Introducing appraisal for general practitioners

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					 HoBtPCT PEC
 Enclosure 3 – September 2002




                   Appraisal for General Practitioners
Introduction
Appraisal of General Practitioners (GPs) is being introduced from 1st April 2002
as a condition of their terms of service, following negotiation with the General
Practitioners Committee (GPC). Appraisal will be rolled out incrementally over
the year remainder of the year commencing October 2002

The Process
Appraisal is a formative and developmental process. It is about identifying
development needs, not performance management. It is a positive process, to
give GPs feedback on their performance, to chart continuing progress and
identify development needs. Fellow, practising, GPs who have been trained for
this purpose will conduct the appraisals annually. The content of appraisal will be
based on the General Medical Council’s (GMC) core headings.

Potential Costs
This document assumes that there are 180 GPs needing annual appraisal. At 1
the April 2002, there were 180GPs. Many of the explicit costs here can be offset
by reengineering existing provision for PLT and PDP provision. Sessional rates
have been estimated at the new BMA rate. (£150).

There are also potential hidden costs that will be absorbed into existing systems
ie managerial and administrative support and costs of “marketing” system and
raising of awareness. This can be achieved via existing PLT arrangements for
GPs only. Administrative support will be picked up via teaching arm of the
organization.

Education/training programme details, will be developed in consultation with the
GP Tutor and in conjunction with the education sub committee.

The estimated base costs for GP time, appraisers, appraisee and locum costs
were detailed in the paper presented to the PEC in July. HoB tPCT already has
earmarked recurring implementation of PDPs for all GPs and also has funding
set aside for education of health professionals. This funding and existing function
could form the basis on which to develop a comprehensive appraisal system for
GPs.

Existing Educational Funding Commitments

      GP Tutors (4)              (6 sessions per week; 24 per month)
      Lead Tutor                 (4 sessions per week; 16 per month)
      PLT locum cover            1 afternoon per practice per month
      Educational courses        (GMS education funding/teaching funds)
The proposal is to utilize existing educational systems (PLT, GP tutors, education
funding) to offset the costs for effective implementation of the GP appraisal
process.

Key Principles
The bulk of appraisals will be carried out in the main on practice based PLT
sessions. There are 12 sessions a year (2 per month for 6 months of the year -
HoB 1and 2). GPs will be able to use practice PLTs to prepare for appraisal also
or they may use other professional development time.

With the existing GP tutor sessions all 4 tutors could do 2 appraisals per month
utilizing 2 sessions per month. (total appraisals under this scheme 48 appraisals
at no additional cost). With additional recruitment of 5 tutors/appraisers this
process would allow 108 appraisals

GP lead tutor 2 sessions per month undertaking appraisal (12 appraisals)

Additional backfill time for appraisals outside PLT process (60 appraisals)


Additional costs above and beyond existing PDP/educational commitments

  Details outside PLT time to allow flexibility and Cover                 Costs
Appraisees – ( DoH estimate 6.5 hours) a maximum of 2 sessions       £9000
per appraisee @£150/session – need an additional 60 appraisals =
150*1*60=£9000 a year. GP should still be able to spend practice
based PLT in preparing the appraisal process

Appraisers – Minimum 5 additional GPs at 1 session per week          £27,600
(230 sessions @£150 =£150X 230. (Training costs – incurred
centrally) This will be offset by switching 1session from existing   (£34,500-£6,900)
tutor.
Costs of remedial education& locum costs Assume all GPs need 2       £54,000
sessions, or one day, remedial education = 150*2*180=£54,000
locum costs (360 sessions)

Total Potential Annual Costs                                         £90,600

The system will be launched in September to commence in October. The
process will be assessed on a monthly basis to ensure operational efficiency.
Where there are potential inconsistencies or flaws in the process, this
methodology will be reassessed. With recruitment and training issues it is
unlikely that the system will have the capacity for another 4 to 6 months. It is
estimated that the part year effect above and beyond what is already committed
including additional training costs will be £20,000- £25,000

				
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