Devon LMCs - Crib Sheet On Your Appraisal – February 2003
Apologies for delay in production of this sheet and the attached detailed notes from Dr John Dean, which unfortunately will come after the event for some of you. This crib sheet is prepared extensively from his document, and a Somerset LMC paper.
You should receive from the PCT
The Pre and Post Appraisal Support Mechanism
Aside from the usual support mechanism
· GP appraisal is supposed to be a supportive formative, educative process.
· It is an opportunity for GPs to consider and reflect upon their clinical practice and professional development.
· It allows the GP to get an objective view of their practice, and how this compares with that of colleagues.
· It should help to identify personal, practice and systems problems and to obtain help in addressing them.
· It will form a substantial part of the material that doctors need to collect for their GMC revalidation.
· It will reassure some patients that an assessment of GPs is being undertaken on a regular basis.
· Individual poor performance is often related to poor practice procedures.
· The value of your appraisal to you will largely depend on your approach and preparation.
· Remember that the appraiser’s primary responsibility is to implement PCT & DoH policy.
· The appraiser has an undefined duty of care to the appraisee.
· GP should be able to select an appraiser from a list, if none are acceptable then contact LMC for guidance.
· GPs should have 2 months notice of appraisal date.
· Half day attendance fee for preparation of Forms 1-3.
· Half day attendance fee for appraisal meeting – Form 4 is completed & possibly Form 5.
We suggest
· You only spend the allotted protected time.
· Prepare and maintain an appraisal folder to form a learning portfolio
· Things should get easier each year as your folder will assist the ongoing process.
Record of basic demographic and professional information.
Record of all current medical and professional activities undertaken by the GP.
“the heart of your learning needs assessment”
· Detailed advice from Dr John Dean is in his attached paper on pages 3 -7. We highlight the following:
· hold any supporting papers available for appraisal meeting rather than submit them.
· You can refuse to complete any items you feel threatening, offensive or invasive of your privacy. The LMC can provide independent confidential advice about such issues.
· You are not expected to provide exhaustive detail.
· It is questionable whether you can be compelled to provide information about non-NHS activities. Helpful to consider them and include within your PDP.
· Be specific in selecting your objectives and ensure they are achievable and measurable.
· Avoid setting too many objectives.
· Whilst constructive to focus on issues that can be locally addressed, do record important issues that affect your clinical work outside of your own and PCT control.
· LMC encourages GPs to identify 2 or 3 points where PCT action could produce improvements in some aspect of the GP’s professional life. It will be a useful measure of the value of appraisal to see whether they have been acted on by time of next appraisal or before!
· www.appraisals.nhs.uk has a range of guidance for helping you complete the appraisal including an electronic appraisal record. However you should consider the advisability of storing confidential material on its host server – no web-based system can be considered absolutely secure.
· Forms 1-3 are not to be shared with any other person without your express written permission.
· All records will be held on a secure basis and access/use must comply fully with the requirements of the Data Protection Act.
Summary of appraisal discussion and PDP.
· Completed during or immediately after appraisal.
· This document is not confidential and a copy will go to the PCT.
· Do not be pressured into including information that you do not wish to share.
· In cases of disagreement, appraiser and GP may wish to seek confidential and independent advice from the LMC.
Detailed record of appraisal meeting
· Use is optional.
· Confidential between GP and appraiser.
· 30 min call/meeting with appraiser at least once during the following year.
· Clinical Governance Lead should collate and submit aggregated and anonymised report on appraisal outcomes annually to highlight emerging training and development needs, and review appraisal process.
Hopefully you will not need this but in case you do …
· You should not sign an appraisal summary with which you are unhappy.
· If you are unhappy with the appraisal outcomes you really should discuss this with appraiser at the appraisal in the first instance to try to reach a satisfactory outcome.
· Appraiser should arrange to return with an independent external appraiser.
· If this fails discuss position with PCT Clinical Governance lead.
· If above fails then ask for a formal panel hearing to be convened by PCT.
· We strongly advise consulting LMC at earliest opportunity.
For those of you feeling anxious about appraisal we invite you to contact the LMC office (01392 834020) to arrange to discuss your worries.
It may also be that during the appraisal itself difficult issues are raised concerning for example partners or practices as well as individual health or career related problems. We should like to remind all GPs in Devon that they have access to a wide range of support to help with difficult situations. We strongly advise that where such issues arise a clear plan is made which involves external advice. This could be from Peter Jolliffe or John Dean at the LMC or for health related advice through the Occupational Health Service in your area. IF YOU ARE UNSURE CONTACT THE LMC.
· Appraisers must be prepared to cope with emotional and personal issues that may be revealed by the GP in the course of an appraisal. Whilst these may or may not be relevant to the doctor’s performance, the LMC considers that the appraiser must ensure that the GP has a plan of action for dealing with any significant issues before the appraisal process is completed.
· Important that GP has choice in setting out own action plan with milestones set out to monitor own progress.
· Very occasionally the appraiser may identify very serious performance or health concerns. He or she should do their utmost to persuade the GP to report these themselves to the LMC, the PCT clinical governance lead, or to Occupational Health. If the GP declines to do so then the appraiser may be required under GMC rules to take action. We recommend the GP and appraiser instigate a discussion with the LMC medical secretary in the first instance.
– ie. your own resources:
· Your own “coping network” of family, friends and activities.
· In practice education, mentoring, pastoral support, planning and training arrangements.
· Colleagues in your own or another practice.
· Your appraiser or another appraiser.
Just to remind you the following support is also available to GPs:
· LMC – Dr Peter Jolliffe 01392 834020 – peter@devonlmc.org
or - Dr John Dean 07831 430324 – john@dean.eu.com
· Education
§ South Western Postgraduate Dept 01392 205205 www.swgped.co.uk.
Tutors N&E: Dr Moris Watt mwatt@cix.co.uk
S&W: Dr Russell Steele rustle@cix.co.uk
§ Your PCT Clinical Governance Leads may be providing training opportunities etc.
§ Practice Manager may have details of companies offering team and individual education or training.
· Occupational Health Service for your area.
· Funding - Devon and Cornwall Workforce Development have funds for the education and mentoring needs of GPs giving cause for concern, as identified during the appraisal process. Access these funds through your PCT or Deanery. Practice and PCT funding of usual PDP requirements will continue as in the past.
· Finally we would point out that you are not alone, some poor b********* has been there before and survived!
· Any personal feedback you wish to make to John Dean or Peter Jolliffe please. Any general feedback on appraisals or this leaflet to Nicola@devonlmc.org please.
Useful Websites See LMC site for links.
www.rcgp.org.uk Quality and Standards section covers Key standards of good medical practice Education section may also be helpful in identifying suitable training opportunities.
Executive Officer
Devon LMCs
01392 834020 - Nicola@devonlmc.org
17 February 2003