Manage connections

Overview

This function will enable HEE administrators to manage the connection of trainee doctors on the GMC's register to them as a Designated Body (DB).

While it is trainees' responsibility to ensure they are connected to the correct DB, local teams are also able to connect and disconnect trainees.

Trainees must be connected to the correct DB in order for that local team to manage their revalidation, therefore it is generally revalidation administrators who deal with any mismatches between the actual location of the trainee and data held in HEE's database, and those trainees listed as connected to their DB in GMC's records (listed on GMC Connect).

Connections:
- Done in batches as part of the on-boarding process for new foundation trainees

- Ad hoc when a trainee transfers to the DB or has/has been disconnected inappropriately (usually too early at end of training)

On-boarding process for new foundation trainees (WIP) VALIDATED

High level timeline for the recruitment of Foundation trainees here:

Conversation with the GMC's Revalidation team on 9th May confirmed that F1 trainees are emailed by the GMC registration department when their registration is changed from Provisional to Full and in that email they are informed that they need to connect themselves to the correct Designated Body Change of trainee registration status from Provisional to Full . If, after four months, the trainee is still not connected to a DB they are contacted again by the GMC to instruct them to connect themselves and warned that action will be taken by the GMC if they continue to remain disconnected. As we know that DBs/Local Offices undertake an audit around each October to ensure all appropriate trainees are connected to their DB the majority of trainees who have not connected themselves will be picked up in this audit (see email below from Andy Petherbridge for confirmation of this assumption).

" In theory, once (a trainee has) full GMC registration (i.e. following their F1 ARCP and before they start their F2 year), they will be prompted by the GMC to connect to a Designated Body; they would then connect to the Deanery/HEE local team through their GMC Online account.

In practice, we get a few connections this way (I emailed all of the F1 trainees progressing to F2 last year with some guidance and contacts regarding revalidation here, and that seemed to work fairly well), but most of them have been picked up when the GMC do a bulk refresh of our connections in October each year." - Andy Petherbridge

Disconnections
- When trainees have completed their programme (CCT or CCT + Grace Period for higher specialty) - either managed by programme team or revalidation administrator
- When trainees resign from the training programme for another reason (or are released from the programme - ARCP Outcome 4)
- Ad hoc when a trainee is noted to be wrongly connected to the DB (usually too soon at start of training)
- Connection to another DB because of a conflict of interest (with agreement)

Mismatched records are usually due to timing issues e.g. a trainee may connect themselves to a DB before they actually commence a programme, or may be disconnected by an administrator before they have been revalidated and fully 'signed-off' from being the DB's responsibility.

There are various local processes to manage this including daily monitoring and comparison using spreadsheets and macros or simply manually comparing lists downloaded from GMC Connect and Intrepid on a weekly or monthly basis. Local teams do get notified by the GMC (automatic notification via GMC Connect) if a doctor connects or disconnects from them. Also Intrepid 'match' functionality - see below.

The main trigger for disconnections is that trainees are beyond the end of their training programme, and have an Outcome 4/6 or have resigned, ITD'd etc.

Trainees are usually connected and disconnected directly on GMC Connect (and trainees always use the trainee version of this channel to connect/disconnect themselves). HEE administrators must connect/disconnect trainees one by one - there is no bulk functionality on GMC Connect, although GMC request an annual spreadsheet of trainees to 'refresh' the connections (annual reconciliation) - this was supposed to have been superseded by new Intrepid functionality (see note Intrepid functionality below).

Data mismatch scenarios and related business decision VALIDATED

	Data issue	Scenario	Business Decision
1	Not connected to Designated Body ____ Start Date of Programme is in the future	New starter recruited but has not started working and not working clinically anywhere else. These doctors will have records and assigned to programmes to commence in the future	Connect to relevant DB Reval Officer from NE says that trainees should not be connected until the day they start with a DB. Trainees do not need to be connected to a DB as they can be revalidated by the GMC. Rare but does happen.
2	Non Trainee Doctors	Non-trainee doctors employed directly by HEE and not working clinically anywhere else . These are usually Associate/Deputy Deans and Programme Managers.	Connect to relevant DB but only if the RO is aware and has approved the connection. This is a verbal approval not a formal process.
3	Vistor Trainee	Visiting training on an Out of Placement (OOP) arrangement : OOPC - Out of Programme ( on a career break) OOPT - Out of Programme (Training) OOPR - Out of Programme (Research) OOPE - Out of Programme (Experience) A visitor trainee will retain their 'home' DB. The visitor trainee must not be connected to recipient/host DB.	This is an exception that should not be connected
4	Military Trainee	Military trainees are managed by the Defence Deanery and not HEE	This is an exception that should not be connected
5	Provisionally Registered Doctors	Provisionally registered trainees on F1 placements	This is an exception that should not be connected. Point of interest, FP1 trainees are connected to their training trust* and change DBs upon successful completion of FP1 and commencement of FP2.
6	Programme End Date has Passed	On completion of training programme - ARCP Outcome 6 Released from training - ARCP Outcome 4. Resignation from programme	Disconnect from DB
7	Attached to the wrong Designated Body	Trainees that are wrongly attached to a DB. This discrepancy is likely to be identified on the GMC list of trainees and on investigation, the trainee will not be attached to a programme	Disconnect from DB

WIP* A Training Trust - is the trust that our trainees undertake their training in. They are just standard NHS trusts but we call them training trusts when referring to the training part to differentiate them from Lead Employer Trusts which are the employers. or example, County Durham and Darlington NHS Foundation Trust (CDDFT) is both a training trust and the lead employer trust here in the North East. Often we have trainees disconnecting themselves from the NE designated body and connecting themselves to CDDFT as that is the trainees' employing body. Trainees will always be connected to their local office as a DB.Training trust information is held as the number for the trust (RXP for CDDFT) is part of the local education provider (LEP) number that the GMC recognise for the approval of that location in a training programme.

User needs
Functionality in TIS to enable a Revalidation Administrator to connect or disconnect individual trainees from the designated body**
Functionality in TIS to enable a Revalidation Administrator to bulk connect or disconnect trainees
Functionality to flag up to a Revalidation Administrator where a trainee is joining a training programme and needs to be connected: new starters they have had an application to transfer between local offices (Inter-Deanery Transfer) approved and the date of the transfer ** have been disconnected inappropriately (i.e. before the end of their training programme or at the end date but before Final ARCP - they don't have an outcome 4/6 - or revalidation has taken place). If a trainee disconnects themselves from their DB an email is sent to the DB informing them. In the NE for example the number of trainees is of a manageable number that the Revalidation Officer can contact the trainee to ask why they have disconnected themselves. This may not work in local offices with a larger cohort of trainees.
Functionality to flag up to a Revalidation Administrator where trainees are not on a training programme with the DB: they have not yet started their programme and have attached too early they are beyond their Curriculum Completion Date and have an Outcome 6 they have an Outcome 4 they have resigned from a programme and the date of their last day they have had an application to transfer between local offices (Inter-Deanery Transfer - IDT) approved and the date of the transfer **
Functionality to flag up to a Revalidation Administrator discrepancies between the GMC Connect list and HEE's database of who should be connected to the local team
** As we develop the new core there could/should be functionality to transfer trainees between designated bodies in a single step i.e. not require one local team to disconnect and another team to connect separately. Will need to be built with appropriate approval workflow based on agreed policy and business rules - e.g. which local office (outgoing or incoming) responsible for changing connection NB: IDT's require approval from Postgraduate Deans (Responsible Officers) from both local teams

Functionality in GMC Connect

Add a doctor

Available from the 'All doctors' screen

'Decline' responsibility

Available from 'All Doctors' or 'Under Notice' screens

GMC Connect API

GMC Connect's web services enable secure data transfer and interaction with external services.

The TryAddDoctor method allows a designated body to add a doctor to their list of connected doctors. Following a successful transaction, the GMC will issue notification to the doctor that they have been connected to the designated body. Designated bodies (local teams) are also be notified by email of the change in connection - this applies when doctors connected or disconnected from the DB (NB - email notifications default to 'on' but admin has the opportunity to turn them off).

The TryRemoveDoctor method allows a designated body to remove a doctor from their list of connected doctors. Following a successful transaction, the GMC will issue notification to the doctor that they have been disconnected from the designated body (and the DB as above).

(Source: GMC Revalidation Web Services User Guide v2.0 + GMC Connect user guidance for revalidation - effective 1 July 2016)

Intrepid functionality

Intrepid v10 uses the GMC Connect API to enable revalidation (and other) administrators to add (connect) and remove (disconnect) trainees via the Intrepid Revalidation Dashboard, however it does not allow users to include key information required by GMC (and enabled by the GMC Connect API):

Doctors to remove - need to include reason for disconnection - options:
- Conflict of interest
- Doctor has retired
- The doctor does not have a connection with this designated body

Intrepid has a bulk update facility. It identifies doctors to add based on comparison of the GMC connect list with Intrepid records and allows you to tick multiple doctors to connect and then click submit for batch connection of these. The same is true for bulk disconnections. It is reported that this functionality is a bit temperamental and therefore not trusted/used.