Supporting information

The GMC lists the six types of supporting information you must reflect on and discuss at your appraisal. These are:

• continued professional development
• quality improvement activities
• significant events
• feedback from patients or those to whom you provide medical services
• feedback from colleagues
• compliments and complaints.

There is also recurring information about your practice that you need to include in your appraisal portfolio, and most portfolio providers will pull this forward from year to year in your portfolio for you to update whenever there is a change.

The GMC emphasises quality over quantity when collecting your supporting information. Your appraisal discussion is then an opportunity to spend time reflecting on what will be most valuable to your personal and professional development.

Make sure your supporting information covers your whole scope of work, including anything outside of core general practice or the NHS. If you’ve had a separate performance review from another one of your roles, you could include a summary of that in your main appraisal, rather than presenting the same information again.

You do not need to include all your learning activities in your appraisal. Some toolkits allow you to use their platform to record all your learning for your own records but only include the most important learning in the portfolio you share with your appraiser. Sharing only the most significant learning with your appraiser facilitates a valuable discussion.

We strongly recommend that you focus on the quality not quantity of your supporting information. Ask yourself what are the two or three things that you have learned this year that have changed your practice. Consider writing a reflective case discussion illustrating how you have put this significant learning into practice or how you shared this learning with colleagues. A useful format for effective reflection is the What? So what? What next? model, in which a short sentence answering each question covers the essentials.

Your appraiser will focus on the quality of your learning and reflection and challenge you to highlight what has been most important over the course of the appraisal period.

We recommend that you keep a simple learning log that you add to throughout the year in a way that is convenient to you so that you can capture your key learning points and their implications for the quality of your care.

There are several useful commercial apps available. A document record, table or spreadsheet can work just as well. If you want somewhere to save relevant scanned certificates, such as those relating to mandatory training, then your learning log or appraisal portfolio may offer a secure way for you to collect and keep them, allowing you to easily demonstrate your fitness for purpose to your employer. If doing so will save you time and effort, then it is appropriate to do so. It should not replace reflective notes or your reflections during your appraisal discussion or add unnecessary effort in your appraisal preparation.

We recommend you spend up to two hours organising the relevant supporting information in your portfolio and making the sign-off statements before your appraisal, though it may take less time than that. You should submit this in plenty of time for your appraiser to review before your appraisal discussion. Your appraiser is likely to be a working GP and can expect your documents at least two weeks before the discussion to allow them to prepare and enable them to help you get the best out of your meeting.

You'll still need to provide enough evidence for your appraiser to feel confident that you remain up to date and fit to practise across your whole scope of work. Providing this in your portfolio ahead of your appraisal discussion will make it easier for your appraiser and enable you to spend that time discussing the things that matter most to you and your practice.

The GMC definition of a significant event is:

any unintended or unexpected event, which could or did lead to harm of one or more patients. This includes incidents which did not cause harm but could have done, or where the event should have been prevented.

The GMC requires you to declare and reflect on those Significant Events in which you have been involved or personally named or in which a patient or patients could have or did come to harm. This means that all significant events that meet the GMC threshold of harm must be included in the Significant Event section of the portfolio and reflected on for your appraisal. You do not need to discuss all Significant Events at your appraisal, but you do need to provide your reflection on them.

If you've had no Significant Events that meet the GMC threshold of harm, you should declare that in the relevant sign-off statement or area of your portfolio.

Remember, Significant Events are not the same as GP learning events. The latter would include any event, positive or negative, that has triggered a learning process for you or your team and could be recorded as an example of a quality improvement activity.

However, in Northern Ireland and Scotland, the appraisal policy (and the electronic platform) includes a requirement to include two significant event analyses. These should be seen as GP learning events and QIA, though clearly any events reaching the GMC threshold of harm should be included within the portfolio as well. We recommend that you ensure you are aware of the requirements of your local appraisal policy in this area.

The GMC doesn't specify what to include in your personal development plan (PDP) each year, the number of PDP goals you should include or if those goals are clinical or non-clinical. Instead, they ask that you make progress with your plan each year or explain why that has not been possible.

Work with your appraiser to make sure your PDP meets your needs in the context within which you work. Remember, this is your plan, for your own personal development. When setting them, try to make sure they are SMART or SMARTER. Again, your appraiser can help you with this. It can also help to work out how you can demonstrate that a change you planned as one of your PDP goals has made a difference by considering what the impact on patients will be. Also consider balancing them across the five-year revalidation cycle and across your whole scope of practice.

Goals around being a good role model for patients and maintaining your personal health and wellbeing in a period of great pressures on the healthcare system are entirely appropriate. It is important to use the PDP to capture those high importance goals that are essential for the coming year if there is something that you need to achieve.

Some doctors like to record lots of PDP items; it is your PDP. Most doctors find three or four PDP items are sufficient to capture their top priority goals. You could have one very big objective that you have broken down into separate interim or smaller goals.

If it is your first appraisal post-CCT your appraiser can expect you to provide them with your post-CCT personal development plan, discussed with your Trainer at your final educational supervisor's review. This enables them to confirm the statement "A review that demonstrates appropriate progress against the previous personal development plan has taken place." The appraiser may need to justify to your RO disagreeing any such statement if you are unable to provide your post-CCT PDP. This is unlikely to cause a problem for a future revalidation recommendation.