Appraisal

1. Appraisal …and revalidation

2. Aims • What is appraisal? • Why do it? • Who does it? • What does it involve? • What is a PDP? • What is a PPDP? • What is revalidation? • So is it all worthwhile? What is in it for me?

3. What is appraisal?

4. What is appraisal? Appraisal is a formative and developmental process. It is about identifying development needs, not performance management. It is a positive process, to give GPs feedback on their past performance, to chart continuing process and identify development needs.

5. Appraisal Why do it?

6. Appraisal What does it involve?

7. GMC good medical practice Good clinical care Maintaining good medical practice Teaching and training, appraising and assessing Relationships with patients Dealing with problems in professional practice Working with colleagues Probity Health

8. Appraisal Learning styles and methods

9. Appraisal The structure

10. Appraisal structure Form 1 Form 2 Form 3 Form 4 Form 5 NHS APPRAISAL Appraisal for General Practitioners working in the NHS www.doh.gov.uk/gpappraisal

11. The Personal Development Plan (PDP)

12. So what is a PPDP then? …and where does it fit into the scheme of things?

13. PPDPs

14. Appraisal What’s in it for me?

15. Revalidation

16. Defining the evidence for revalidation • “Doctors will be required to provide evidence from their medical practice over the specified period, and must routinely collect and retain data from their day-to-day practice to support their case for revalidation.” • “In primary care, in order to sign-off a GP, the responsible PCT will need evidence to support this decision.”

17. Defining the evidence for revalidation • “What counts cannot always be measured; what can be measured does not always count”.

18. Summary of evidence set • Participation in appraisal5 robust appraisals and PDPs • Evidence of meeting minimum standards under “Good Medical Practice” • General statement of “absence of concern”

19. Evidence of meeting minimum standards under “Good Medical Practice”

20. Good Clinical Care • Audit: Evidence that the doctor is engaged in reflective practice • The doctor should provide a resume of his/her engagement with audit, giving examples. • This does not necessarily require the doctor to generate his/her own audits, but he or she should be able to describe how their practice develops as a result of audit outcomes, be these from PCT, practice or individual measurements. • Evidence of meaningful participation in significant event audit • To include a minimum 5 reviews in 5 years. • Each to include a learning outcome. Examples of suitable such events include: death in-surgery, new diagnosis of cancer, terminal care at home, a complaint, a suicide, a section under the Mental Health Act

21. Maintaining Good Medical Practice • Evidence of re-training in basic cardiopulmonary resuscitation(at least once in each revalidation cycle) • Documentation of clinical learning over the preceding five years • This can be lifted directly from the evidence provided by the doctor for appraisal, and might include, among other things: • Course certificates • Learning diary • e-learning records • Reading diary • Clinical items included on PDPs

22. Relationships with patients • A record of at least two patient surveys in the preceding five years, at least one of which is individual to the doctor, with appropriate action taken • Communication skills: evidence of at least one half-day of learning in communication skills in the preceding five years, to include resulting learning pointsExamples of such learning could include: • Attendance at a communications skills course • Shared surgeries with another doctor • Peer review of audio- or video-taped surgery • Self-analysis of audio- or video-taped surgery • Production of practice complaints procedure • List of all complaints within the past five years, involving the individual doctor, and subsequent appropriate action taken

23. Relationships with colleagues • Audit of records for legibility and accuracy • To the standard defined by the RCGP • This item also relates directly to the doctor’s provision of Good Clinical Care (pages 17-18) • Done by an external assessor?

24. Teaching (if appropriate) • The doctor provides evidence of performance review within teaching role eg • Trainer re-accreditation • Record of teacher training activities • Feedback from students

25. Research (if appropriate) • Proof of adherence to local research governance procedures • Declaration of research involvement

26. Other activities (management outside the practice, GPwSIs, GP Appraising, etc) • the doctor provides evidence of periodic performance review within these contexts

27. Probity • Self-declaration of GMC Status, NCAA Status, Criminal Status, to be verified by the PCT. • Self confirmation of other potential conflicts of interest

28. Health • Self-declaration of health status, as in appraisal

29. Evidence of annual personal development plan • To include review of previous year’s plan and comment on level to which planned items were fulfilled

30. Recommendations for priority development of new items of evidence Possibilities • Prescribing data. • Referral data. • Video review. • 360-degree review. • Away days and team meetings. • Equipment list.

31. Other methods of support Why is support important?

32. The mindset shift

33. I don't perceive I need help except in a crisis Support is valuable