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Navigating Changes in Appraisal: Insights and Strategies by Dr. Paula Wright

This resource delves into the shifting landscape of medical appraisals, detailing changes in emphasis, evidence requirements, and strategies for demonstrating performance and growth. Dr. Paula Wright offers expert guidance on navigating these changes effectively, providing valuable insights and practical advice for preparing for appraisal sessions. From understanding Form 3 requirements to maximizing evidence relevance and quality, this valuable resource equips doctors with the knowledge and tools necessary for a successful appraisal experience.

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Navigating Changes in Appraisal: Insights and Strategies by Dr. Paula Wright

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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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