Out of Hours
The aim of doing Out of Hours work is to experience urgent and unscheduled care.
The requirements for Out of Hours and Urgent Unscheduled Care changed in August 2019.
UUC FAQs (Wessex) explains how this guidance is implemented in Wessex.
You will need sufficient evidence of engagement with and performance of Urgent and Unscheduled care for your Educational Supervisor to make a judgement of progression in this area during training and a judgement concerning competence in this area at the end of ST3. Evidence may be generated throughout your GP training, including whilst in hospital posts. During your GP training posts in ST2 and ST3 you must develop and demonstrate capability in UUC work, including OOHs, outside your training practice.
UUC and OOHs in ST2 GP training posts
In ST2 you should organise observational sessions with other community services providing urgent and emergency health and social care in your area (e.g. Crisis Mental Health, Community Palliative Care, Social services, District Nursing Team, Ambulance service, 111/999; for other suggestions see the document on HEE Wessex GP School website, AIT handbook or talk to colleagues, your TPDs and your GP trainer). You should use the UUC observation session record form to record your attendance at such a session and describe your learning. If this record is attached to and expanded on within an ‘OOHs session’ learning log entry then it could provide an effective piece of evidence towards attainment of UUC capability. These sessions are entirely educational (you should not provide clinical care or take any clinical responsibility for patients) and therefore contribute to the educational component of your 40 hour working week. Some could be done ‘in hours’ during your personal study session or on Wednesday mornings when you are not attending Day Release, but it is also important that several are done OOHs when there is a more limited range of services available and patients/clients are likely to be unfamiliar to the team.
UUC and OOHs in ST3
UUC experience outside your training practice during ST3 will be done with the Out of Hours provider(s) for your area. You should identify early on who provides urgent primary care services for your practice in the OOHs period and approach them directly to organise training shifts.
PHL have the contract for the Clinical Assessment Service (telephone triage) and are subcontracted to provide OOHs home visiting service across Hampshire.
The three types of consultation in UUC and OOHs work are Telephone Assessment (triage), Face to Face (clinic) and Home Visiting (car). Gaining experience in all of these is important to develop fully your capability in UUC and OOHs. You must complete an UUC session record form for each session that you work and attach this to an OOH Session learning log entry. This form records the hours you worked (to justify ‘time off in lieu’ from clinical sessions in your usual working week), the type(s) of consultation and level of supervision, learning points, any competencies demonstrated and future learning needs. It must be countersigned by your clinical supervisor for the session. An example of a completed form is UUC session record- completed. All UUC/OOHs clinical sessions must be supervised – the level of supervision will vary depending on your prior experience and current competence and should be agreed with your clinical supervisor for each session.
Your GP trainer is ultimately responsible for deciding whether your UUC/OOHs experiences are appropriate and adequate to demonstrate UUC capability for your final ARCP and CCT. It is important that you meet regularly to discuss your progression in this area, identify your main pieces of evidence and consider where there is need for further development and the best way(s) to achieve this. Ultimately you must identify your main pieces of supportive evidence using the UUC Evidence for ARCP document which is then uploaded to your ePortolio so it is available for the ARCP panel to review if required. It may be helpful to review and update this document together regularly during the ST3 year to help guide your future UUC/OOHs work.