Appraisal and Revalidation VTS Teaching Tom Lawes

GP Appraisal  What is the purpose of appraisal? is a formative and developmental process gives individuals feedback on past performance charts and acknowledges continuing progress identifies learning needs produces a Personal Development Plan (PDP).

GP Appraisal  ‘professional process of constructive dialogue’  ‘positive process to give doctors feedback on past performance, to chart their continuing progress and to identify development needs.’  ‘help doctors consolidate and improve on good performance’  ‘can help to identify reductions in performance at an early stage’

Purpose of GP Appraisal  Summative as well as formative: Key part of recertification with RCGP Meets requirements of relicensing with GMC Participation in appraisal is a requirement of revalidation and provides required evidence Change in function has produced debate – now judgmental rather than supportive?

Preparing for Appraisal  Should have at least 2 months notice  Should have protected time set aside to prepare  Identify any issues to raise with appraiser  Ensure sufficient evidence covering headings  Draft PDP for coming year

NHS Toolkit  Comissioned by DoH to facilitate appraisal process.  Widely used by GPs for appraisal.  Funding from DoH withdrawn  Currently no clear decision on future vehicle for appraisal  RCGP ePortfolio

NHS Toolkit  DoH Forms: 1. Basic details 2. Current medical activities 3. Material for appraisal 4. Summary of appraisal discussion and personal development plan 5. Detailed confidential account of the appraisal interview

NHS Toolkit  Form 3 – Material for appraisal: Follows 9 headings based around Good Medical Practice (GMC and RCGP) Slightly different questions under each heading generally covering:  a commentary on your work  an account of how your work has improved since your last appraisal  your view of your continuing development needs  a summary of factors that constrain you in achieving what you aim for.

NHS Toolkit  PDP Review last year’s PDP Complete needs that have been achieved Identify unmet development needs and reasons for not meeting them Add proposed PDP needs to unmet needs and agree on resulting PDP for coming year  Summary of discussion – follows appraisal and signed by both parties

Can I fail an appraisal?  Essentially ‘no’ at present, as long as engaging with process  Ongoing discussion about future requirements  Will probably involve assessment of evidence: Quantity Quality  Will need standardised training of appraisers

Revalidation  Includes recertification and relicensing – currently single assessment for both  Four domains of good medical practice produced by GMC  13 evidence areas in RCGP proposed revalidation guide  May be subject to addition by GMC to meet relicensing requirements

Revalidation  4 Domains: Knowledge, skills and performance Safety and quality Communication, partnership and teamwork Maintaining trust

Revalidation RCGP Evidence Areas: 1: Statement of professional roles and other basic details 2: Statement of exceptional circumstances 3: Evidence of active and effective participation in annual appraisals 4: A Personal Development Plan from each annual appraisal 5: A review of the Personal Development Plan from each annual appraisal 6: Learning credits in each year of the revalidation period and in the revalidation period overall 7: Multi-Source Feedback from colleagues 8: Feedback from patients 9: Description of any cause for concern and/or formal complaint 10: Significant Event Audits 11: Clinical Audits 12: Statement on probity and health 13: Additional evidence for areas of extended practice

RCGP Revalidation PDPs  A valid PDP must contain the following key elements for each goal:  a statement of the development need  an explanation of how the development need will be addressed (the action to be taken and the resources required)  the date by which the goal will be achieved  the intended outcome of the goal.

RCGP Revalidation Learning Credits  Minimum 50 credits per year  250 over 5 years  Impact MSF – 2 questionnaires in each 5 year cycle Patient Surveys – 2 per cycle

RCGP Revalidation Significant event audits  5 in 5 years  Comprise detailed review of event including description, good/bad aspects, how it related to GMP domains, consequent changes. Clinical audits – 2 full cycle audits in 5 years

RCGP Revalidation  Unanswered questions: Exactly who will decide on revalidation of an individual doctor? What happens if they are deemed unfit to be revalidated? Will all areas be ready?  Difficult Cases  First cohort likely to submit evidence in 2012/13