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John Pike, NASGP blogger

The new @RCGP learning credits system puts locums at a disadvantage

From NASGP blogger John Pike

I was concerned by several aspects of the Learning Credits system described in this article in “GP” today.

My concerns are:

1.       We all have different learning styles that suit us. Personally, I enjoy using a very wide range of media for learning, but there are many who do not find courses helpful and others who do not benefit from internet learning. These preferred learning styles need to be respected.

2.       Personally, I find the limits on the number of annual credits GPs can claim from more basic training too restrictive and inflexible. I would prefer to see a more flexible scheme where appraisers check that the balance of learning is reasonable and appropriate to the doctor’s preferred learning styles.

3.       The article states that “Workplace learning is so important that the RCGP gives no upper limit”. This puts the country’s estimated 15,000 locums and other non-practice based doctors at a very considerable disadvantage compared to practice-based doctors. It is very difficult for locums to demonstrate workplace learning, other than PUNs and DENs. We are not able to make changes to practice systems as a result of learning. All we can hope to achieve is to give examples of patients for whom we acted differently as a result of a learning activity. I entirely agree with Richard (Fieldhouse)’s comment in the article that “locums will only be able to show impact ‘with difficulty’ because of their short-term contact with patients”.

My concerns are not for lack of trying myself. I now spend virtually my whole time on work, meetings, learning, preparing for appraisal and other work-related activities, such as commenting on documents or news items. I am just finalising my appraisal documentation for this year and note that I have spent 262 hours over the year across the following activities: courses, internet learning, mentoring group meetings, meetings of my clinical governance group, meetings of Bristol Association of Sessional Doctors, RCGP Severn Faculty Board meetings, doing an audit, practical sessions at the hospital for the DFSRH qualification, commenting on documents and other activities agreed for my PDP. This may seem excessive but it soon adds up when one tries to meet the requirements as they emerge and to respond to learning needs as one identifies them.

One of the key stated aims of revalidation was to improve quality of patient care. However, I am not alone in finding that the workload for appraisal and revalidation is now increasing so much that considerable extra stress is being generated. The point will come where this extra stress, far from improving quality of care, will actually have an adverse effect on it.

The State We’re In

From NASGP blogger John Pike

The quality of the care we provide to our patients is central to everything we do, and we are constantly thinking about how we can improve this, but I wonder if we are neglecting some crucial factors that influence quality of care. They include the psychological condition of the doctors providing that care, the decisions they must make and the time pressures they face. I have written a short article about these and related issues, which you can read here.