If your practice has used the clinical governance tool  http://www.wales.nhs.uk/sitesplus/888/page/44038 you may wish to reflect on the process and the results shown.

You can download a template here. 

Section 4: Practice skill mix

All practices have individuals with skills; the mix of these skills contributes to the efficient running of the practice. It is not feasible for every GP to be highly skilled in all areas and as such it may be useful to plan the mix of skills within the practice. This skill mix may put a greater or lesser emphasis on an individual’s PDP. The template below allows the practice to look at skills it may need to provide a good/better service and the reflective template allows the individual an opportunity to examine their individual skills and needs for the future. The template is not exhaustive and the practice should identify skills required in their own area (e.g. dispensing does not apply to all practices)

A template can be downloaded here.


SkillWho possesses it?Is this enough provision?Training needs (for whom?)
Child health surveillance Dr A, Dr B and 2 health visitors Yes the clinic alternates between the two doctors and the health visitors only once have we needed to cancel a clinic due to absence of both partners. Dr A did a course 18 months ago. Dr B needs to do an update course. Both health visitors receive annual training from the trust
Minor Surgery Dr C and to some extent Dr D Probably not Dr C is doing the vast majority of minor surgery and as a consequence has a 2 month wait for non urgent cases. The procedures (payment) is capped by the LHB so extending our provision would not increase income Dr C is up to date with training Dr D would like to extend her skills and is to attend an update course in 2 months and will have some in house training from Dr C
IUD fitting Dr D and Dr A Yes probably more than enough – each partner insert 10-12 per year which is just about enough to maintain skills No not at present
Cytology Sister A Sister B Drs A, C ,D and E Yes probably enough Dr B used to perform smears but has not undertaken liquid cytology training No Dr B is happy not to take cytology
Diabetic annual check Dr E sister B Not enough to cope with the volume. Sister B is overwhelmed with annual checks and Dr E cannot possibly see all the patients himself The structure of the diabetic care in the practice needs evaluating and Dr E Sister B and Dr A have agreed to look at this and identify structural changes and training needs
Add other skills below      

Practice training needs overview

NeedHow need will be filledCompletedAny change to practice?
Dr B needs to do an update course in Child health Local course runs annually (next course booked but not for another 4 months)    
Dr D is to attend an update course in Minor Surgery Update in minor surgery at local postgrad centre Completed 23rd June Dr D now to have 3 or 4 supervised sessions with Dr C and will take a bigger role in the practice
Diabetes care Under examination at present by Dr E, A and sister B    



If your practice has completed the template above you may wish to examine your role and possible training priorities for the future by using this template


Do I possess specific skills or am I responsible for a specific area of the work of the practice? I run child health clinics once a fortnight and have received training within last 18 months. I fit IUDs and take cytology I have an interest in cardiology but do not perform a specific role within the practice. I am just about to become involved with diabetic care.
Are there gaps in the skill mix of the practice that I need training in order to fill? I will need to update my diabetic care when I move in to helping run the annual review clinic. I am confident with the cardiac prevention side of things but am less confident on the physical examination – particularly the eyes. I am also less familiar with the newer oral glycaemic agents
What are those training needs and what are the ways in which to meet them? I think I need to look at the elements of an annual check and which examinations I will perform and if there are others in the (extended) team better placed – for instance I am rusty on examining fundii but all diabetics now have annual retinal photography – so do I need this skill? I certainly need to update my knowledge on oral glycaemic agents and insulin. I will do this in a number of ways – there is a diabetic course that runs fairly regularly locally and there will be an element of personal reading but I also intend to write up a couple of case histories and discuss them with Dr E
Are there any areas you would like to develop (even if its not an area that the practice needs more provision) I would like to do a little minor surgery and I will attend a practical course, I will probably confine myself to smaller procedures but it does interest me (perhaps next year)