Out of hours (OOH) is a mandatory component of GPST training and you must demonstrate competence in six key areas to your Educational Supervisor to allow a CCT to be issued.

OOH is defined as work undertaken between 18.30 and 0800 Monday to Friday, all day Saturday, Sunday and Bank holidays.

OOH is an important part of your experience as a GPST and allows you to experience a different perspective to that in hours. You will enhance your problem solving skills, team working abilities and time management skills.

Look at OOH positively. It is a rich learning environment. You are paid a significant uplift in your salary for this aspect of your work/training and cannot opt out. You must do out of hours to complete your workplace based assessments for the MRCGP.

The six generic competencies are defined:

  1. Ability to manage common medical, surgical and psychiatric emergencies in the out of hours setting.
  2. Understanding of the organisational aspects of NHS out of hours care.
  3. Ability to make appropriate referrals to hospitals and other professionals in the out of hours setting.
  4. Demonstration of communication skills required for out of hours care.
  5. Individual personal time and stress management.
  6. Maintenance of personal security and awareness and management of the security of others.

Our OOH providers are GoToDoc and BARDOC. Which provider you will attend and how to book sessions will be explained at induction. Attendance at induction is mandatory before undertaking any OOH sessions and this can be counted as one of your sessions. You must undertake a minimum of six sessions at ST 1 or 2 when in General Practice and a minimum twelve sessions at ST3. More may need to be undertaken if your educational supervisor feels you have not met the described competencies.

These sessions must be documented using the OOH feedback forms and scanned into your portfolio. Each provider uses different feedback forms and should provide you with one at the end of your shift when you will also have protected time with your supervisor to discuss cases and be given feedback. Each session must be entered into your learning log with reflection and further learning discussed. Your Educational Supervisor will monitor your progress in OOH competencies.
A session is a minimum of four hours but may be up to seven. Each OOH provider has different shift patterns. You should undertake a balance of base, triage and visiting sessions. You should not exclusively perform overnight sessions. The number of sessions to be undertaken is the same for Less Than Full Time and Full Time GPST’s. 

All OOH sessions are supervised by an appropriately trained clinical supervisor (OOH CS). The initial sessions at ST1-2 should be observing the delivery of care and when your education supervisor (ES) feels you are ready, you may see patients in a supervised manner. As you progress through the sessions at ST3, the supervision will become at a greater distance and you should be consulting alone with remote supervision at the conclusion of your OOH sessions.

If you are unable to undertake a particular session it is up to you to swap with a colleague. Not turning up or cancelling last minute results in your Educational Supervisor being informed and is potentially regarded as a fitness to practice issue and may be explored by your programme director.

Please arrive for sessions in plenty of time. Arriving late will potentially compromise patient care and your clinical supervisor may not wait for you, especially if undertaking a visiting session.