What have we achieved this month?

• Secured the future of GPSA through funding beyond 2022 and an increased role in supervision of doctors and doctors in training. We thank the Health Department for their collaborative and solutions focussed approach
• NTCER – We are working closely with GPRA to deliver an updated National Terms and Conditions for the Employment of Registrars (NTCER) that best reflects the needs of the changing sector. While we undertake the stepwise approach GPSA and GPRA has agreed to for the review, we will make a minor amendment to the document in its current form to replace reference to RTOs with reference to the colleges for the initial post-transition training term. All GPSA members have been asked to complete a survey so we can better reflect your views while negotiating with GPRA on the next iteration of the NTCER.  Click this link to complete the survey
• Payroll Tax – Recognising the alarm this issue is causing across Australia, GPSA made sure this was a key item on the August meeting of the NCPCD through our Payroll Tax brief. Different practices have been given different advice. We have asked that all peak bodies unite to inform both state and federal governments on the impacts of payroll tax and have medical practices excluded.
• Q&A with RACGP and ACRRM on Transition – Click this link to watch 

As February 1, 2023 inches closer, GPSA would like to acknowledge the amazing work done by the RTOs in GP training, and recognise their contribution to this sector. While two RTOs will remain a presence in their respective locations – GPEx, who will be heading up the Workforce Prioritization Placement (WPP) work in SA, and JCU in Queensland – we can all rest assured that the majority of the staff we have been supported by from the remaining seven RTOs will likely be carrying on their work as they shift to their new homes in the colleges.

RACGP Presidential Election
Voting commences Monday 29^th  August  – Thursday 8^th September
If you would like to know more about the candidates click here RACGP Presidential Nominations 2022
I have put my hand up as a candidate to ensure the continuity of GP training at a time when our profession is in crisis and needs a steady hand to ensure the future of general practice. Whether for me or one of the other candidates, if you are a FRACGP, please vote.

Yours in training,

Dr Nicole Higgins
GPSA Chair

Good working relationships and collaboration have been a key focus the last 18 months. GPSA and GPRA are renegotiating the NTCER. We have worked together with the colleges to support paid parental leave for registrars. GPSA meets regularly with both RACGP and ACRRM, the RTO’s and Department of Health to ensure the needs of training practices remain a central focus in policy development.

The current issues facing supervisors and practice managers are now the detail of what training looks like. GPSA has seen the practice agreements and provided feedback that they are simple and easy to understand and some minor changes. GPSA has provided feedback around the Work Based Assessments to ensure that they are easy and simple to use. We are yet to see what the computer system looks like or how this will integrate with Services Australia.

Payroll tax is another issue that GPSA is aware may impact upon training practices. The situation in NSW couldn’t have come at a worse time when general practice is struggling to attract and retain GP’s. We would love to hear from training practices who have been affected by recent rulings or have received letters from the government.

Last week I was in Cairns and visited the Aboriginal Community of Yarrabah regarding the North Queensland Pharmacy Trial. Local GP supervisors and the GP and medical community came together with our peak organisations AMA, RACGP, ACRRM and RDAQ. If this gets rolled out in north Queensland then it will be rolled out Australia wide. This gives the pharmacist the ability to prescribe for 23 conditions including heart failure and asthma. It makes a mockery of the training that GP registrars receive around safe prescribing and disease management when pharmacists only have to complete the equivalent of 3 weeks or 120 hours of training.

So it is with pride, sadness and joy that I thank the board of GPSA, the operational team and CEO Carla Taylor for making my time at GPSA so rewarding.

I encourage all RACGP supervisors to vote and have your say.

Yours in training,

Dr Nicole Higgins
GPSA Chair

Having been through a transition in 2015 I understand the hurt and loss.  We  appreciate that for many staff within the RTOs, GP training has been their life; for some as long as 20+ years. So there is considerable grief and in some cases anger, even contempt for the change that directly affects and  impacts them. To all RTO staff, leadership and boards struggling with what the transition represents, we see you, we hear you and we feel your pain. GP Supervisors have forged strong alliances with all of you across those 20+ years and we hope to see many of you continue working with the colleges in 2023 and beyond.

All players within the sector are here to ensure transition goes smoothly – including GPSA.

No organisation or individual is immune to change. GPSA will enter a phase of renewal over the next six months as the board seeks to bring fresh skills and eyes to its governance through the call for expressions of interest in joining the board that was put out last month. The EOI closes on the 20th of May.  We have had a wonderful response from our community and we will continue that process and keep you up to date as new directors are appointed.

There is also a new opportunity emerging within the GPSA leadership. Glen Wallace, our CEO of over seven years, has accepted a leadership position within the RACGP Profession Led Training team. 

Glen took on the position in 2015 – two years after GPSA was formally funded by the Department of Health. At that stage the organisation barely had any educational resources developed to support the membership, had really no research portfolio to speak of and about a third of today’s membership. 

Glen has led the organization and an impressive team to what has now evolved into two research journal publications annually and the production and maintenance of over 350 educational resources which continues to grow annually and importantly be consumed and used by stakeholders. 

Glen’s approach has always been pragmatic and oriented to what matters most to GP supervisors. We congratulate Glen on his new position within the college and thank him for his service to the GP supervisor community. His vision, collegiality and pragmatism will be an asset to the RACGP and to the profession as we head into the business end of this transition.

We are now seeking expressions of interest (EOIs) from the General Practice and GP Training community to fill the position of CEO at GPSA. To this end we have placed the position description online. Prospective candidates are encouraged to initially make themselves known to the GPSA board by emailing a CV with their expression of interest to governance@gpsa.org.au.

On a personal level, I have loved working with you Glen and how our ‘brains go ping’ to develop ideas and solutions. You will be missed and I wish you all the best in your new role.

Yours in training,

Dr Nicole Higgins
GPSA Chair

All doctors-in-training must be supervised

Patients deserve to be treated by a doctor-in-training who is supervised. No matter what program – AGPT, Fellowship Support Program (PEP), MDRAP or RJTIF, our learners deserve an equitable system that supervises and supports them through their learning journey.

Adequate resourcing

The nationally consistent payment of supervisors and training practices needs to be applied consistently across all GP training programs including John Flynn, RJTIF, MDRAP, PEP, FSP, IP, and AGPT (including RVTS supervisors and training practices). Acronyms are confusing aren’t they? Shows you how complex this has become!

Hard to fill priority locations should be supported with bespoke registrar and practice supports to fill them as a priority as RTOs have done. 

National, Plain Language Practice Agreements

We currently have 9 RTOs each with their own practice agreements ranging from 5 to almost 30 pages in length. Some in plain language and others thorough in their legal language. Practices want to be able to quickly and plainly see what they agreeing to in taking on registrars – now and into the future.  

Adequate Supervisor CPD

Supervisor CPD needs to be funded and flexible. Face to face peer networking and support combined with online training with training pitched to the right level of experience. Just like a new registrar – new supervisors learning needs are very different.

Adequate Practice Manager CPD

Practice Managers are truly unsung heroes in the GP training space. They are most often the information gateway to supervisors, as well as the key enablers of so much of the GP training program. So much so you don’t notice their work until it is absent. This important group need to be catered for in the new GP training paradigm as they have been under the RTO training providers.

Adequate Supervisor Liaison Officers (SLO) representation and support

SLOs are an essential cog in GP training. They reflect the vast and specific needs of supervisors nationally and provide a local and contextualised view of GP training in the regions. SLOs need to be recruited, retained, resourced, and connected nationally as a peer support network promoting best practice. 

Our SLOs need to:

• know who the supervisor cohort they are supporting, 
• have support and resourcing to communicate Best Practice in their liaison with supervisors and training practices.
• have support and resourcing to network with their national counterparts to advance Best Practice 

Adequate Practice Liaison Officers (PLO) to support local delivery

RTOs have evolved over time in their service delivery to practices. Those that rate highest among supervisors, practice managers have a highly effective practice liaison and support staff. This must be replicated by the colleges as they move forward.   

IT and communications systems developed for the end user

GP Supervisors and Practice Managers need to be placed as a priority in IT development and communications systems. This will require adequate user acceptance testing by Supervisors and Practice Managers to build best practice into the systems being developed now.

GPSA has approached the colleges and the department to be involved with their development of management systems and with the Health Services Australia payment system.

Continuous Improvement vs Quality Assurance

GPSA is excited to introduce the GP Clinical Learning Environment (GPCLE) Framework to supervisors and practices. This is a system that makes finding and doing anything to do with training a registrar simple and easy. I am a supervisor and a practice owner so anything that can easily support me to improve the training I deliver and support my practice manager is a big yes from me. 

The common denominator between high performing and low performing training environments is that both are accredited. There is no review of quality. Practices and Supervisors are best supported by a consistent orientation to best practice and continuous improvement. The GPCLE and resources must be integrated with accreditation and CPD in the future training program and adequately resourced.

GPSA is a small organisation with a big heart and a big impact.

Last month we held our strategic planning weekend and board review. It was wonderful to see the team face to face and to plan for an exciting next 4 years. GPSA and the board thanks Dr Collie Mullins who is stepping off the board. Collie has made a great contribution and she will be missed.

GPSA is about to put out an EOI for new board members.  We are an experienced board who gets stuff done. AS GPSA are committed to diversity, we encourage EOIs from:

• early career junior supervisors looking to diversify their career
• supervisors from culturally and linguistically diverse backgrounds
• ACRRM supervisors.

If you would like to know more email me at chair@gpsa.org.au

Yours in Training,

Dr Nicole Higgins

GPSA Chair

A new year brings new registrars who bring renewal and optimism. As a supervisor, this means increased demands on your time as you orientate and support them through their first weeks in your practice. GPSA has free resources which can be downloaded through our website. Whether you need NTCER compliant employment contracts, policies, procedures and teaching resources, we have you covered.

I welcomed GPT1’s Win and Anna this week. It was a lovely distraction from the stresses of Covid and day to practice. I was inspired by my kid’s teacher who gave new charges a Survival kit. I would love to hear what your practice does to celebrate the arrival of new registrars.

In December and January two new guides were sent out to training practices:

• LGBTQIA+ Health and Inclusive Healthcare in General Practice: An introduction to teaching and learning; and
• Helping your registrar plan their learning in general practice

Both guides are now available free to download on the GPSA website. Every GP training practice was sent a hard copy of these new guides as a thank-you from GPSA.

Do you want to be the best training practice that you can be?

GPSA have published resources for training practices to self assess the quality of your clinical learning environment. As we know, holding an accreditation certificate alone is not equivalent to a quality learning environment. Not only will working through the resources support you to identify opportunities for improvement but it will also provide you with an effective evidence base for your accreditations into the future. These resources are available on this page: https://gpsupervisorsaustralia.org.au/gpcle-practice-setup/

Don’t be a stranger. GPSA staff are here to support you throughout your supervision journey. If you need something clarified or support to resolve an issue we encourage you to contact us on admin@gpsa.org.au or via the office landline on 03 5440 9077.

So it is with cautious optimism that I welcome the 2022 training year.

Yours in training,

Dr Nicole Higgins

GPSA Chair

While 2022 will have its challenges, there have been some wins in 2021. GPSA have long advocated for greater resources and consistent remuneration for GP supervisors who perform the same role nationally. We do so because from every supervisor survey we have ever conducted you tell us it is important. And… because strangely GPSA and more recently GPRA have advocated almost uniquely for appropriate resourcing of GP supervision.

GP Training Grant Opportunity

We will be communicating with the colleges and the department in the new year about the grant opportunity they will be responding to. Notably registrar satisfaction of supervision is a KPI. Our feedback about this item is simple:

Clinical supervision is completely unpaid. So exactly what meaning will the colleges and the department apply to a registrar’s satisfaction or dissatisfaction of the supervision provided when the supervisor provides that supervision at a cost to themselves?

While we have all been waiting to see what is in store in the new world order of GP training, now the pressure rests with the colleges to put forward a funding proposal that adequately meets supervisor and registrar needs.

GP supervisor Professional Development

The non negotiable elements for GPSA are supervisor professional development opportunities that are not less than what is currently available via each RTO. GPSA cannot stress the importance of face to face peer networking and education. This needs to be adequately funded and facilitated. We cannot and should not accept online education and networking as the default.

Nationally Consistent Payment Model about to be announced for 2023

Shortly the Department of Health will release an advisory for National Consistent Payments for Supervisors, Teaching Practices and Registrars. There is a lot to like about the new package.  While most supervisors and training practices will receive an increase in teaching payments from 2023 as far as we can see no one will be worse off than they currently are and there will be, for the first time ever, national consistency; Equal pay for equal work.

Rural practices will see the most dramatic increases and this recognises the complexity in attracting and retaining supervisors in rural and remote locations and thereafter the additional work involved in supporting a registrar in a rural and remote location.

GP Synergy EGM

This month saw GP Synergy propose an amendment to its constitution, which sought to remove all members other than the RACGP. GPSA ran a survey of NSW members to seek your views ahead of the EGM vote. We did not seek to convince you one way or another because as a membership organisation our members are ultimately who inform our decisions. Wisely, GP Synergy adjourned the proposed EGM on 22 December until 20 January 2022 to further communicate their reasoning with you and its members.

What this represents is: Your voice is clear, concise, consistent and it matters!

Many of us will be working over Christmas to afford our teams the break they so deserve after a couple of relentless years – Thank you if you are doing this for your team and your community. For others please enjoy your hard earned break. Replenish and please stay safe.

The GPSA team and Board have worked hard to deliver for the membership throughout 2021. From all of us, may your Christmas cup runneth over, be bright, joyful and filled with cheer.

Merry Christmas!

Sincerely,

Dr Nicole Higgins

GPSA Chair

What the practices said:

• It’s not just the supervision and teaching
• The practice manager invests substantial time too
• Teaching a registrar takes a village
• There are other financial and non-financial costs
• It is difficult to quantify
• It is not a one size fits all model
• It is part of a complex bigger picture

What makes it easier….

    Practice level 

• Patient scheduling
• Experienced supervisors and practice
• Flexible practice
• Efficient medicare billings
• Relationship with registrars
  
  System Level

   

• Available suite of resources
• Supervisors engaging in activities they enjoy and see the value in
• Practice-registrar fit
• Multiple registrars
• Opportunity for longer placements

Why do we do it?

• Keeping registrars after training
• Keeping up to date
• Intrinsic motivation to support the development to training our future GPs
• The love of teaching

Visit the GPSA Research page for future updates on this research and it’s findings.

The good news for supervisors is that the Government has recognised the importance that we play in GP training. The Nationally Consistent Payments system means that for most supervisors and training practices remuneration will be increased and nobody will be worse off which is great news in a limited training budget.

GPSA has strongly advocated for our members with the Department of Health and with the colleges during negotiations in the Transition to Profession Led Training.

NTCER

GPSA and GPRA have started discussions on reviewing the NTCER. We have a good working relationship and have developed a set of principles to support a collaborative negotiation. Both organisations have the best interests of the future of GP training as the focus of negotiations. Separate to the NTCER, we have been advocating for a paid parental leave scheme at GPTAC (GP Training Advisory Committee) with GPRA, RACGP, ACRRM and AMA. This has progressed and I am looking forward to some great news by mid 2022.

SLON Meeting

Our Supervisor Liaison Network met via Zoom last week. We thank Martin Rocks and Dr Susan Wearne for attending from the Department of Health and for providing an update on GP training and answering questions. We also thank the Department for continuing to fund the network. Both colleges provided an update on transition. The SLON is a valuable resource which provides feedback to GPSA and decision makers as well as supervisors on the ground.

I thank our supervisors and practice managers for their support this year. I have missed seeing you all face to face. The team and the board at GPSA have worked tirelessly behind the scenes to ensure that supervisors have a voice and are heard.

Yours in Training,

Dr Nicole Higgins

GPSA Chair

In the last few weeks, I have met face to face with NTGPE, GPTT and GPTQ and local supervisors. The colleges have reassured GPSA that the transition will be smooth for registrars and training practices and will continue to be regionally delivered. RACGP has consulted with GPSA on its draft RACGP (PLT) Profession Led Training Plan which we have endorsed. There is not a great deal of change from what we already do now. We will all know a bit more at the end of this month when the grant opportunities go out to the colleges. Curiously, we have recently heard that the Universities may also be delivering training due to their pipeline model and end to end training so watch this space.

GPSA has commenced working with GPRA to negotiate the NTCER. Both organisations are taking an integrative negotiation position and collaborative approach to get the best outcome for all. The maturing of the relationship with GPRA and GPSA ensures a strong position for both organisations to advocate for their membership whilst working together to get the best outcomes for trainees and supervisors in GP training.

GPSA held its AGM – highlights of our year include;

• Membership grew 8%
• 41% of supervisors are women
• 3500 training practices represented by GPSA
• Resources downloaded > 100,000 times
• Total membership 8343 – 5952 supervisors, 2391 hornorary which include Practice Managers, registrars as future supervisors and stakeholders.

Download 2020/21 Annual Report.

Yours in Training,

Dr Nicole Higgins