Enhanced Appraisal Pilot
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
• 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• (Westminster - currently withdrawn)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
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
1-1s Meeting with PCTs individually to develop a
Form 4/PDP review QA framework for GP appraisal
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
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
• 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-
• 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
• 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
• 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
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