GP appraisal to re-start from 1 October in stripped-back format

NHS England has set out details of a stripped-back appraisal process that will take effect from 1 October in a first step towards reinstating full appraisal from next April.

GPs: appraisal to re-start (Photo: sturti/Getty Images)
GPs: appraisal to re-start (Photo: sturti/Getty Images)

In a move welcomed by doctors' leaders, the appraisal process that will kick in from October has undergone 'significant simplification'.

Guidance published by the Academy of Medical Royal Colleges (AoMRC) confirms that appraisal will be rebalanced 'to include an enhanced focus on wellbeing and development and avoiding an approach that is tick-box or burdensome'.

The demand for pre-appraisal documentation should be reduced through a shift towards 'recognising the value of verbal, rather than written, reflection' - in recognition of the impact of the COVID-19 pandemic on doctors' ability to collect written evidence to support the process.

GP appraisal

The AoMRC guidance says: 'It is appropriate to reflect this by requiring proportionate pre-appraisal documentation from each individual. Doctors should consider what information they need to reflect on and discuss at appraisal and avoid doing administrative activity to present additional information at their appraisal.

'At the same time, there should be an increased emphasis on the role of the appraiser to prompt sufficient reflection during the appraisal discussion, and document it, to demonstrate that the doctor continues to work in line with Good Medical Practice.'

Supporting information produced by the AoMRC on the process says doctors taking part in appraisal should 'submit any supporting information that you have gathered since your last appraisal', with pre-appraisal portfolios to include 'any significant events, compliments and complaints' or other items requested by the appraiser.

It adds: 'If there is specific supporting information required in order to make your revalidation recommendation and it is difficult for you to gather this, discuss with your appraiser how you plan to collect the information and reflect on it in your next appraisal in your current revalidation cycle.'

Supporting information

However, the guidance also confirms: 'If you engage with your annual appraisal process, it will not matter if you have collected no supporting information during the pandemic.

'You will be asked to do some focused written reflection before the appraisal, which in testing has taken around 30 minutes to prepare, and then discuss your reflections on what you have learned and what changes you have made as a result during the appraisal meeting. Appraisers are explicitly being trained to adjust their expectations to take account of the impact of the pandemic on your ability to collect supporting information.'

Dr Mark Sanford-Wood, BMA GP committee deputy chair, said: 'A robust appraisal process benefits both doctors and patients, upholding standards and best practice, and encouraging professional development.

'Following the necessary pausing of appraisals during the height of the pandemic, the BMA has been in discussion with NHS England to ensure the planned restart is not overly disruptive for practices while allowing public confidence to be maintained.

Professional development

'We’re encouraged by the significant simplification of the requirements and the reduction in paperwork, which allows both appraisers and appraisees to focus on treating patients rather than bureaucracy. This slimmed down system is a step forward in empowering doctors to use their appraisal to reflect on their professional development, and forms part of a wider drive by the BMA to reduce bureaucracy.'

In a letter outlining plans to re-start appraisal, national medical director Professor Stephen Powis said: 'Within NHS England and NHS Improvement we intend to take this opportunity to simplify appraisal as far as possible in all respects. I encourage responsible officers in other organisations also to think creatively about how appraisal can help your doctors maintain the highest possible standards of patient care in the prevailing circumstances.'

The letter warns that plans to re-start appraisal must be focused around the fact that the ongoing pandemic has been among 'the most significant things to happen' in many doctors' careers, warning that a second wave of COVID-19 or local outbreaks will mean responsible officers will need to adopt a 'flexible approach'.

The revamped appraisal process will start from 1 October, Professor Powis confirms, 'with a view to resuming normal levels of activity by 1 April next year'.

The AoMRC advice confirms that most doctors due for annual appraisal by the end of September 2020 'will NOT be expected to have an annual appraisal this year' - in line with confirmation earlier this year from the GMC that doctors who miss an appraisal will be able to revalidate.

It adds: 'Their appraisal will be carried forward twelve months. This is a pragmatic decision to free-up clinicians at this time and to avoid creating a year-end bunching problem by postponing the appraisal instead of cancelling it. There will be no repercussions for doctors who miss an appraisal due to these exceptional circumstances.'

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