While the RCGP completes revalidation pilots and publishes final guidance on GP recertification, GP appraisers can focus on preparing themselves for the new challenges ahead.
1. Anticipate the changes to the GP appraisal system by regular searches for information on the DoH, RCGP, GMC and Revalidation Support Team websites.
Check on the content, purpose, revised systems and processes of GP appraisal, and how the focus on improving quality and raising the standards of all doctors can be combined with identifying GPs whose performance is sub-standard.
2. Contribute to the development of the quality assurance of appraisal in your area so the process is trusted and fair, consistent between appraisers, proportionate, transparent, underpinned by clinical governance systems and demonstrates clear accountability.
3. Prepare well for your own appraisal of your role as an appraiser, and as a GP. Map out your learning needs. Think of more sophisticated skills, such as managing difficult colleagues and situations, responding to early warning signs, developing people, listening and questioning, constructive challenge.
While doing appraisals, log your unmet needs as an appraiser and as an appraisee, then collate. Attend or participate in relevant learning activities.
4. Test yourself on the college's continued professional development credit system, with a balance of at least 50 credits of learning activities in the past year, gauging the impact on patient care, you or others, and/or the service.
Then look at how you would demonstrate this to your own GP appraiser.
5. Enjoy your role as an appraiser, promoting a learning and development culture in your local primary care organisation (PCO), making appraisal a positive experience for the GPs you appraise.
6. Ensure you have sufficient protected time for carrying out appraisals.
This should include reading and reflecting on the appraisee's paperwork before the appraisal, the session itself (is that three hours or do you rush away after less than an hour?), agreeing the completed plan afterwards and providing any interim support.
7. Remember that the appraisee's PDP belongs to them, not you. Avoid intruding on their learning plan.
8. Measure who does the talking in your next appraisals. You should be speaking for less than 20 per cent of the time.
9. Remember that multi-source feedback from colleagues is a tricky area.
The RCGP has still to select tools that GPs can use, though many GPs have tried one of those available. Encourage GPs who share their results with you to focus on their strengths, while acknowledging their weaknesses and planning to address them, but not to become dragged down by negative remarks.
10. Be factual and not subjective in your conversation with an appraisee or in writing the Form 4, or any associated report. Facts will help the PCO resolve performance issues quickly so that the doctor can continue to be (or return as) a safe and effective practitioner.
11. Be active in your PCO's evolution of how its responsible officer will work and interact with GP appraisal. It needs appraisers' experience and know-how to create the most effective and acceptable system.
12. Understand the rules for reporting any concerns or issues about a GP's performance.
13. Encourage GPs to self assess and reflect on their strengths and weaknesses, the relevance and impact of their learning, and anticipate future career aspirations.
14. Insist on GPs providing a minimum amount of evidence in their appraisal folder; postpone the appraisal if a GP submits insufficient information before the appraisal session. Talk to the appraisees to explain the minimum requirement.
15. Build a wealth of ideas for further learning activities or review tools to suggest to the GP you are appraising. This might include a variety of patient surveys, or a catalogue of educational events.
16. Ask your PCO and appraisal lead for the support you need to do a good job as an appraiser. This might include training and development for you, a supportive peer network, local leadership for appraisal, resources and help for doctors about whom you have concerns.
17. Seek peer support to reflect on challenging appraisals and significant events in an anonymised and confidential discussion.
18. Understand the national guidance on the evidence to expect from those GPs who have been working in unusual circumstances or who have had substantial sick leave in the previous year, and be aware of the next steps.
19. Be sure about local rules and national guidance for you as a generalist appraising a GP with a special interest in a clinical specialty or management, for example practice-based commissioning.
20. Be a good role model. Ensure you are up to date on best practice and let it be obvious to the GPs you appraise that you practise in this way yourself. Be familiar with NICE guidelines, expect to make changes as part of clinical audit and be patient-centred.
- Professor Chambers is a GP and clinical champion for the Quality Improvement Framework at NHS Stoke on Trent
- Catch up with other articles and resources in this series at www.healthcarerepublic.com/revalidation