Project aims 

The aims of this project are as follows: 
 
To develop an intervention which supports primary care clinicians who may be experiencing difficulty at work or may be struggling to return to work. 
To evaluate the impact of the intervention in terms of workforce retention and applicability. 

Project team 

The project is funded by workforce retention funds from NHSE and is being delivered by Nottinghamshire Alliance Training Hub (NATH) in collaboration with the Phoenix Programme (PP). Laurence Quirk and Dr Gemma Wilkinson are organisation leads and Dr Rashbal Ghattaora is overall clinical lead for this project. 
 

Eligibility criteria 

Primary care clinical colleagues who: 
 
Either live or work in Nottinghamshire. However, there is some flexibility on a case to case basis if they are based within the East Midlands. 
May be working at the moment but are struggling and/or may be planning to stop working. Or are currently off work but keen to return. 
Wish to be part of the BUILD Pilot must consent to partake in structured interviews as part of the evaluation process. 
 
Participating colleagues must also agree to sign the NATH BUILD Pilot: Client and Facilitator Agreement. 

Details of the BUILD Project 

For the purposes of this project, Primary care clinical colleagues enrolled onto the pilot will be referred to as clients and colleagues supporting them will be referred to as facilitators. 
 
The project has finite resources and will endeavor to support all those that enroll but the clinical lead may prioritise colleagues based on need. The project has recruited five experienced facilitators with a background in education, appraisal, mentoring and coaching. 
 
The role of the BUILD facilitators DOES NOT replace or duplicate the activities of an NHSE appointed clinical or educational supervisor. 

Referral onto Pilot 

Primary Care clinical colleagues who meet the eligibility criteria can self-refer into the pilot by emailing alliance.hub1@nhs.net. 
Initial assessment will involve completion of a self-assessment pro-forma followed by triage by a senior facilitator with opportunity to sign-post to local services. 
Following the initial triage, the client will be allocated to one of our experienced BUILD facilitators. 

Intervention 

Intervention(s) will be delivered by a trained BUILD facilitator using a variety of tools including self-regulation educational theory and coaching skills. The aim is to involve the client in designing the intervention. 
As part of the intervention, clients who may be struggling financially can access a small bursary to undertake specific CPD activities agreed with the facilitator and linked with plans to return to work. 
Clients will be offered opportunities to meet with peers who are also part of the project, in a safe space, with facilitation by a trained coach. 
The facilitator will offer a total of 8 hours support to the client, with flexibility on scheduling over a 12-month period. 

Example of the session content 

Please note that this will be be-spoke to each client. 

Session 1 

Developing rapport 
Agreeing client-facilitator contract 
Clarifying context and issues 
Agreeing goal 

Session 3 

Review of progress 
Accessing further support including role plays 
Identifying barriers and challenges 
Identifying support and resources 

Session 2 

Joint planning of intervention 
Agreeing educational personal development plan 
Identifying support and resources 
Agreeing initial steps 

Session 4 

Review of progress 
Evaluation 
Supporting transition to “return to work” programme in collaboration with Phoenix Programme 

Key principles underpinning Interventions to the BUILD Pilot 

Creating a safe space but reaffirming confidentiality (within the same caveats as in appraisal). Reaffirming that this is not a summative assessment and that there will no formal reporting to anyone (although the facilitator may discuss issues with the clinical project lead for advice only). Acknowledging the motivation and dedication of colleagues. Showing empathy and positive regard. 
Providing specific feedback, and avoiding generalised judgements 
Maintaining the colleague’s professional identity and respecting their autonomy by involving them in the intervention. 
Ensuring any agreed goals are realistic and achievable (i.e. SMART). 
Supporting the colleague who maybe experiencing isolation from peers, by inviting them to a peer networking session where other colleagues receiving the intervention can meet. 
Contrasting the colleague’s perceptions of their good practice against performance data on their actual practice. A role player can be used, if required, to demonstrate the disparity. Although this may cause some professional dissonance, it can in turn lead to an acceptance to change. 
Being positive, affirming the colleague’s strengths and prior achievements. Breaking issues into manageable chunks and setting realistic goals. 
Supporting colleagues in identifying those aspects of performance that have caused problems. Including an exploration of any emotional triggers. Aiming to enhance self-efficacy, which in turn will provide motivation to change. 
Framing the intervention in a positive way to avoid stigmatisation, hence involving the colleague in all the stages. 
Providing an opportunity for the colleague to practice new behaviours or skills either through simulation or in situ if appropriate. Providing appropriate feedback and guided reflection. 

Evaluation 

Clients who enroll onto this project, consent to partake in structured interviews as part of the evaluation process. 

Client and Facilitator Agreement 

Please see Appendix 2 (pages 9-11) in the BUILD Pilot Flyer which provides an example of the Client and Facilitator Agreement. 

Meet the team! 

Dr Anjla Sharman 

I qualified as a GP in 2005 and work as a portfolio GP combining clinical, educational and management roles. Having experienced career challenges myself, I have a strong interest in supporting colleagues encountering difficulties. I have a particular interest in equality, diversity and inclusion and helping colleagues from all backgrounds achieve their full potential. 
 
I have worked in a wide range of different roles and bring these experiences to my work as a BUILD facilitator. I am trained as a mentor and coach and co-founded GP-S, a mentoring and coaching service that operates across the Midlands and Yorkshire. I have more than 15 years working in clinical education and have more than 10 years’ experience working as an NHS appraiser and locality lead appraiser. Other current roles include working as an OOH GP, examiner for the RCGP, and Associate Postgraduate Dean for HEE. 

Dr Catherine Worsey 

I’m a Nottingham salaried GP with a portfolio career including being an advisor to Nottinghamshire Healthcare Trust and an appraiser. I’ve been a psychiatry specialty trainee, GP partner, locum and worked in Australia which gives me a good insight into the struggles we can face working in healthcare. I’m interested in medical education and have been a GP trainer. I’ve trained in mentoring and more recently in CBT coaching. 

Dick Churchill 

I was a ‘late career’ GP with extensive experience as a GP Principal and Partner in a large practice in the suburbs of Nottingham, and more recently as a salaried Clinical Lead GP in Nottingham City. For many years I worked at the University of Nottingham as Director of Clinical Skills, supporting undergraduate healthcare students. 
 
Since 2017 I have been an NHS Appraiser and also currently run an HEE-commissioned programme, based on self-regulation learning principles, to support struggling GP trainees. Over the years I have had roles in the RCGP at both local and national level, and an academic interest in adolescent health has resulted in my involvement in some international projects. Away from my career I enjoy spending time with my family, reading, walking, travelling, and trying to play a saxophone! 

Phil Parker 

I qualified in Birmingham in 1991 and I have worked as a fulltime GP partner for 22 years and GP Trainer / Foundation Supervisor linked to Chesterfield VTS. I moved into GP Appraisal 15 years ago and have been Lead Appraiser for the last 5. I have an interest in medical education, personal development, mentoring and coaching. 
 
I have been recently appointed as lead for Derbyshire LMC Taskforce GP recruitment and retention programme and currently Coach for Practice manager scheme via same taskforce. I am excited to offer support to Doctors at a time of significant personal and professional pressure. I hope to offer proactive person-centered approach focusing upon realistic goals and aspirations. Outside of medicine I am a keen dog walker and rubbish electric guitar blues player! 

Graham Todd 

After qualifying from Sheffield University in 1994, I studied for a Postgraduate Certificate in Education whilst working as a junior doctor. After teaching in a sixth form college for 2 years I returned to full-time medicine, qualifying as a GP in 2003. I worked as a locum before becoming a salaried GP in Buxton and then in Bakewell. Due to my interest in supporting colleagues I became a GP tutor in 2009, working for HEE to provide educational events for local doctors. I also trained as a Mentor and was involved in the GP-Support mentoring programme at the beginning. In 2012 I became a Primary Care Educational Lead, teaching Quality Improvement Science both regionally and nationally. 
 
Until December 2019 I was an assistant Programme Director helping to organise the local GP training scheme and in recent months I have worked as a Clinical Supervisor supporting a GP returning to work under NHSE restrictions after a period of difficulty. I continue to work as an Educational Supervisor for Peak and Dales Medical Partnership, and in my free time help to run a local counselling charity. I remain interested in education and helping colleagues who need extra support. My unusual portfolio career has seen me in a wide range of different roles and I bring these varied experiences into my work as a BUILD facilitator. 

Dr Rashbal Ghattaora 

I am overall clinical lead for the BUILD Pilot. I have been a GP Partner for over 18 years. I have a portfolio career with a particular interest in education and assessment. I am GP trainer and GP Appraisal lead for Midlands team (Nottinghamshire), NHSE. I also work for NATH as a GP Educator and I am an examiner for the RCGP. I have also trained as a mentor for GP-Support. I enjoy martial arts but my passion lies in surfing, although I am not very good! 
Tagged as: NATH Projects
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