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Our stories and aspirations

Up to Welcome - share your thoughts!
November 28. 2010
Chris Hewitt

My story

I qualified from Birmingham Medical school in 1989 and completed GP training in Chester in 1993.  I was a full-time GP principal briefly in Yorkshire and then for 14 years in North West Leicestershire before by June 2008 I began to burn out and seek a new challenge.  I enjoyed working as a jobbing GP but also as a GP appraiser, student teacher, trainer and MRCGP examiner. 

In 2004 a much respected local colleague committed suicide while struggling with the intervention of the PCT and Deanery into his referral rates and prescribing. Prompted by this I developed an interest in clinical governance and I chaired an effective and supportive locality group. 

In 2008 I trained and worked for the MDU as a full time medico-legal adviser before returning to sessional GP work on 1 April 2009.  I now consider myself as a portfolio GP doing surgery and Out of Hours sessions- I do occasional sessional work as a Clinical Complaints Adviser for the MDU (supporting colleagues attending meetings, hearings etc). More recently I have worked for my local deanery as a GP training programme director and associate postgraduate dean. I work as a GP appraiser and lead a team of GP appraisers in North Leicestershire. 

In January 2010 I was appointed as a medical director and prospective responsible officer at NHS Northamptonshire.

My aspirations  

I believe passionately in supporting GPs and think that the main emphasis of responsible officers should be in encouraging occupational health, coaching, mentoring, personal and team development and peer support of GPs.  I believe the challenge for ROs is to help colleagues to survive practising as GPs whatever the age or gender, whether working part-time, as a partner, salaried, locum or in out of hours services.  I believe we need to be proud of the work that we do but that we also need to be seen to be capable of scrutinising ourselves by identifying when services are below the threshold of good enough.  I hope as an RO to sympathetically and proactively encourage three Rs - refreshment, remediation and retirement (when appropriate). 

The job of RO is a significant responsibility which I do not expect to bring popularity or an easy life. I hope that GPROC will help me to learn from and gain support from fellow congress members and I will strive to reciprocate.  I hope that as a group we can share ideas and develop and present positive solutions to decision makers.  I hope that the congress will lobby to ensure clinical governance and support of our colleagues is given the highest priority.

Please share your stories and aspirations....

Chris Hewitt

December 01. 2010
Jonathan

Chris

thanks for setting this up; hopefully we can use it as a site to assist us.  I sit as the MD of Worcestershire PCT but like many have an extensive background in appraisal, education and assessment incl poor performance assessment and remediation (I will not bore you with the details).  We have some excellent appraisers, who are trained, calibrated, meet regularly and quality assured so we start from a very good place.  My concerns (and West Mids colleagues have already heard this) are around the "sign off" process.  Matters are complicated because in Apr 12 PCTs (and SHAs) will (on current plans) either not exist or only have one year to run. So............

Where will the appraisal system sit?  It might be consortia who in my eye seem to be turning into "mini PCTs" by the day, or the NCB.

Where will the RO sit?  With the consortia or the NCB?

What process will we use to undertake sign off?  I certainly would not be able to QA the 468 Drs that we have on our list, so there will need to be a system (perhaps analagous to Deanery ARCP panels) that allow me to undertake the responsibility.  The second order question of course is funding!

We have very limited resources for performance assessment.  A figure of 5% is being used (based upon the % who failed to complete (please note this is not fail) summative assessment), but in reality we have no idea until the pilots are finished.  Based upon when the new MRCGP was introduced I estimate that there will be in reality two groups of Drs of concern. Those who fail to engage and those who in reality do have performance concerns. Of course you can be in both!

I hope that this forum will allow us to share best practice and where we are able influence, so that despite the current turmoil in the system, we end up with something that actually works.

Thoughts from everyone............

Jonathan

 

 

December 01. 2010
Chris Hewitt

Previously Jonathan wrote:

Chris

thanks for setting this up; hopefully we can use it as a site to assist us.  I sit as the MD of Worcestershire PCT but like many have an extensive background in appraisal, education and assessment incl poor performance assessment and remediation (I will not bore you with the details).  We have some excellent appraisers, who are trained, calibrated, meet regularly and quality assured so we start from a very good place.  My concerns (and West Mids colleagues have already heard this) are around the "sign off" process.  Matters are complicated because in Apr 12 PCTs (and SHAs) will (on current plans) either not exist or only have one year to run. So............

Where will the appraisal system sit?  It might be consortia who in my eye seem to be turning into "mini PCTs" by the day, or the NCB.

Where will the RO sit?  With the consortia or the NCB?

What process will we use to undertake sign off?  I certainly would not be able to QA the 468 Drs that we have on our list, so there will need to be a system (perhaps analagous to Deanery ARCP panels) that allow me to undertake the responsibility.  The second order question of course is funding!

We have very limited resources for performance assessment.  A figure of 5% is being used (based upon the % who failed to complete (please note this is not fail) summative assessment), but in reality we have no idea until the pilots are finished.  Based upon when the new MRCGP was introduced I estimate that there will be in reality two groups of Drs of concern. Those who fail to engage and those who in reality do have performance concerns. Of course you can be in both!

I hope that this forum will allow us to share best practice and where we are able influence, so that despite the current turmoil in the system, we end up with something that actually works.

Thoughts from everyone............

Jonathan

 

I agree Jonathan - I hope my story did not send too many to sleep - like patients who say it all started just after the war....  I think Andrew Lansley is in full steam ahead mode and expects answers to many of the questions you raise to be proposed to him and developed from the bottom up - this is where we can share ideas, best practice and hopefully have our suggestions heard.... 

Chris

 

December 09. 2010
TMills

My background is predominately in post graduate GP education and training untill 10 yrs ago when I became locality rep on the Professional Executive Committee in Nottingham City. I then got dragged into being prescribing lead and form there I got involved with more and more. I became Clinical Governance lead and then almsot 3 yrs ago was succesful in being appointed as MD. Since then I have always been on our Board and anactive and fully included member of the Exec Team.

My concerns for the future are documented in a paper I have just asked Chris to put on this site. I have made some proposals and these have been sent to Jane Povey fpor her to consider along with the many other sI am sure she is recieving. I know you will not all agree with all my current thoughts ( I may not myself in a few weeks!) but I hope it stimultes debate. If you agree with various bits then do let Jane know as she is now seconded to Dame Barbara's team to help sort out our futures amongst other things!.

My biggest fear is that we take our eye off poor practice and loose quality due to the drain of excellent and experienced staff whilst someone decides where primary care commissioning and independednt contracator performance governance is going. Similarly the same risk will occur id GP consortia can choose ROs and pick someone who has no previuos knowledge of the GPs in the area. 

I am still at a loss as to how the governance of RO will work out and I have a suggestion in my paper.

I havent even though about funding 'cos it makes my brain hurt!

Trevor ( Mills) NHS Nottingham City

 

 

 

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