Urgent and unscheduled care

One of the requirements during GP training is to demonstrate your capabilities in Urgent and Unscheduled care.  This includes delivering safe patient care, demonstrating effective communication skills, maintaining continuity for patients and colleagues, coordinating across services and enabling patient self efficacy.

The requirements for urgent and unscheduled care, which includes out of hours have recently changed and the below will explain in more detail what is required in order for you to demonstrate your capabilities within this curriculum area.

Trainee and ES guidance

One of the RCGP Curriculum requirements is to provide general clinical care to patients of all ages and backgrounds.  This includes the provision of Urgent and Unscheduled care.

The mechanism of delivery of Urgent and Unscheduled care (UUC) which includes Out of Hours (OOH) services varies across the four countries of the UK. GP trainees have different contractual arrangements in each of the four countries and this affects what they are required to demonstrate and record in their ePortfolio.

The RCGP curriculum and the supporting guidance document on Urgent and Unscheduled care do not specify the number of hours needed to meet the capabilities within this setting, nor a specific number of log entries.  However, it is stated that “whilst it is recognised that knowledge and skills needed to develop Urgent and Unscheduled capabilities may be gained “in hours” and in varying secondary / community / urgent care services there remain particular features more likely encountered in a primary care urgent care setting that require specific educational focus. Thus, to gain experience of, for example, working in isolation and with relative lack of supporting services GP trainees will need significant opportunities to develop these capabilities in primary care based Urgent and Unscheduled care  / Out of Hours provider organisations.”

It is the responsibility of the individual trainee, in discussion with their Educational Supervisor, to ensure that they have sufficient experience across a range of settings to be able to meet the required capabilities. It is the responsibility of the Educational Supervisor to ensure that they are satisfied that these have been met before signing off the final Educational Supervisor Report (ESR).

Please refer to the mapping document linking Urgent and Unscheduled Care to the RCGP curriculum capabilities [Word DOCX].

It should be noted that in some areas of the UK, GP trainees will have a contractual requirement to complete a specified number of OOH sessions / hours.  Fulfilling this contractual requirement should not be seen as equivalent to meeting the curriculum capabilities. Trainees will still need signed off as competent in these capabilities by their Educational Supervisor and this may require more hours than the contractual requirement.

What does this mean for the ePortfolio and the Educational Supervisor Report (ESR)?

Experiences of and learning from individual cases in UUC / OOH should be recorded in the trainees learning log to demonstrate progression and achievement of capabilities, as it is for all other settings.  These entries should be linked to the clinical experience group for Urgent and Unscheduled care. Individual cases seen in OOH do not need to be entered into the learning log if no learning took place.

An UUC/OOH form needs to be completed by the UUC/OOH supervisor and trainee after each session, (it is recognised this will not be possible when the trainee has gained sufficient experience and is working remotely with the supervisor only available by telephone).  The trainee should share any completed forms with their Educational Supervisor and/ or note relevant cases seen in the session for discussion with their Educational Supervisor.  These forms can also be attached by the trainee to the OOH section* of their learning log. It is recommended these forms are added as evidence of your attendance and experience in UUC/OOH.

A template is also provided where the trainee can add the date of learning log entries to demonstrate their coverage of the capabilities. It is hoped going forward this will be auto populated to avoid duplication of work. It is optional to complete this document.

From August 2020 there will no longer be a requirement for the Educational Supervisor to sign a statement that the trainee “has met [their] out of hours session requirements”.  The capabilities required to provide UUC/OOH will be assessed as part of the overall ESR.

However, for those trainees who have a contractual requirement to complete UUC/ OOH sessions / hours, a spreadsheet will need to be completed and uploaded to the OOH section* of their learning log so that it can be reviewed before the completion of training.

* From August 2020 this will be renamed as ‘supporting documentation’

You will need to provide evidence of your engagement with UUC. Similarly you will need to provide evidence of your performance in this setting. 

Documentation of Urgent and Unscheduled care can be done in 2 ways:

  1. Clinical encounters (will be renamed clinical case reviews from August 2020), where new learning has occurred and you wish to reflect on this learning.
  2. Completing the UUC /OOH session feedback forms with your supervisor for this session. These should be shared with your ES and also uploaded to the OOH (will be renamed as supporting documentation form August 2020) section of your learning log. 

If you have a contractual requirement to complete Urgent and Unscheduled care/OOH the number of sessions and the hours spent in these sessions will need to be documented. A spreadsheet will need to be completed and uploaded to your ePortfolio under the OOH / Supporting Documentation heading so that it can be reviewed before the completion of training.  

The following documents provides further explanations of Urgent and Unscheduled care:

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