1. Appraisal In General Practice
Appraisal for GPs
Appraisal In General Practice

2. 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, James Street Family Practice, Louth

3. 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, James Street Family Practice, Louth

4. 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, James Street Family Practice, Louth

5. 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, James Street Family Practice, Louth

6. 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 performance
ScHARR 2001
Dr Andrew Mowat, Primary Care Tutor, James Street Family Practice, Louth

7. What’s the difference between Appraisal and Revalidation?
Distinctions
What’s the difference between Appraisal and Revalidation?

8. 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, James Street Family Practice, Louth

9. 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, James Street Family Practice, Louth

10. 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, James Street Family Practice, Louth

11. 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, James Street Family Practice, Louth

12. 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, James Street Family Practice, Louth

13. Continuing Training Initial Training Continuing Training
2-3 days per year for:
ongoing training in appraisal
general administration
e.g. preparation of overview reports
Dr Andrew Mowat, Primary Care Tutor, James Street Family Practice, Louth

14. 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, James Street Family Practice, Louth

15. Dr Andrew Mowat, Primary Care Tutor, James Street Family Practice, Louth

16. 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, James Street Family Practice, Louth

17. 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, James Street Family Practice, Louth

18. 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, James Street Family Practice, Louth

19. 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, James Street Family Practice, Louth

20. 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, James Street Family Practice, Louth

21. 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
Dr Andrew Mowat, Primary Care Tutor, James Street Family Practice, Louth

22. Questions?