BHR GP SPIN
GP SPIN can be considered an 'ST4 without the pressure' Dr Dean Yang, PD
Background of GP SPIN
The NHS Long Term Plan identifies the “insufficient staff and capacity to meet rising patient need” as a significant challenge in primary care. While London is a popular destination for training, there continues to be issues around retaining GPs in local areas in the long term.
In 2017 and 2018, Health Education England (HEE) and the Healthy London Partnership (HLP) surveyed GP Specialty Trainees (ST3) across London, to gain a better understanding of the career intentions of trainees upon completion of training. It was hoped that the data would inform employment models to improve GP retention.
Trainees were asked about their career aspirations; their sense of preparedness for working as a GP, which roles they were interested in, where they would like to work and for how many sessions.
Findings of both the 2017 and 2018 survey indicated that most trainees are seeking a portfolio career, with flexible working arrangements to achieve a work-life balance. In the 2018 survey most ST3s wanted to stay in London, particularly in the geographical area where they trained.
What is the SPIN scheme, how does it work?
Early-career GPs are identified and recruited (through engagement with the local GP Training Scheme as well as targeting early career GPs through local networks) to work in general practice for between 4-7 sessions per week. They take up their posts in August or January and are employed by the host practice on a permanent contract. In addition to their practice sessions they engage in approx. 2 sessions in an alternative setting. Opportunities could include CCG-based leadership opportunities, system-wide development activities, acute/MH/community trust specialisms and educational fellowships.
The support offered encourages newly qualified doctors to remain in their local area, and more importantly, for these GPs to remain in primary care with an exciting, happy, long and rewarding career.
The scheme targets GPs in the first five years after their VTS, which are crucial for ensuring they feel valued, remunerated, have a manageable workload and work life balance, and career and educational opportunities to further develop professionally and clinically.
Practices and host organisations benefit from increased capacity and specialist knowledge. Diversity of thought in both organisations is improved and understanding of primary and secondary care is shared between partners.
Portfolio element meets ask of newly qualified GP and promotes career progression.
Offers preceptorship style ongoing support for newly qualified GPs who may otherwise feel overwhelmed or isolated.
Encourages integrated system working and collaboration between partners.
Patients benefit from their GPs’ specialist knowledge and their good working relationships with, and knowledge of, other healthcare partners.
Potential example offers of portfolios for each area
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1- 2 years in urgent and acute care. Monthly Training Hub's peer support group.
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1-2 years as medical educator fellow via medical school (med school funded). Monthly Training Hub's peer support group.
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1 year in postgraduate certificate in health and wellbeing (HEE funded) 1 session per week in CCG for system redesign (1-2 years) (CCG funded) Monthly Training Hub's peer support group.
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1-2 years in mental health (community or mental health trust funded). Monthly Training Hub's peer support group.
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1-2 years in dermatology (acute trust funded). Monthly Training Hub's peer support group.
1 x GP permanent contract, GP funded (4-7 sessions), 2 sessions for 1-2 years in frailty (trust or CCG funded). Monthly Training Hub's peer support group.
All sessions are paid at £9,250 per year
Roles and Responsibilities
SPIN Programme Director
The SPIN Programme Director will provide leadership for BHR GP SPIN, working with all involved partners to ensure the successful delivery of the SPIN programme.
VTS Programme Directors
This role will have responsibility for promoting awareness of the scheme amongst trainees, supporting trainees to attend additional related learning sets and local recruitment events for SPIN and linking with the SPIN PD and Training Hub as an additional support to trainees.
The Training Hub will provide ongoing support to the GP SPIN candidates, GP Employers and support the design and delivery of portfolio programmes along with the PDs and all partners across the system. The Training Hub will bring local partners together with portfolio hosts to form a pathway option, forming the overall makeup of the scheme. The Training Hub will also play a role in coordinating the delivery of peer support sessions in liaison with the SPIN PD and SPIN GPs.
GP Lead Employer
It is anticipated that the GP Employer will offer a permanent placement to a participating SPIN GP into the GP Employer’s practice, using their own resources to meet the requirements of a salary, including sickness, annual leave, and any other leave deemed necessary and relevant. The GP Employer will take all necessary and appropriate responsibilities as an employer, including the provision of payroll services, and ensure the SPIN GP is available for release to attend the agreed one peer support session per month and two portfolio sessions per week, which form the core of the GP SPIN model.
The portfolio host will identify specialist pathways consisting of 2 sessions per week for one year e.g. dermatology, paediatrics, children’s MH, emergency medicine, general practice in alternative settings, etc. The Portfolio host will also liaise with the practice employer to arrange payment for the doctor’s time undertaking the portfolio pathway.