Appraisal for GPs
Appraisal In General Practice
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Appraisal
"a process by which clinicians can chart their continuing progress and identify their development needs"
(Department of Health 2001)
“a positive, developmental, employer-led, two-way, action-oriented process, primarily directed at quality improvement”
(ScHARR 2001)
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
References
Supporting Doctors and Protecting Patients 1999
NHS Plan - Annual appraisal, condition of contract by 2001
GMC Revalidation Procedures ScHARR View of Appraisal SCHIN NHS Appraisal Toolkit
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Purpose of Appraisal
appraisal as performance assessment assessing, rating or scoring an individual's
current performance against predetermined standards
appraisal as performance development developing capability, promoting education and
personal development, and facilitating future achievement beyond current levels
ScHARR
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
An Appraisal is …
an annual process for: Exploring role expectations, negotiating relative
priorities, and staffing, and aligning individual and organisational objectives at local level.
Reviewing progress towards achieving previously agreed objectives and agreeing future objectives.
Recognising, acknowledging and valuing achievements.
Exploring what is needed from the organisation to help and support the individual in making the best contribution that they can.
ScHARR 2001
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
And also …
an annual process for: Identifying personal development needs and the
means of addressing them, and forming a personal development plan.
Helping the individual to produce information for any external accreditation procedure
Exceptionally - early identification of an individual struggling or performing poorly.
Securing overall improvement in performanceScHARR 2001
Distinctions
What’s the difference between
Appraisal and Revalidation?
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Appraisal is …
led by the organisation/employer and focused on the performance of the individual employee
a way of aligning organisational and individual objectives part of a wider systematic approach to performance
management and development within the organisation an annual process a process internal to the management organisation a local process, customised to suit local and individual
circumstances
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Appraisal is also …
a two way process, because it can encompass consideration of contextual,environmental or systemic factors inhibiting individual performance
primarily performance-developmental (or `formative', to use the medical education parlance)
action orientated, with agreed action commitments on both sides
as far as possible, a process with accepted, agreed outcomes confidential, with many outcomes shared narrowly
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Whereas, Revalidation is …
led by the professional regulatory body (in this case the GMC)
a way of checking that an individual doctor is fit to practice part of the individual lifelong requirement of being able to
practice as a doctor a quinquennial process a process external to the management organisation a national process which is standard for all doctors, whoever
employs them
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Revalidation is also …
a one way process an assessment process (‘Summative’) status oriented (i.e. confirming fitness to practice), with
required actions (if any)on one side only a process with imposed outcomes a matter of public record
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
ScHARR schematic
Planning process Practice Visit Report process 6-month follow up
School of Health and Related Research, University of Sheffield
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
ScHARR schematic
The Appraiser will need (minimum) Initial Training 1 hour preparation 1-2 hour appraisal time ½ hour writing up report ½ hour midyear review ½-1 hour travel each time
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Appraiser Training
Cascade system Initial programme Feb – Jun 02 Max 3 appraisers per PCT Trained appraisers then cascade training in
locality
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Continuing Training
Initial Training Continuing Training
2-3 days per year for:ongoing training in appraisalgeneral administration
e.g. preparation of overview reports
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
The Appraisal
Initial Aims: to begin to establish the appraiser/appraisee relationship to ensure that GPs have personal development plans, or have begun
work on them to explore one or two other aspects of practice, agreed locally, for
which robust information is available to produce a basic action plan for the GP for the coming year to generate information for the revalidation folder to produce limited, sensible recommendations for action to be
supported by the HA/PCT or practice to develop GP/practice to explore how appraisal should develop in future
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Prior to the visit …
achievements and challenges in the last twelve months (clinical and non-clinical), seen where relevant in the context of earlier appraisals
service, practice and (where relevant) wider objectives for the next year and beyond
in the light of objectives, personal (and perhaps practice [if appropriate to a discussion about the individual in context]) development needs
progress in collecting evidence for revalidation purposes share information before the meeting and agree a joint
agenda
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
The Appraisal Discussion
Preparation Appraiser& Appraisee
Agreed Agenda beforehand Comfortable work setting
free from interruption protected time (at least 90 minutes)
Two-way discussion Work through agenda
agree points for action by each side
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Appraiser Techniques
Prepare for meeting including travel arrangements, directions etc
Confirm the agenda has been agreed Ask about achievements in previous period
celebrate success Problem-solving style Seek opportunity to learn yourself Finish on a positive note
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
The Report
The appraiser and appraisee should agree a written overview of the appraisal which should minimally include:
a synopsis of achievement in the previous year objectives (an action plan) to be pursued by the appraisee over the
next year including milestones and review dates actions expected of the HA/PCT to address needs in the local
context or wider system the key elements of a personal development plan for the appraisee a standard summary of the appraisal as recommended by the GMC
for the individual's revalidation folder a declaration that the appraisal has been carried out properly
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Contentious issues
How confidential is the appraisal? Who “owns” the report? How is the feedback given? How is support given to those with identified
needs? Who supports the appraisers? What liability would the appraisers be assuming? Who reviews/appraises the appraisers?
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Costs
Initial setup Training Costs Backfill (Locum Costs)(1 whole day)
Appraiser time: @ £60 per hour (LMC suggestion) £300 per appraisal administrative support (confidentiality)
5 hours minimum work per appraisal: 41 principals, ?5-10 non-principals in locality
Dr Andrew Mowat, Primary Care Tutor, Dr Andrew Mowat, Primary Care Tutor,
James Street Family Practice, LouthJames Street Family Practice, Louth
Summary
Appraisal is different from Revalidation Allows identification of areas of success, and
future needs Sets an action plan to meet those needs,
involving the individual Is confidential to appraisee & appraiser Will need significant investment by ELPCT
Questions?