Under the current appraisal and revalidation process, GPs are expected to achieve 50 continuing professional development (CPD) credits per year - defined by the RCGP as equivalent to fifty hours of learning activity.
A GPonline poll found that almost two thirds (63%) of GPs spend longer than this on learning activities in preparation for appraisal. A total of 43% spend 50-75 hours, 15% 75-100 hours and 6% more than100 hours on learning or CPD - double the amount recommended by the RCGP.
Meanwhile, nearly all of the 570 GP respondents to the survey said they spend further time preparing for appraisal and revalidation each year - completing administrative work or paperwork, for example. Two thirds said this added 10 hours or more to the process, and a third reported spending more than 20 extra hours a year on admin and paperwork for appraisal and revalidation.
Appraisal and revalidation
Despite the huge workload involved in preparing for these processes, most GPs are not convinced that appraisal and revalidation are worthwhile. Just 37% of respondents said revalidation was worthwhile, and 48% said appraisal was worthwhile.
One GP participant described the appraisal and revalidation process as ‘time consuming’ and ‘patronising’, adding: ‘A much more useful tool would be to have coaching [or] mentor sessions each year. We are not recompensed for our time and we also have to pay to use the online appraisal tool which seems ridiculous for a mandatory tool.’
Another wrote: ‘Way too much work involved - it's like an extensive interview every year, another demoralising part of being a GP.’ A third commented that the process was ‘a further burden on time when we are already under enormous time and work pressures’.
However, some GPs found the process useful, with one saying: ‘It's good to keep us updated and to refresh our knowledge,’ and another calling the process a 'fundamental part of demonstrating ongoing professional development and fitness to practise’.
Una Lane, director of registration and revalidation at the GMC, said: ‘We believe that appraisal and revalidation can help to foster a culture of reflection and support doctors in developing their skills so that they can provide even better care to their patients.
‘We’re pleased that many of the GPs who responded to this survey find appraisal and revalidation useful and worthwhile and we’re striving to make sure it’s a positive and meaningful experience for everyone.’
Ms Lane added that the GMC would continue to work with employers and other stakeholders to ‘reduce any unnecessary burden and deliver further improvements’ for GPs undergoing appraisal and revalidation.
A motion listed for debate at this year’s UK LMCs conference, which takes place in Belfast on the 19 and 20 of March, will call on the GPC to work with the GMC and other NHS bodies to overhaul revalidation and appraisal.
LMC leaders will argue that the appraisal system should return to a formative rather than summative process and say the emphasis should shift ‘from information gathering meetings to pastoral care and mentorship by appraisers’. They will also say that appraisal should provide opportunities to offer 'practical support and assistance to colleagues in distress'.
The motion put forward by Nottinghamshire LMC calls for the appraisal process to be 'streamlined' so that those GPs who have had five consecutive successful appraisals should only be required to undertake a full appraisal every three years.