Starting out as a newly recruited primary care employee is exciting – the start of a stimulating and rewarding career. But it can also be tough. You can feel overwhelmed, unsupported, isolated: these are words sometimes mentioned by those who have left their training posts and start out as independent practitioners. What should be the beginning of an inspirational and fulfilling journey can be tainted by clinical uncertainty, time pressures and a lack of sense of direction.
Why is this? Because individuals recruited via the Additional Roles Reimbursement Scheme (ARRS) have ongoing training needs in areas such as clinical care, non-clinical care, self-directed learning, and leadership. While some roles receive support through a one-to-one professional relationship with their mentor/trainer and an accredited training practice, there has been a gap in the educational provision for many staff, both in terms of quantity and quality.
To ensure the best possible start for any ARRS staff working in general practice, regardless of their prior experience, a quality orientation and induction programme is essential, as is education and ongoing continuing professional development (CPD). A robust induction and welcome will help the new member of staff to integrate and feel part of the team, supporting the sustainability of the roles in primary care.
The role and remit of the ARRS roles working in primary care can be wide and varied, and new staff entering the field will have many transferable skills but will require additional skills to proficiently carry out their role.
Practice Orientation & Induction
Every practice large or small is likely to have an orientation and induction programme. It should provide all the information that a new employee needs, without overwhelming or diverting them from the essential process of integrating into the existing team.
When entering a new post, it is always good practice to review the job description and person specification to clarify the responsibilities and requirements of the role, and to identify any professional development needs.
New starters will usually sign a contract of employment within the first few days of their new appointment. Most General Practices are independent businesses, and the responsibility lies with the individual practice for recruiting and developing their own employees, which may differ from processes within the NHS. Probationary periods may vary with different guidance and stipulations around performance as an independent employer
Employees should be offered a performance appraisal on an annual basis (ideally more frequently for a new staff member). This should include a review and evaluation of job performance and be formally documented.
All new starters should receive orientation; this should include a tour of the building (including emergency exits and fire points), meeting new colleagues and becoming familiar with the IT system.
Health Education England (HEE) suggests that practice orientation includes the following elements:
- Tour of the building/site
- Health and safety requirements and responsibilities
- Meeting other members of the team
- Contracts and terms of employment
- Set up of NHS.net account and arranging access to GP clinical systems
Induction Programme
Induction aims to acclimatise staff to their new job and working environment, helping the new staff member work out their role and how they fit into the team.
The length and nature of an induction depends on the complexity of the job and the background of the new employee; this may need to be adapted to suit. A standardised induction programme is unlikely to comprehensively meet anyone’s needs; HEE suggests a practice induction should include the following elements.
- Basic Life Support and Anaphylaxis
- Equality and Diversity
- Fire Safety
- Infection Control
- Information Governance
- Mental Capacity Act
- Moving and Handling
- Safeguarding Children
- Safeguarding Adults
- Prevent
- Chaperoning
- Primary care structure and funding
- Practice IT systems
- Electronic record keeping procedures and processes
- Audit and information collation/analysis
- Care Quality Commission (CQC) regulations and outcomes
- Equipment ordering and stock management
- Quality Outcomes Framework (QOF) monitoring
- Team working responsibilities (internally) and MDT collaboration
- Importance of working with patients, carers and their significant others
- Effective primary care consultations and using appropriate communication skills (training in this is available through the Training Hub)
- Support for conflict management and managing difficult conversations (training in this is available through the Training Hub)
- Supervision, appraisal and on-going professional development
Day one
- Meet and greet: a named person to meet up with the new starter and welcome them into the practice.
- Introduction to team members.
- Provide computer log in, telephone log in and any keys/fobs for access to the building.
- HR processes: check ID documents, DBS, bank details. Refer the new starter to practice policies and procedures, such as sick leave, annual leave, and information governance policies.
- Set up on clinical system and provide Smart Card. Provide training on clinical system if required.
Week one
- Introduction to clinical supervisor to agree and plan training and support needs.
- Complete mandatory training via Blue Stream online platform.
- Access Primary Care Peer Mentoring scheme
- Overview of operational matters, e.g. referral pathways, tasking the admin team, internal meeting dates, emergency contacts, etc.
- Timetable to shadow various clinicians in the team, such as GP / ANP / clinical pharmacist and/or other established ARRS staff.
Week two
- Clinics and appointment scheduling, for example: 20 minute appointments for face to face and telephone consults (10 appointments in the morning with a 20 minute admin slot, a 30 minute lunch break, and 10 appointments in the afternoon with a 30 minute admin slot).
- Structure the diary to allow the new starter to participate in team meetings and MDT meetings to integrate with the team.
- Identify a medic to provide daily debriefs and assist with medication queries.
- Ensure all members of the team understand the role of the new starter, particularly reception staff to enable them to book patients into appropriate clinics. Advise the team what is in and outside of their scope of practice.
Continuing Professional Development
We are committed to supporting primary care workforce development, education and training. As part of this commitment, local places will work in collaboration with each other, the Training Hub, local Higher Education Institutions and Health Education England to ensure that health care professionals can access high quality CPD.
A range of local CPD and development opportunities are available for staff in primary care, including:
- Clinical & non-clinical education forums
- Training workshops
- Apprenticeships
- Accredited training, such as spirometry and cervical cytology
- Higher education programmes and modules, such as prescribing
- Portfolio career opportunities
- Peer mentoring
As you may be aware from previous years, NHS England (formerly HEE) funds limited places on the MSc Advanced Clinical Practice (ACP) and also the Fundamentals of General Practice Nursing courses (“Fundamentals”).
For this financial year, we have been allocated funding for the following courses:
- Fundamentals of General Practice Nursing
- Advanced Clinical Practitioner MSc – Full course or Top Up
- Advanced Clinical Practitioner MSc - Apprenticeship
PLEASE NOTE: If you are applying for ACP Course, please ensure you have been working in practice for the period specified in the university guidelines around advanced practice trainees. (it’s usually 3 years in their current clinical setting) and you have the support of your practice for supervision.
We will be able to allocate funding to staff who have successfully applied for a place on the course at one of the universities listed below. In order to secure this funding we will need you to complete the relevant form - https://forms.office.com/e/53VzDgh9Sa with the name of the university who have offered the place and details of your line manager. For all spring programmes (Jan – March 2024) this will need to be completed by Thursday 24th November 2023.
The contact details for the courses are shown below – ANY QUERIES REGARDING APPLICATION PROCESSES PLEASE CONTACT THE UNIVERSITY DIRECTLY: email addresses for the general admissions team will be on the university website
It is advised that you start your application once you submit the funding request form. This will also need your line mangers approval.
Please feel free to show this to those who may be interested, including nurses, pharmacists and any other Allied Health Professions in your practice such as Paramedics or Physios.
Any problems please contact the Training Hub email address primarycare.