In July 2008, CMO Sir Liam Donaldson published the long awaited report Medical revalidation: principles and next steps. Within the report he supports annual appraisal as the basis for revalidation but recognises that it has to be of high quality.
Throughout the report it is emphasised that the quality of the appraisal process will need to be improved in some areas. Preparation by the appraisees is essential for a good appraisal process.
Appraisal is not only good for your development but it is also essential for revalidation.
Use the appraisal for you
Often the appraisal is seen as an annual chore but afterwards the appraisee feels that he or she benefitted from the process.
The way to reduce the stress, like any big task, is to spread it out over the year; acquire systems and habits that will make it all easier.
Use a box file or folder to keep all the possible relevant supporting papers over the year including letters of thanks, complaints, reflection sheets from CPD, certificates of attendance, audits in which you have been involved, significant event reports, lists of books or articles that you have read, reports from educational meetings, results of the patient surveys and multi-source feedback.
This will stop the panic of trying to find them three weeks before your appraisal.
Acquire information about appraisal in plenty of time. Probably the best tool is the NHS Appraisal Toolkit. This has all the forms that you will need and lots of suggestions and guidance. It can be filled in online.
Form 1 and form 2 require factual detail about your work. Form 3 requires more data and thought to complete it well.
At the time of preparation of your portfolio your papers will need to be put into order based on Good Medical Practice headings (see box). Leave enough time for this to allow you to see what you have and what else you might need.
Portfolio examples of good medical practice
The Leicester Statement - Essential Evidence for Appraisal
Reflect and develop
When you have the forms, the guidance and the supporting papers, you will need to set time aside to fill in the forms and answer the questions. As an example, the questions in the first heading, Good Clinical Care, are:
- Commentary: what do you think are the main strengths and weaknesses of your clinical practice?
- How has the clinical care you provide improved since your last appraisal?
- What do you think are your clinical care development needs for the future?
- What factors in your workplace, or more widely, constrain you significantly in achieving what you aim for in your clinical work?
You will see that these questions are designed to make you think about your clinical care and how it has developed over the year.
Often in the day-to-day rush and pressure of general practice we do not reflect on what we are doing. Use this opportunity to look back over the year and think what you might wish to change or develop. Try to be honest with yourself.
It often helps to think 'What would I like to be doing in three years and am I moving that way? If not, why not?' Your appraiser might well be able to help you with developing the answers.
At the end of form 3 there is a summary of the year for your reflections.
It has three boxes with the headings:
- Overview of development during the year
- Overview of development needs
- Overview of constraints
Giving some time and thought to filling in these boxes will really help you get the best out of your appraisal.
The effort put into preparing for your appraisal will be amply rewarded in assisting your development and increasing the enjoyment of your job.
In reviewing all the things that you have done over the past year and the things that you wish you might have done, it is wise to think about the next year.
Your appraiser is able to help you decide and plan what you might like to do. Have a look at form 4 and the PDP in the appraisal papers and see what you might like to do in each of the Good Medical Practice areas.
It might be that you would like to monitor an aspect of your practice; do a higher qualification; become a trainer; talk through work-life balance; find help with managing relationship difficulties within the practice; find help with heartsink patients; in fact any development in any area of professional life.
Do not miss the valuable opportunity that an annual appraisal can offer you.
- Dr Havelock is a retired GP trainer in Wooburn, Buckinghamshire
- This topic falls under section 3.1 'Clinical Governance' and section 4.1 'Management in Primary Care', of the RCGP curriculum www.healthcarerepublic.com/curriculum
1. Spread out the preparation for your appraisal throughout the year.
2. Keep a collection of letters and supporting papers.
3. Research the appraisal system online.
4. Think ahead about what you would like to achieve in the coming year.