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At the heart of general practice since 1960

Education and training

Dr John Couch continues our series by looking at the requirements needed to earn points from education and training

Points achieved with complete ease

Education 3 All practice-employed nurses have an annual appraisal

Value two points

Most practices will already have staff appraisals in place, if not they should be introduced urgently. For nursing staff it is advisable to have clinical input, such as from a GP. Review your appraisal process to ensure it follows ACAS guidelines and that appraisers are adequately trained. Draw up a written description of your appraisal process as evidence for points.

Education 4 All new staff receive induction training

Value three points

Once again, practices that do not have an induction process should set them up before 31/3/05 – see the new contract blue book guidance notes. Include regular progress reviews. Induction will bring new staff up to speed more rapidly so benefits are not merely in extra points.

Education 6 The practice conducts an annual review of patient complaints and suggestions to ascertain general learning points that are shared with the team

Value three points

Most practices have a complaints system but not all have team reviews. An annual review is not onerous and should ensure group learning, change and development. Remember to keep minutes as evidence, including any changes to current practice.

Education 9 All practice-employed non-clinical team members have an annual appraisal

Value three points

See education 3. One team member should be the appraiser. They will be questioned as part of the evidence process.

Points achieved with good planning

Education 1 There is a record of all practice-employed clinical staff having attended training/updating in basic life support skills in the preceding 18 months

Value four points

Ideally this training should be organised more often to take into account absences due to holiday or sickness. Larger practices will find it more efficient to bring in a trainer.

Speak to your PCO, A&E department, or co-op for contact details. Use this as an opportunity to review your resuscitation equipment. Keep copies of certificates or a list of attendees. The indicator says 'all staff', so ensure new staff, especially those joining near to a points cut-off date (March 31)

have evidence of recent training, or send them to a course urgently.

Education 2 The practice has undertaken a minimum of six significant event reviews in the past three years

Value four points

Many practices will not currently fulfil this indicator but there is enough time to comply by 31/3/05. As for education 6 there are positive outcomes to be gained for all team members from reflections, learning and changes made in a blame-free environment. Remember to include good practice too. The blue book guidance notes are useful. Record and save each review using the blue book format.

Education 5 There is a record of all practice-employed staff having attended training/updating in basic support skills in the preceding 36 months

Value three points

See education 1. There is a longer timescale here but it makes organisational sense to have annual in-house training for all staff at the same time. Once again beware of staff without this training joining close to March 31. Send them on an outside course as soon as possible. Just one staff member without training could cost a large practice more than £1,000.

Education 8 All practice-employed nurses have personal learning plans which have been reviewed at annual appraisal

Value three points

Include this as a routine part of the annual appraisal. Personal learning plans can be shaped to fit the needs of the practice as well as individual. Include learning plans as part of your written appraisal process. Consider personal learning plans for non-clinical staff too. Although this is not a points requirement it should improve skills and team performance.

Points achieved with real striving

Education 7 The practice has undertaken a minimum of 12 significant event reviews in the past three years which include (if these have occurred): lAny death on the practice premises lTwo new cancer diagnoses lTwo deaths where terminal care has taken

place at home lOne patient complaint lOne suicide lOne section under the mental health Act

Value four points

See education 2. As many practices have not yet started significant event reviews, 12 such meetings in a year will be difficult to achieve by 31/3/05, especially given the work needed in all other areas of the Q&O framework. Aim to meet quarterly at least and only try to get 12 done in 2004/5 if you do not jeopardise points in other areas. The indicator takes account of some practices not having occurrences of all the examples given, although this must be stated.

John Couch is a GP in Ashford, Middlesex

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