Trainee clinicians
At St Georges Surgery we are a training practice, and we are proud to be growing the NHS workforce. The NHS has been struggling to recruit and retain workers to meet the needs of our population and we thank you for supporting us in expanding the NHS capacity for care.
You may have noticed that the range of clinicians we offer appointments with is wider than before and it won’t always be clear exactly what they can do.
Some of these staff are fully qualified in new, emerging roles within primary care such as, Clinical Pharmacists, Physicians Associates and Mental Health Practitioners.
Others may be qualified doctors, who are here to gain experience in order to become GPs or to become more well-rounded hospital specialists. These may be foundation-year doctors (FY 1 or 2), or GP specialty trainees (GPST 1, 2 or 3).
We also train medical students, and it is well recognised that this has a positive impact on attracting doctors into primary care. It is also recognised that being a training practice helps improve staff morale and raise practice standards.
All these types of clinicians have varying capabilities and differing requirements for supervision and support. I have set out what the different types of clinicians working at St Georges can offer and what level of support is in place for them.
Clinical Pharmacists: (CP)
These staff are qualified in reviewing medications to check for safety, interactions, side effects, benefits, cost-effective prescribing, dosage adjustments and ensuring our prescribing is in line with government directives. Their work is invaluable in maintaining safety, quality and meeting prescribing standards that are monitored by a range of authorities. They can work independently and discuss medications with patients. They will raise queries with doctors or senior pharmacists when uncertainties arise. They have ongoing appraisal and review sessions with a supervisor to ensure they are supported; they are working within their capabilities and their knowledge levels are up to date.
Physicians Associates: (PA)
These are clinicians who work in a very similar capacity to GPs. They are trained and qualified to be independent in making diagnoses, examining patients and making treatment decisions. They can request blood tests and make referrals for further care. If scans or X rays are required, or if a prescription is needed then they can discuss this with their supervising GP who will arrange for these. If they are in doubt, if they need advice or would like the supervising GP to examine or talk a patient, then they can come and ask for this. How much support they need will depend on the amount of experience they have. There is time blocked out with a GP for them in every session for this type of support.
Mental health Practitioners: (MHP)
These are independent clinicians who are qualified diagnosing and supporting patients with mental health problems. If a prescription is required, they can ask a GP to facilitate this. GPs can refer patients to Mental Health Practitioners or receptionists can book patients in with them directly. When they need supervision or advice – they have access to the community mental health team.
Foundation year doctors (FYs):
These are qualified doctors who have gained their medical degree after a minimum of five years of training. They are either in their first or second year of work since getting their degree, they are provisionally registered with the general medical council (GMC) and they must perform satisfactorily in these two years before they become fully registered with the GMC. They can diagnose, prescribe medications, request tests and refer. They discuss all their patients with their on-the-day supervising GP who will have time blocked off for this purpose. If needed, the supervising GP can also speak with or examine their patients.
One main supervising GP will be giving them weekly tutorials, helping them reflect upon cases they have seen, complete their learning portfolio and workplace-based performance assessments.
GP Specialty Trainees: (GPST)
These are doctors who have successfully completed their two foundation years and are fully registered with the GMC. They can diagnose, prescribe medications, request tests and refer to specialists.
They can be in their first, second or third year of specialty training. So, an ST1 on their first day may never have worked in general practice before and ST3 on their last day may be ready to start working completely independently as a newly qualified GP.
Depending on their level of experience and confidence, they may discuss all, or some of their patients with an on-the-day supervising GP who will have time blocked off for this.
One main supervising GP will be giving them weekly tutorials, helping them reflect upon cases they have seen, complete their learning portfolio and workplace-based performance assessments. They will also be recording videos of their consultations for training and sitting for practical and theoretical exams.
Medical Students: (Y3 & Y5)
These are university students, usually coming to us from Lancaster University or University of Central Lancashire (UCLAN) and they may be at any stage of their 5-year degree course. They must report on all the patients they see to their supervisor and the supervisor must speak to all their patients. The supervising GP will confirm diagnosis, request tests, prescribe and refer as needed. Time will be blocked off with a supervisor for this purpose.