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Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 3.2 Education and training

Our practice supports and encourages quality improvement and risk management through education and training.

Criterion 3.2.1

Qualifications of general practitioners

All GPs in our practice are appropriately qualified and trained, have current Australian registration and participate in continuing professional development.

Indicators

► A. All of our doctors can provide evidence of appropriate current national medical registration.

► B. Our practice demonstrates that all our doctors are recognised GPs, with the exception of:

  • doctors enrolled in a recognised general practice training program
  • other specialists practising within their specialty
  • trainees undertaking a placement to gain experience in general practice as part of another specialist training program
  • where recruitment of recognised GPs has been unsuccessful, our practice demonstrates that doctors have the qualifications and training necessary to meet the needs of our patients.

► C. Our practice can provide:

  • evidence of satisfactory participation in the RACGP QI&CPD Program by all our GPs, or
  • evidence that our doctors participate in quality improvement and continuing professional development to at least the same standard as the RACGP QI&CPD Program.

► D. Our GPs have undertaken training in cardiopulmonary resuscitation (CPR) in accordance with RACGP QI&CPD recommendations.

Explanation

Key points

  • General practitioners must be suitably qualified and trained and maintain the necessary knowledge and skills to provide good clinical care
  • For practices unable to recruit vocationally recognised GPs, other doctors can be recruited provided they have the qualifications and training to meet the needs of patients
  • General practitioners must undertake CPR training in accordance with RACGP QI & CPD recommendations.

General practice is a specialist discipline

General practice is a distinct discipline in medicine and requires specific training. Doctors in general practices need to be appropriately trained and qualified in the discipline of general practice and be either vocationally recognised, or have achieved Fellowship of the RACGP (FRACGP).

The RACGP defines a GP as a registered medical practitioner who is qualified and competent for general practice in Australia; has the skills and experience to provide patient centred, continuing, comprehensive, coordinated primary care to individuals, families and communities; and who maintains professional competence for general practice through continuing professional development.

Where vocationally recognised GPs are unavailable

In some areas it may be impossible to recruit vocationally recognised GPs. In such circumstances, practice doctors who are not recognised GPs need to be appropriately trained and qualified to meet the needs of the local community. Doctors who have not yet met the equivalent of the RACGP Fellowship need to be assessed for entry to general practice and be supervised, mentored and supported in their education to the national standards of the RACGP. Adequate professional and personal support for doctors entering general practice is critically important.

Continuing professional development requirements

Doctors working in general practices who are not enrolled in the RACGP QCPD Program need to demonstrate recent and continuing participation in activities equivalent to Group 1 activities of the RACGP QI&CPD Program. The RACGP QI&CPD Program is based on adult learning principles (ie. knowledge is more likely to be gained when the adult undertaking the learning recognises a need to know, goes looking for the knowledge and reviews what has been learnt). The RACGP QI&CPD Program requires GPs to undertake two Group 1 activities in each triennium (eg. small group learning or clinical audits). Further information about the RACGP QI&CPD Program is available at http://qicpd.racgp.org.au.

Cardiopulmonary resuscitation skills

The RACGP recognises that CPR skills are used infrequently and thus may diminish over time. The College’s QI&CPD Program states the requirements for CPR training:

Although Indicator D does not mandate CPR training more frequently than 3 yearly, many general practice professionals believe CPR training should be conducted on a more frequent basis, preferably annually.

MBA Code of Conduct

The Medical Board of Australia has adopted a code of conduct for Australian doctors, which sets out expectations on good patient care such as recognising and working within the limits of an individual’s competence and scope of practice and ensuring adequate knowledge and skills. The code also sets out expectations for maintaining professional performance and professional behaviour. The MBA Code of Conduct is available at www.medicalboard.gov.au/codes-and-guidelines.aspx.

Standard 3.2 Education and training

Our practice supports and encourages quality improvement and risk management through education and training.

Criterion 3.2.1

Qualifications of general practitioners

All GPs in our practice are appropriately qualified and trained, have current Australian registration and participate in continuing professional development.

In a nutshell

General practice is a distinct discipline that requires suitable training and qualifications. These qualifications need to be maintained through regular participation in CPD activities. If your health service is unable to recruit vocationally registered GPs, other doctors can be recruited so long as they have the qualifications and training necessary to meet the needs of your patients or they are enrolled in a recognised general practice training program and are supervised, mentored and supported in their education.

See the Other information for Standard 3.2 for more about GP supervision in remote health services. 

Key team members

  • Health service manager
  • Doctors 

Key organisational functions

  • Human resources management
  • Staff records
  • Staff training and CPD calendar and records

Indicators and what they mean

Table 3.5 explains each of the indicators for this criterion. Refer to Criterion 3.2.1 Qualifications of general practitioners of the Standards for general practices for more information and explanations of some of the concepts referred to in this criterion. 

Table 3.5 Criterion 3.2.1 Qualifications of general practitioners
IndicatorWhat this means and handy hints

▶ A. All our doctors can provide evidence of appropriate current national medical registration.

National medical registration means registration with the Medical Board of Australia (see Australian Health Practitioners Regulation Agency in the Other information for Standard 3.2 section).

▶ B. Our practice demonstrates that all our doctors are recognised GPs, with the exception of:

  • doctors enrolled in a recognised general practice training program
  • other specialists practising within their specialty
  • trainees undertaking a placement to gain experience in general practice as part of another specialist training program.

Where recruitment of recognised GPs has been unsuccessful, our practice demonstrates that doctors have the qualifications and training necessary to meet the needs of our patients.

Ideally all the doctors at your health service will be recognised GPs. If they are not, then they should fit into one of the exemption categories listed in indicator B.

▶ C. Our practice can provide:

  • evidence of satisfactory participation in the RACGP QI&CPD program by all our GPs, or
  • evidence that our doctors participate in quality improvement and continuing professional development to at least the same standard as the RACGP QI&CPD program.

Your doctors should be suitably trained and qualified to carry out their professional role. They also need to maintain their skills by participating in continuing professional development – for example, the RACGP QI&CPD program or another program to at least the same standard as the RACGP QI&CPD program.

 

▶ D. Our GPs have undertaken training in cardiopulmonary resuscitation in accordance with RACGP QI&CPD recommendations.

The RACGP recognises that CPR skills may diminish over time due to infrequent use. The RACGP QI&CPD program requires GPs to undertake CPR training in accordance with Australian Resuscitation Council (ARC) guidelines at least once every 3 years.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure that its GPs are appropriately qualified and trained, have current Australian registration and participate in continuing professional development. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

All new GP staff members are credentialed prior to being offered employment. All GP employment files contain copies of current Australian medical registration (every year) and CPD points (every 3 years), which includes the completion of a basic CPR course. The service ensures that GP registrars are supervised and enrolled in approved training courses.

All new GPs, including locums, participate in an induction program, and are provided with the necessary information they need to perform affectively in their roles, including cultural safety training. This includes ensuring they know how to access different sections of the Medicare website (www.medicareaustralia.gov.au/provider) for all the relevant information it contains. New staff members are provided with a mentor to provide support and advice as required.

Administrative staff access the AHPRA practitioner registration website (www.ahpra.gov.au) to ensure all GPs have current Australian registration. Copies of registration certificates are placed in each staff member’s employment file. Administration staff maintain a register of professional registration expiry dates for GPs.

Position descriptions include formal designation of responsibility for specific roles in addition to core job functions – such as continuous quality improvement, complaints management, information technology, risk management, cleaning, infection control, sterilisation or vaccine management.

All staff members participate in an annual performance management planning and review, which includes a review of training undertaken and the identification of training required or requested for the next year.

Staff members can describe their roles and responsibilities and this is consistent with documented position descriptions. In the smaller satellite clinics a number of these responsibilities are included in the one staff member’s position description. The main clinic has a number of staff members who are allocated only one core responsibility and this is also included in their position descriptions.

Training calendars from state health departments, Medicare Locals, local health services and NACCHO state or territory affiliates are available in varied locations within the service and are also distributed by email to staff.

The health service’s strategic plan includes a staff training and development plan, with a budget.

Clinical supervision is provided to staff members when required.

Administration staff maintain a register of all staff members’ CPR training and its expiry. The service organises CPR training in accordance with RACGP guidelines (in other words, consistent with ARC guidelines) for all staff members to attend. CPR training should be at least once every 3 years but some health professionals consider it should be done annually. 

Showing how you meet Criterion 3.2.1

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the Standards. Please use the following as examples only, because your service may choose other, better-suited, forms of evidence to show how it meets the criterion.

  • Annually update employee files for each GP with current registration records.
  • Utilise the recruitment process, including certification that your health service was unsuccessful in recruiting a recognised GP where applicable, if this was the case.
  • Keep QI&CPD records.
  • Conduct annual performance planning and keep review documents indicating identification of training needs and training completed.
  • Keep training log records for GPs.
  • Keep a training and development calendar.
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