The first competency in the RCGP Curriculum for urgent and unscheduled care1 is that GPs must qualify with the skills to ‘Recognise patients with urgent needs and act promptly … to ensure correct and timely treatment and reduce the risk of death or morbidity.’
But where are UK GP residents learning these skills?
One might assume that GP residents have adequate time during their foundation training (or equivalent), and NHS ST12 hospital rotations, to acquire the required knowledge and skills to manage emergencies — but data we collected suggest this may not be the case.
All final-year GP resident doctors on the Dorset Vocational Training Scheme in November 2024 were asked which emergencies they had experience of managing in a hospital and primary care setting.
One hundred per cent of GP residents reported managing sepsis in secondary care, but fewer had managed acute coronary syndrome (84%), severe asthma (84%), cardiac arrest (80%), hypoglycaemia (80%), or seizures (72%), and less than a quarter had managed anaphylaxis (24%) or meningitis (24%) in a hospital setting.
Their experience in general practice was even more limited. Sixty-three per cent reported managing sepsis in primary care, but fewer had managed acute coronary syndrome (47%), severe asthma (32%), hypoglycaemia (11%), or anaphylaxis (5%). None of the final-year GP residents had experience of managing cardiac arrest, meningitis, or seizures in primary care.
With an ambition for GP residents to spend all 3 years of their specialist training in general practice, there is an urgent need for more comprehensive training in emergencies. Grieg et al
2 highlight that, while medical emergencies are increasing in primary care, individual clinicians may go ‘months or even years without having to manage one personally’. There is no requirement and few opportunities to receive regular training, over and above Basic Life Support (BLS), which does not equip GPs adequately for peri-arrest, time-critical emergencies.3,4
Checklists may be helpful, but doctors also need training. In Dorset, simulation-based workshops, focusing on the practicalities of managing emergencies, are now an integral part of our GP Vocational Training Scheme.
