After every surgery, the trainee does a debrief. One evening during this discussion our trainee told me that she was not yet on the performers list.
The next day I phoned the dean and the medical defence organisations and established this was a big deal. My trainee then established that fellow trainees in practices across Oxfordshire were not on the performers list.
I spoke to Dr Paul Roblin [Berkshire, Buckinghamshire and Oxfordshire LMCs chief executive] and he kindly sent an email out to other training practices to inform them.
We were given clear advice that the ideal thing to do would be for the trainees not to see patients, and only undertake non-clinical work. If they were to see patients, they would need to be fully supervised – effectively meaning doing each consultation twice.
The immediate impact was on our patients. The trainees had a full schedule of patients booked, so we had to cancel those appointments.
We had to find capacity to see more patients and at the same time find useful non-clinical work for the trainees to do.
In fairness, as soon as the problem was identified, the local area team did all it could to rectify it, and prioritise it. Some trainees were able to work a few days after the problem was identified, but others had to wait longer.
But then our trainee got a deanery email saying that the RCGP would not accept her doing more than two weeks non-clinical work, therefore if the problem was not resolved within a week, there was a strong possibility that they would suspend her training. She found this pretty stressful.
The fundamental error was a misunderstanding in the primary care support services team. They believed that, as long as they had all the paperwork in their office, it was fine for the trainees to work – but this was wrong.
We have been warned to expect a CQC inspection in the next two months and, in their ‘well-led’ domain, they want us to tell them about any significant problems. But we are worried that they might hold this against us, and not understand that it was a countywide system error.
We want the local area team to inform the CQC about this so no practice gets penalised. But we have had to really push them to do this.
Dr Jessica Harris is a GP in Oxford, and is a member of the Oxfordshire LMC