RTO sounds alarm over college-led training

WAGPET has warned the DoH and colleges that the transition will destabilise general practice.

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The transition to college-led GP training risks destabilising a speciality already under great pressure, the West Australian training organisation says.

The chairs of WA’s Supervisor, Registrar, and Practice Manager Advisory Councils (part of WAGPET, the state’s RTO) sent an open letter this week to the Department of Health, ACRRM and the RACGP expressing concerns about the return of training to the colleges in 2023.

Dr Naomi Jupp, a signatory on the letter and the chair of the WA Supervisor Advisory Council, told TMR that despite the changes to training being just 18 months away, there were no detailed plans in place.

“This letter really came about because we, as supervisors, registrars and practice managers working in GP training, have been waiting for someone to talk to us about training, find out what we think is important and work with us to help develop the changes,” she said.

Instead, there had been silence from the DoH, RACGP and ACRRM.

Dr Jupp said that while WAGPET was not opposed to the return of training to the colleges in principle, it was disappointing that key stakeholders in GP training had not been consulted.

As previously reported by TMR, the DoH’s plans for the future of general practice training could spell the end of RTOs within two years – the funding of these agencies is due to expire in mid-2023.

However, Dr Jupp said she had only heard anecdotally about the plan to abolish RTOs and that there had been no official decision from the DoH yet.

“We were told at a meeting on 8 May that the DoH has been challenged regarding that decision, and that they are now on the fence about whether the RTOs could continue to be utilised by the colleges to provide the training,” she said.

So, in the absence of a seat at the table in Canberra, the RTOs like WAGPET continue in limbo for a determination of their future past 2023.

“Our biggest fear is that this new program will have lost contact with the most important stakeholders – the supervisors, registrars and practice managers,” Dr Jupp said.

While the chairs’ letter acknowledges room for improvement, it lists further problems with the current state of the transition including:

•  That centralisation will result in a loss of capacity for local context and support, especially in WA;
• That there will be an increase in administrative burden for practices and supervisors;
• That there will be a reduction in flexibility of training for registrars and practices;
• That there will be a reduction in already stretched funding for GP training;
• That the uncertainty regarding the transition will prompt some doctors to leave or delay entering the training program or becoming supervisors.

It notes that GP registrars form a crucial part of the WA primary care workforce, with some servicing the most vulnerable communities.

Here is the full letter:

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17 May 2021 

WA GP Training Advisory Councils Open Letter 

We write to express our significant concerns regarding the current state of the transition to College-led training. 

It is not news that Australia’s General Practice system is already under immense pressure due to numerous factors, including COVID-19. The transition to College-led training will need to be thoroughly researched, carefully planned, and well-executed in a timely manner to minimise the risk of adding to that pressure and destabilising General Practice further. 

While some would argue that General Practice training should be treated as separate from workforce supply, the reality in Western Australia is that GP registrars form a crucial part of the primary care workforce, some in our most vulnerable communities. 

On 08 May 2021, a combined meeting of the WA Supervisor, Registrar and Practice Manager Advisory Councils met to discuss the forthcoming changes to GP training. These Councils comprise representatives from all regions in WA and meet regularly with WA’s RTO, WAGPET, to provide feedback and guidance on the current GP training program. We acknowledge that there is room for improvement in GP training and embrace the transition as an opportunity to bring about appropriate change and ensure national consistency. 

However, we have several concerns: 

• The dearth of details of the training programs, with less than a year until applications open; 
• The lack of consultation with registrars, supervisors and practices (the core of GP training); 
• That centralisation will result in a loss of capacity for local context and support, especially in WA; 
• That there will be an increase in administrative burden for practices and supervisors; 
• That there will be a reduction in flexibility of training for registrars and practices; 
• That there will be a reduction in already stretched funding for GP training; 
• That the uncertainty regarding the transition will prompt some doctors to leave or delay entering the training program or becoming supervisors. 

We identified the following needs and strategies to support a smoother transition: 

• The Department of Health and Colleges seek feedback and collaborate with WAGPET, its practices, supervisors, and registrars to identify both the strengths of the current system to be preserved and built upon, as well as the weaknesses which can be used to drive change; 
• WA’s special needs due to population distribution and isolation, at the level of both the state and individual communities, continue to be considered and accommodated; 
• High quality GP registrars and supervisors continue to be attracted and enrolled in GP training; 
• Practices, supervisors and registrars continue to receive quality education, training and support uninterrupted, with a particular focus on maintaining local staff and existing experience; 
• The details of the new education and training program and a clear plan for the actual transition be developed in a timely manner; 
• Information about the plan be communicated clearly and well in advance of the actual transition; 
• GP training continue to be a financially viable option for the registrars, supervisors, and practices; 
• Assessment, administrative and placements processes be available to road-test and kept simple. 

We, the Chairs of the three WA Advisory Councils, speak on behalf of practices, supervisors and registrars across WA. We also speak out of concern for a specialty already under significant strain, and those who are most vulnerable to disruption in general practice training and services, our patients. 

We invite the Department of Health, RACGP, ACRRM, GPSA, GPRA to meet with us to hear more details of our concerns and work towards effective and sustainable GP training and subsequent workforce. 

Yours sincerely 

Dr Naomi Jupp, chair, Supervisor Advisory Council

Dr Erin O’Donnell-Taylor, chair, Registrar Advisory Council

Ms Raelene Tully, chair, Practice Manager Advisory Council 

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