Document Sample
					NHS North Lancashire

Dental Peer Appraisal Documentation

April 2011

     Appraisal for Primary Care Dental Practitioners

                  Pre-Appraisal Forms

Please keep the ORIGINALS of these forms in your folder
         and send COPIES to your Appraiser.

   All forms are available electronically – please email

Appraisal for Primary Care Dental practitioners


Registered address and telephone number

Main practice address and telephone number (if applicable)

Professional Qualifications UK or elsewhere, with dates

GDC Registration Type now held, registration number and date of first full registration

Date of appointment to current post (if applicable)

Main current post in practice

Other current posts Please list any other current appointments with (1) starting dates (2)
average time spent on them

Previous posts last five years, with dates, including locum appointments lasting more than one

Other relevant personal details Please give any other brief information you wish that helps
to describe you eg membership of professional groups or societies

Appraisal for Primary Care Dental practitioners

This form requires a brief and factual description of the work you do in general
practice and in other posts. You will be able to give more detail later.



Please summarise the ‘in-hours’ activities you undertake in general
practice e.g. minor surgery, sedation, orthodontics

Emergency, on-call and out-of-hours work

Brief details of other clinical work eg as clinical assistant, hospital practitioner etc

Any other NHS or non-NHS work that you undertake as a GDP eg teaching,
management (nb clinical posts which have a management element should be included in the previous
section), research, examiner

Work for regional, national or international organisations

Other professional activities

Appraisal for Primary Care Dental Practitioners

This form, and the papers you supply with it, will be the main basis of your appraisal.
There are four sections, and it is strongly recommended that you look at Standards
for Dental Professionals provided by the General Dental Council before you start.
The same headings will be used to summarise your appraisal discussion.

The wording under each heading differs, but typically you are asked to provide:

   o   a commentary on your work
   o   an account of how your work has improved since your last appraisal
   o   your view of your continuing development needs
   o   a summary of factors which constrain you in achieving what you aim for.

It is not expected that you will provide exhaustive detail about your work. But
the material should convey the important facts, features, themes or issues, and
reflect the full span of your work as a dentist within and outside the NHS. The form is
a starting point and framework to enable you and your appraiser to have a focused
and efficient discussion about what you do and what you need. It is a tool, not an
examination paper or application form, and it can be completed with some flexibility.
Common sense should be exercised if you feel you are repeating yourself, or if
you want to include something for which there is no apparent opportunity. And
if a section or a page really needs only a word or two there is no need to do
more. Complete as many sections as are relevant to your work.

The work you put into completing this form is your main preparation for appraisal,
and the value of your appraisal will largely depend on it. It will also be an important
part of your appraiser‟s preparation.

The form is fairly open-ended, although some prompts and suggestions are supplied
to help you. Please expand the spaces available as necessary, or attach extra

You are invited to submit documents in support of what you say in the form. You are
not expected to “prove” your assertions about your work, but your appraiser will
probably want to test some of them with you through discussion and the documents
will help both of you.

The papers you assemble in support of the form should be listed in the appropriate
spaces and supplied for your appraiser in a folder, organised in the same order. If the
same material is listed in the form more than once, to illustrate different points, do not
include it twice in the folder but explain on the form where it is to be found.

Form 3: Additional Guidance

This document is designed to give you some more assistance in filling in the form 3
of your appraisal documentation. As mentioned earlier, the GDCs “Standards for
Dental Professionals” should be read alongside this form.

For each section of the form there are a number of questions that you may wish to
reflect upon before you attempt to fill it in. There is also a list of suggested support
documentation. This list is not meant to be either prescriptive or restrictive, but
merely a suggestion. Try and be as honest as you can. This form belongs to you and
is shared, confidentially, only with your Appraiser remaining in your possession at the
end of the process. Do not be afraid of taking a close look at all aspects of your
working life to identify those areas where you may seek help to achieve your goals.

It will be useful to put the list of „suggested evidence/documentation‟ for each section
alongside the form as you fill it in, to assist you to get everything together for the

You will notice that there is a certain amount of overlap in the 4 sections we are using
for your appraisal. The documents that you present in support of your activities may
well be used more than once if it is appropriate to do so.

If you have any questions or concerns, you are encouraged to contact your
appointed appraiser or the appraisal lead, David Bradley at

Making a start as you reflect on your practise:

Has the past year been good/bad/satisfactory or otherwise for you, and why?

What do you consider to be your most important achievements of the past year?

What do you like and dislike about your work?

What elements of your job do you find the most difficult?

What elements of your job interest you the most, and least?

    Section 1: Good Clinical care
    This section focuses on your clinical practice and invites you to ask the basic
    question “how good is my dentistry and how can I show it?”

             What was the most helpful course you attended last year? What changes to
              your practice did you make as a result?
             Have you in the past year provided a course of treatment that concluded with
              a particularly good outcome for your patient?
             Have you in the past year undertaken a course of treatment which, on
              reflection, was beyond your current knowledge, competence or ability?

    To assist you in reflecting on your current clinical practice you may find it helpful to
    consider individual clinical areas:
        consultation, diagnosis and treatment planning
        evidence based preventative practice
        periodontology
        direct restorations (e.g. amalgams)
        root canal therapy
        extractions
        crown and bridge
        removable prosthodontics (full and partial)
        tooth wear
        surgery
        trauma
        children‟s dentistry
        orthodontics
        gerodontology
        special needs

    You may also want to include other areas of your practice, for example: cosmetic
    dentistry, special care dentistry,

    Suggested written evidence/documentation:

             audit data: third party verifiable data is of greater value than in house data
             PCT clinical governance reviews (as appropriate)
             relevant clinical guidelines you use
             records of any significant event audits to demonstrate you are working within
              your competence
             CPD records on clinical topics with certificates
             Evidence of further qualifications
             critical incident reports or near misses
             any plaudits you have received
             „in-house‟ or personal monitoring materials
             references or feedback from colleagues peer review
             Participation in evidence based prevention program

This table is to help you evaluate your own performance. It will be used in your discussion with your
appraiser to help you identify your development needs. You will retain this document.
For each clinical area try and score the quality of your clinical care against the following scale. This is clearly
quite a subjective process, but you might find it helpful to refer to the FGDP manual “Standards in Dentistry.”

                                                         - 10 -
 Clinical Area   I regularly find      This is           Of an        I regularly
                       this         occasionally      acceptable        achieve
                   challenging       less than        standard in   better than my
                                    satisfactory     the majority      minimum
                                                       of cases        standard



 Root Canal




 Tooth Wear






Special needs

                                            - 11 -
Section 2: Communication –How well do I relate to patients and keep them

Acting in the best interests of our patients is fundamental to our work in the dental
profession. How well do you relate to your patients, whilst respecting their diversity
and equality, and keep them informed of all their choices?

Before filling in this section, please read the relevant section of the GDC document
“Standards for Dental Professionals.” You may also find it helpful to review their
document “Principles of Patient Confidentiality.” (See

You may find it helpful to consider the following questions:

      Are my clinical records consistently clear and legible (if handwritten)?
      If another colleague were to read my records, would it be clear to them what
       clinical care have been undertaken for my patients, and why?
      Have I in the past year, received a complaint against myself which I feel could
       have been handled better? What would I have done differently?
      Do I believe I consistently give my patients enough information when
       discussing treatment options?
      Do I routinely provide my patients a written treatment plan?
      How often, and in what circumstances, do I seek patient‟s consent? In what
       form is this consent (written or verbal)?

Suggested written evidence/documentation:

      example of clinical records (anonymous)
      clinical records audit
      dental reference service report; practice confidentiality policy;
      examples of referral letters sent (anonymous)
      information to patients about your service
      patient satisfaction surveys, examples of treatment plans offered
      copies of FP17 with comments
      examples of written consent
      any complaints and records of their investigation
      information for patients about services in the practice(s)
      any complaints material, including your handling of it
      appreciative feedback (e.g. letters/cards)
      patient survey data (as appropriate)
      relevant significant event reports
      protocols eg for handling informed consent, child protection and whistle

                                          - 12 -
Section 3: Management and leadership – narrowing the margin for error

Before filling in this section, please read the relevant section of the GDC document
“Standards for Dental Professionals.” You will also find it helpful to review the GDC
document “Principles of the Dental Team Working ”. (See

You may find it helpful to consider the following questions:
    Am I aware of any incidents when there has been a breach of confidentiality
      for one of my patients?
    Consider the quality of my referral letters. Do they consistently include all
      essential and relevant information?
    Consider the other dentists and dental care professionals (dental nurses,
      hygienists, therapists, crown, bridge and denture technicians,) I work with or
      communicate with. Do I consider I have good working relationship with them?
    Are there any examples of miscommunication in the past year (for example,
      errors with laboratory work)?
    Have I completed a third party, verifiable, scheme demonstrating good
      practice management?
    Do I engage in regular, well documented, staff meetings?
    Is there staff training for all the team?

Suggested written evidence/documentation:
    a description of the team structure in which you work
    references from colleagues
    referral protocols
    examples of referral letters sent (anonymous)
    example of lab sheets with written instructions
    information about any problems that have arisen between you and colleagues
    evidence of staff meetings

                                         - 13 -
Section 4: Professionalism –What does it mean to be a Dental Professional?

Before filling in this section, please read the relevant section of the GDC document
“Standards for Dental Professionals.”
Clearly, this is a difficult area to provide objective, written evidence. In many ways the
information and feedback you‟ve provided in the other sections will give an indication
of your trustworthiness (patient confidentiality for example).

You may find it helpful to consider the following questions:
    What opportunities have I had to discuss my professional work with other
      colleagues in the past year?
    Has the section on good clinical care helped me identify areas for further
      study and training?
    What does it mean to me to be considered by society as being a member of a
    What do I do to justify my patient‟s trust in me?
    Has my professionalism or trustworthiness been questioned in work or out in
      the past year? Were those questions justified?
    Do I keep up to date?
    Am I always „legal, decent, honest and truthful‟?

Suggested written evidence/documentation This list is not meant to be either
prescriptive or restrictive, but merely suggestions.

      your current PDP
      your practice development plan (if applicable)
      records of all CPD activity
      membership of professional bodies or other opportunities for group learning
       with colleagues.
      A summary of your professional reading habits.
      Patient surveys
      Other patient feedback (Letters/cards etc.)
      Staff surveys
      DRO report
      Complaints protocols and records
      Significant event reports
      Minutes from practice meetings
      Audit results
      CPD records
      Sample (anonymous) clinical records
      Sample (anonymous) referral letters
      Post graduate qualifications
      BDA Good Practice
      Denplan Excel
      Investors in People
      Practice protocols (evidence that these are customised to own practice and
       have been supported where appropriate with staff training)

                                          - 14 -
As we come to the end of your reflection it would be useful to consider the following
non-clinical areas (this is not meant to be a comprehensive list):

      Cross infection control
      Radiological protection
      Health and safety
      Communication skills
      Practice management
      Finance issues
      Information technology
      clinical governance
      Risk management

Are there any areas where you feel further training would be appropriate?

                                         - 15 -
         Form 3 (To be completed and a copy sent to your appraiser)



Section 1: Good clinical care
Commentary - what do you think are the main strengths and weaknesses of your
clinical practice?

What steps have you taken since your last appraisal to maintain and improve
your knowledge and skill.

What do you think are your clinical care development needs for the future? What
aspirations do you have?
This is in preparation for agreeing an updated PDP.

                                                - 16 -
What factors in your workplace(s) or more widely, constrain you significantly
in achieving what you aim for in your clinical work?
It may be constructive to focus on issues that can be addressed locally, or ways wider issues could be
addressed locally.

Documents seen in support of good clinical care;

                                                 - 17 -
Section 2; Communication

Commentary – what do you think are your main strengths and weaknesses in
this area? Consider;
Record cards (anonymised samples)

Information leaflets


Have you identified difficulties with diversity and equality?

What factors in your workplace(s) or more widely, significantly constrain you
in achieving what you aim for in your Patient;



What would you like to do better? What do you think your current needs are in
this area?
This is in preparation for agreeing a PDP

                                            - 18 -
Documents seen in support of good communication

                                 - 19 -
Section 3: Management and leadership
Commentary –What do you think are the main strengths and weaknesses of
your record keeping, confidentiality and information sharing?
 Have you completed a 3rd party verifiable scheme which demonstrates good

What do you think are the main strengths and weaknesses of your
relationships with colleagues?

What would you like to do better? What do you think your current
developments needs are in this area?
This is in preparation for agreeing a PDP

What factors in your workplace or more widely significantly constrain you in
achieving what you aimed for in this area?
What can be addressed locally?

                                            - 20 -
Documents in support of good management and team leadership

                                 - 21 -
Section 4: Professionalism
Commentary –What safeguards are in place to ensure propriety in your
financial and commercial affairs, research work, use of your professional
position etc? Have there been any problems?

Do you feel you have any health-related issues that may put patients at risk?
Please mention any problems or concerns raised during the year and any steps you feel should be
taken to safeguard the position.

What professional or personal factors significantly constrain or compromise
you in this area?

What would you like to do better? What do you think are your current
development needs in this area?
This is in preparation for agreeing a PDP

                                               - 22 -
Documents produced in support of good Professionalism

                                  - 23 -
The GDC have issued guidance that all dentists undertake verifiable CPD in
three core subjects from the beginning of the next CPD cycle. In addition,
CPD is recommended in two other areas. This form will help you to plan your
future CPD requirements with this in mind.

       GDC recommended core CPD Requirements
Medical Emergencies (and basic life support) (10 hours in a 5 year
Basic life support attendance certificate/date:

Other medical emergency training (if applicable):

Disinfection and Decontamination (5 hours in a 5 year period)
Decontamination training certificate/date:

Radiography and Radiation Protection (5 hours in a 5 year period)
Training certificate/date:

                             Other CPD Activity
Legal and Ethical Issues
(Consent, confidentiality, employment law, health and safety)

Complaints Handling

CPD Declaration to the GDC
Date of last declaration:

Number of CPD hours declared:

                                     - 24 -
Any other additional information

                                   - 25 -

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