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EAP-April2009-EditedVersion-BrentPCT.ppt

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					   London Deanery
Enhanced Appraisal Pilot
      April 2009
The thinking behind the Pilot
“Medical Revalidation - Principles and Next Steps” DH (July 2008)
•    Revalidation should be introduced incrementally through piloting to
     ensure that it works well
•    Revalidation should provide reasonably consistent assurance of
     standards across the United Kingdom, whatever the practice model;
•    Revalidation will depend on the quality, consistency and nature of
     appraisal to ensure the confidence of patients and doctors.

RCGP/CoGPED Position Statement on GP Appraisal (Sept 2008)
“...how GP Appraisal should develop in England”
•      Provision and accountability of GP appraisal should remain a PCT
       responsibility
•      Strategy and local standards should be developed by Postgraduate
       Deaneries with engagement of the PCTs
Elements now removed from original Pilot proposal

1.   We are no longer using a version of the Welsh IT interface (we are
     encouraging use of the NHS Appraisal Toolkit - see next slide for Toolkit
     use in participating PCTs)
2.   We are not adding on a version of the GMC Good Medical Practice
     (GMP) module - but await developments with the NHS Appraisal Toolkit
3.   We are not matching Appraisers and Appraisees centrally, but are
     helping PCTs with this as required
4.   There is no individual sign-up of Appraisers and Appraisees in
     participating PCTs - we require “100%” coverage to avoid development
     of a two-tier model
NHS Appraisal Toolkit use in participating PCTs
KEY: Red=Compulsory Blue=Encouraged to use Green=No policy


     North West         North Central         North East
     • Brent            • Camden              • Newham
     • Ealing                                 • Redbridge
     • Harrow                                 • Tower Hamlets
     • (Westminster - currently withdrawn)

     South West                               South East
     • Kingston                               • Bexley
     • Sutton & Merton                        • Greenwich
                                              • Lambeth
                                              • Southwark
What we are doing now in the Pilot

1.   We are providing participating PCTs with assistance in the recruitment of
     Appraisers and Appraisal Leads - where required
2.   We are providing basic, update and advanced Appraiser training for
     Appraisers in participating PCTs
3.   We have outlined a set of requirements for PCTs in order to enable them
     to performance manage their appraisers, with a PDP for the Appraiser
     arising from that process and feeding into Appraiser training - see left
     hand column in yellow on next slide
4.   We are supporting PCTs with Appraisal admin processes through a
     series of 1-1 meetings between the Deanery and the PCTs
5.   There are enhanced Tutor sessions in the Pilot PCT areas - the Tutors
     are meeting with, and conducting interviews with, new GPs on PCT
     Performers Lists, to guide them with the PDP from their Appraisal
6.   We are evaluating the pilot
PCT tasks in pilot                                     Deanery tasks in pilot
A Performance Management Framework for                 Ensure that GPRs on PLs have had an appraisal
their appraisers - to include:                           and have a PDP and are using the appraisal
                                                                          toolkit

1-1s                                                   Meeting with PCTs individually to develop a
Form 4/PDP review                                      QA framework for GP appraisal
Appraisee feedback
Attendance at 75% of Appraiser Dev/Support             Quality Control - Developing Documentation
QA standard: sign off within 3 weeks of Appraisal      to support the QA Process


  Appraisal activity over the past 2 years -i.e. how
 many appraisals were done in each month of 0708
                                                                 Provide Appraisal Training
                       and 0809




                                                             GP Tutors

                                                        Appraiser Support Groups with support from
Do a Training Needs Analysis - PDP:                                Deanery PCDU ADs

 Review appraiser population (have they got enough)
                                                       Attend Interview Panels - PCDU and Tutors
Look at their needs


                                                       Appraisee support workshops - toolkit training

Recruit new appraisers
                                                        Meeting with, and conducting interviews with,
                                                                   new GPs on PCT PLs
Summary - Background to pilot
•   London Deanery has positioned itself into a co-ordinating role for developing
    quality assured GP appraisal across London PCTs through the QAWG (quality
    assurance of appraisal working group) established in 2004.
•   QAWG has sought to defend and maintain the developmental supportive side of
    appraisal against performance management / clinical governance processes.
•   All London PCTs have engaged with the QAWG at some point.
•   DH and RCGP documents on GP appraisal gave clear indications about the
    development of appraisal that we felt best placed to take a lead on in London.
Summary - Intended impact on pilot PCTs
•   Development needs of appraiser network addressed through educational
    processes including 1:1 reviews and appraisers working to an individually
    negotiated PDP.
•   Reflection on the role and person spec of the appraiser lead.
•   1:1 support to PCTs in pilot from Deanery team about how they meet their
    responsibilities with appraisal, developing consistency and standards pan-
    London.
•   Support and reflective space for PCTs with the emerging revalidation agenda.
•   Opportunity to share best practice highlighted in PCT 1-1s via QAWG
Summary - Intended impact on pilot PCT Appraisers
•   An opportunity for a developmental review of their work set within a Deanery
    defined framework of who conducts that review, what is covered and the
    outcomes.
•   Training and support opportunities through centrally run events and local
    appraiser groups to meet their developmental needs.
•   Greater confidence in the knowledge of standards and governance for appraisal.
Summary - Intended impact on pilot PCT Appraisees
•   All GPs in the pilot areas to have their appraisal conducted by an appraiser who
    has been prepared through training and support to conduct that appraisal
    according to the current NHS Appraisal Toolkit standards.
•   Specific support for GPs in transition - new to PCT list or moving from GP
    registrar year to post-CCT. These GPs will be offered 1:1 meeting with GP tutor
    to review their PDP from last appraisal and for advice on taking the objectives in
    the PDP forward. Plus general advice re SDLGs, LMC, sources of employment -
    OOH providers etc.
•   General support for all GPs on PCT list around preparation for revalidation
    including IT skills for the NHS Appraisal Toolkit.
Summary - Intended “generic” impact on non pilot PCTs
•   Increased appraiser training opportunities for appraisers in non-pilot PCTs
    despite pilot PCT appraisers being prioritised for training due to overall increased
    provision.
•   All pilot processes shared via QAWG and website so available to all PCTs.
•   Raising of awareness of the developmental needs of appraisers in relation to
    revalidation.
Summary - Intended “generic” impact on Tutor network
•   Tutor JD being revised in consultation with Deanery HR and Tutor network to
    streamline it to prioritise appraisee needs.
•   Intended that pilot will demonstrate benefit of specific support for GPs in transition
    and therefore evidence for increasing Tutor sessions from 2 per PCT to 3 per
    PCT.

				
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