The Neston Surgery has been a training practice for over 20 years and training remains an important facet of the practice which all the partners enjoy and take part in
All the partners are dedicated to training. They all have special interests and as such registrars can draw from, and benefit by, a wide knowledge base. All partners take part in giving tutorials and supporting the registrar during their attachments. The practice premises are specifically designed with training in mind, with a separate room for the registrar.
The practice is fully computerised using EMIS. This system is one of the best GP systems available and comes into its own when doing searches and medical audit. There is a practice library that has a broad selection of books and journals that are regularly added to.
Our premises are adjacent to Neston Clinic where our district nurses, health visitors, midwifes and CPNs are based. The clinic also has community paediatric clinics run by CMOs with a specialist enuresis clinic. Community dentistry and chiropody are also in the same building.
All the primary health care team are well used to registrars being based at Neston Surgery and registrars are expected to spend some time with each member of the team to better understand their role and what they have to offer. The whole primary care team works well together with regular team meetings and this provides an excellent learning experience for registrars.
New registrars on joining the practice are given an introductory pack setting out as details of the practice area, important phone numbers and maps, instructions on how to use the computer and important practice protocols. The pack also contains information regarding details of formative assessment, assessment tools and the requirements of summative assessment.
The registrar will have an initial evaluation on joining the practice based on the "Programmed Evaluation Package" from the RCGP. This together with the registrar's own self-assessment is used to define areas of strengths and weakness from which the programme of tutorials is formulated.
Two tutorials a week are time tabled for the registrar, time being taken out of surgery to make sure that tutorials take place as planned and are not missed. There is a lot of additional teaching in the form of dual surgeries where the registrar sits in with the trainer and vice versa, video is also used in this regard.
We make it a point that the registrar is never left alone doing a surgery without a partner being available in the building; the registrar is encouraged to seek advice whenever they feel unsure or uncomfortable about a problem. Similarly, a partner is always available when the registrar does home visits or is on call out of normal surgery hours.
The practice out of hours cover is provided by the "Out of Hours" centre at Arrowe Park hospital. This is a Wirral wide co-operative covering a population of approximately 300,000. The centre is staffed by Wirral GPs who see patients at the centre and on home visits, no commercial deputising services are used. The partners take part in the shift system at the centre and the registrar is expected to accompany the trainer or another principal from the practice during their shift at the centre. In this way, the registrar can get adequate exposure to out of hours cover.
Registrars are encouraged to come to practice meetings and staff meetings to express their opinions, in this way they begin to understand the process of partnership decision making and about the business side of general practice.
Courses in Child Health Surveillance, Minor Surgery and Family Planning are available and the registrar is encouraged to use these to develop his or her skills. The registrars will attend a half-day release course every week, and there are numerous post-graduate meetings to take advantage of.
Preparation for Summative assessment is an important part of the training. Video work (the practice has its own equipment), past audit projects and MCQs are all used in the training process. All tutorials are recorded on computer and on feedback forms for evaluation purposes and these form basis of an Objective Trainers report.
If registrars wish to take the MRCGP examination as well as the Summative assessment, they are given encouragement and practical help with mock vivas, practice MCQs and MEQs, together with help in preparing their videos and log diaries.
It is our aim to make sure when registrars finish their final six months of training with us that they are not only equipped for independent practice, but also have the knowledge and experience to select practices with confidence.