Frequently Asked Questions

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    Appraisal is not a process of assessment that one passes or fails, and the new scheme is not about scrutinising doctors to see if they are performing poorly.Appraisal is not a process of assessment that one passes or fails, and the new scheme is not about scrutinising doctors to see if they are performing poorly.Appraisal is about helping individuals to improve the way they work and the services they provide, themselves and with others. Appraisal goes beyond simply judging individuals on what they have achieved over the past year. It offers a framework for planned, constructive, professional dialogue. It provides the opportunity for reflection about current performance and progress. This is used as a platform to set goals for future professional practice and development which will also contribute to the needs of the organisation in which the individual works. Appraisal should therefore be a positive, constructive process which is mutually beneficial to both the individuals being appraised and also to the organisation in which they work. In addition to the above the aim of appraisals now being introduced now is to provide a report to the responsible officer or body in lieu of the RO, upon which a recommendation to the GMC can be made as to the practitioner’s fitness to practice.
    Most organisations already operate systems of appraisal among professional staff groups. Indeed, NHS organisations have already introduced appraisal for medical staff. They believe that they should have access to the same sort of frameworks as other professional groups for supporting personal development within a constructive performance review process and aligning this with organisational needs. Such local arrangements are valued by the doctors participating in them. In recent years health care and health improvement become ever more sophisticated, requiring the application of greater levels of knowledge and skills. In keeping with higher expectations from patients, the public at large, and indeed the profession itself, doctors increasingly accept that they must monitor, review, and improve (if necessary) their clinical skills and practice. Appraisal will be an important tool for meeting these requirements in a positive way. In addition, the General Medical Council is in the process of introducing a compulsory revalidation process for doctors, the purpose of which is to monitor doctors’ clinical performance, and now all doctors and healthcare organizations have to demonstrate high standards of clinical governance. It is against this background that appraisal is now being introduced for all licensed doctors in the UK
    Revalidation is the process whereby the General Medical Council will establish a doctor’s fitness to practice and with it, the right to remain on the medical register. The process will have a five-yearly cycle. The GMC has agreed, following discussion and agreement with the UK Health Departments and the profession’s representative organisations to allow the appraisal process to be the principal vehicle through which the evidence required for revalidation will be collected and presented for all doctors, provided the process proves to be satisfactory for this purpose. The revalidation cycle is essentially a retrospective process looking at clinical performance over the previous five years. In the case of appraisal, it will be employed in a formative way on a year-to-year basis to ensure development of professional practice and to set professional objectives. Clinical governance has been defined as “corporate responsibility for clinical performance” and is a clear responsibility of all NHS organisations. They are required to fulfil this responsibility by pulling together and monitoring the systems that ensure services meet quality and safety standards. NHS organisations are also required to ensure that we learn from mistakes, and that we continually develop services to meet new demands and standards of care. The new appraisal arrangements will be an important element in that overall process. A combination of these requirements _ revalidation, personal development and clinical governance _ has led to the mandatory introduction of a national appraisal scheme. While such an approach may not be ideal for all local circumstances and requirements, it does mean that appraisal becomes established practice applied through a consistent approach throughout the profession. Sensitive and flexible implementation of the national requirements can ensure that these are effective in meeting local needs.
    Appraisal will only succeed, and be of value to individual participants, if they recognise that the process provides appraisees with opportunity and support for reflection, and constructive feedback on which personal and professional development can be based. Of course, at a more basic level, doctors who do not meet the GMC evidence requirements will not be revalidated and will therefore not be allowed to practice. However, dwelling on this would place appraisal in a somewhat threatening and negative context. Suffice to say that doctors are likely to get more out of appraisal overall if they focus on the developmental aspects of the process which will benefit their practice in the long run. HOW WILL THE APPRAISAL SYSTEM WORK? At the core of the appraisal process will be an annual meeting between the doctor (appraisee) and his/her appraiser. The purpose of this meeting is to ensure the opportunity for constructive dialogue through which the doctor being appraised can reflect on his/her work and consider how to progress his/her professional development. These meetings will provide a positive process to give doctors feedback on their performance, to chart their continuing progress and to identify and plan for development needs. The appraisal meeting should be arranged well in advance to afford the opportunity for the appraiser and appraisee to gather together the necessary data to support a meaningful and constructive dialogue at the meeting. The content of the appraisal will be based on the headings contained in the GMC’s “Good Medical Practice” document
    Hopefully, when you have learned more about the new scheme, you will recognise the value of the process to you, and will decide that you are keen to participate. In addition, appraisal is now a condition of the national employment contract for consultants and refusal to participate would be a breach of contract and a disciplinary matter. The national conditions of service are also clear that non-participants would be precluded from consideration under the discretionary point and distinction award schemes. Finally, you must also bear in mind that the GMC has agreed to appraisal as the vehicle to revalidation, which will be necessary for a doctor to remain on the medical register s a licensed doctor and therefore maintain the right to practice. In certain less common cases, a doctor may choose to remain registered as a medical practitioner, without a license to practice. If you believe this category of registration applies to you, contact the GMC for advice, or contact us at the Doctors Appraisal Consultancyfor more information.
    The first appraisal cycle will commence towards the end of 2012, but it is now a requirement by the GMC to have annual appraisals. The period leading up to then should be used by doctors to start thinking about preparing their appraisal folders and to familiarise themselves with the requirements of the process. Obviously, the process will not be perfect from day one. In a whole range of areas, participants’ comfort with, and their ability to make best use of, the new process will develop with experience. However, if the right degree of effort is applied to its introduction we might reasonably expect that after two or three years the appraisal of consultants will have become a well-established process that is valued by all participants.
    At the time of writing appraisals can be conducted by a medical practitioner who has been registered for at least 5 years, and has received approved appropriate training in the doctors appraisal process. Crucially for such an appraisal to be accepted for revalidation purposes the RO must have created a relationship with the appraiser, to enable him to rely on the appraisal to enable a recommendation for re-licensing to be made. In the independent sector there are a number of appraisers who have developed experience in appraisal processes through the NHS appraisal system. The appraiser that you choose does not have to come from the specialty from which you are practising. Appraisal training provides the appraiser with the tools to provide a comprehensive and fair appraisal to any medical colleague. Many doctors prefer to have an appraisal from an appraiser with a different background to themselves. Others feel that their specialty raises specific issues that only a colleague in the same specialty can review fairly, and prefer to see a peer from their own specialty. However under the current regulations it is evident that the responsible officer of your designated organisation (the body through which you are being revalidated) will need to use the information from the appraiser as a basis to make their decisions as to your fitness to practice. In this situation the responsible officer will need to check the experience and training of the appraiser, so they will have confidence in their abilityto provide an appraisal process of high quality. In the event of your designated body not being able to provide you with an appraisal with an appraiser of whom you approve, or for more general information about the issue of choosing an appraiser, contact us at the Doctors Appraisal Consultancy for more information
    The appraisal process is not intended to require the generation of significant amounts of new evidence or information; rather it should aim to capture relevant information that already exists. What goes into the folder will, in many cases, be available from clinical governance activity, the job planning process and other existing sources. The process itself may assist doctors to identify the data they would consider relevant to their specialty or personal clinical practice that would be usefully brought to their appraisal. One result of the appraisal process will be to identify areas where there are gaps to be filled or where perhaps data need to be better collated or presented. This is likely to be more apparent in the early years after appraisal is launched. Doctors will need to consider which documents they will require to collect for the appraisal process in light of the circulars and other guidance they receive. Your designated bodyshould, in due course, issue guidance on good practice within its specialty.
    There is no definite answer to this at the time of writing, as appraisals in the independent sector are gradually being introduced. What can be said is that the accepted policy is for the appraiser to provide the appraisal interview at the venue of their choosing, i.e. the appraisee goes to the appraiser for their appraisal. Travelling expenses are met by the appraise, but in the situation where the appraisal takes place at the appraisee’s place of work, travel costs are at the expense of the doctor having the appraisal. However in situations where these arrangements caused difficulties contact us at theDoctors Appraisal Consultancy, as appraisals can be arranged more conveniently for you. The timing of the appraisal will be by mutual consent and the appraiser will usually endeavour to provide flexibility to allow you to do this at the most convenient time for you, whether this was after working hours or during the working day.
    Please contact Dr Myers here at theDoctors Appraisal Consultancy on 07956 393916 or by email to, to discuss any issues relating to the new revalidation arrangements.