Balancing life as a GP with appraisal and revalidation

Professor Rodger Charlton discusses the challenges GPs face in preparing for revalidation.

Collecting the evidence: it is always better to do this as you go along (SPL)

Life as a GP is busy enough, without having to worry about collecting evidence to justify that you are doing a good job.

However, appraisal is here to stay, as is revalidation, as part of a five-year cycle of appraisals.

We all try to do a good job, but we have to keep the necessary information to make our appraiser and responsible officer aware of this.


For CPD we are most likely to self-assess any learning we undertake and justify the learning in units of hours or RCGP learning credits to our appraiser, who will confirm them if they are appropriate.

This could involve attending a clinical meeting, reading an article, recording a significant event, completing an e-module or attending a course.

Most appraisers will not worry about you producing certificates of attendance, but rather the reflection you have undertaken, what you have learnt and how it confirms good practice by you or leads to changes you will make.

What your appraiser will look for is a variety of types of learning and formats, such as attending meetings or electronic learning.

Personal development plans

Your personal development plan (PDP) should state more than just 'keeping up to date'.

Try to identify with your appraiser a few areas where you would like to develop or update, for example, diabetes or spirometry and COPD.

You can then target your learning during the year to these needs. Make sure that each defined PDP objective is SMART (Specific, Measurable, Achievable, Relevant and Time-bound), because many appraisals are looked at by the responsible officer for quality assurance purposes.

Your e-portfolio

There are many e-portfolios available and while we are discouraged from keeping a paper folder, each region has regulations about what will be acceptable.

For me, the key is to record something as soon as the learning has happened. If you decide to comb through a diary a few weeks or even days before your appraisal to recall what learning you have done, this can be stressful. Far better to do it as you go along.

Tablets and smartphones allow you to record information easily and even make notes at meetings.

For reflection on your learning, you can make use of voice recognition software on these devices, which you can use at home or in your consulting room.

Some appraisers will be happy for you to keep a paper folder of certificates, rather than scanning everything in, but you should check with them first.

Feedback surveys

You will need to do a patient and colleague survey every five years and they can take a bit of thought and preparation.

If you are in a group practice, you will all be in the same situation, so it is best to use the same method and co-ordinate it through your practice manager.

Warn colleagues and non-clinical staff in the practice that they will receive an email asking them to do a survey and check they are happy to do so.

It is best to organise patient surveys when you are in the practice and let the staff know, for example for a day or more, to make it easier to collect enough surveys in one go.

The results of both methods have to be collected and analysed independently and your locality will have guidelines about the approved means of analysis.

Clinical audit

You need to play a significant part in a full clinical audit once every five years, preferably in an area that interests you and is relevant to your daily practice.

You need to prepare for this and the key is to remember that you also have to complete an audit cycle. Once you have any recommendations in place as a result of the audit, you need to re-audit to see if there has been any improvement.

Be sure to undertake and record one significant event audit analysis, together with reflection and any associated learning, once a year.

Advance preparation

To balance all this with being a busy GP requires preparation and thought about collecting the evidence and trying not to put it off until next week or next month, at which stage you will remember little about it.

In particular, try to ensure your revalidation appraisal is done about eight weeks or so before your revalidation date, because it can take a while to process. Good luck and remember, keep putting material in your e-portfolio.

  • Professor Charlton is a GP in Hampton-in-Arden, a GP appraiser and professor of primary care education, University of Nottingham

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