UCL Medical School


Impact of Changes in VTS

An evaluation of the impact of changes to the General Practice educational programme within local Vocational Training Schemes (funded by Health Education England (HEE))

Heath Education England (HEE) piloted a new scheme to develop and deepen General Practice (GP) trainees’ understanding of population health and community orientation, by bringing together Community Education Provider Networks and Vocational Training Schemes in two London areas.

The research team in the Research Department of Medical Education were commissioned to evaluate this pilot scheme. Our team conducted this evaluation using a questionnaire and focus groups to gain insight into trainees’ and stakeholders’ thoughts about community orientation and population health, patient and education network involvement in developing the training, and also into trainees’ future career plans. 

Using descriptive statistics and thematic analysis, guided by a realist framework, we found that both groups thought that community orientation and population health were key to General Practice, and that familiarity with community health systems and local population needs helped trainees’ sense of belonging to the area in which they worked, motivating them to remain in the area after completing training. 

However, there was some confusion between the concepts of community orientation and population health, with trainees not clearly distinguishing between the two. Some trainees also found it challenging to contribute to these areas due to where they were placed on rotation, or having short consultation sessions with patients. Both groups valued the patient voice in General Practice, and felt that patient-centredness was key, but trainees had some concerns about how much input patients should have into the detailed planning of their training. Trainees knew little about the education networks involved in their training. 

Overall, while trainees and stakeholders agreed on the importance of community orientation, population health, and patient involvement, trainees were less clear in their understanding of these concepts. Understanding the contexts in which trainees work and learn can help when developing interventions to improve their engagement with these concepts.