Norfolk / Suffolk International GP Recruitment (IGPR)

Transcription

1 1 Norfolk / Suffolk International GP Recruitment (IGPR) Master Question List Background Q: How does the IGPR scheme work? A: NHS England have been working closely with the Royal College of GPs and Health Education England to design a programme that enables us to recruit at scale and make sure we are consistently recruiting doctors to the high standards expected in general practice. In this first phase of the roll out, NHS England has appointed five recruitment agencies to work across England. One of those is looking after the East of England. We want to make sure the recruits get full individual attention and also keep it manageable for the practices so we re doing the recruiting in small groups. Initial interviews will be held (using Skype) in the applicant s home country. Those who are successful in this initial selection will then be invited to visit the local area in England, meet with the GP practices which have told us they are interested in taking on international recruits, and have a second interview. Each doctor who is successful in this second round will be matched with a practice and offered a place. The doctors will be required to meet all of the regulatory requirements they need to be GPs in the UK. Once here, they will undergo a range of training, developed with Health Education England, covering induction training; language support, with a focus on communication and consulting skills, and any top up training that is needed for the individual GP. The practices will employ its international doctors and be responsible for all usual employment responsibilities, including salaries, once the recruited GPs complete the training and induction programme. We re working to get the first GPs over here and starting their training in the autumn.

2 2 Q. What countries are International GPs being sourced from? A. The original 3 target countries of Croatia, Romania and Greece have been expanded to include Bulgaria, Hungary, Spain, Estonia, Latvia, Portugal, Czech Republic, Lithuania and Poland. Q. What has changed in the International GP Recruitment scheme since a practice first expressed interest? A. The General Practice Forward View (GPFV) included a commitment to deliver a major international recruitment drive to attract up to 500 appropriately trained and qualified GPs from overseas by On 22 August 2017, NHS England announced a major expansion of the International GP Recruitment (IGPR) Programme. The expanded programme will now accelerate the original plans, and aim to recruit 2000 GPs from overseas by Q: How can NHSE extrapolate its current learning from the pilots when the model has changed so much? A: The fundamental model has not changed recruitment companies are being used to search for and identify suitable candidates; there will be a web-based interview panel which will include an NHS England medical, HEE or RCGP lead; and a face to face interview at which practices and IGPR doctors will meet to start the process of matching doctors to practices. The key difference is that the majority of the scheme is now organised at national level, reducing the workload required from STPs/CCGs to manage the process, and increasing economies of scale. Q: Original timeline projections for numbers shows that the first cohort of 25 should be almost ready to progress onto recruitment/matching weekend, is this still on schedule? A: The recruitment agency were unable to undertake any active GP recruitment during the tender process with the NHS and this has impacted on both their and our original timelines. The agency are also making sure that applicants meet the minimum requirements as set out by NHSE. The expectation is that there will increased activity at a later point to bring the numbers up to those originally projected. Current revision of timelines is underway and these will be published in due course

3 3 International GP s Q. What can International GPs do? A. International GPs are qualified GPs in their own country of residence, however it is recognised that when entering the UK these doctors will need an extensive period of induction and training (which could be up to 9 months) before they are fully on the Performers List without conditions. The induction and training covers both the contextual aspects of primary care in the UK as well as describing non-clinical roles that the doctor must take part in. Q. What assessment will International GPs go through before being offered jobs? A. Candidates will go through a rigorous two stage interview and selection process before they are accepted on to the scheme. They need to be eligible for GMC Registration and eligible to go on the GMC s GP Register. They must have a minimum language competency of IELTS 7.0 (or equivalent) on entry. The language training whilst they are on the scheme will bring them up to the minimum of IELTS 7.5 (or equivalent) which is required by the GMC and Performers List. They are expected to undertake the RCGP Self-test MCQ on entry to the scheme and the results from this will guide their development needs between acceptance on the scheme and starting in a practice in the UK. This self-test is not conducted under exam conditions. Candidates will be expected to work on their learning needs using online resources throughout the scheme. After starting work in a practice, the GP will prepare for the standard national Induction and Refresher scheme assessments. This preparation period could take up to six months. The I and R assessment includes an MCQ on clinical knowledge and a Situational Judgement test both under exam conditions. The results from this indicate whether further development is needed or whether they can pass to the Simulated Surgery. The Sim Surgery also acts as the final language assessment. After passing the Sim Surgery, the GP then works through a Supervised Placement lasting up to six months. At this point, they join the Performers List with Conditions. Successful completion of this leads to unconditional placement on the Performers List. Q. Will International GPs be MRCGP qualified? A. International GPs are qualified GPs in their country of residence and are eligible for GMC Registration and to be on the GMC s GP Register. They are unlikely to have the MRCGP. They will be placed on the Performers List with conditions if they have successfully completed the Induction and Refresher scheme assessments and Simulated Surgery. Successful completion of the supervised placements will lead to full inclusion on the Performers List.

4 4 Q: What is the likely flow rate of the trainees i.e. all at once or a rolling trickle? A: Recruitment will be split into manageable cohorts. Cohort sizes will be based on factors such the numbers of GPs that can supported locally by both practices and HEE. It will also be important to ensure that each cohort is large enough to deliver the training and education package at scale in each area. Q: Are the IGPR recruits required to take the MRCGP exam? A: No, this is not a requirement for GPs recruited under the IGPR scheme. Q: What is included in the International GP induction? A: Health Education England are developing a curriculum aligned to the GMC s Generic professional capabilities framework. This curriculum aims to maximise the International GPs exposure to UK General Practice, and for their supervisors to assess the doctor s needs in order for them to successfully complete the I&R scheme and achieve inclusion onto the Performers List. This curriculum allows overseas GPs to have a period of induction prior to taking the Clinical Problem Solving test (CPS) MCQ, Situational Judgement Test (SJT) and Simulated Surgery assessments before commencing the supervised placement. The doctors should complete the RCGP Self-test learning needs assessment prior to starting the clinical observership phase in order to identify areas of clinical need and these can be followed up by appropriate reading and on-line modules. Q. Will the international doctors need to complete an e-portfolio? A: We have been advised that an eportfolio is being developed and to date some forms for clinical and Educational Supervisors have been produced for completion, further information on this will become available in due course. Q. Can international GPs prescribe? From what point? A: They can only prescribe once they are on the Performers List (which is after they complete the Sim Surgery at which point they will be put on the performers list with conditions)

5 5 Employment Q. Who will employ International GPs? A. Practices wanting to recruit to GP posts that can provide the necessary supervision and training will directly employ International GPs. The CCG will suggest a standard contract template which includes probationary clauses and NHSE are to provide a standard HR Learning Agreement (which is intended as HR Guidance which could support the employment with contract if the practice wishes) and have indicated the salary range. Q. How many days will the GP be in practice? A. As part of the induction programme the GP will be out of practice 2 days a week until the clinical observership period is signed off e.g. at language and communication skills, plus HEE s day release. Please also note that during the observership, clinical activity will be restricted and will be under the direct scrutiny of the supervising GP and other clinical staff as agreed by the supervisor. Q. How much input will be required from the supervisors (time wise)? A. This is dependent on the IGP and as a minimum is expected to require non patient facing dedicated time of 30 minutes per supervised session and a separate 1-1 tutorial session in the practice. Q. We are not a training practice; does this mean we cannot benefit from international recruits? A. International GPs do not need to be placed in a training practice however; nontraining practices will need to have an Associate Trainer who links to a proper trainer/supervisor. The associate trainer still needs training and accrediting and the proper Educational Supervisor (who supervises the associate trainer) needs to sign off the workplace based assessments. Q: How much flexibility is there in the training and employment model at local level? A: NHS England has nationally commissioned HEE to deliver training, which will take account of each individual s Drs learning needs. The employment model is the same as for UK trained GPs; the Drs will be employed by the Practice.

6 6 Q: Who will be the employer at the various stages of the process? A: The employment model is the same as for UK trained GPs; the Drs will be employed by the Practice. Q: When will we get to see the contract (sick leave, maternity leave, holiday, time commitment, etc.) for the training posts? A: NHSE are unable to offer a contract of employment template as the practice is the employer for recruited GPs. Any standard contract developed locally will need to cover recommended salary levels, contract length and any penalties or claw back measures for GPs that exit the programme early. These contracts can then be tailored by the employing practice.. The contract of employment will be held between the recruited GP and the employing practice. NHS England will however fund the incomes of recruited GPs during their induction/training phases. Income levels have been currently (January 2018) set at: 3000 per month during the clinical observership phase 3500 per month during the supervised placement phase 1250 indemnity support (lump sum). There is a nationally agreed discounted rate for IGP s Q: Where/who do trainers contact if the trained GP is having problems? A: NHS England has nationally commissioned HEE to deliver the training package, including trainer support. You would contact the local HEE lead. Q: How much choice will practices get as to their trainee? A: The panel for the second (face-to-face) interviews will consist of a local NHS England Medical Director (or nominated medical representative), local HEE lead and (if agreed locally) a nominated representation from the recruiting practices in the area. Q: What happens to GPs who can t be placed after their training? A: Each STP will undertake a readiness assessment, part of which will be the identification of the vacancies/practices for the Drs to be placed. As with UK trained GPs, once the GPs are on the NPL they can be employed by any Practice.

7 7 Q: What is the expected employment model/contract for the trained GPs and their expectations of final salary? A: The project are looking to develop a standard contract of employment for recruited GPs. This will cover recommended salary levels, contract length and any penalties or claw back measures for GPs that exit the programme early. These contracts can then be tailored by the employing practice. Final salaries will also be affected by market forces at the time Q: Is there any need for indemnity until they are on the performers list? A: During the initial clinical observership period (which could be up to six months) the GP will only be able to undertake a limited range of tasks and will not be clinically responsible for anything. At this stage, they will not be on the Performers List. As such and the practice should check the usual practice indemnity scheme will cover the activity of the GP alongside other practice staff. Once the GP is put on the Performers List with conditions (and when they will start to see patients properly as part of the Supervised Placement) then the GP will require specific indemnity. The scheme makes a financial contribution to the indemnity. Before that, they are covered by the practices existing indemnity policy (for non-gp staff, receptionists, nurses, etc.) without any extra cost but as each practice has a different policy, the practice needs to check the small print of their policy to check all is in order Q: Is there a nationally mandated salary level/range? A: There is national instruction on the salary level that should be offered, this should be based on local requirements. An application may set out a scaled salary range over a period of years to encourage retention; local consideration should be given to the salary of GPs currently employed and that offered to overseas GPs. Q: What is the timeline from the GP being identified to the GP working in a practice? A: The delivery model is still being defined and any timeline will vary depending on the individual, but we expect a timeline of approximately 9-12 months.

8 8 Q: At what point does the GP become attached to a practice and therefore become responsible for training and indemnity? A: The GP is expected to become attached to a practice at the point their employment contract starts. Just like any other recruitment process there will be a definitive start date for their employment at which time the usual employer/employee relationship will begin. Indemnity is only needed once the GP joins the Performers List. Before this, during the clinical observership phase the practice should check their policy the GP should be covered under the practice indemnity policy along with other practice staff. Q: Where is the line between being in training (and receiving a bursary) and becoming an employee? We want to be clear about when our responsibilities as a practice begin. A: The GP is an employee of the practice throughout the scheme and after. The scheme provides salary support until the GP fully completes the scheme. Q: Is there a maximum time in which training is expected to be completed and if so which organisation will be responsible for advising the GP that training is taking too long and that they will not progress to full employment? A: We expect a timeline to be up to six months clinical observership before the I&R assessment, plus six to nine months going through the I and R scheme and supervised placement. HEE will advise on whether the GP is making satisfactory progress Q: What happens if a recruited GP needs to take maternity leave before being employed by a practice? A: They will have usual maternity rights. Q: Is there a national definition of full time? We want to ensure there is a level playing field for employment contracts. A: There is no national definition specifically for this scheme; the BMA definition should be used

9 9 Funding Q. Who will pay for International GPs indemnity? A. During the initial clinical observership period (which could be up to six months) the GP will only be able to undertake a limited range of tasks and will not be clinically responsible for anything. At this stage, they will not be on the Performers List. As such and the practice should check the usual practice indemnity scheme will cover the activity of the GP alongside other practice staff. Once the GP is put on the Performers List with conditions (and when they will start to see patients properly as part of the Supervised Placement) then the GP will require specific indemnity. The scheme makes a financial contribution to the indemnity. Q. Will supervisors be paid? A. Yes, HEE educational contract with supervisor (HEE pays supervisors- could include hub and spoke) Q. The 2,500 per candidate is a one off payment to cover which expenses? A. Yes, it s a one-off payment per recruit and will be managed by the project rather the IGP s practice. The funds should be used to create local integration and retention arrangements. The 2,500 is not ring-fenced to each recruit; it can be pooled across the STP. For example, an application for 10 GPs could use the 25,000 as a lump sum to fund local schemes. Q: Indemnity what are the costs, and whether has to be MPS to avoid the partnership being responsible if the training Dr uses MDU and does not fund retrospective cover after leaving the practice? A: NHSE is contributing 1,250 to the cost of indemnity which will, as for UK trained GPs, depend on a number of factors. There is a nationally agreed discounted rate for IGP s however we are not aware whether this includes a requirement to use a specific indemnifier. Q: What is the funding for the two stages of the training process? A: Recruitment, relocation and training costs will now be funded nationally. Funding for staffing and other costs such as the second interview stage will be managed by the NHS England regional and DCO teams. HS England has nationally commissioned HEE to deliver an induction and training package for all recruited GPs. This national curriculum plus flexible modules will build on the existing I&R Scheme and cover the following key elements:

10 10 Induction training Language support, with a focus on communication and consulting skills Clinical top up training required by EU GPs Q: Is there funded training for the trainers to address the specific needs for this training cohort? A: NHS England has nationally commissioned HEE to deliver the training package, including trainer support. Q: What peer support is going to be funded? A: Health Education England has established four task and finish groups to agree arrangements in relation to a number of key aspects of the programme. One of the groups is focusing on Networks, mentoring and support - the ongoing retention of international GPs starting from when the doctors arrive in England until they are able to work as independent GPs. This will also be the framework for support after the I&R assessments when they are working in practice. Q: What ongoing pastoral support is going to be funded after the initial relocation? A: Health Education England has established a task and finish group covering Networks, mentoring and support - the ongoing retention of international GPs starting from when the doctors arrive in England until they are able to work as independent GPs. This will also be the framework for support after the I&R assessments when they are working in practice. Q: What is the funding available for the involvement in the interview processes? A: Recruitment, relocation and training costs will be funded nationally. Funding for staffing and other costs such as the face-to-face interview will be managed by the NHS England regional and DCO teams. Q: Can some of the 2,500 for retention and integration be used as a deposit for a rented house or to contribute towards the cost of the indemnity A: No the 2,500 is specifically for local integration and retention measures. It might cover things like social events. Costs such as a contribution towards accommodation will be met out of the nationally managed relocation budget..