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Preparing for appraisal: what’s changing ?

Preparing for appraisal: what’s changing ?. Dr Paula Wright GP tutor for Newcastle East GP tutor for Sessional GPs Deanery Adviser on Retainer and FCS. Preparing for Appraisal. Form3 Evidence –general issues & specifics Pulling it together. Changing emphasis of appraisal.

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Preparing for appraisal: what’s changing ?

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  1. Preparing for appraisal:what’s changing ? Dr Paula Wright GP tutor for Newcastle East GP tutor for Sessional GPs Deanery Adviser on Retainer and FCS

  2. Preparing for Appraisal • Form3 • Evidence –general issues & specifics • Pulling it together

  3. Changing emphasis of appraisal • Shift to summative emphasis (to performance review) • Explicit standards of performance against which doctors are judged • Explicit standards of evidence • Will need to be more robust (QA) because of link to revalidation

  4. Form 3 (I) • Factual statement about role (and changes) and working circumstances • Factual statements about Progress against last years “actions” and PDP aims supported by evidence • Factual Statements about personal performance explicitly supported by evidence

  5. Form 3 (II) • Reflective Statements about performance showing insight into level of competence and areas of weakness. • Intentions for developmentlinked to reflections & evidence on performance

  6. FORM3- MGMP • How were learning needs identified ? • Why were these learning activities chosen ? • What reflection has taken place ? • (Difference between GCC and MGMP)

  7. Evidence • Ideally: • Relevant to the doctor’s individual work (not just practice work) • Relevant to patient outcomes (not just process measures) • Objective/ Verifiable/ Validated tool for which there are benchmarks But…. Tension between 1 and 3

  8. Challenge of evidence • Most care is delivered by teams NOT by individuals • So difficult to link clinical OUTCOMES measures to PERSONAL PERFORMANCE (sp locums) • Can audit PROCESS MEASURES linked to personal practice (e.g. BP monitoring, TSH monitoring etc)

  9. So what can we do ? • Aim for personal evidence (personal audit, GPAQ etc) not just practice aggregated data • Personalise the evidence where practice data used: personal role ? • Personal reflection on each item of evidence submitted

  10. Commenting on Evidence in FORM3 • What does this evidence SAY ? • What does it say ABOUT YOU ? • How have YOU CONTRIBUTED to the level of achievement demonstrated ? • How will YOU ALTER YOUR PRACTICE in response to the performance demonstrated ?

  11. Napce –EVIDENCE STATEMENT Feb 2007 • Essential evidence-personal • Essential evidence-organisational (practice folder) • Optional evidence (Leicester/ NAPCE statement) http://www.appraisalsupport.nhs.uk

  12. Evidence: Good medical care- AUDIT • personal care-OUTCOMES or • Group care OUTCOMES in area where has taken an initiative or lead role (e.g. COPD etc) • PROCESS AUDIT E.g. referrals, admissions, records, prescribing, • Structured case reviews • … less useful • Qof, PACT,

  13. Evidence: Maintaining Good medical practice • Educational log of activities with reflections • Last years PDP with statement of what has been achieved and what not (evidence) • Evidence of assessment of knowledge • Structured reflective template • Less useful: Certificates, Handouts or programmes • Note- for revalidation probably determined by colleges (knowledge test)

  14. Relationships with patients • Patient survey • Complaints data or declaration of none • optional • Evidence of consultations skills training • Less useful are • Practice policies about patient removals, confidentiality, and consent etc

  15. Relationships with colleagues • 360 degree feedback (online or paper) facilitated by 3rd party, validated tool • Account of team working • …optional • Evidence of learning in context of colleague relationships • Minutes of practice meetings

  16. Teaching and training • Outline of teaching sessions developed • Feedback • Development of educational skills

  17. Probity • Probity statement from Scottish RCGP revalidation toolkit. • CRB • Conflict of interest statement- specially where moving towards new models of GP with profit arm • Gifts • Disciplinary actions/ investigations

  18. Health • Health statement from RCGP revalidation toolkit • Hep immunity • Comment: time off work/ adaptations to work on health grounds, Registered with GP

  19. Appraisal Toolkit • Many tools for recording evidence: • educational diary with reflections • PUNS AND DENS; Audit, complaints etc • can carry over things from one year to next (e.form1,2 pdp etc) • Can access from various sites • Organises all info including documents which can be uploaded • Extracts- go into overview/summary • Administrative- linking pct/appraisee/appraisers

  20. Pulling it all together • Forms 1-3 • Evidence • Last years form4 and PDP • Draft PDP for next year • Index your appraisal folder • Use appraisal toolkit

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