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									Table 15 Good clinical care Level 1 CCA1.Evidence of reflective practice e.g. log of PUNS and DENS from surgery consultations, out of hours care, telephone consultations, abnormal results, medication enquiries etc. CCB1.Record of complaints and compliments in the last 3 years. (QOF Edu 6) CCC1.Awareness of PACT and other personal prescribing data Level 2 CCA2.Evidence of action taken as a result of reflective practice Level 3 CCA3.Evidence of change/improvement as a result of reflection. Presentations of publications of clinical activity/cases

CCB2.Evidence of reflection CCB3.Evidence of and learning from complaints change/improvements as a result of complaints (QOF Edu 6)

CCC2.Evidence of reflection CCC3.Role in Prescribing of PACT and other personal awards/incentives achieved by Prescribing data practice. Involvement with PCT prescribing strategy. CCD1.Self-assessment of CCD2.Self assessment CCD3.Consultation videos consultation skills/ consultations videos or discussion and feedback by communication skills. E.g. reflection on a random case peers. reflection of feedback analysis of notes Evidence of patient centred from patients consultation style using questionnaires recognized consultation analysis model. Passing video component of FBA or MRCGP CCE1.Outcome of patient CCE2.Reflection of outcome CCE3.Changes/ improvements satisfaction surveys of patient satisfaction survey implemented as a result of undertaken (QOF –DoH, patient satisfaction survey 2004- Patient experience 2,3,4) CCF2.Evidence of practice CCF3.Demonstration of procedures that adherence to personal role in the achievement NICE guidelines, NSF and of practice QOF points. local clinical governance guidelines. CCG1.Involvement in or CCG2.Evidence of reflection CCG3.Involvement in changes awareness of practice and dissemination of audit or development of the practice as audits e.g. audit of findings Evidence of a result of audit or research referrals, routine and involvement in completed findings emergency admissions, audit cycle. prescribing, morbidity or mortality data CCH1.Significant event CCH2.Evidence of CCH3.Evidence of changes as a audits undertaken and dissemination of learning result of significant event audit lessons learnt (QOF from significant event audits Education 2) CCJ1.Evidence of good CCJ2.Audit of written and CCJ3.Audit of data quality /

written and electronic record keeping to recognized standards. (QOF Records 2,14,18)

electronic record keeping. Use of a recognized coding system (e.g. Read codes). Evidence of use of computerised decision support systems such as Prodigy during consultations. CCK1.Evidence that Data CCK2.Involvement in Protection policy complies significant event analysis or with legislation. other audit of data use CCL1.Demonstration of CCL2.Audit of access and adequate appointment appointments systems and access arrangements. (QOF Information 3) CCM1.Evidence of CCM2.Audit or case adequate systems for analysis of response to responding to emergencies emergencies. (QOF Information 1, 2, 8) CCN1.Statement of how CCN2.Audit of equipment equipment and drugs for and drugs emergencies are kept up to date (QOF Management 4, 7, Medicines 3) CCO2.Personal evidence of good practice from external reviews e.g. PCT clinical governance reviews CCP1.Evidence of adherence to Health and safety guidelines and regular risk assessments. (Applies only to doctors who are employers) . CCQ1.Compliance with fire regulations and electrical equipment certification. CCR1.Recording of accidents and actions taken to prevent recurrence


CCK3.Risk assessment of potential problems with use of data. CCL3.Patient satisfaction with system for access and waiting times

CCN3.Changes implemented as a result of audit of equipment and emergency drugs.

O3.Involvement in the RCGP quality practice award. Participation in Fellowship by Assessment. QPA. Examples of areas of clinical excellence.

Table 16 Maintaining performance Level 1 MPA1.Education log of CPD activity to demonstrate how the doctor keeps up to date, e.g. learning from meetings, courses, reading, e-learning records, etc. MPB1.Previous year’s appraisal summary and evidence of action taken to achieve PDP learning objectives from appraisal MPC1.Evidence of keeping up to date in areas of special interest e.g.GPwSI in Family Planning, IUCD insertion, minor surgery, teaching. Level 2 MPA2..Evidence of cyclical PDP with, self- assessment, reflection, education planning, learning outcomes and further reflection Level 3 MPA3.Evidence of change/improvement as a result of reflective practice

MPB3.Evidence of change/improvement in practice as a result of appraisal.

MPC2.Research or audit of areas of special interest areas

MPC3.Higher professional qualifications obtained or pursued. FBA/QPA/GPwSI/ MSc/ Trainer or appraiser status/ cert/dip/master. Participation in training related to specialist role Participation in periodic appraisal of specialist role

MPD1.Attendance and learning from CPR courses. (QOF Education 1)


MPE2.Participation in MPE3.Improvement in practice knowledge based tests e.g. as a result of learning from MCQ, MEQ, the RCGP PEP knowledge based tests CD.

Table 17 Relationship with patients Level 1 Level 2 PA1.Consultation or PA2.Consultations videos communication skills self- self- assessment. assessment. E.g. reflection of patients’ questionnaires. PB1.Participation in a patients’ satisfaction survey. E.g. GPAQ. PB2.Documentation of the practice discussion and action planned as a result of the outcomes of the patient satisfaction survey PC1.Evidence of empathy PC2.The doctor with patients e.g. in demonstrates involvement in consultation videos, the continuity of care of patient satisfaction surveys patients with chronic and (GPAQ) and letters and terminal diseases cards from patients. Can be inferred from GPAQ. PD1.The doctor’s practice PD2.Details of the doctor’s leaflet contains details of involvement in assessing and services provided, how to improving how the practice access them and how to communicates with patients. give feedback (QOF Management 5) PE1.Details of in- house PE2.Examples of personal complaints procedure learning from complaints (QOF Education 6) PF1.The doctor complies PF2.Demonstration of with accepted guidelines understanding of the for consent, principles of ethics. confidentiality, the use of chaperones and equal opportunity legislation. PG1.The doctor’s reception and waiting room provides privacy and security for patients and staff (Doctors who are employers) PH1.Involvement in special arrangements for patients with special needs and disability PJ2.Involvement in practice team training in telephone communication skills. Level 3 PA3.Peer review and consultation videos using recognized assessment methods Participation in video component of MRCGP/MAP PB3.Evidence of change/improvement as a result of the patient satisfaction survey

PD3.The doctor demonstrates how patients are involved in practice decision-making. The doctor’s involvement in or any part in the organization of the patient participation group. PE3.Improvement in own practice as a result of learning from complaints PF3.The doctor participates in case reviews of patients who posed ethical challenges. Higher qualification in medical ethics obtained or courses attended. .

PJ3.Participation in practice team training in customer care

Table 18 Working with colleagues Level 1 CA1.Doctor’s availability to other members of the PHCT in day to day practice and in emergencies CB1.Personal contribution to PHCT meetings and away days. CC1.Formal or informal feedback from other PHCT members. CD1.Involvement in practice PHCT development. (GP Principals only) (QOF Education 3, 5, 8, 9) CE1.Significant event audits undertaken (QOF Education 2) CF1.Evidence of dissemination of learning from significant event audits CG1.Personal role in improvement or change as a result of significant event audit. Level 2 CA2.Evidence of appropriate delegation of work and appropriate use of all members of the PHCT in delivering care. CB2.Outcomes and learning from PHCT meetings Level 3 CA3.Evidence of contribution to shared care management protocols.

CC2.Participation in 360degree appraisal. CD2.Personal reflection on contribution to primary health care team development

CB3.Personal role in the implementation of changes as a result of PHCT developmental sessions CC3.Improvement in personal practice as a result of 360degree appraisal. CD3.Involvement in practice mentorship, buddy scheme or proactive well being initiative for staff

CH2.Involvement in assessing and developing practice communication systems

CH3.Role in investors in people award, BS 1550. QTD, QPA award.

Table 19 Teaching and training Level 1 TA1.For doctors involved teaching. Evidence of the application of recognized teaching strategies, curriculum planning and assessment methods. TB1.For doctors involved in teaching. Personal reflection of teaching skills. Completion of a reflective log of teaching TC1.For doctors involved in teaching. Documentation of appraisal /performance review of teaching roles TD1.For doctors not directly involved in teaching. Supports the practice as a learning environment. Level 2 TA2.Attendance at teaching courses and conferences. Level 3 TA3.Detail of teaching, experience, certificates or qualification obtained. University or other teaching posts held. Teaching publications and presentations

TB2.Action taken as a result of reflection of teaching. LUN and EEN (learners unmet and educator’s educational needs Student and self-evaluation of courses/tutorials/workshops facilitated.

TB3.Video analysis of teaching. Reports and feedback from training inspection visits/interviews by the Deanery or other educational bodies. Peer review of teaching TC3.Evidence of effectiveness of teaching. Examples of success of learners taught or facilitated. E.g. MRCGP passes and distinctions and summative assessment passes.

Table 20 Probity Level 1 PrA1.Statement of the practice accounting and book keeping systems. PrB1.Signed practice agreement for earnings, workload and property sharing. (GP Principals) PrC1.Examples of procedures in practice to deter fraud. ( QOF Man 8) PrD1.Awareness of conflict between private and NHS work. Declaration of outside financial interests. PrE1.Clear notices of private fees displayed in the practice PrF1.Personal or practice policy on dealing with pharmaceutical companies PrG1.Practice policy on personal gifts PrH1.Practice guidelines for confidentiality, equal opportunities and informed consent. PrJ1.Statement of whether or not there are convictions, cautions or cases pending PrK1.Statement of whether or not there is a current referral to local disciplinary, conduct or performance committees PrL1.Statement of whether or not there are current referrals to the Level 2 PrA2.Statement of the doctor’s input in the practice financial management PrB2.Evidence of external accountant’s audit and certification of yearly practice accountants. PrC2.Results of PCT financial and claims checks or external audit Level 3 PrA3.Minutes of practice business meetings PrB3.Discussion and analysis of any problems or disputes between partners.

PrH2.Practice policy for confidentiality and equal opportunity displayed in waiting room

PrH3.Clear guidelines for difficult ethical areas e.g. Termination of pregnancy and living wills. Analysis or audit of equal opportunities

GMC, NCAA or other regulatory body PrM1.Statement of whether or not there is evidence of noncompliance with acceptable standards of professional behaviour as outlined in good medical practice PrN1.Compliance with employment law for staff including salaried doctors. (QOF Management 6, 10) PrO1.Compliance with Health, Safety and Welfare legislation.

Table 21 Health Level 1 HA1.Statement that no health issues pose a risk to patients HB1.Declaration Hepatitis B vaccination status (QOF Management 3) Level 2 HA2.Completion of health status questionnaire (e.g. MAGP1) Level 3 HA3.Declaration of time off sick each year. Spells of sickness absence and reason for sickness absence.

HB2.Declaration of health problems that impact on patient care and measures taken to ensure patient care is not compromised HC1.Steps taken to HC2.Statement of maintain or promote attendance at Occupational appropriate work life Health or other sources of balance. E.g. Stress and time help if appropriate. management programmes, recreational activity and wider interests and hobbies HD2.Demonstrates a positive attitude in dealing with colleagues who have health problems. HE2.Evidence of following practice guidelines in dealing with alcohol, stress, drugs, burn out and other health issues in colleagues

HD3.Acts as mentor or buddy to a colleague.

Table 22 Management Level 1 MA1.Reflection of roles and responsibilities in management in the practice. Level 2 MA2.Evidence of learning needs assessment, CPD and completed learning cycle for management or leadership roles in the practice. Peer review of management or leadership roles in the practice. MB2.Evidence of learning needs assessment, CPD and completed learning cycle for management or leadership roles out of the practice. Peer review of management or leadership roles out of the practice Level 3 MA3.Undertakes or completes higher degree in management or attends courses relevant to areas of responsibility in the practice. .

MB1.Reflection of roles and responsibilities in management out of the practice

MB3.Undertakes or completes higher degree in management or attends courses relevant to areas of responsibility out of the practice.

Table 23 Research Level 1 RA1.Ethical approval of research undertaken and compliance with the principles of informed consent, confidentiality and record keeping. RB1.Evidence of adherence to local and national research governance procedures RC1.Declaration of research funding and any conflicts of interests Level 2 RA2.Statement of research in progress, research completed and research published. Level 3 RA3.Presentation of own research findings at local or national seminars or conferences

RB2.Evidence of links with PCT, university or other R and D group

RB3.Publication of own research in peer reviewed journals

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