GP Mentor Application (SWL GP Mentor Scheme) Survey

The South West London GP Mentors Scheme - Mentor Application.

If you are a GP in SWL who would like to become a GP Mentor to support GPs working in SWL.

GP Mentors must be in permanent roles delivering a minimum of 3 NHS clinical sessions per week.
Mentoring sessions may be face-to-face or virtual and will be arranged at mutually convenient times for GP Mentor & GP Mentee.
The GP Mentor supplement is £72 / hour and may be paid directly to the GP Mentor or via an employing practice (subject to terms)*
The scheme also includes provision of mentorship training or refresher training as needed.

For further information and guidance about the Supporting Mentors Scheme please click here.

Thank you

Merton Training Hub
On behalf of South West London Training Hubs
zehra.safdar@nhs.net
nisha.patel16@nhs.net

1.Your details

Name

Email address

Phone number

2.Please select the borough you work in

3.Eligibility criteria

I am on the National Medical Performers List

I hold full registration and a license to practice with the General Medical Council (GMC)

I am not subject to interim suspension under section 41A of the Medical Act 1983

I am working 3 or more NHS clinical sessions per week

4.How many NHS clinical sessions do you work each week in primary care?

5.Please provide details of your main employing practice

Practice name

Practice address

6.Please confirm how many years' post -qualification you are

7.Please let us know why you would like to be a SWL GP Mentor?

8.In order to support a standardised GP mentor offer across SWL, please choose either mentor training (1st time) or mentor update training (refresher)

Mentor Training (1st time)

Mentor Update Training (refresher)

If you hold an existing mentoring qualification or similar, please state: date obtained, awarding organisation?

9.Could you describe any particular challenges you might encounter as a GP mentor and how might you approach these?

10.How many GP fellows / mentees could you potentially support each month (1.5 - 2 hours per mentee)

1 mentee per month

2 mentees per month

3 mentees per month

4 mentees per month

Other (please specify)

11.Declarations

I am aware my details will be processed by Merton Training Hub in order to facilitate and deliver the SWL GP Mentor Scheme and will be processed in accordance with our Privacy Notice, accessed here.

*GP mentors will be asked to sign a separate Memorandum of Understanding to acknowledge and agree to the Terms and Conditions as stipulated by NHSE/I, including changes in circumstances which may affect eligibility for this scheme.

I understand the mentor supplement will be paid following submission of a valid invoice and timesheet.

I understand I may occasionally be asked to provide feedback on this process, to support evaluation.

I understand sessions will be confidential and will be related to personal and professional career development, not clinical competence.