Restarting GP appraisals

3 September 2020

Today we have heard that GP appraisals in England will be restarting from October 2020. This follows similar announcements for doctors in Scotland and Wales.

With the prospect of a long and difficult winter ahead for all of us working in general practice, I appreciate that this may not initially seem like the news you would choose to hear. However, there are positive signs that the temporary suspension of appraisals has been used to rebalance the appraisal process for all doctors in the context of the COVID-19 pandemic, with significant reductions in the pre-appraisal documentation required and an increased emphasis on the support we all need.

The College has consistently campaigned for the reduction of bureaucracy for GPs. At the outbreak of COVID-19, our efforts led to the temporary suspension of appraisals and routine CQC inspections. We led the campaign for a new Medical Appraisal 2020 process that is different to the system that was in place pre-COVID. CQC routine inspections remain suspended.

We are currently developing a range of support materials specifically for GPs and primary care appraisers, including FAQs, which we’ll share with you on our website shortly. These are also being reviewed by our Revalidation Working Group members in the Devolved Nations as there will inevitably be some variations in the implementation of the appraisal restart across the four nations.

The main differences to the process are as follows:

  • A considerable reduction in pre-appraisal documentation - verbal reflection facilitated by the appraiser will carry the same weight as written reflection provided beforehand in the previous process (we’ve been told it will take 30-40 minutes to complete your focused written preparation)
  • Increased focus on the impact of the pandemic on the GP as a professional and personally, with an emphasis on how they have maintained their health and well-being
  • Appraisers will need to update their training to include an understanding of this re-balancing and greater emphasis on support and development, rather than documentation
  • Appraisals will be GP-led and used to plan the personal and professional development of the doctor for their benefit and for the benefit of patients
  • Appraisers will be able to provide GPs with links to local, regional and national support resources, as well as signposting to appropriate additional or ongoing support outside the appraisal process where the doctor identifies a need.

As GPs, we are very good at looking after others but not so good at taking care of ourselves. It’s often the case that those of us who need support the most are least likely to seek it, so it’s encouraging that over the next year, all GPs will have the support of a trained peer without needing to pro-actively seek help.

The GMC has already confirmed that an appraisal conducted under this process will count as a full medical appraisal for revalidation.

We now want to see a thorough evaluation so that the outcomes of this streamlined and rebalanced process - for both doctors and patients - can be properly assessed.

We will also continue to oppose burdensome regulatory processes that have little benefit for GPs or patients.

On behalf of the College, I would like to thank Susi Caesar, RCGP Medical Lead for Revalidation, and her team for all their hard work in pursuit of an appraisal system that is professionally-led and focused on the professional development of GPs.

Such is Susi’s expertise in this area that she is also Chair of the Academy of Medical Royal Colleges’ Professional Development Committee. The importance of having a GP in this key role cannot be underestimated and we are in good hands.

Thanks also to you, our members, for everything you are doing to keep general practice up and running and ensuring that your patients continue to receive quality care in these difficult times.

The contribution of GPs and general practice to the COVID-19 effort has been phenomenal and I am extremely grateful to you all.

Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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