As part of your GP training, you need to gain competencies in ‘out of hours’ (OOH) work as part of your workplace based assessment for nMRCGP. GP surgeries are open for routine matters and emergency cover between 8 am and 6.30 pm Monday to Friday. OOH is defined as emergency cover outside of this time. (New ‘extended hours’ bookable surgeries do NOT count as OOH.) See the attached document for the deanery guide to OOH.
What do I have to do?
The Deanery requirement for OOH work is for you to complete the equivalent of 6 hours per month for the period spent in General Practice placements (in total 36 hours for a six month placement, 72 hours for a year). For individuals training less than full time this will be a pro-rata requirement.
The total number should be completed by the date of final e-Portfolio completion, ie: 2 months before the end of ST3 or one month before the end of ST1/2.
It is important to enter the number of hours of the session at the start of the learning log entry about each OOH session.
Out of hours experience is gained by undertaking shifts at increasing levels of supervision, designated as Red (observational only), Amber (consulting with close supervision) and Green (consulting with access to a supervisor remotely or on-site) shifts. A trainee should usually undertake approximately 6 red, 6 amber and 6 green shifts in total, moving from amber to green when the educational supervisor feels appropriate.
What competencies do I need to achieve?
The six generic OOH competencies are embedded within the RCGP Curriculum Statement on ‘Care of acutely ill people’, and are:
- Ability to manage common medical, surgical and psychiatric emergencies in the out-of-hours setting.
- Understanding of the organisational aspects of NHS out of hours care.
- Ability to make appropriate referrals to hospitals and other professionals in the out-of-hours setting.
- Demonstration of communication skills required for out-of-hours care.
- Individual personal time and stress management.
- Maintenance of personal security and awareness and management of the security risks to others.
Who provides OOH services?
Oxford Health co-ordinates the OOH across Oxfordshire
Where does OOH care take place?
The Out of Hours Base Centres are located at:
- Horton Hospital, Oxford Road, Banbury, OX16 9AL.
- Bicester Community Hospital, Kings End, Bicester, OX26 6DU.
- Witney Community Hospital, OX28 6JJ.
Patients contact the OOH service by phone. Phone calls are handled by a call centre and then triaged by the clinical OOH staff working at the base centres. They will arrange for a visit by doctors or paramedics, or an appointment at the base centre with a doctor or emergency nurse practitioner.
There needs to be a balance of sessions undertaken, not all your out of hours sessions should be at one location.
In ST1/2 but NOT in ST3 trainees can also use out of hours time to experience non-GP services out of hours for example:
•The ambulance service
•Community psychiatric teams
•District nurses and palliative care nurses
•Social workers and social care services
•Walk in clinics
How do I book my OOH shifts?
Contact the OOH ST co-ordinator:
The ST co-ordinator will be sent the montly rota in advance and will circulate it to all STs working in general practice. Please reply with your shift requests.
You must supply your name, ST year, email, mobile number and your OOH status red/amber/green.
Shifts are only bookable a few weeks in advance, as GPs often change their shifts around and it is important that a GP registrar is booked with an appropriate team member.
If you have a particular GP you want to work with who you know is doing a particular shift, that is fine, but the shift MUST be booked via the OOH service or there may be insufficient rooms.
There is also the option to organise red OOH sessions with another health professional such as a paramedic or emergency nurse practitioner. As with other OOH sessions it is essential that your log entry demonstrates learning in the out of hours competencies.
How long are OOH shifts?
Shifts would usually be at least 4 hours long. But it is the number of hours you do overall (not the number of shifts) which is important. You must complete the equivalent of 6 hours per month for the period spent in General Practice placements
How do I record my OOH experience?
At the end of each shift you need to fill in a paper log sheet of your learning. Your shift supervisor will add comments and sign this.
You must record each OOH shift in the e-Portfolio as a learning log ‘OOH experience’ entry. Upload your paper log sheet as an attachment.
It is your responsibility to show the number of hours of OOH to ensure you do the equivalent of 6 hours per month for the period spent in General Practice placements. START YOUR LEARNING LOG ENTRY WITH THE NUMBER OF HOURS DONE ON THAT SHIFT. This makes it easy for you and ARCP to tally the number of hours overall.
How am I signed off as ‘competent’ for OOH at the end of my training?
When your e-Portfolio is signed off by your educational supervisor at the end of year 3, a box will come up asking him/her to confirm there is ‘evidence of OOH competency’, which, after reviewing your OOH log, he/she will tick if it is satisfactory.
Record of OOH Session
Out of Hours Guide for GP Trainees