Strengthened appraisal for revalidation 'quicker and more effective'

A DH pilot study has found that the 'strengthened' appraisal model set to be introduced as part of revalidation is more likely to change doctors' practice and quicker than current appraisal systems.

DH: Revalidation Support Team pilots show strengthened appraisal has more impact and is quicker
DH: Revalidation Support Team pilots show strengthened appraisal has more impact and is quicker

Revalidation looks set to go ahead as planned from December after the BMA agreed to support it following a pledge from the NHS Commissioning Board to fund remediation in England. The GMC also looks set to advise health secretary Jeremy Hunt - who will announced a final decision within weeks - to press ahead after receiving advice that all four UK governments are behind the scheme.

The pilot findings do not address BMA concerns that appraisal will vary substantially from area to area because local organisations are free to add additional requirements, but add further weight to the case for implementing revalidation.

The Revalidation Support Team (RST) - a DH funded body set up to support the implementation of revalidation – carried out the pilot in 2011 to test the effectiveness of a revised ‘strengthened’ model of appraisal, as laid out in its Medical Appraisal Guide.

The RST said its model for appraisal met standards required by the health secretary to ensure it  ‘supports high quality care and makes effective use of a doctor's time’.


The Medical Appraisal Guide and its appraisal model are designed to help organisations to build on and improve their existing model of appraisal, in preparation for revalidation. It is not intended to replace effective existing processes where these are in place.

The pilot showed that 60% of doctors changed their practice after following the strengthened appraisal model. Just 40% of doctors who completed a standard appraisal did so.

The study also found that the 719 doctors who took part viewed it as more efficient, enjoyable and focused than standard appraisal.

Over two thirds (65%) of the doctors who took part did not have any difficulties gathering the supporting information required. However, GP locums did face problems, and just under half (46%) said they had problems accessing information relating to colleagues and patients.

Despite these difficulties, doctors and appraisers who took part in the pilot found that the time they spent on appraisal work was reduced by the Medical Appraisal Guide model.

The study found that appraisers who piloted the Medical Appraisal Guide spent an average of 4.2 hours in total on appraisal activity - less than appraisers using existing appraisal systems.

The median time taken for doctors in the Medical Appraisal Guide pilot to prepare and participate in appraisal was nine hours – three hours less than was spent on standard appraisals.

Despite the positive findings the study did highlight GP concerns about maintaining the developmental aspects of the appraisal process and the need to ensure clear lines of communication between the responsible officer, appraiser and doctor.

The report also looked at the public view of revalidation. A study conducted by Ipsos MORI and The King’s Fund on behalf of the RST found that the public did not think revalidation should be interrupted.

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