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Patchy appraisal of doctors could undermine new system

11% of GPs and consultants have not had an appraisal since April 2009

Adrian O'Dowd

Thursday, 24 March 2011

A survey of clinicians has revealed the system for appraisal of doctors is inconsistent and patchy, which could undermine the plan to introduce revalidation next year.

A new BMA survey with responses from 3,629 GPs and consultants found that as many as two-thirds said their trusts were unable to provide them with sufficient information on their performance.

The BMA Revalidation and Appraisal Survey, published yesterday, found that some trusts were unable to provide information that related to doctors’ personal appraisals and information that included basic quality and safety information.

A strengthened form of appraisal will provide the basis for the revalidation of doctors across the UK when it is introduced in 2012.

The final process for this has not yet been agreed, but the component parts of it will continue to be tested this year at pathfinder pilots in England in order to gather further information about the costs, practicalities and potential benefits.

The BMA commissioned the survey to provide further information on the current standard appraisal process, the nature and range of supporting information that doctors have access to, and what resources are required along with the length of time that it takes to complete the process.

Most doctors responding to the survey (89%) had had an appraisal since April 2009, which meant that 11% had not.

Just around a third (34.8%) of respondents said they had sufficient continuing professional development or supporting professional activity time within work hours to complete the appraisal process.

Within the overall people responding, 258 said they were involved in the revalidation pathfinder pilots, including 143 GPs and 115 consultants – collectively 7% of all respondents.

The majority (72.5%) of the respondents involved in the pathfinder pilots reported that they had access to sufficient help, advice and support in the course of the pilot.

However, when these respondents were asked about the performance of the revalidation pilot toolkit in particular, the comments on the toolkit were overwhelmingly negative.

They found it difficult to navigate, time consuming, felt that it dominated the appraisal process rather than supported it, not user friendly, unreliable and prone to losing data, and many experiences of glitches and being logged out unexpectedly.

The vast majority of respondents involved in the pathfinder pilots (79.1%) said it would take them eight or more hours to complete the strengthened appraisal process in the pilots as appraisee.

The report authors said: “The results of this survey show that a significant amount of work needs to be undertaken before revalidation can be introduced.

“The BMA will use these results to inform our ongoing discussions with the various stakeholders taking forward the design and implementation of the process.”

Responding to the survey findings, Dean Royles, director of the NHS Employers, said: “All NHS staff, including doctors, are expected to have annual appraisals and we are pleased that the BMA survey demonstrates that 90% of doctors are currently receiving them.

“It is clear that the appraisal system for doctors needs to be of a high standard across the service and we are working with the GMC, and other stakeholders, to provide guidance and supporting information for employers.”

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