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GP Return to Practice Programme FAQs and Glossary of Terms

Who is this programme aimed at?

The scheme aims to update qualified GPs to be able to return to practice safely, keeping up high standards expected within the NHS. There are two parts to the programme:

  • Learning Needs Assessment Route (LNA) for qualified GPs with previous NHS experience who have not practised for two or more years and would like to return to work as an NHS independent practitioner in England. This includes doctors:
    • Who are not currently on the Medical Performers List, and
    • Who have remained on the Medical Performers List but have not undertaken an NHS GP clinical role for two or more years
  • Portfolio Route (PR) for GPs who can produce a portfolio to demonstrate that they have maintained their skills while working in another role or abroad as a GP and kept up to date with changes in NHS practice (please see separate guidelines for this). They are not required to following the Learning Needs Assessment pathway.

 

How long will the programme be in place?

National programmes to support GP returners have been in place since 2003. This programme was revised in March 2015 and again in 2020.

How do I apply for the programme?

The programme is co-ordinated through the GPNRO website. You will find information to guide you through the application process. If you are eligible, you will be able to download the registration form, complete and return to the NRO.

How long will it take to complete the programme?

The time taken to complete the programme is entirely dependent on the doctor’s circumstances and clinical placements are based on identified need and can vary from six to one month.

It is entirely possible for a doctor to apply to the scheme and to the Medical Performers List, be interviewed, achieve a band 5 result in the MCQ, complete a one month practice placement and exit the programme within a three month period.

How am I reviewed and what is required?

Each doctor will have a formal review of their qualifications and work experience and learning needs (using the RCGP Self-Test) by a local HEE programme lead. You do not need to be on the GMC register at this stage.

You will usually be invited to take a formal learning needs assessment (MCQ) which will, if passed, gain you entry to and help inform the length of a supervised placement to see if further assessment or training is required. You do not need to be on the GMC register to sit the MCQ.

Practice placement length varies and is planned around an individual doctor’s learning needs.

What qualifications, approvals and certificates do I need?

You need to be:

  1. Medically qualified and have completed formal training as a general practitioner in the UK (CCT), hold a recognised EU GP qualification or hold a Certificate of Eligibility for GP Registration (CEGPR)
  2. Have previously worked as a NHS GP before in the UK
  3. Before starting the clinical placement, you need to be on the GMC GP register, in good standing and hold a current Licence to Practise (LtP) as a GP
  4. Have the right to work or hold a visa that permits you to work in the UK
  5. Before starting the clinical placement, you need to have applied to NHS England and been admitted to the Medical Performers List (MPL) with conditions.

 

Any doctor with formal GMC conditions or undertakings who is required to complete a remedial training plan imposed by NHS England and is considering a return to NHS general practice should contact their NHS England regional team to discuss their circumstances and level of support.

I trained abroad and have no UK experience. Am I able to apply for the programme?

No, you are not eligible for the RtP programme

Any qualified GP who has been granted a CEGPR or is an EU qualified GP and is on the GMC GP Register (without GMC conditions or undertakings - except those relating solely to health matters) with a licence to practise is eligible to apply for the GP International Induction Programme (ADD LINK).

I have previous UK work experience as a NHS GP but not practised recently. Am I able to apply for the programme?

Any doctor (UK or EU qualified or holding a CEGPR) who has previously worked as an NHS GP but has been out of general practice for two or more years and previously was on the GMC GP Register (without GMC conditions or undertakings - except those relating solely to health matters) with a licence to practice is eligible to apply.

Do I need to sit assessments?

Doctors on the RtP programmes are required to arrange an educational and career review with the local HEE programme lead.

If formal learning needs assessments are required (most doctors apart from those on the Portfolio Route) then you will be asked to sit the two-part MCQ assessment which are held 8 times per year (Clinical Problem Solving (CPS) and Situational Judgement Test (SJT))

These may be sat in the UK or overseas in designated assessment centres. Dependant on the outcome of these, you may also need to do a Simulated Surgery assessment.

During the practice placement the educational supervisor will provide regular feedback and document this on the e-portfolio.

RtP GPs who are undertaking the Portfolio Route will not need to sit the Learning Needs Assessment.

What happens if I fail or do not complete any of the assessments?

The local HEE programmee lead will be able to give you advice and options. Applicants are able to attempt the scheme up to a maximum of four times. The GMC will be informed of the outcome of all assessment attempts. Successful applicant assessments will remain valid for a year from the pass date.

What happens if I do not complete my supervised practice placement?

You will not be able to work as an independent GP in England without full inclusion on the Medical Performers List and removal of the Medical Performers List conditions agreed by the NHS England regional team.

Are there jobs available if I do complete the programme?

You will be able work in the NHS as a locum GP, apply for formal GP salaried posts or partnerships in England. There are many areas where there are GP vacancies and these are frequently advertised in the medical press.

If I am not working, how do I get my DBS?

If you are unable to find a suitable umbrella body from the https://www.gov.uk/find-dbs-umbrella-body website, then there is a company called GP Systems who have helped a number of doctors obtain their DBS. Their website is http://www.gpsystems.org/.

What exactly is needed in terms of occupational health clearance and how do I know which provider to approach?

Your Occupational Health Clearance should state that you have had the necessary blood tests and are fit to practise. It is also a requirement that you are cleared for EPP (Exposure Prone Procedures). There is a copy of the NHSE Health Assessment form that covers all of the requirements on our website. The OH provider needs to be a SEOQHS accredited provider (or working towards it). A list of OH providers can be found at http://www.nhshealthatwork.co.uk/find-providers.asp. Please note it is worth ringing around a few providers as the charges can vary a great deal.

Do I need evidence of past appraisals? What happens if I don't have this evidence? How can I retrieve proof of previous appraisals?

Ideally you should provide copies of your last appraisals, whether they were done in the UK or abroad. You may be able to obtain a copy by contacting your previous employer. If you are unable to provide a copy or have never had an appraisal then please state this on the Medical Performers List application.

If you have used one of the commonly used on-line appraisal toolkits e.g. Clarity, Fourteen Fish, GP Tools or MAG then you should be able to retrieve a copy from there. You may need to contact the toolkit provider if you can longer access the system.

Clarity is the only toolkit that requires a subscription to be maintained. If you have maintained your subscription with Clarity, you will be able to retrieve a copy of your past appraisals. If not, then you can contact Clarity direct and request a copy. The contact details are:-

T: 0845 113 7111

E: doctors-appraisals-enquiries@clarity.co.uk

What medical indemnity am I required to hold?

From 1 April 2019, NHS Resolution has a new state indemnity scheme for general practice in England called the Clinical Negligence Scheme for General Practice (CNSGP). The scheme covers clinical negligence liabilities arising in general practice in relation to incidents that occurred on or after 1 April 2019. CNSGP provides a fully comprehensive indemnity for all claims within its scope.

The CNSGP is provided free to all doctors on the scheme. If your Medical Performers List application is straightforward and there are no issues, then we would advise that the Medical Indemnity is the last thing you sort out for your Medical Performers List application.

Not all roles or activities are covered by the CNSGP and therefore all doctors should take out “Top Up” private indemnity as well. You will need to maintain membership with an MDO or other indemnity provider or insurer to retain cover in respect of activities and services not covered by CNSGP – including non-NHS or private work, inquests, regulatory and disciplinary proceedings, employment and contractual disputes, and non-clinical liabilities.

If your indemnity is more complex (e.g. indemnity being provided by a commercial organisation), then NHS England and NHS Improvement will need to review the policy before you agree to it to ensure that it is adequate and appropriate. In these cases, you will need to start the process earlier.

At what point is it best to ask to have my GMC licence to practise reinstated?

As you will need to be registered with the GMC and on the GP Register before you can be accepted onto the Medical Performers List, it is advisable to ask for your licence to practise reinstated as soon as you have decided to proceed with your application to one of the schemes.

What happens if my revalidation is due before or during my placement?

Please contact the NHS England team who are your Designated Body - in most cases this will be the team at Cheshire & Mersey (ENGLAND.IandRScheme@nhs.net). They can issue you with a REV11 - provision of Medical Services Statement (PMSS) which you email to the GMC and confirms that you are currently on the scheme.

 

Glossary

CCT Certificate of Completion of Training (GP)
CEGPR Certificate of Eligibility for GP Registration
CPD Continuing professional development
CPS Clinical Problem Solving
DBS Disclosure & Barring Service
EU European Union
GMC General Medical Council
HEE Health Education England
HMRC HM Revenue and Customs
IIP International Induction Programme
MCQ Multiple choice questions
MD Medical Director
MDDUS Medical and Dental Defence Union of Scotland
MDO Medical Defence Organisations
MDU Medical Defence Union
NHSE NHS England
MPL Medical Performers List (England)
MPS Medical Protection Society
MSF Multi source feedback
NRO National Recruitment Office
PD Professional Dilemmas
PSQ Patient satisfactory questionnaire
RO Responsible Officer
RTP Return to Practice
SJT Situational Judgement Test
WPBA Workplace Based Assessment