Appraisals

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Stages of an appraisal

A medical appraisal is undertaken annually at a meeting between a doctor and a colleague who is trained as an appraiser.

The doctor is required to collect supporting information that is relevant to their scope and nature of work.

If more detailed guidance is needed, individuals should contact their appraiser responsible officer. It may also be appropriate to discuss specialty issues with the appropriate college or faculty.

 

  • Stage 1: Inputs into appraisal

    Scope and nature of work

    The doctor should define the scope and nature of the work that they carry out as a doctor.

    The GMC has confirmed that this should include all roles and positions in which the doctor has clinical responsibilities and any other roles for which a licence to practise is required.

    For example, it should include work for voluntary organisations and work in private or independent practice and should include managerial, educational, research and academic roles.

     

    Supporting information

    The GMC guidance 'Supporting Information for Appraisal and Revalidation' sets out the six types of supporting information that a doctor will be expected to provide over the course of each five-year cycle in relation to their scope of practice:

    1. Continuing professional development
    2. Quality improvement activity
    3. Significant events
    4. Feedback from colleagues
    5. Feedback from patients
    6. Review of complaints and compliments

    Collectively, this evidence should address the four domains of the Good Medical Practice Framework for Appraisal and Revalidation.

    These four domains are:

    • Knowledge, skills and performance
    • Safety and quality
    • Communication, partnership and teamwork
    • Maintaining trust

    Attributes within these four domains and examples of principles and values may be seen in the Good Medical Practice Framework for Appraisal and Revalidation

    The medical royal colleges and faculties have produced specialty guidance frameworks that offer additional guidance and detail and assist the doctor in preparing for appraisal. You should refer to these if you are within a specialty.

    It is not always necessary for the doctor to record reflection on each and every item of supporting information. It may be more appropriate for the doctor to record reflection on a summary, or category, of the information. The appraisal process should ensure that this reflection occurs.

    The preparation of the supporting information is important but it is the reflection on the information that will lead to identification of areas for development and improvement. It is not always necessary for the doctor to record reflection on each and every item of supporting information. It may be more appropriate for the doctor to record reflection on a summary, or category, of the information. The appraisal process should ensure that this reflection occurs.

     

    Review of last year's personal development plan (PDP)

    The doctor should provide a commentary on the previous year's personal development plan (PDP).  It is generally expected that the previous year's objectives would have been completed although circumstances and priorities may have changed (for example, a doctor's job may have changed). 

    It may also be that some objectives take longer than a year to complete and it may therefore be inappropriate for the plan to be completed, although this should normally be recognised and agreed at the time the plan is written.

    The appraisal portfolio should include the personal development plan and summaries of appraisal discussion for each year in the current revalidation cycle.

     

    Achievements, challenges and aspirations

    The doctor may also wish to include a commentary on recent achievements, challenges and aspirations, to help review practice and plan for future development needs.

     

    Declarations before the appraisal discussion

    Doctors should make a declaration that is visible to the appraiser that demonstrates:

    • acceptance of the professional obligations placed on doctors in Good Medical Practice in relation to probity and confidentiality
    • acceptance of the professional obligations placed on doctors in Good Medical Practice in relation to personal health
    • personal accountability for accuracy of the supporting information and other material in the appraisal portfolio

    Organisations have an obligation to assist doctors in collecting supporting information for appraisal. A doctor cannot be held responsible for genuine errors in information that has been supplied to them.

  • Stage 2: The confidential appraisal discussion

    The discussion, which normally takes between 1 and 2 hours, explores the evidence that the doctor has submitted and considers the development needs of the individual. 

    The discussion is confidential although there may be circumstances in which the appraiser must share information with others, in line with their professional duties - where issues of patient safety are raised for example. 

    When in doubt the appraiser or the doctor may wish to discuss this with the appraisal lead, responsible officer or nominated deputy.

  • Stage 3: Outputs from appraisal

    The doctor's personal development plan (PDP)

    The doctor and the appraiser should agree a new personal development plan at the end of the appraisal. The plan should contain a list of personal objectives with an indication of the period of time in which items should be completed and how completion should be recognised.

    The personal development plan represents the main developmental output for the doctor. It may be appropriate to combine this plan with any objectives arising from job planning and from other roles so that the doctor has a single development plan.

     

    The summary of the appraisal discussion

    The doctor and the appraiser should agree a written summary of the appraisal discussion, including an overview of the supporting information and the the extent to which the supporting information relates to all aspects of the doctor's scope and nature of work. It should also include the key elements of the appraisal discussion itself.

    It may also be helpful for the appraiser to record a brief agreed summary of important issues for the doctor in that year to ensure continuity from one appraiser to the next.

     

    The appraiser's statements

    The appraiser should make a series of statements to the responsible officer that will, in turn, inform the responsible officer's revalidation recommendation to the GMC. The appraiser should discuss these with the doctor.

    The appraiser's statements should confirm that:

    1. An appraisal has taken place that reflects the whole of a doctor's scope of work and addresses the principles and values set out in Good Medical Practice
    2. Appropriate supporting information has been presented in accordance with the Good Medical Practice Framework for Appraisal and Revalidation and this reflects the nature and scope of the doctor's work
    3. A review that demonstrates appropriate progress against last year's personal development plan has taken place
    4. An agreement has been reached with the doctor about a new personal development plan and any associated actions for the coming year.

    There may be circumstances where an appraiser is unable to make a positive statement. For example, a doctor may not have made significant progress with the previous year's personal development plan because of a period of prolonged sickness. In this event, the issue is drawn to the attention of the responsible officer and it does not mean that the doctor will not be recommended for revalidation.

    The doctor and the appraiser should each have the opportunity to give comments on the statements to assist the responsible officer in understanding the reasons for the statements that have been made.

    The appraiser must remain aware when conducting an appraisal of their duty as a doctor as laid out in Good Medical Practice. The appraisal summary should include a confirmation from the appraiser that they are aware of those duties.

    "I understand that I must protect patients from risk of harm posed by another colleague's conduct, performance or health. The safety of patients must come first at all times. If I have concerns that a colleague may not be fit to practise, I am aware that I must take appropriate steps without delay, so that the concerns are investigated and patients protected where necessary."

    This provides the context for a further statement that:

    1. No information has been presented or discussed in the appraisal that raises a concern about the doctor's fitness to practise.

    The appraiser and the doctor should both confirm that they agree with the outputs of appraisal and that a record will be provided to the responsible officer.

    If agreement cannot be reached the responsible officer should be informed. In this instance the appraiser should still submit the outputs of the appraisal, but the responsible officer should take steps to understand the reasons for the disagreement.

  • Timetable

    • 4 weeks before
      Agree a time and place to meet with appraiser. Prepare supporting evidence.
    • 2 weeks before
      Complete documentation and forward to appraiser
    • Appraisal
      Discuss supporting evidence and agree development needs
    • Within 2 weeks
      Complete appraisal forms and submit summary and PDP to Clinical Director and Responsible Officer

    The GMC will inform doctors of their revalidation date on two separate occasions. Doctors will also be given notice by the GMC nine months before the due date and be asked to confirm their GMC details. Doctors will then be reminded of this date approximately three months beforehand.