scheme. Dr Ken Rowland had been
grades from August 2007 the deanery has               a trainer for 28 years and a CO for 16 and
made a case for an additional 188 posts to            more recently an HPE Tutor. Dr Robin
allow 151 three year programmes. All three            Gleek has been appointed as his
year programmes now have August starts.               successor.
February starts for short programmes and
GPR posts will continue for the time being.           As at 1 September 2006 there are 20
                                                      medical and one non-medical Course
The Deanery                                           Organisers in post.
Following yet another NHS reorganisation,
Liverpool and Manchester have again                   GP Tutors
joined together under the new North West              During the year the decision was made to
SHA. The two deaneries are continuing to              make the GP Tutors redundant. Since the
function separately but with increasing

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new GMS contract had removed the                      Margaret Goddard, Suzanne Macdonald,
responsibility for CPD from the deanery               Steve Maxwell, Koratty Mohanan, Dennis
their roles were largely to support the               O’Brien, Bob Royle, Sanj Shridhar, Nigel
PCTs. In the stringent financial climate this         Stones, MikeTate and David Unwin.
could not be justified. Redundancy was a
long drawn out process complicated by                 GP Registrars
reorganisations within the SHA. The loss of           As at 2 August 2006 there are 149 GP
this group of senior and dedicated                    Registrars in post in the deanery against a
educationalists is a severe blow and we               funded establishment of 151. Lack of
thank them all for their efforts over the last        availability of prerequisite SHO posts is the
decade.                                               main reason for under-recruitment. The
                                                      following statistics are instructive:
Higher Professional Education Tutors                   111 Registrars are full time in their first
Despite    strong     protests   the   CMO                 or second six months up from 108 last
announced that funding for the scheme                      year.
would cease on 1 April. It was hoped that              7 Registrars are part time, down from
the money would be transferred to the VTS                  10.
budgets to support longer training in GP but           There are no Registrars undergoing
this has yet to be realised.                               refresher training.
                                                       There are 0 Registrars in their third six
PRHO Supervisors                                           months undergoing further training for
Dr Richard Frood in Halton is now the only                 remedial purposes compared to 2 last
doctor running a PRHO rotation.                            year
                                                       There are 6 Registrars undertaking an
                                                           agreed third six months for personal
                                                           development purposes, of whom five
VOCATIONAL TRAINING                                        are Teaching Fellows.
                                                       There is 1 Registrar under the
Trainers                                                   Accelerated Route Scheme for doctors
It is with great sadness that I report the                 who are trained GPs from outside the
tragic death of Dr Mark Gradwell, a trainer                EEA. This scheme has now been
in Poynton.                                                abandoned by the PMETB.
                                                       There are 8 doctors based in General
During the year four trainers have resigned                Practice as part of their middle year of
or retired including Dr Chris Hulbert from                 training. They have substantial release
Malpas, three have moved away from the                     to a hospital or community specialty
deanery and one has died. Four of these                    during the attachment. One of these
seven were single handed trainers and their                posts is a formal part of the Countess
practices have been lost to us for the time                of Chester Rotation.
being. Sixteen new trainers have been
appointed; eleven women and five men.                 In April 2006, with four week’s notice and
These new trainers come from five new                 no consultation, and in the middle of a
practices; four on Wirral and one in                  recruitment round, the Home Office
Macclesfield. One trainer has moved from              changed the regulations relating to Permit
one training practice to another within the           Free Training for doctors.           It was
same PCT. At the end of the year there are            announced that in future doctors from
191 trainers of whom 57 (30%) are women               outside the EEA and without right of
and these are in 116 practices. The                   residence would require work permits and
comparative figures for 1991 were 134 and             that these would only be granted if a doctor
14 (10%).                                             was appointed to a post for which there was
                                                      no appointable EEA or residentially
I am delighted also to report that at its two         qualified candidate. Thus appointment on
General Meetings in this year the RCGP                merit was abandoned. A loophole allowing
has appointed the following trainers as               doctors in training to acquire Highly Skilled
Fellows: Drs Kit Oi Chung, David Cragg,               Migrant Status despite the fact that they
Mike    Cranney,     Graham      Davenport,           were not yet highly skilled caused confusion

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and the situation of doctors who had time             Trainers’ reports
limited status was equally troublesome.               No Registrar failed only as a result of an
The recruitment process continues to                  adverse Trainer’s report although it should
develop and in October 2006 we will use               be reported that nationally failing the
actors for the first time as a pilot in the           Trainer’s report has now overtaken the
interview phase.                                      video as the major reason for refusing
For August 2006 there were 460 total                  certification.
applications of which 377 were valid                  MRCGP
applications. There were almost 15                    The number of registrars using single route
applications for every full VTS place, 4 for          video for MRCGP and Summative
every shortened VTS place and only 0.75               Assessment has continued to increase. Of
for every GP Registrar place. Almost 61%              88 tapes submitted, 59 passed for MRCGP
of applications came from the Indian sub-             purposes and 26 passed summative
continent with three quarters of these from           assessment. There were three failures.
India. 16% came from the UK.                          Dr Kini, has continued to hold preparation
For February 2007 a significant number of             courses twice a year for summative
English Deaneries did not recruit. Mersey             assessment. In comparison with other
did not recruit to full three year VTS                deaneries our MCQ results are excellent
rotations as we are moving their start dates          and our video results are in line with
to August. We received 401 applications.              national results unlike some deaneries
                                                      which have extremely low failure rates
Hospital posts                                        suggesting lack of rigour.
Currently the GP Education Committee                  Remedial training
recommends to the PMETB that 632 of the               During the year, 7 doctors required a six
deanery’s 801 SHO posts are selected for              month period of remedial training after
vocational training. Of these approved                summative assessment failure. All these
posts, 13 are on the Isle of Man. The new             have now completed their training.
PMETB Regulations have changed the
allowable    combinations     of    hospital          General Medical Council / National
specialties.                                          Clinical Assessment Authority
Because of the need for F2 pilot posts there          During the year most of the time under this
have been no further Trust Grade                      heading has been taken up by four doctors,
conversions to GP SHO.                                three of whom have been undergoing
                                                      remedial training under the GMC’s
New arrangements for induction and                    direction.
support of VTS SHOs led by Chris Dainty
continue to be successful and very well               Budget
attended.                                             The Deanery Business Plan submitted to
                                                      the Strategic Health Authority envisages a
Summative Assessment                                  budget, including GP Registrar salaries and
The deanery statistics for the year are as            expenses, of some £13m.
MCQ                                                   UK CONFERENCE
129 Registrars took the MCQ. Only 3 failed            The annual conference of Directors and
when taking it for the first time. One failed         their Deputies and Associates in 2006 was
at the third attempt and one at the fourth.           held at the Carden Park Hotel in June. It
One Registrar passed at the third attempt.            was extremely successfully run by Dr Kini
Audit                                                 and Dr Howard, Gill McMurray and her
111 Audits have been submitted and there              team in the absence of the Director on sick
were no referrals to National level.                  leave. Delegates were enthused by a high
                                                      quality    academic    programme       and
Video                                                 entertained by a medieval banquet at
30 videos were submitted for summative                Ruthin Castle.
assessment. There has been 1 failure at
national level.

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CONTINUING PROFESSIONAL                               THE OFFICE
DEVELOPMENT                                           We welcomed Michaela Choi back in
Revalidation and annual appraisals                    August after the birth of her twins. She has,
Following the publication of the Shipman              however, decided to take a career break
Report the Chief Medical Officer has                  and we welcome Stephanie Miller as the
published his proposals for revalidation for          Director’s PA. Tracy Kenwright and Susan
consultation. Much of the report deals with           Goodfellow will soon be taking maternity
the General Medical Council. There are no             leave. Wendy Pain has left us to work in a
specific detailed proposals for revalidation.         senior position for North Yorkshire Council
                                                      and Craig Skelhorn is now the webmaster.
DOCTORS RETAINER SCHEME                               He has been joined by Michelle Diable as
There are 112 practices currently approved            part of the IT team.
under the scheme and 32 retained doctors              Gill McMurray is now taking a wider role
are in post. Following the loss of the GP             within the deanery senior management.
Tutors Dr Jenny Fox is reviewing these
doctors. Those doctors nearing the end of
their time on the scheme are seen by the
Director. There is a need for improved                Tony Mathie, DPGPE, September 2006
career counselling for these doctors who
are often quite unprepared for leaving the
Scheme and have narrow views about their
future role in general practice.

This    scheme     was     summarily    and
retrospectively suspended in 2005 and
PCTs have had to negotiate continuing
funding. It has now closed to new
applicants leaving a gap in career planning,
especially for women GPs.

The Returner Scheme has also stopped
being funded centrally and PCTs have to
make individual decisions to support these
doctors. There is currently one doctor in

Dr Kishor Vithlani, a trainer in Liverpool,
has taken over as chair of the GP
Education Committee. The Committee has
been pleased to continue to benefit from
the experience of its Lay Member Mr
Thompson. In future this Committee will
translate to become the Board of the
Postgraduate School of General Practice

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