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The updated RCGP guidance on supporting information for appraisal and revalidation is to be welcomed, as it recognises that appraisal has become excessively burdensome in some areas and needs to return to its formative and developmental focus.
It is good to see a mention of the need to ensure that appraisal does not take us away from patient care, and indeed from time with family and friends. A number of changes provide for greater flexibility and may reduce the workload involved in appraisal. A more detailed account of these is captured in our updated appraisal and revalidation guidance.
The requirements for QI (quality improvement) consolidate a trend of several years, away from audit to a broader more flexible range of options. This includes formats which sessional GPs in more enlightened areas may already routinely choose, such as reviews of personal outcome data, reflective case reviews, significant events, reflection of patient and colleague feedback.
I have written some practical guidance on QI activities for sessional GPs in our local guidance and have also recently collated a portfolio of anonymised QIAs which you can read through for ideas.
SEAs (significant event analysis) can be submitted as an example of QIA and there is no longer a requirement to submit two SEAs each year, but all GMC level SEAs must be declared and submitted.
Fifty credits over 12 working months (regardless of hours worked) covering the whole scope of your practice is sufficient and there is no need to obsessively reflect and document on every area of activity once this has been achieved. One entry for a course of several hours is sufficient.
We are encouraged to include some learning with colleagues outside of the workplace so time spent on self-directed learning groups, courses, etc. are all valuable to complement in house education. There is no longer the option to double credits through 'impact' claims but CPD credits can be claimed from learning arising from QIAs, SEAs and feedback.
Regarding patient feedback the guidance is no longer prescriptive about acceptable tools for the formal five yearly GMC complaint feedback we collect. We can also use other tools for colleagues' feedback relating to non-clinical roles, however we do need to show we are reflecting annually on other forms of formal or informal patient feedback.
If you juggle several portfolios (requiring a licence to practice), you must now include contact details for each organisation or employer so that the responsible officer (RO) can confirm that there are no outstanding clinical governance issues, concerns or investigations, before they make a revalidation recommendation. You should also include any formal outputs or summaries of performance reviews in these roles.
We are encouraged to document our continued professional development (CPD) via a structured learning log, including learning points and reflections regarding impact, without the need to exhaustively upload lots of certificates (except for mandatory training).
Paula Wright is a GP appraiser and Northern Region representative on the Sessional Sub-Committee of GPC.
appraisal departments seem to be forgetting appraisal was initiated to support doctors . I left my post as appraiser in March 2015 once I realised the department was getting exceedingly obsessed in the concept of whole practice appraisal. I also had a great difficulty getting colleague and patient feedback and the whole process took nine months , it seemed pointless and did not contribute to my work.
Up until now my appraisals have been both onerous and extremely stressful. I did not sleep properly for 6 months after one appraisal, worrying about the next. I now view myself as an appraisal machine who does some doctoring. Appraisal will be the reason I give up medicine. My appraiser confirmed to me that this would be the case (very encouraging, not).
My wife has given up because of appraisal. I know of colleagues who have done the same.
I hope that the above changes can be enforced. I have my doubts.
Has there been any "reflection" on whether or not Appraisal has been effective in weeding out poor performing doctors or revealing any possible "Shipman" candidates. If so, how many and has the monumental amount of work involved been justified. After all this is the main reason it was initiated.
Previously I was an Appraiser with the Welsh Deanery. When questioned all the Drs appraised privately admitted that they found this process a complete waste of time and yet another Tick Box exercise with no value. Many also said it would hasten their taking early retirement a situation re-emphasised by all my contempories most of who have left the NHS. It is time this is recognised and Appraisal/ Revalidation abandoned.
I left general practice and community hospital medicine because appraisals as separated family, weekly commutes were too onerous . in someone's wisdom doing GP work in a community hospital did not count as general practice and I became de registered as a GP . Where was the mentoring? the support? # sorry there's a locum crisis# thanks for the support# farewell
I don't want Appraisal tinkered with, I want it quietly put to death. It does not do anything useful and it is used to bully and intimidate doctors. It is a significant factor in the premature departure of many older experienced, capable doctors who still have enough self-esteem not to put up with the nonsense. Why is our Union not fighting it's very existence tooth and nail?