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Supervision in After-hours

 

Supervision in After-hours environments has changed considerably. In recent years, the traditional model whereby GPs served their community both day and night have largely been replaced with alternatives, in the form of deputising services, stand-alone after-hours providers, and/or referrals to a tertiary hospital.

Both the RACGP and ACRRM acknowledge the importance of provision of and competence in providing General Practice and emergency services outside of normal hours. With this acknowledgement, comes the necessity for adequate training in the skills required to work in after-hours environments as well as an understanding of the variability of supervision.

Medico-legal considerations

As with in-hours work, GP supervisors potentially are legally liable for the after-hours work performed by their GP registrars. While GP registrars themselves carry most of the liability, their clinical supervisor and/or employer may have some vicarious liability in the event of a claim or complaint. Allegations in a legal claim against a GP supervisor in the event of negligence by a GP registrar could include:

• failure to properly train the GP registrar;
• failure to properly supervise the GP registrar;
• inappropriate delegation to the GP registrar; and
• failure to have proper systems or treatment protocols in place.

Minimising medico-legal risk

This medico-legal risk can be minimised by:

• following relevant clinical guidelines;
• ensuring the registrar is appropriated supported and supervised for their level of training and competence;
• provision of an adequate orientation process outlining the responsibilities of both the GP registrar and the GP supervisor;
• provision of a clear criteria for when the GP supervisor is to be called; and
• having an approachable GP supervisor available to provide assistance whenever the GP registrar is working.

GPSA have produced a flyer to assist you as GP Supervisors to assess and document supervision requirements and capacity for GP Registrars working after-hours.  CLICK HERE to download the flyer and useful framework for approaching supervision responsibilities in an after-hours setting. Use this to develop a supervisory agreement with your GP Registrar for in- and after-hours work.

More information on Supervision in After-hours Environments in General Practice can be found in the last GPSA guide available HERE.