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Central North East • Brent • Camden • Newham • Ealing • Redbridge • Harrow • Tower Hamlets • (Westminster - currently withdrawn) South West South East • Kingston • Bexley • Sutton & Merton • Greenwich • Lambeth • Southwark What we are doing now in the Pilot 1.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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