Professor Mike Pringle, RCGP medical director for revalidation, said the department should never confuse appraisal of doctors with performance management of practices.

Last week GP newspaper revealed DoH guidance instructing PCTs how best to terminate GMS contracts where practices are underperforming.

As well as scrutinising GP contract clauses and performers list rules, it recommends that ‘evidence of poor performance be built up from a variety of sources such as complaints, appraisal and reviews'.

But Professor Pringle said appraisal was not designed to improve the performance of practices.

‘Revalidation will improve an individual's quality through reflection and learning and can reveal performance issues locally or nationally.

‘But discussing practice performance is not the right avenue for evidence taken through appraisal,' he said.

The DoH guidance Raising The Bar recommended PCTs call upon relevant experts, such as health and safety experts, to scrutinise practices' adherence to key contractual clauses.

The document said ‘it is essential to take an aggressive approach'.

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