About DocRick

Having worked in the UK National Health system as a doctor and educator for thirty years I have seen vast changes in treatments and provision of healthcare.

The NHS is one of the most cost efficient healthcare systems in the world providing comprehensive healthcare based on need. But there is so much more to do and it can be much better.


The focus in this website, started in 2009, is on the principles and ideas behind quality of healthcare and education. Hopefully clarifying and breaking down some of the theory into simpler practical steps.


News – David Black at JRCPTB announces outcome based training to end tick box competencies. What a trainee is trusted to do. BMJ June 2016 Go to “Education” and drop down to “Outcome based education”

Your feedback on the website, ideas and examples is much appreciated as it will add to what is here already. The website is based on personal archives of references and experience along with national guidance and literature wherever possible.

My intention is to indicate the source of ideas and comments at all times. It is very helpful if people can let me know about original sources so that the website can link to them. If I have misquoted please let me know so that I can correct it.

I hope you get a few ideas from docrick that we can then all build on from.

Contact myself at Mark.Rickenbach@nhs.net or  “DocRick”  if you have any comments.

Contact me if you would like me to  provide any of the following:

  • Talks, seminars or meetings based on any, or a selection, of these website topics.Currently I am looking at proactive healthcare consultations, learner centred education or rapid information recall.
  • Support with review of healthcare or education qualityMentoring /coachingAppraisal contentVideo Review of consultations

For background information the following extract is from the University of Winchester website:

Professor Mark Rickenbach has worked in the NHS for twenty five years in the hospital acute setting and the community setting with a focus on education and research.

He worked from 1993 to 2014 as a course organiser, then programe director, then associate dean with a lead on the quality of postgraduate medical education for trainees within the Wessex Deanery area of Southern England.

Mark is a Visiting Professor of healthcare and education quality at the University of Winchester. Mark previously assisted the Postgraduate Medical Education and Training Board (PMETB), from its inception in 2005, with its focus on developing the UK system for trainee and trainer feedback. This system continues under the General Medical Council (GMC).

As a general practitioner/family physician he is based in a practice near Southampton as one of the doctors leading the care of 15,000 patients.

He also works as a GP trainer, GP appraiser and GP mentor, alongside his role as a supervisor of Healthcare, PhD students and research fellows. He leads a GP research team at Park and St Francis surgery. He is an educational assessor for the Royal College of General Practitioners, an assessor for the National Institute of Health Research and a reviewer for the British Medical Journal.

Mark holds fellowships with the Royal College of Physicians, Royal college of General Practitioners and the Higher Education Academy. His PhD, also published as a book, looked at ways to improve the quality of education and sits alongside publications and presentations on clinical and educational research.

Mark’s research has both a clinical and practice based element and covers areas such as asthma inhaler fullness, counselling, appraisal and education. His main contribution has been in supporting the professional educator to reflect and develop their own practice using feedback and systems for clinical and non clinical information.

Currently Mark is looking at ways to support primary care and tackle the workload crisis general practitioners. This includes work on doctors assistants, counselling models, pre consultation questions, information retrieval  with wiki indexing  and frailty care services.


Intrahepatic Cholestasis associated with co-trimoxazole. Oliver RM, Rickenbach MA, Thomas M, Neville E. Br J Clinical Practice 1987;41

Guidelines on Palliative care. Rickenbach MA. J R Coll Physicians Lond 1992;6:112

Assessing fullness of asthma patients’ aerosol inhalers. Rickenbach MA, Julious SA. BJGP 1994;44:317-8.

Problem lists in letters. Rickenbach MA. BMJ 1994;306:580

Hospital Vocational Training. Rickenbach MA. BMJ 1994;309:196

Television programme’s realism. Rickenbach MA. BMJ 1994;309:132

Acute myocardial infarction. Rickenbach MA. BJGP 1995;386

Assessing and counselling trainees. Rickenbach MA. J R Coll Physicians London 1995;29:177-8.

Deaths caused by asthma. Rickenbach MA. BJGP 1997;47:125

Senior house officer training. Impact of existing peer review visits needs to be increased. Rickenbach MA, Dunleavey J, Little P, Mullee M. BMJ 1997;314:1829-30.

Natural history and management of dizziness. Rickenbach, M.A. and Rickenbach, L.A. BJGP 1998 48, 1435

Primary care education centres. Rickenbach, M.A. BJGP 1998  48, 1527

The RCGP’s questionnaire for measuring SHO’s satisfaction with hospital training. Rickenbach, M.A., Dunleavey, J., Little, P. and Patterson, W. BJGP 1998 48, 1788

Oral contraception and health: what do GPs monitor? Rickenbach, M.A. BJGP 1998  48, 1874

Equipping junior doctors for a career in primary care. Rickenbach, M.A. ImpAct 1999 1, 5-6.

Improving education for senior house officers. Rickenbach MA, Dunleavey J. BMJ 2000;321(7259):511-2.

Association of Course Organsiers Conference 2000, in Portsmouth. Rickenbach, M.A. Education for General Practice (2000) 11, 452-453.

A new kind of vocational training SHO post in woman’s health. Rickenbach, M.A., Smith, F., Shepherd, E. and Osgood, V. Education for General Practice  (2000) 11, 456-458.

The hospital component of vocational training. Rickenbach, M.A. and Smith, F.Education for General Practice (2000) 11, 453-456.

Ethical guidance for teaching applies to postgraduate education as well. Rickenbach, M.A. and Smith, F. (2001) BMJ 323,48

Incentive payments may reduce time for clinical care. Rickenbach, M.A. 2001 BMJ 323, 1369-1370.

Interventions to improve education: The National Health Service and junior doctors. Rickenbach, M.A. 2001 Bournemouth University. pp.1-12. Summary report of draft thesis for the NHS R&D. PhD.

Unfinished business: an opportunity for General Practice. (editorial) Smith F, Rickenbach M, Pitts J, Illing J. Education for Primary Care 2003;14:15-17

Medical Education, professional learning and action research in the Health Service: Assessment, interventions and future models for general practice training of senior house officers. Rickenbach,M.A. 2003 PhD thesis Bournemouth University http://eprints.bournemouth.ac.uk/294/

A Local Linked Addresses Management and Advice (LLAMA©) system for General Practice CDROM 2004

Innovative Training posts: trust attached general practice registrars. Rickenbach M A, Mullee, M., Smith, F. and Scallan, S. 2006 Education for Primary Care 17, 130-137.

Appraisal in post and NHS appraisal: functions and terminology Ball K , Rickenbach M , Scallan S, Goodman J, Smith F. 2007; Education for Primary Care18:665-776

Rapid Access to Locally Relevant Information during the Patient Consultation in Primary Care and review of  The Local Linked Addresses, Management and Advice (LLAMA) Information database Rickenbach.M, Kibble.S, Scallan.S, Leach.C, Phillips,A Report April 2009 NHS Education South Central and University of Winchester

Counselling in primary care a low cost educational model NICE Shared learning database 2009

The Formative Impact of GP Appraisals: a post-appraisal questionnaire survey

Zolle.O,.Rickenbach.M, Scallan.S, Gorrod.E..Education for Primary Care 2010

An alternative Educational Model for Providing Psychological Therapy in Primary Care: Zolle.O,.Rickenbach.M, Scallan.S, Dunkley. C Primary Healthcare Research and Development Cambridge University Press 2010

The PMETB National Trainee Survey – is it a useful tool? 2010 Rickenbach,M,  Wedderburn,C. Education for Primary Care

Giving Feedback for Medical Educators: Action Research and Professional  Learning in the setting of postgraduate medical education 2010 Rickenbach, M. Lambert Academic Publishing ISBN 978-3-8383-3785-2

Questionnaires, questionnaires  Wedderburn C , Rickenbach M. BMJ Careers 2011 342(7808):GP172–GP173.

Identification of poor performance in NHS organisations Locke R, Scallen S, Leach C, Goodman J, Rickenbach M. May 2011 Winchester University

The role and value of ITPS to specialty training in general practice Scallan, S, Lyon-Maris.J, Rickenbach,M. Education for Primary Care 2011 22: 283-5

A GP at the Olympics. Rickenbach M. Bulletin Wessex Faculty RCGP August 2012

Follow the yellow brick road: integrated care – can we do better? Rickenbach M, Wedderburn C BJGP 2012 62 (601) 441-442

Gaining a wider perspective on life in medical education.  Rickenbach M. from Creativity in the Classroom  editors Paul McIntosh, Digby Warren: Intellect Ltd, Bristol 2013 Ch 8 p115-123

How do Departmental Lead Educators Review the Quality of Postgraduate Medical Education and Training Provided within Their Departments El Bakri F, Rickenbach M. (2014) MedEdWorld

Local Assessment of the Quality of Postgraduate Medical Education and Training by Directors of Medical. El Bakri F, Rickenbach M. (2014) MedEdWorld

An ideal training for the future career patterns of family medicine. 2015 Rickenbach M. Ch 64 from WONCA worldbook editor Carl Steylaerts WONCA

Issues relating to use of a Wiki index in primary care. Mark Rickenbach RCGP annual conference, Harrogate 2016

Frailty clinics within integrated healthcare. Mark Rickenbach and Abigail Barkham RCGP annual conference, Harrogate 2016

Counselling provision in primary care – a low cost sustainable model. Mark Rickenbach and Ken Lawrence RCGP annual conference, Harrogate 2016

The Impact of using Pre consultation questions. Mark Rickenbach RCGP annual conference, Harrogate 2016 Highly commended http://www.rcgpac.org.uk/posters-2016-winners-and-highly-commended/

An Integrated care clinic for frail patients and the use of action research Mark Rickenbach CARN annual conference, Lincoln 2016