How ready are we for the GP training transition?

In which we fire a barrage of questions at RACGP CEO Paul Wappett.

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There’s only four months to go until the colleges formally take over GP training from the RTOs.

Given the logistical challenges, such as employing 900 staff before February, TMR asked the RACGP’s CEO Paul Wappett as many curly questions as we could come up with on how the transition is going from the college’s perspective.

He did a pretty good job of answering them.

TMR: How confident are you that you will have all 900 positions filled, on boarded and ready to go for the Feb 1 deadline?

PW: We are as confident as can be reasonably expected for a program of this scale within such a short time frame. 

We are thrilled with the level of interest we’ve received from existing Regional Training Organisation staff members through the recent expression of interest for roles within our new GP Training unit at the RACGP. This has reinforced our confidence that we will be well positioned to have team members on board, well inducted and trained and ready to support registrars, supervisors, practices and the program from 1 February.

We know that covid has led to changes in the employment market and the availability of great people, and we are confident that what we have to offer employees is attractive to the sector and competitive within the employment market. We also know that those who work in the industry find contributing to the health outcomes for their communities through GP training meaningful, rewarding and desirable work.

So, we are cautiously confident while keeping a close eye on the demand for all of our roles.

If you have confidence, why?

In designing our delivery operating model and organisational structure, we have worked closely with the RTOs so that we know what’s required to support registrars, supervisors, practices and communities through the training program and to meet the KPIs under the AGPT funding agreement.

EOIs have been extended and received by RTO employees and we are in the process of contracting these positions.

We aren’t in a position to confirm personnel until such time as we have contracts fully executed, but we will keep the sector informed.

Are there any other versions of what you are doing with GP Synergy and James Cook University – essentially, continuing a form of the existing arrangement or taking over the existing entity to create continuity? If not, what is the nature of the transition plans with each other RTO?

To be clear, the role that JCU will play is as a local delivery agent for the RACGP in north and western Queensland, and from 1 February; GP Synergy will not be directly involved in the delivery of GP training but will be integrated within the RACGP.

The RACGP delivery model is one of local delivery teams, supported by state and territory regional leadership and support teams, all of whom will be supported by national leadership roles and support services. The operating model affords each regional and local team to influence regional responses to training delivery that best meets the needs of their communities.

Our GP training practices and registrars represent continuity. Over 90% of GP training occurs within a GP training practice. The college’s work is focused on minimising disruption for training practices, supervisors, practice managers and registrars. 

Have you got a org chart for the new training organisation part of the business, and if so who in the management team is in place already? 

The organisational charts are in place and have been provided to RTOs and their staff to help them understand the roles that are on offer, their reporting lines and how they fit within a national operating model. Senior leadership appointments – both in the national and regional roles – are in the process of being made and will be announced to the sector in the near future.

How do you propose to establish regional services offices? Will you need to lease new offices in all the regions? Will your offices have FTEs or contractors?

Office locations are currently being negotiated by the our property management unit, on the advice of experienced GP training personnel about requirements. All office locations will be announced when we are in a position to do so. 

Are you doing anything different for WA, given its unique set of rural and remote training requirements and capabilities?

Every state and territory – including Western Australia – will have its own unique local delivery and regional support mechanisms that will be informed by skilled staff that know their state and territory best. The operating model has been designed with the flexibility to respond to each state and territory in a way that makes sense in that environment, while having the national consistency and regional support structures in place. 

We are collaborating with regional agencies to understand how we can optimise partnerships and training networks to collectively optimise training outcomes into the future. 

At what point will the college need to start taking over placements in 2023 itself entirely?

Many of the RTOs will place their registrars for both terms in 2023 now. For those areas where the RTOs are placing registrars for term 1 only (the first six months), the RACGP will be undertaking the placement process in term 2, which commences mid-year. And, of course, we will need to be engaging in placement processes for 2024 as early as August 2023.

Will that be enough time for WPPs (GP workforce planning and prioritisation organisations)/PHNs to do enough work to establish accurate needs assessments to guide your placements?

It is broadly understood that the WPP needs assessments will become more granular – and therefore useful – over time.

The WPP providers and the colleges understand the wicked problems of rural and remote workforce challenges. These are not simple problems and therefore neither will the solutions. The college intends to build respectfully on initiatives currently in place, which local and regional staff employed from existing RTOs will help build and inform along with the guidance the WPP reporting supports. 

Is there any danger that splitting training and workforce distribution (between colleges and WPPs/PHNs) may create a disconnect between the needs of a region/town versus the optimal training needs of a registrar?

Not as far as the RACGP is concerned; we have been clear on our position that the registrar experience cannot be compromised, and we will continue to draw on the expertise of WPPs and others to inform our training program. The WPP, College and Department of Health meetings that have been held to date have demonstrated how well all organisations understand that the health, safety, personal and professional wellbeing of a registrar has to be a priority. There is no requirement to fill areas of need identified in the WPP reporting without regard for the optimal training needs of a registrar, and having appropriate supervision arrangements to enhance safety for patients and registrars.

How confident are you that the PHNs, having never been in charge of workforce distribution needs before, can also get up to speed in time for when you are doing placements?

The very best outcomes for these projects come from consortium approaches which link in broad sector knowledge. Though each of the WPP providers have named consortium organisations, the meetings we have been attending with WPP providers are in fact much broader than just the PHNs listed.

We are aware that the QLD WPP staff member is presently co-locating with GPTQ, The NSW provider is managed by Megan Cahill (former CEO of GPET, RWAV), the South Australian provider is a consortium led by GPEx. In Tasmania, it is HRPlus who have worked closely with GPTT throughout. In WA it is PHN-led but their consortium is bigger than just the PHN. And in the NT again the consortium model brings in a variety of collaborators that will help inform the work.

The college is heartened by the collaborative approach all the WPP consortia have taken to date. PHNs have been responsible for conducting needs analysis within their footprints as part of their function for a long time, and while training adds further complexity to this work, we will be working closely with them to ensure training requirements and imperatives are better understood within the context.

Is there anything else you’d like aired on this topic?

We want to acknowledge the extraordinary work done by the RTOs over a long period of time to improve GP training outcomes across the country, to acknowledge that they are feeling some legitimate grief and sadness over the end of their tenure, and to assure them and the community that we see the RACGP’s role as one of the next custodians of AGPT, training on behalf of, and for the betterment of, its participants and the community.

This is a massive exercise. There is unlikely to be any other organisational program anywhere in Australia in the next two years that involves the merging of the people, operations, data, systems, assets, cultures, processes, policies and procedures from nine separate organisations into a single unified model, especially within such a short time frame. We know that we will encounter a few bumps along the way – nothing of this scale, complexity and community impact will ever be completely incident-free – but we have planned well, we are executing things in an organised but flexible and adaptable manner, and we are sure that the outcomes of the return of GP training to the colleges will be positive.