The Targeted GP Training (TGPT) scheme will focus on doctors who left GP training before the increase in extensions to training which came into effect from 31 January 2018 (as detailed in the Reference Guide for Postgraduate Specialty Training in the UK (The Gold Guide, 7th Ed.)) having passed two of the three assessment requirements, with success in Workplace-Based Assessments being a prerequisite. A change in exam rules by the RCGP will enable doctors who re-enter training through the Targeted GP Training scheme to re-sit with a maximum of two additional attempts. This will not be affected by the number of attempts already had. TGPT programmes will be available at ST3 entry level only for a duration of 18 months.

All submitted applications for TGPT will be assessed using a standard, national and consistent staged process outlined below. This is an established and well-researched selection process using modern methodologies that are fair, robust and fit for purpose. The competency-based selection process allows applicants to demonstrate their abilities and suitability to re-enter GP training.

Applicants will make a single application for all available TGPT training posts in participating regions. The assessment and selection processes involve the Multi-Specialty Recruitment Assessment (MSRA) which is a computer-based assessment and a face-to-face assessment at a Selection Centre. Successful applicants will be considered for appointment across the whole of the UK (based on their performance and rank). This method is known as Single Transferable Score (STS) as applicants are not restricted to being considered for appointment in a single specific region. The STS system is designed to maximise opportunities for successful appointment.

Applicants should also refer to both the Oriel Applicant User Guide (for general guidance on how to navigate Oriel and technical help with the on-line application form) and the 2018 Medical Specialty Recruitment Applicant Handbook (for general information about the administration of national recruitment processes).

All applications will be assessed against the essential criteria outlined in the TGPT Person Specification 2018, i.e. applicants must meet all the following criteria:

• Have current GMC registration with a license to practice at the point of application
• Have previously held a GP National Training Number (NTN)
• Left GP training between August 2010 and January 2018
• Have satisfactory Workplace-Based Assessments (WPBA)⁽¹⁾
• Have passed one of either Applied Knowledge Test (AKT) or Clinical Skills Assessment (CSA)
• Have taken, but not passed, the other exam of the two
• Been in medical practice in the NHS in the last two years.
• Be able to demonstrate compliance with all NHS Revalidation, CPD and Appraisal requirements since leaving GP training

Applicants who are unable to satisfy the eligibility requirements will have their application rejected. For clarity the following doctors are not eligible:

• Passed one of the exams; not attempted the other
• Failed both exams
• Unsatisfactory WPBA

All applications must be made electronically via the on-line Oriel recruitment portal by the specified deadline. Late applications will NOT be considered. The dates and deadlines relating to recruitment activity are available on the GPNRO website.

The TGPT application form will only ask for factual information about you, your previous GP training and your employment history. Once your application has been submitted you are unable to make any changes, apart from to update your own contact and referee details so please ensure that you do not submit unless it is complete.

Please be aware that Oriel does not support internet browsers that have reached the end of their product support lifecycle.

Communication regarding your TGPT application will be via direct messaging through Oriel. An email will also be sent as a secondary form of communication however, as emails are external to Oriel, delivery cannot be guaranteed and therefore this method of communication should not be relied upon. Therefore, please ensure you check your Oriel account regularly for messages throughout the entirety of the recruitment process.

You should also make sure that you are using an email account that you can access at any time and will not be blocked by your employer’s IT security system. If you are uncertain about this, you should check with your IT department at work.

To ensure messages from the GPNRO are not filtered by your email provider’s junk / spam filters, you are strongly advised to add gpnro@hee.nhs.uk and noreply@oriel.nhs.uk to your email whitelist.

Applicants are permitted to submit ONE application, per Round, for a standard TGPT programme. At the time of application, you will be asked to indicate your preferences from all programmes available in England and Scotland, in rank order. This means that you can be considered for appointment across the whole of England and Scotland.

Important: please only preference the programmes that you would be prepared to work in, including those listed with zero vacancies as posts may become available at a later date. If you preference a post, it is assumed that you are able to accept this, if offered. It is therefore imperative that applicants consider their preference choices before submitting them. In making those decisions, researching regions carefully is recommended.

Applicants are advised to read the regions’ profile pages and access individual region websites for more information about the opportunities available. It is suggested that you research not only the types of programmes offered in each region but also the geography of each region, the main Trusts within the geography, transport links to home and so on.

The ability to record your preferences will be locked at point of application submission however you will be presented with a further window to continue preferencing; this window will span from the date of invitation to the Multi-Specialty Recruitment Assessment until 48 hours before the first offers date; these dates are published on the GPNRO website for all relevant rounds. Applicants who successfully complete the recruitment and selection process will have a further opportunity to amend their preferences once the offers process commences. See section 20.1 Offer Exchanges/Enhanced Preferences for details.

The TGPT Programmes that you preference in your application will be used to make you an offer, subject to the successful completion of the selection process.

5.1 Targeted Enhancement Recruitment Scheme (TERS)

TERS will not be available for TGPT programmes.

In 2017, England and Scotland introduced formalised processes to better assist applicants with training in their desired locations of the country.

6.1 Special Circumstances

A standardised national process is available for all specialty recruitment to ensure that applicants with special circumstances and a requirement to train in a specific region are treated in a fair and consistent way.

Any applicant who falls into one of the following eligibility criteria will be pre-allocated into a post, subject to it meeting the requirements of entering GP training:

• Criterion 1 – the applicant is the primary carer for someone who is disabled, as defined by the Equality Act 2010,
• Criterion 2 – the applicant has a medical condition or disability for which ongoing follow up for the condition in the specified location is an absolute requirement.

Applicants wishing to be considered for special circumstances should complete the special circumstances application form (available from the Oriel Resource Bank) and forward this, together with the appropriate supporting evidence by email to mdrs.nationalrecruitment@hee.nhs.uk as soon as their application has been submitted.

It is important that you review the relevant section in the 2018 Medical Specialty Recruitment Applicant Handbook for full details on the eligibility criteria and administrative process.

6.2 Facilitated Placements

This process aims to offer solutions to applicants who have been allocated to different regions to their partner or family.

The process is open to all applicants, except for those who applied to academic posts, locally recruited posts or those looking to move into or out of Northern Ireland, who are not participating in the initiative. Applicants are only eligible for one facilitated placement per recruitment year.

Important: applicants deferring their commencement in training will not be permitted to apply for a facilitated placement.

Applicants who accept a post but would like to try and swap this for another post should contact GPNRO as soon as possible. Whilst the swap cannot be guaranteed, recruiters will try and accommodate this, where possible. Applicants who would be happy for either their post or their partner’s post to be swapped should contact GPNRO and the other lead recruiter independently. You need to ensure that you mention your partner and the specialty that they have accepted. This will allow GPNRO to liaise with the other lead recruiter, if applicable, to try and agree a mutually acceptable swap.

As applicants can now change preferences up until the upgrade deadline (see Section 21.1 for more details), the GPNRO will only review facilitated placement requests once the upgrade deadline has passed and offer exchanges/enhanced preferencing can no longer be utilised. Any requests received before this date will not be reviewed. Facilitated placements requests received after the upgrade deadline will be reviewed as soon as a request is received. The deadline for submit requests is two weeks after the upgrade deadline of the round in which the application was submitted. Requests received after this date will not be considered.

Applicants can only defer the start of their TGPT programme on statutory grounds such as personal ill health or maternity/paternity/adoption leave.

The Step On Step Off Training policy for deferred entry will not apply to recruitment to TGPT programmes.

All recruiters are aware of the requirements of the Equality Act 2010 and in this regard, recruiters will make reasonable adjustments to accommodate applicants at Assessment and Selection Centres provided these are made known in advance. Applicants who require adjustments (e.g. wheelchair access, extra time, nursing mothers) will be required to submit supporting evidence to substantiate the required adjustment. This evidence will need to be uploaded to Oriel via the Document Upload dashboard as “Supporting evidence” and attached to the application form at the point of application.

Adjustments cannot be guaranteed if evidence is provided late and no adjustments can be made on the day of the assessment.

In some instances, to satisfy requests for adjustments, it may be necessary to schedule an Assessment/Selection Centre place at a specific time or a specific location.

Applicants without right of residence will be able to apply in all rounds of TGPT recruitment. Applicants without right of residence will not be rejected solely due to their immigration status and, should they be successful, will be considered for an offer in this round. For these applicants to be appointed, the Resident Labour Market Test (RLMT) will need to be satisfied.

It is strongly suggested that you read the 2018 Medical Specialty Recruitment Applicant Handbook to familiarise yourself with the immigration information contained within.

Applicants’ evidence of English language skills will need to comply with the requirements set by the GMC and the Standard Operating Procedure (SOP) or Guidance issued by the relevant Primary Care Organisations (PCOs) responsible for maintaining a medical performers’ list in either England or Scotland.

PCOs are NHS England in England and primary care divisions within area Health Boards in Scotland.

If you answer yes to any of the Fitness to Practise questions on the application form, you will be required to send information about this declaration to the GPNRO at gpnro@hee.nhs.uk.

Failure to provide this evidence by the application closing date will result in your application not progressing any further in the recruitment round.

Successful applicants will not be able to shorten their TGPT programme via the accreditation of transferable competences.

Specialty training posts and programmes are not normally available to any doctor who has previously relinquished or been released or removed from that training post/programme. However, this requirement has been waived for applicants to TGPT who will not require support for re-application to GP specialty training.

As you progress through your application it may become apparent that you will be required to upload some form of documentation to allow GPNRO to assess your eligibility.

If you are required to do this you must:

• Ensure that the document is uploaded as a single document and not in separate pages
• Ensure that the document label describes the nature of the document
• Ensure that the document is uploaded in to the correct document section

GPNRO reserves the right to request re-submission of documentation if the above rules are not followed.

All eligible applicants (i.e. those who have been assessed as demonstrating evidence of eligibility as outlined in section 2) will be invited to attend the next stage of the recruitment and selection process. The MSRA is a computer-based assessment which forms the first part of the selection process. The assessment has been fully researched and evaluated and has been shown to have high predictive validity.

GPNRO lead on the delivery of the MSRA and has developed a separate guide which provides GP applicants with information about the whole MSRA process (e.g. registering to sit the test, centre locations, format of the assessment, etc.)

All applicants are expected to read this document in full to develop an understanding of this particular stage of the recruitment process and what is expected of applicants; it is available from the GPNRO website.

15.1 Direct Pathway to Offers

The Direct Pathway to Offers route is not available for entry to TGPT programmes.

On completion of the Multi-Specialty Recruitment Assessment (MSRA) process, applicants who have met the minimum required standard will be considered for Selection Centre.

Applicants who are successful at the MSRA will be able to choose where they would like to attend Selection Centre. Applicants will be invited to attend one Selection Centre and will be considered for appointment to programmes in all preferenced regions.

16.1 Booking a Selection Centre

If you are invited to attend a Selection Centre, you will be required to log into your Oriel account and use the self-service functionality to the book an appointment at a centre on a date and time of your choosing, subject to availability. The only exception to this is if you have requested a special accommodation under the Equality Act 2010; in this instance, the GPNRO will pre-book your appointment at a Selection Centre hosted by your first preference region.

When booking your Selection Centre, it is strongly recommended that you avoid booking from a mobile device or internet browsers that have reached the end of their product support lifecycle as these are unlikely to be supported.

16.2 Confirmation of booking

Once you have booked your Selection Centre, you will receive an automated confirmation of booking message in Oriel and a secondary automated message will be sent to your registered email address. If you do not receive confirmation, log into your Oriel account to confirm if the booking process was completed in its entirety.

The Selection Centre involves applicants completing several exercises which are observed and assessed by trained assessors. This competency-based selection process has been researched and evaluated. We are confident that it is fair, robust and fit for purpose.

On the day of the Selection Centre, please ensure that you allow yourself plenty of time to get to the Selection Centre venue to allow for applicant registration. Applicants can expect the Selection Centre to last approximately 3 hours, however this can vary.

If you are booked to attend Selection Centre and are unable to attend due to unforeseen circumstances or an emergency, you must contact the organising region directly to ascertain whether alternative arrangements can be made. Alternative arrangements cannot be guaranteed.

All recruiters are aware of the requirements of the Equality Act 2010 as detailed in Section 6. Extra time is only available for the written assessment. If you feel that there are any particular issues related to a disability need you may have, you MUST discuss these with the region before the assessment as no adjustment can be made for any applicant afterwards.

Applicants should note that children are not permitted at Selection Centre.

Important: On arrival at Selection Centre, if you find you have a conflict of interest with a panel member, for example you are already familiar with them and you are not comfortable in being assessed by them; it is your responsibility to inform a member of the recruitment team at your earliest opportunity so that alternative arrangements can be made, such as being interviewed by a neutral panel member.

17.1 Dress Code

Recruitment and selection may involve contact with simulated patients who should be treated as if they were patients, for clinical communication and assessment of clinical performance. Conventionally in the UK, formal professional practice between doctors and patients is appropriately marked by a certain formality of dress. The same dress code will apply for selection centre as it does for day to day clinical practice/contact with patients; this means that forms of dress should not constrain the applicants’ ability to demonstrate recognised skills. All doctors should ensure their appearance does not impede their professional roles and responsibilities; including communication with patients, relatives, carers and other staff. Casual streetwear, sportswear, revealing styles such as low-cut necklines and mini-skirts, dangling jewellery/accessories will normally be deemed inappropriate. Equally, forms of dress that cover the face will also be deemed inappropriate in such consultations.

17.2 Selection Centre Format

There are no interviews and assessors do not have access to your application form, your CV or any other biographical information.

The competences that are assessed at Selection Centre are:

• Communication Skills,
• Empathy & Sensitivity,
• Conceptual Thinking & Problem Solving,
• Professional Integrity.

Please refer to the TGPT Person Specification for more information about these.

There will be a briefing session at the start of your Selection Centre session and an opportunity for questions at the end of it; this is NOT a feedback session. Feedback on your performance will be given later and will be after the offers have been made.

17.2.1 Simulation Exercises

These will involve simulators and 3 different situations:

• A consultation with a patient
• A consultation with a relative or carer
• A consultation with a non-medical colleague.

They do not involve a physical examination and clinical expertise is not specifically assessed. The time allowed for each is 10 minutes.

17.2.2 Written Exercise

The written exercise will require some prioritisation or ranking of issues and a justification of your responses. The time allowed for the written exercise is 30 minutes.

All exercises will have specific and individual written instructions, with advice to spend time reading and being familiar with the requirements of the exercise. You can download example Selection Centre scenarios from GPNRO website.

17.3 Preparation Hints

• Be yourself and be natural. Do NOT “act”
• Listen to and, carefully read carefully all instructions given on the day about the exercises>
• Be honest
• Trust the process which has always had excellent applicant evaluation; specifically the evaluation says the process is fair, even from those who are not successful first time Practice the example scenarios with your colleagues by all means but we do NOT recommend you book commercial courses or purchase advice and guidance books specifically aimed at doctors undertaking the GP Selection Centre. None of the GP assessors take part in or endorse any preparation courses or books

We understand that applicants may wish to revise and prepare for Selection Centre with each other in small groups and would encourage this. However, sharing information about the actual Selection Centre is unacceptable and is viewed as unprofessional behaviour. Assessments at Selection Centre are competency based and there is published evidence demonstrating that prior knowledge of the content and context of assessment does not positively affect performance. We would counsel applicants against altering their behaviour based on the advice of other applicants. We also remind applicants that entry to GP Specialty Training is competitive.

All applicants will be notified of their final results on the published offers date. The offers date can be found on the Recruitment webpage of the GPNRO website.

The results, including your final national rank will be published in your Oriel account against your GP ST1 application as interview scores. Detailed guidance on how to locate or view these scores is contained in the Oriel Applicant User Handbook.

18.1 Composition of Final Result

The final mark for all applicants that have undertaken GP selection is calculated by combining results from both the MSRA and Selection Centre. To give an applicant’s final selection score, the PD element of the MSRA and Selection Centre scores are weighted at 40% each and the CPS element of the MSRA at 20%.

To achieve an accurately weighted final score, it is important that all results use the same scale. Therefore, the weighted MSRA scores for the PD and CPS have to be rescaled to allow them to be combined with Selection Centre scores.

An applicant’s final score is then calculated by combining the weighted PD, CPS and Selection Centre scores in the agreed manner. A cut-off will be set to determine the minimum mark an applicant needs to achieve to be deemed ‘successful at selection’. Applicants who achieve this score or above will be ranked and offers allocated accordingly. An applicant’s final score, their rank, and the agreed cut-off score will be provided as feedback.

18.2 Appealing the Outcome

The outcome is final and cannot be reviewed, re-marked or disputed. There is no appeals process.

If you feel your application has not been managed correctly and have evidence of a failure in the process, there is a national complaints policy and procedure. You should explore this route if you have any concerns about your application. A copy of the policy can be located in the GPRNO Resource Bank.

All offers will be made via Oriel by GPNRO. Offers received in any other way will be deemed invalid. If you are made an offer, you will need to respond to this on Oriel.

Applicants will be ranked in a single national list based on their performance throughout the selection processes. Applicants who qualified for Direct Pathway to Offers will be ranked first, above those who were deemed appointable via the Selection Centre. Offers are made in rank order based on this national ranking.

Initial offers will be released by close of business on the first offer date published for the current round (see the GPNRO website). Please do not contact GPNRO about offers prior to this date, as it could delay the release.

You will be given 48 hours (exclusive of weekends) to respond to an offer and you have the option to accept, decline or hold. Only one offer can be held at any one time, across all specialty applications in a given round. If you fail to respond to an offer within the 48-hour window you will be deemed to have declined the offer.

If you are holding an offer and try to hold another, the original held post will be automatically declined on your behalf by Oriel.

Once you have accepted a post, you will not receive any further offers from any other specialty in this round (i.e. Oriel will automatically withdraw you from all other applications you have in the given recruitment round).

Offers that are declined will be reoffered in rank order to other applicants.

If you choose to hold an offer, you can keep this offer held up until the hold deadline published for the current round (see the GPNRO website). Before this deadline, you will be required to go back into Oriel and make a final decision on the offer. Any offers still held when the deadline is reached will be deemed to have been declined and the system will automatically change your status to show that you have declined the post.

After the hold deadline has passed, any offers made will only have the option of accept or decline.

Please note:

If you rank highly enough to be made an offer, this will be made to the highest ranked Training Programme preference that is available when your final rank is reached. If this Training Programme offer is suitable for you and you do not want to be considered for any other preferences you have ranked higher, you can choose to simply accept it.

However, applicants do have the option of getting one of their higher ranked GP Training programme preferences, should they become available, by opting into upgrading. The upgrading option is available to all offers that have been held or accepted, but not where an offer has been declined. An applicant who has accepted or held an offer can opt in or out of upgrading at any time during the window which runs until the upgrade deadline published for the current round (see the GPNRO website). Please be aware that due to the ranking of your GP Training Programme preferences you may move into a different region if you are upgraded.

If you opt into upgrades and a higher preferenced offer becomes available, the upgrade will be automatic. You will be placed in the higher preferenced post and an automated message will be sent to you Oriel informing you of the upgrade; you will not be given 48 hours to decide whether you wish to accept or decline the upgrade. If an upgrade is made, the previously held or accepted post will be released and will be reoffered to another applicant.

Once you have been upgraded you will be sent an automated message through Oriel to inform you of this. Details of the upgrade made will be available in the relevant section on Oriel.

Once the upgrading deadline has passed, no further upgrades will be offered, even if a more preferred GP Training Programme becomes available at a later date.

20.1 Offer Exchanges/Enhanced Preferences

Applicants can have a change in circumstances for any number of reasons in the time between programme preferences being made and offers being released. To assist applicants in this situation, flexibility around preferencing has been introduced for 2018 recruitment.

For applicants who have accepted or held a post, there will be an option to select upgrade options which not only include those programmes that were originally ranked higher than the offered post, but also those that were ranked lower.

Please note: Any changes to preferences made between the offers algorithm being run and offers being released will not be considered until the next offers match is run.

Applicants who have not been made an offer may also have a change in circumstances that requires them to make amendments to their expressed preferences. GPNRO will keep their programme preferencing open throughout the recruitment process, however this will be temporarily disabled before each offer algorithm is run, until the offers have been released.

These processes will continue up until the upgrading deadline in each recruitment round (see the GPNRO website).

More detailed guidance on this process is contained in the Oriel Applicant User Handbook.

Referees should be contacted at the earliest opportunity to confirm that they are happy to support the application and provide a reference. You are required to give details of your last three clinical or educational supervisors from your current post, your previous post and the post before that.

All offers made will be on the condition of the offered region receiving three satisfactory references. Obtaining references is an applicant’s responsibility. The offered region will NOT chase your referees.

21.1 Reference Requests

Reference requests are an automated process in Oriel. A request will be triggered and sent electronically to your nominated referees when you accept or, accept with upgrades an offer of GP training. To ensure that the requests are not blocked or filtered by your referees’ email providers you are strongly advised to inform your referees to add noreply@oriel.nhs.uk to their email whitelist.

21.2 Completing a Reference

Referees are required to submit references electronically, using the online referee portal in Oriel. You will be advised, via your Oriel portal, when your referee has submitted a reference.

In rare cases there may be a need for your reference to be provided on paper. We will instruct you if this is necessary. You can download a Structured National Reference Form from the Oriel Resource Bank and you will need to ask the affected referee to return the completed form directly to the offered region.

21.3 Changing Your Nominated Referee

For any references that have not yet been submitted you are able to update the details of or, change your, nominated referees. However, if a referee has already submitted your reference, you will not be able to make any changes to their details.

If you change the email address against a referee, a new reference request will be sent to the newly provided email address, and the original request will be withdrawn.

Once you have accepted an offer of training at a region and the upgrade deadline has passed, you will be asked, by the offered region, to indicate your preferred geography and/or rotational posts from those that are available within the Training Programme that you have accepted.

Information regarding these further preferences will be published on individual region websites.

The GPNRO does not have any involvement in this process. Any queries relating to this should be sent to the region where the training offer was received.

22.1 Allocation of Trainees within Local Training Programmes

Once offered a Training Programme within a region it is expected that further preferences will be based on individual ranking and achievement over the exercises involved in the selection process, i.e. higher performing applicants are offered a higher preference from the pool of local placements/rotations on offer.

There is, however, a risk associated with the lower level of allocations to programme level if done purely by choice. Therefore, each region has developed its own allocation policy to mitigate risk. You should visit the website of the relevant region for further information on this.

Using the Single Transferable Score model in GP recruitment means there will be no option for clearing. Therefore, if you do not receive an offer in this round of recruitment it will be for one of two reasons:

1. All of your GP Training Programme preferences being accepted before your rank is reached (this could happen even if you are considered appointable in the process).

2. You were unsuccessful at a certain part of the recruitment process (you will be notified if this is the case).

Applicants will be given feedback throughout the recruitment process and will not need to make a formal request to receive it.

Applicants that are rejected at the longlisting stage will be advised of the reason why their application was rejected. Applicants that are rejected following MSRA will be advised of their total scores, and the scores needed to be invited to Selection Centre. Selection Centre feedback will be released within seven days after the initial offer date.

Applicants who wish to request feedback above and beyond the standard feedback that is provided (i.e. their actual score sheets) can do so by making a request to the GPNRO.

GPNRO expect the score sheets to be sent back to applicants within 20 working days however applicants must understand that in busy periods this could take longer to receive.

There is no further feedback that can be provided after score sheets have been requested.

The offer and allocation of a Training Programme referred to above is NOT an offer of employment. An employment contract detailing the terms and conditions of employment will be issued by the responsible employing organisation and is made subject to satisfactory pre-employment checks. Your offer of employment will include the name of your employer, the start date and length of the period of employment, the location, the hours, the minimum rate of remuneration and the notice period applicable.

Information regarding pay, hours, sick pay and annual leave entitlements, notice period, study leave, pension scheme etc. are set out in the national terms and conditions available from NHS Employers. A framework for a written contract of employment for GP specialty registrars is also available from the BMA. Individual region websites may also provide additional local information and links to individual employer websites.

The employing organisation carry out a number of pre-employment checks before an offer of employment can be confirmed. These will include verification of identity, registration and qualifications, right to work (immigration), employment history and employment reference checks (these are different from the clinical reference checks that the region needs), a Disclosure and Barring Service (DBS) check and an occupational health check. Some of these (verification of identify, registration and qualifications and right to work for example) may also be undertaken by the region during the recruitment process.

Any claims for expenses incurred in travelling to a Selection Centre should be made to the region that interviewed you, not the GPNRO. This should normally be a venue close to your residence or place of work. You will be expected to explain why this is not the case if you appear to have excessive expenses.

Please contact the organising region for further guidance on their expenses policy.