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Appraisal questions and answers - GPs

Who undertakes GP appraisal?

The person carrying out the appraisal will be another GP, in order to be able to have an understanding of the working conditions of the appraisee. The appraiser will have been properly trained in carrying out appraisal.

How long does a GP appraisal last?

The actual times are obviously likely to differ according to each individual taking part in appraisal. However, research commissioned by the Department suggests that the average time commitment for appraisal is a minimum of 4.5 to 6.5 hours. This includes between 2 and 4 hours for preparation.

How is the GP appraisal process funded; locum cover, protected time?

It is important that PCTs make appropriate provision for supporting appraisal in consultation with their LMC. PCTs will be responsible for ensuring that resources are in place to fund the GP appraisal system. Initial guidance on PCT funding of GP appraisal was included in the Health Authority Revenue Resource Limits 2002/03 Circular (HSC/2001/024) issued on 6th December.

Adequate time should be allocated for the preparation and appraisal meeting, for both the appraiser and appraisee. PCTs should recognise that preparation time and time for carrying out appraisal are instead of, rather than additional to a GPs existing duties and workload, and should therefore take place during usual working hours.

Recognising that time will be required to prepare for and undertake annual appraisal, and for fulfilling educational and development needs identified through the process, PCTs should therefore have a funded policy on the provision of locum cover. Precise arrangements will vary according to local circumstances. PCTs should consult with the Local Medical Committee and other interested parties when developing their appraisal policy.

What if a GP does not like his/her appraiser? Does the doctor have a choice in who appraises him or her?

Where there is a recognised incompatibility between the proposed appraiser and appraisee, the PCT Chief Executive will be responsible for nominating a suitable alternative.

Is appraisal in addition to what GPs already do for CPD?

Key development objectives for the following year and subsequent years should be set in the PDP. These objectives may cover any aspect of the appraisal such as personal development needs, training goals and organisational issues, CME and CPD. CPD activities are what will result from the appraisal discussion and resulting PDP. Thus, CPD will not be in addition to appraisal, it will be an outcome from it.

What happens to PGEA?

The PGEA will continue to be available for supporting continuing professional development in the usual way.

What is the role of the PCT?

Formal responsibility for appraisal will rests with the PCT. The responsibilities of the PCT should be as follows:

• To ensure that an appraisal scheme is in place that covers all doctors working in general practice within the span of the organisation and that commands the confidence of the profession and their representatives locally (i.e. the LMC and usual professional channels).
• To ensure that all doctors undergo annual appraisal in line with the scheme.
• To establish workable arrangements for identifying, appointing and training appraisers.
• To ensure that appropriate mechanisms are in place to quality assure appraiser and appraisee training; to regularly review the appraisal process in the light of participant experiences and changing circumstances; and to take the necessary action to redress any concerns with the process.
• To ensure that robust processes are in place to deal with worries or complaints from individual GPs about the process or outcomes of appraisal.
• To ensure that action is taken as far as possible to address the education and development needs of GPs and service development requirements identified and agreed in the course of appraisal.
• To make adequate financial provision to support the appraisal process. This should include a funded policy on the provision of locum cover. Examples might include one-to-one cover, locum cover through a practice, or locums provided by a co-operative or an Out of Hours’ service provider.
  

If PCTs are expected to resource appraisal, won’t this take much-needed money away from patient care? How can this be a good thing?

The primary aim of appraisal is to help doctors consolidate and improve on good performance, aiming towards excellence. In doing so, it will identify areas where further development may be necessary or useful: the purpose is to improve performance right across the spectrum, from the best to the worst. Ultimately, this will lead to an overall improvement in the quality of healthcare that patients receive.

How many GP appraisers will each PCT have?

The number of appraisers within each PCT will depend on how appraisal is arranged locally.