It just gets busier!
Hi all, Carla and I have been very busy again since my pre-Easter report, but all the hard work is definitely paying off!
As mentioned in the previous few months, we have been meeting with various states and territories to insert the argument for quality supervision into their individual plans for Single Employer Model (SEM) pilots. With every jurisdiction doing things differently, we continue to have a particular affinity with the Tasmanian model, which is very strongly rooted in the goal of supporting the private model of general practice over increasing their numbers of hospital employees.
The Tasmanian team is even considering our preferred model, where the registrar might complete GPT1-2 (or RG equivalent) under the state Single Employer then transition to practice employment governed by the NTCER, allowing access to earnings against billings only when they have had time to acclimatise to the general practice environment and gained an understanding of how to bill correctly, etc. We have also floated this option by a number of sector stakeholders, government representatives from NT, WA and Queensland, and have started working with ACRRM to explore potential for other options to give senior RG registrars greater flexibility than traditional practice-based employment allows at the tail end of their training.
What seems key at present is that alternate models of registrar employment are coming, and we need to be open to ideas that may well change what we have built our business models around as training practice owners. Not all change is detrimental… But we are working very very hard to ensure that we as a community of practice have visibility over and a prominent voice in any decisions leading to change for our sector.
I implore you to please maximise the opportunities we offer for you to have a say in all that’s happening around us in the GP training landscape. Activate your free membership to the GPSA Community Platform and join a Community Group (or 10)! Take a few minutes to complete the National Supervision Survey, which feeds into our work on Advisory Councils for the Workforce Planning and Prioritisation organisations across the country as well as guiding our research, education and advocacy priorities. It is so important that we all contribute to the findings of this important survey. You can read more about this here or contact our Director of Research & Policy, Dr Samia Toukhsati, with any queries here.
GPSA is committed to supporting the people and businesses that underpin the future of primary healthcare in this country. We are a sector conduit, a driver of innovation and quality, and an advocate for respect and recognition for this community. GPSA is not a group of Board members or the small team of employees who deliver educational interventions and resources, members supports, research and policy. GPSA is the community we serve… So don’t be a stranger!
Date reviewed: 27 April 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
Date reviewed: 20 April 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
It might not make great material for a Netflix doco, but a day in the life of the GPSA Chair is certainly proving far from dull as Carla and I navigate all the meetings with and requests from members and sector stakeholders! And this is only a couple of months into the training year!
Our accomplishments are starting to stack up though, making it all worthwhile…
GPSA’s Community Platform
On 19th March we started inviting our members to join the new community platform tied to the GPSA website, where we still offer all 1,000+ resources free and open-access. This new concept is designed to enable our members to more readily connect with one another, with us, and ultimately with representatives of the Department, Colleges and other sector stakeholders. This has been a really quiet “soft” launch as the last thing we want to do is overwhelm anyone with so many changes afoot through the Transition, especially in terms of IT systems. But hats off to our practice manager members, who have jumped in and started helping one another develop strategies and solutions by creating discussions under their private community Discussion tab. Now the challenge is on for our supervisor and practice owner colleagues!
If you haven’t activated your account already, it’s really easy to log in, join one or more Community Groups, and virtually step outside the consulting room for a few moments: if only to reduce the feeling of isolation that comes with our profession.
2023 National Survey
On the topic of our wellbeing, I note that this year’s National Survey is being launched on Thursday 6th April, and will include some follow-up to last year’s survey which produced this report summarising our perspectives on wellbeing and selfcare. Importantly, this annual survey will give you a chance to share your individual reflections on the new training regime and what it will take to make this a thriving sector into the future. Please make the most of this opportunity as we really are in a position to influence change with your participation – noting the data we collect from this questionnaire is used for our advocacy work and representation on advisory committees such as for the various Workforce Planning and Prioritisation (WPP) organisations. AND you can be credited for an hour of CPD as an added bonus!
New branding, new identity
The new GPSA logo has been developed and will now start to be rolled out across our various touchpoints – website, emails, social media etc.. The new icon is indicative of our evolution from GP Supervisors Australia to GP Supervision Australia, really reflecting what we do and the partnership between the Supervising Practices, Supervisors, Practice Managers and the GP Registrars that we are collectively supporting. When asked “who” GPSA is, traditionally we would have pointed to the voluntary Board of Directors at the top of the triangle, beneath us the small team (<4FTE) of employees, and at the bottom the community we represent. By contrast, today we refer to GPSA as the community first and foremost, with the team supporting you from below, and the Board beneath them as the cornerstone of the organisation, with our new branding symbolising this new identity especially as it relates to whole-of-practice scaffolding of the learner / trainee, and flattening of the hierarchy in supervision.
CPD made easy
I hope that you are all attending our Webinars, there are so many great topics being covered and wonderful hints for how to work with your Registrars. Pearls of wisdom keep getting dropped by presenters and participants. AND, now we are approved CPD providers for RACGP (soon ACRRM also), we can automatically add a CPD hour to your CPD Home account when you attend these (generally webinars are approved for Educational Activity) and an additional hour for Reviewing Performance when you go on to complete the post-webinar activity we now offer. The team is currently working on converting recordings of past webinars and other static educational resources on the website into online modules to help increase CPD opportunities for you. All free for our members: so be sure to make use of this!
GPSA keeping your voice heard out there
We have regular meetings with RACGP and ACRRM regarding their training developments and both Colleges are very supportive of our role in assisting with this. Member feedback has been that the Transition has predominantly gone smoothly; but, as always, there have been a few hiccups along the way. Mostly these are small and fairly easily resolved. We also meet regularly with GPRA, continuing to work together to enhance the experience of Registrars and Supervisors, and with the Government at different levels and in different groups. I believe that the respect that we have earned with all our engagement has been well worthwhile. We continue to advocate for all our members at all levels and are being listened to.
One space that we are working hard to involve our community in is the Single Employer Model pilots being rolled out across Australia. This is a departure from how GP Registrars have been employed in the past, mainly as a solution for the rural sector, so we are keen to understand and help shape these models in order to drive the best outcomes possible for all Registrars (our future workforce!) and with minimal unintended consequences. These pilots will look different across the country, but quality of training must remain paramount: we will keep pushing the Quality barrow always. A quick note that any Tasmanian Practice Owners / Practice Managers or Supervisors are invited to join the private group we have created on the community platform called “Tasmania’s SEM”, to which we have given members of the team running the Tasmanian pilot access so they can answer any questions you may have as potential participants in their trial.
Well, all the best from me and enjoy your Easter, but just remember, not too many Easter Eggs!!
Kevin
Date reviewed: 15 April 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
The Strengthening Medicare Taskforce Report has been described as outlining “a vision for Australia’s primary care system of the future”, recommending “significant changes to how primary care is funded and delivered to enable high quality, integrated and person-centred care for all Australians”.
Date reviewed: 01 March 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
From 2023, all doctors across Australia are required to complete and record 50 hours of CPD each year. CPD activities must include of a mix of:
While we are being set up in the RACGP CPD Home platform, we are happy to email you a Certificate of Attendance for these activities using the details you provide in your registration and evaluation forms.
Noting that equivalent CPD Provider status is in progress with ACRRM, we likewise offer Certificates of Attendance for this and any other non-RACGP CPD Home in accordance with the details you provide us.
GPSA’s comprehensive range of supervisor and general practice resources also count towards your CPD. You can access these here.
The RACGP has packaged GP supervision activities into a simple, pre-approved format for all GP supervisors.
If RACGP is your CPD Home, depending on your role in supervision, a specific number of CPD hours will automatically be applied for the year.
For example, if you are registered with the RACGP as a primary supervisor of one or more registrars, up to 30 hours will automatically be applied to your CPD.
Secondary supervisors will benefit too, but for a smaller number of hours (we will share this once RACGP provides this information).
The RACGP also recognises the activities of GPs who teach and supervise medical students as CPD.
As a GP supervisor you have at least 2 roles. One is as a GP in clinical practice and the other is as a teacher / supervisor. Your role as a supervisor is very important and much of what you do in this role is captured as CPD.
Your CPD comprises 2 parts: that done to prepare to be a supervisor (modules, workshops) and the supervision you do in practice, week to week, with a registrar.
1.Preparation for supervising and teaching involves:
2.The act of supervision involves:
Date reviewed: 01 March 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
It is hard to believe we are already a month into the new era of GP training! For all the teething problems there might have been, all in all it has been a remarkably smooth process thanks to a whole lot of hard work behind the scenes. Well done to both Colleges (but know that we will continue to badger you until all of the SLO and PMLO roles have been filled)!
Just in time for the first semester of GP training under ACRRM and RACGP, we jointly announced the completion of the 2022 NTCER Review with GPRA, producing what I consider a fair outcome not only for registrars but also for supervisors and practice owners. Broad consultation throughout this lengthy review involved every GPSA member having multiple opportunities to contribute their views and raise their concerns around the minimum terms and conditions for employing registrars. While we always hope for higher levels of participation by the members we are representing in matters like this, there were some terrific insights provided by those supervisors, practice owners and practice managers who participated in our survey, open submission, and working groups. Many thanks to all involved.
Close on the heels of our NTCER announcement, in early February the Tasmanian government announced its plan to introduce a Single Employer Model (SEM) for 20 registrars across the state, with an emphasis on rural and regional GP training. This announcement was shortly followed by news that multiple additional SEM pilots are being planned for NSW. We can now reveal that a total of ten SEM pilots are scoped for rollout across the country by the individual states / territories, these being on top of the original SEM pilots ongoing in Murrumbidgee and Riverland. Recognising the possible negative impact on our combined memberships by a wide range of unintentional consequences of these SEM pilots, together with GPRA we are reaching out to the states and territories to do what we can to ensure the needs of supervisors, training practices and registrars are met in these pilots. As the peak organisations for GP training, we are keen to lend our support: to guide successful outcomes that focus not only on increased community access to doctors-in-training, but on high quality registrar placements that foster a passion for the general practice specialty and an attachment to the community in which the training is undertaken. We will be updating you on our work and inviting your contribution in this space throughout the year.
Another significant demonstration of high-level focus on improving primary healthcare that’s at risk of undermining the value of high-quality GP supervision is the Strengthening Medicare Taskforce Report… Despite some very important recommendations, did anyone else notice that there was not a single reference to registrar, supervisor or training practice?! But seriously, this report once again brings into focus the topic that started our year with a bang in Queensland and beyond: the new and far-from-improved payroll tax ruling. Despite the 2-year amnesty / stay-of-execution announced on 3rd February (at least in Queensland), the application of the newest SRO ruling is still likely to make a large number of quality training practices reconsider the viability of continuing to take on registrars; additionally, recommendations from the Strengthening Medicare Taskforce such as Voluntary Patient Registration – and any other payments to practices to help coordinate care – would be considered subject to payroll tax, deleting the potential fiscal benefits. GPSA will continue to demand fairness and logic on this matter, for our members and for the future of general practice.
Lastly, I wish to address the news that’s caused more than a ripple among RACGP members since the publication of this article in newsGP. The College’s transparency on their financial situation may have sparked some controversy; but, for our purposes as the nation’s peak organisation for GP supervisors and training practices, this is the message I want to highlight – quoting the RACGP Board Chair, Dr Lara Roeske:
GP training will not be impacted by the cost reduction program in any way. This work is funded by the Commonwealth, and it is a requirement that we do not comingle funds.
In other words, the RACGP’s funding for delivering the AGPT program is completely quarantined, ensuring the College’s ability to support supervisors and training practices will not be impacted by the cost reductions planned across the other areas of the organisation.
So rest assured that GP training is not going to suffer from RACGP’s dip into the red… and maybe spare a thought for GPSA’s tiny team, continuing to support supervisors, practice owners and practice managers on the smell of an oily rag!
Date reviewed: 01 March 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
General Practice Supervision Australia (GPSA) and General Practice Registrars Australia (GPRA) are happy to announce the conclusion of the biennial 2022 Review of the National Terms and Conditions for Employment of Registrars (NTCER).
Key NTCER amendments to be implemented across the next 4 training semesters (2023.1-2024.2) include:
As the peak organisations charged with administering the NTCER, GPSA and GPRA have finalised this review as it began – with collaboration, mutual respect, and a positive outlook. Both organisations recognise there is more to be done and will press ahead with advocacy for increased support and investment in the future of primary health care.
The main win for both organisations is the relationship forged through the underpinning principles GPRA and GPSA set for this review process in July 2022:
1) Models of employment for GP registrars across Australia need to be fair and equitable, delivering working conditions and remuneration that compares with other specialist trainees while taking into account the context of training practices;
2) General practice is a rewarding medical specialty and an attractive vocational pathway for junior and/or pre-vocational doctors;
3) GP trainees and GP supervisors are equally desirous of and entitled to a quality training experience;
4) GPRA and GPSA, as the recognised national peak bodies representing all GP registrars, GP supervisors and GP training practices, have a critical role in advising all levels of government on all matters of relevance to the GP training sector;
5) Appropriate support and funding for GP supervisors and GP training practices is crucial for the sustainability of the nation’s primary health system, which in turn underpins the nation’s wider healthcare system.
As part of this process, future collaborations between GPSA and GPRA on a variety of projects have been agreed, including the co-development of:
Recognising the need to minimise the impact on training practices in the current climate, agreement has been reached to stage base rate and administration changes across the next 4 training semesters, leading into the next review period in Semester 2 of 2024. A summary of these changes and their timing is included below:
Educational release (clause 9.2) Where GPT3s have mandated workshop requirements during standardly rostered hours, these will be included as paid time by practice (unless on a weekend or after
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Restrictive covenant (clause 17) Clause to be removed from NTCER and replaced with non-solicitation of patient and
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Parity for part-time registrars re Training practices to provide part-time GP trainees educational release in parity with full-time GP trainees
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Redrafted “Preamble” and “About the Updated to reflect staging of changes and new framework for biennial
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3% increase to minimum base rate (per current Remuneration Schedule) on top of indexation
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Administration time (clause 9.3) Increase to scheduled 30 mins per session (half day) to max 5 hours per week |
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| 1% increase to minimum base rate
on top of indexation
Next biennial review To be carried out under mutually agreed process and timeframe in 2024.2, with view to conclusion before recruitment for training placements commences (i.e. by September 2024 for 2025.1) |
The updated NTCER Agreement is available for viewing and downloading here.
Date reviewed: 01 March 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
GPSA represents GP supervisors and training practices, without whom the future for the general practice specialty would be very bleak.
By extension, any threat to the profession that poses a threat to GPs who supervise, and the training practices that offer employment to registrars through their training, is of major concern to GPSA.
If this payroll tax threat results in a mass departure of GPs from the specialty, inevitably there will be a great many experienced GP/RG supervisors amongst them.
If registrars find themselves impacted by a shrinking pool of supervisors, extra pressure on practice workforce with departing GPs, and/or heightened tensions in the training practice as new structures and systems are rushed into place to mitigate the likely effect of the payroll tax ruling, this will undermine the sustainability of GP training and in turn the profession. So this is what is making GPSA concerned.
Through this rapidly-implemented, quick member survey, our goal was to give your individual voices the volume of this community of practice, loudly adding the unique and very important perspective to the College and AMA discussions with state and federal governments on this issue.
With a little luck and a lot of determination, three minutes of your time could make a mighty big difference.
Read here how your voice on this issue has been interpreted in the ongoing media coverage.
Date reviewed: 25 January 2023
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
The transition of GP training from the RTOs to a College-led model has dominated sector conversations for what seems a very long time; however, with February just around the corner, time is fast running out to ensure we are all set for the new era of training.
Is this all we should be worried about?
It’s easy to be distracted by the negativity surrounding us, but I’m yet to meet a GP who took on the supervision of a registrar because it was “easy”. As supervisors, our role is to transfer our passion for quality and continuity of patient-centred care onto the next generation of GPs, regardless of political or economic pressures, major changes in the GP training model or even a little thing like a pandemic! This means we need to be focusing on solutions rather than being dragged down by the many challenges and threats the profession is currently facing. To this end, the power of one is real. You as an individual have a voice through GPSA: a voice given volume by this community of practice we are working to support through innovative networking opportunities underpinned by new and improved systems.
Right now, we are ensuring your voice is present in discussions about the transition, and in our review of the NTCER with GPRA. We are speaking on your behalf at sector stakeholder fora like the meetings of the General Practice Training Advisory Council (GPTAC) and the National Council of Primary Care Doctors (NCPCD), and frequent meetings with ACRRM, RACGP and the Department. We have also started working with the Workforce Planning and Prioritisation (WPP) organisations to contextualise their reports on training needs and capacity with your localised narratives; and we speak regularly with the CEOs of the RTOs to ensure nothing slips through the cracks in the transition, noting that GPSA has been offered the regionally-based training modules and other resources developed by these organisations so we can provide our members with ongoing free and open access to these valuable materials.
A big concern for us has been how GPSA can best support supervisors and practices to make the transition as seamless as possible and keep the sector focused on sustainability of the profession to guarantee continuity and stability in GP training. Taking our role of conduit quite literally, we have devoted a lot of our resources to providing you with regular transition updates via webinars, e-newsletters, social media and links on our website; we have also been madly reviewing new College policies, guidelines and handbooks specific to the supervision of vocational GP trainees, determined to minimise the burden on our members – and maximise the attractiveness of GP training – under the new regime.
We recognise our work in this space has only just begun, and will continue devoting significant time and energy throughout the next triennium to hold the Colleges to account as the new custodians of GP training in this country. But what we need in order to maximise our efforts going forward is your contribution, your questions and feedback and requests for our input. In 2023, we will be introducing a forum-based website to create easily accessed channels of communication for our members to connect with us, with the Colleges and DOHAC, but most importantly with each other. GPSA has a voluntary Board of Directors and a very small number of paid staff; we are a not-for-profit organisation that exists for the benefit of its members, so we really do need the connection with you we are planning for this new platform and implore you to be active in the community this will help to enhance.
In the meantime, we are still trying to get a solid handle on a few of the new concepts to better prepare you for 2023, like RACGP’s Work-Based Assessments (WBAs). At this stage we can confirm that the WBA program will be implemented progressively across 2023 and 2024. There will be a soft rollout of the program with the first assessment not due until the middle of the first GP term. The assessments are very similar to those currently being completed by supervisors in existing programs. The RACGP teams in each region will provide education and support for supervisors about the WBA program.
While we had a Q&A-style webinar on the National Consistent Payment (NCP) framework with DOHAC’s Martin Rocks in mid-November, we are only now being presented with how each College will apply the Flexible Funding that will top up the NCP payments. ACRRM will deliver a webinar with us on their Flexible Funding model on 15th December to explain their priorities and how supervisors, practices and registrars will be able to access these funds.
Still on the subject of webinars, if you’re one of the many struggling to register for practice / supervisor payments under the NCP (even after the two webinars GPSA ran in November, plus the FAQs we developed, to tackle the confusion), Services Australia has accepted our request to do a live walk-through of the PRODA and HPOS processes for our members, which we will of course record and make available for those who can’t attend. Carla is just awaiting confirmation of the date, but will make certain this happens this side of Christmas (and will let you know once this date is locked in).
So it’s not all doom and gloom in general practice, as we found in October at the ACRRM/RDAA RMA22 conference. For the 1500+ RACGP members in Melbourne for the last weekend in November, three years without large-scale face-to-face events made GP22 extra special too.
Despite the temptation to wander further into the Melbourne Convention and Exhibition Centre to check out the other conferences (one in particular), the turn-out was great and the energy high as we took the opportunity to chat within the same postcode and without the computer screens!
Amongst the many topics of interest at GP22, personally I’d rank CPD right up there. From 2023, the Medical Board of Australia (MBA) is changing CPD for all doctors, in all disciplines, across Australia. Moving from a points-based to a time-based model, three new CPD activity types will need to be covered in 50 hours per annum:
In response to these changes and our advocacy around reducing burdens for GP supervisors, the College is looking at opportunities for primary supervisors to have our supervision work recognised as significantly fulfilling the new MBA requirements in terms of CPD hours. We are also working with both Colleges to have participation in GPSA research and attendance of our webinars / workshops automatically applied as CPD, which will be helpful for secondary supervisors and anyone not supervising a registrar in 2023 too.
I can’t mention GP22 without acknowledging the GPSA team there with me – Carla Taylor (CEO), Leonie Chamberlain (COO), Jane McMahon (Admin), Karen Andrews (Governance), Lachlan Butcher (Member Services), Dr Samia Toukhsati (Research), Dr Simon Morgan (Education), Dr Justin Coleman (my fellow Board member) and Dr Nicole Higgins (my predecessor!). If watching Nicole step into the role of President at the RACGP AGM was an honour, I’ve yet to find the words to describe how it felt to listen to Simon and Justin hammering out the crowd favourites as members of the all-doc band at the conference dinner!
As December kicks in, I wish you all a very Merry Christmas, and a rewarding, enjoyable, stress-free New Year.
Date reviewed: 01 December 2022
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
At the GP22 conference in Melbourne at the end of November 2022, GPSA’s Director of Research, Dr Samia Toukhsati, presented the findings she developed with Monash University’s Dr Rebecca Kippen and GPSA’s former and current CEOs, Glen Wallace and Carla Taylor.
The aim of GPSA’s study was to explore the wellbeing and selfcare of GP supervisors in Australia.
The method included use of the 16-item Oldenburg Burnout Inventory to evaluate disengagement and exhaustion through a procedure involving:
Burnout impacts over 70% of GP supervisors
Modifiable personal risk factors include:
Benefit of increasing personal agency to set boundaries: empowerment and choice
Burnout represents a systemic workplace and workforce problem
Change needed at the sector level, requiring a systems and government response(7)
THIS IS JUST ONE EXAMPLE OF THE RESEARCH GPSA UNDERTAKES IN OUR EFFORT TO DEVELOP BEST PRACTICE RESOURCES, CREATE POLICIES FOR THE IMPROVEMENT OF GP TRAINING CONDITIONS, AND ADVOCATE ON BEHALF OF OUR MEMBERS.
TO REPRESENT YOU FAITHFULLY, WE NEED TO HEAR YOUR VOICE. PLEASE CONSIDER PARTICIPATING IN OUR MEMBER SURVEYS AND RESEARCH INTERVIEWS, AND REACH OUT TO US WITH ANY ISSUES / CONCERNS / QUERIES AT SUPPORT@GPSA.ORG.AU.S
Date reviewed: 01 December 2022
Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
GPTA Ltd t/as GP Supervision Australia
PO Box 787 Gisborne Vic 3437
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admin@gpsa.org.au