Summary of GP appraisal in North Cumbria

What happens? How is each appraisal set up and managed?

The Clinical Governance Directorate manages the programme.

All doctors on the PCTs’ GP performers list are included as appraisees.
Appraisals should be undertaken 12 months after of the previous year’s appraisal was due.
Appraisers cannot appraise their partners and are asked whether any other doctors would be inappropriate.
The appraisee may request a different appraiser within two weeks of allocation of appraiser
Normally appraisers may only appraise the same doctor twice in succession

Two months before the appraisal is due the appraisee is sent Forms 1, 2, 3, 4 and 5 together with a PDP checklist and an outline of the complaints procedure. The appraisees are given the month of their appraisal and the name and contact details of their allocated appraiser. They are also asked to contact the appraiser one month before their appraisal is due to set up a venue and date for their appraisal.

The appraiser is informed two weeks later, and sent the appraisee’s previous Form4 and PDP.

It is the responsibility of the appraisee to make initial contact with the appraiser.
If the appraisee does not contact the appraiser then the appraiser should contact the appraisee or the directorate.
The venue is to be agreed by both parties. Usually the appraiser travels to the appraisee.

When the appraisal is signed off the completed Form 4 and PDP, signed off, and with Printed Names and GMC numbers, is sent to the directorate. Payment to the appraiser is triggered by receipt of the completed Form 4.and PDP fully signed off.

In North Cumbria it has been agreed that follow-up between appraisals is not routine but may be agreed by appraiser and appraisee, or initiated by the appraisee at any time.

Confidentiality and access to completed Form 4s and PDPs

The appraisal discussion is fully confidential. The only exception is when the appraiser’s duty as a doctor overrides this.

The form4 and PDP produced as a result of the discussion must be agreed by both parties.

The completed form4s and PDPs:

Are kept in a locked filing cabinet in a locked office – the only people who have keys are Russell Thompson and Carolyn Marshall
The GP tutors see Form4s for quality assurance of the Appraisal process itself only (consent may be withdrawn for this by the appraisee)
The PCT chief executive has right of access but it has been indicated that consent would be requested.
The appraiser in the following year will be given the previous years Form4 and PDP.
Needs identified in PDPs are supplied randomised and anonymised to the GP Tutor to inform educational provision.
Other access requires the consent of the doctor whose Form 4 and PDP it is.

When ‘duties of a doctor’ may require breach of confidentiality

If during an appraisal an appraiser has a major concern regarding fitness to practice, the appraisal should be terminated and the reason explained. Referral would be to the PCT or the GMC. It’s preferable that this is in agreement with the appraisee. The person to contact within the PCT is the PEC chair.

If the appraiser has other concerns he/she may discuss these anonymously, with the GP Tutor for specific professional problems or with Ian Tod for general advice and or as a mentor

Evaluation and Quality Control

An evaluation form is sent to the appraisee to evaluate for the appraisal process and to evaluate the appraiser. This is sent one month after the appraisal.
A form will be sent to the appraiser to allow his/her evaluation of the appraisal.
The quality of appraisal documentation is assessed by the GP tutors on anonymised Form4s except where individual appraisees have declined this.

Administrative structure

The PCT has responsibility for organising and providing appraisal
The Healthcare Governance Directorate of the PCT is responsible for administering appraisal. Russell Thompson, Clinical Governance Manager and Carolyn Marshall, Clinical Governance Officer are the administrative team involved. The GP Tutor is educational lead and responsible for quality assurance and education for appraisal.
The core group with representatives of the appraisers, the LMC, the PCT, a lay member, and the administrative team, advise on policy and the administration of the scheme.

Contract and maintaining appraisal skills

Each appraiser is required to sign an annual contract. This is kept at the Clinical Governance Directorate. Included in this is a requirement to undertake between 6 and 15 appraisals a year

There is an annual study day and It is expected that each appraiser will attend this day and/or other education activities to support appraisal. The expense of this is included within the appraisal fees received.

The appraiser is paid £500 per appraisal – generous compared with other PCTs. However all travel, time, and continuing education connected to appraisal is expected to be covered by this payment.

Complaints procedure

Complaints should be made in writing within one month of the appraisal and sent to the Appraisal administrator. They should be acknowledged in writing immediately on receipt.

The Appraisal Administrator will ask the Appraiser concerned for his/her response to the complaint. This should be provided within one month.

Members of the Core Group will review the complaint and the response within two months of receipt of the complaint. If the Appraiser involved in the disputed appraisal is a member of the Core Group, he/she will not be party to the review.

If the complaint is upheld, the group investigating the complaint would recommend the action to be taken. If the complainant does not accept the decisions made the case would be referred to the Professional Executive Committee Chair.

The establishment of appraisers at March 06

Appraisers for Principals

Carlisle & District 7 appraisers
Eden Valley 8 appraisers
West Cumbria 10 appraisers

Appraisers for Sessional Doctors

6 appraisers in North Cumbria