Derbyshire CPDEducation CentreRoyal Hospital CalowChesterfieldDerbyshire, S44 5BLTel: 01246 512057
Two electronic portfolio tools are currently available.
1. Medical Appraisal Guide (MAG) Model Appraisal Form
This is free to use and can be downloaded, stored and completed without needing further internet access. Please save it and email to your appraiser when complete. Safely store the locked down version of the MAG form completed after your appraisal and returned to you by your appraiser.
The updated and improved second version of the MAG form was published earlier this year and GPs should be looking to transition to this new form as soon as possible, due to the fact that the previous version cannot be used beyond the present appraisal year i.e. ending March 2017. You can access the new version of the form along with a user guide via the link below.
Appraisers and doctors will have noticed there are some new features such as the ability for the appraiser to comment on each of the various sections of the MAG form to reflect how the appraisal conversation may flow.
Also the previous MAG form did have the facility to create a new form for the following year. The new form does not allow you to do this, so once the form is locked the appraiser will send it back to the doctor and the doctor must download a new MAG form for the following year.
Please click on this link to open the new MAG form: https://www.england.nhs.uk/revalidation/appraisers/mag-mod/
2. Revalidation e Portfolio
The RCGP has partnered with Clarity Informatics to produce the enhanced Revalidation ePortfolio toolkit for GPs. This portfolio is not free and requires internet access to operate.
The new enhanced revalidation system is now available at https://appraisals.clarity.co.uk.
This replaces the RCGP Revalidation ePortfolio tool and the previous Clarity Appraisal Toolkit.
Please note if you have not previously used Clarity you will need to register on Clarity's website. Please contact the Clarity helpdesk for user and registration support on 0845 113 7111.
Clarity Informatics helpline for enhanced ePortfolio Registration and support: 0845 113 7111
You will receive a letter from the appraisal support team every year (usually in March) detailing the month of your appraisal and your appraiser. You can appeal for allocation of a different appraiser at this stage if you feel this is necessary (complete the form below). You should be contacted by your appraiser about 8 weeks before your appraisal is due to arrange a mutually convenient time and place to meet for your appraisal. Your appraiser will need to know what electronic method of appraisal you will be using.
If you have not heard within one month of your appraisal date please contact your appraiser or the appraisal support team (see contact details below).
During your appraisal you will agree a Personal Development Plan for the following year.Your appraiser will complete a summary of the appraisal discussion. Once approved by you the appraiser will complete agreed statements to the responsible officer and it will be locked down. The enhanced Revalidation ePortfolio toolkit sends copies directly to the appraisal support team and yourself. If using the MAG your appraiser sends a locked down copy to you and to the appraisal support team. It is important you keep this copy safely as you will need it to create a new form for the following year’s appraisal.Your appraiser also completes a checklist (see Appraisal Checklist Template below) which is sent to you and the appraisal support team. The appraisal support team uses this to collate a dashboard of your appraisal supporting information. This helps them to advise you if you are fit for revalidation at the end of each five year cycle; if not they will advise you in advance what additional activity you will need to undertake.
Appraisal Checklist Template
Appealing against Appraiser Allocation
The team cover Shropshire, Staffordshire, Nottinghamshire & Derbyshire
For any general queries about appraisal/revalidation this should be your first port of call.
E-mail: England.firstname.lastname@example.org – (For all queries relating to GP appraisals and revalidation)
Direct Dial – 0113 8254625
Derbyshire Appraisal Lead: Dr Carl Egdell, email: email@example.com
Nottinghamshire Appraisal Lead: Dr Rashbal Ghattaora, email: firstname.lastname@example.org
Medical Director/Responsible Officer for North Midlands: Derbyshire and Nottinghamshire, Shropshire and Staffordshire: Dr Ken Deacon
Appraisers with queries about administration, contracts or pay: Email: email@example.com / Tel: 0113 8255501
Your appraiser will require the following supporting information from you before your appraisal:
You may find it helpful to read:Revalidation Officer’s letter to GPs regarding revalidationGMC advice on Supporting information for Appraisal and RevalidationRCGP powerpoint update on appraisal revalidation guidance
This is any activity you undertake which you can show improves the quality of patient care. Most GPs will undertake several of the following:
AuditThis is the gold standard QIA which most GPs will undertake at least once during each 5 year revalidation cycle. It can be done on an individual basis or as part of a practice team activity. It is important that you are personally involved in the audit activity. If you are involved as part of a team you need to include a list of people involved including their designation and explain what your role has been. A full audit cycle involves two stages. The first stage outlines and reflects on the level of compliance achieved against the audit standard. The second stage (usually 1-3 years after the first stage) measures and reflects on whether compliance has improved with changes made after the first audit.
Audit resources: How to do a Clinical Audit SuccessfullyClinical Audit Report Template for GPsCancer Audit Template (RCGP): This template has been created by the RCGP for national data collection about cancer diagnosis and referral rates. You will see it is a tool enabling collection and review of data. If you use the tool to prospectively record all new cancer diagnoses it will provide data which can be compared on a yearly basis. This may then show changes in speed of referral, cancer diagnosis and outcomes.
Significant Event Audit (SEA) If using the MAG appraisal form these SEAs are entered in section 8.
The GMC definition of a significant event means a serious untoward event that could or did lead to patient harm. For many GPs there will be no such events in an appraisal year. However for the purposes of appraisal a broader definition of events is used. This includes
Current SEA guidelines:It is recommended that at least 2 such SEAs are discussed and the outcomes summarised using one of the following forms which are submitted at appraisal. If a GP has not had 2 SEAs then 2 Case Reviews (see below) or 1 SEA and 1 Case Review can be submitted.
Most practitioners will come across several SEAs every appraisal year. They should aim to discuss them in a forum including all members of the team, including relevant clinicians and administrative and reception staff when appropriate. This is much easier to conduct within primary care teams. Single-handed general practitioners and locums may therefore experience difficulties in conducting SEAs. They should try to discuss them in the practice in which the event occurred. If that is not possible, they may join a group of similar general practitioners who can, together, confidentially discuss each others’ SEAs. They can be summarised using the SEA reporting forms below:
An SEA record should contain the following items :
Serious Untoward Incident (SUI)If using the MAG appraisal form such SUIs are entered in section 9.
A Serious Untoward Incident (SUI) is an incident that occurred during NHS funded healthcare (including in the community), which resulted in one or more of the following:
Serious incidents requiring investigation in healthcare are rare4, but when they do occur, everyone must make sure there are systematic measures in place to respond. These measures must protect patients and ensure that robust investigations are carried out, which result in organisations learning from serious incidents to minimise the risk of the incident happening again.
Primary Care Examples 5
1https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/142016/Never_events_policy_framework.pdf 2 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/142013/Never_events_201213.pdf 3 http://www.connectingforhealth.nhs.uk/systemsandservices/infogov/links/suichecklist.pdf 4 100 incidents were reported to D & N Area Team in the past year and 80% of incidents were pressure ulcer related5 Please note that this is not an exhaustive list, any incident causing serious harm or death should be reported as a serious incident
To assist you with the reporting and investigation of serious incidents the above and following documents are attached for your information, please be aware that you may choose to continue to use your own organisational templates however the Area Team may request further information where additional assurances are required:SUI reporting form
Please be aware that the Area Team requires to be informed of all Primary Care Independent Contractors Serious Incidents/Never Events/High Level Incidents (as per attached guidance policy and Serious Incident Framework March 2013). This framework is currently being updated therefore further guidance and tools may be shared later this year.If you have any queries regarding the above please do not hesitate to contact the Area Team firstname.lastname@example.org.
Case reviewIf a GP has not had 2 SEAs then 2 Case Reviews (see below) or 1 SEA and 1 Case Review can be submitted. Examples include:
Case review structured reflective template for GPs
Referral reviewA doctor can keep a log of a certain type of referrals, for example emergencies, 2 week waits, suspected skin cancers, for a defined time period. The outcomes of these referrals can be logged in a spreadsheet. This can be used to produce a review of outcomes including appropriateness of referral.
Prescribing reviewA review of a group of patients' medication to assess if this is in keeping with current prescribing advice.Starting a group of patients on new medication following new guidelines or advice and reviewing the outcomes after an appropriate time period.
All these forms of QIA should ideally be discussed within an MDT meeting to allow group input and learning. However if undertaken by for example a locum doctor where this may not be possible discussion at appraisal is acceptable.
The feedback requirements have increased. Previously doctors had to complete formal patient and colleague feedback once in every 5 year cycle. This requirement remains:Annual Patient Feedback There is a new RCGP requirement to include patient feedback, and a doctor’s reflection upon it, in every annual appraisal. This feedback could be from a range of sources and could include:
Five Yearly Patient and Colleague FeedbackAt least once in every 5 year revalidation cycle doctors are required to collect both patient (PSQ) and colleague (MSF) feedback. The most frequently used RCGP acceptable methods are:
Additional RCGP acceptable tools are:Sheffield Peer Review Assessment Tool Version 2 (GP-SPRAT) General Medical Council Colleague Questionnaire2Q MSF For each of these tools there is a set requirement for the number of completed returns. It is also a requirement that the scores are benchmarked so a doctor can reflect on their feedback compared to other doctors. For the GMC feedback tools benchmark scores are published, the commercial providers of feedback tools will also carry out benchmarking.Click here to access benchmarking resources:Benchmarking patient and colleague feedbackBenchmarking tablesAlthough you could choose to use a different toolkit:
A key part of the process is the doctor’s reflections on feedback.Low scores are not a specific bar to revalidation; clearly some doctors must be scored below average. However, if feedback scores are low, I would expect to see evidence that the doctor had reflected upon this, and usually adapted their PDP accordingly. It may also be appropriate in such cases for doctors to consider repeating the feedback within the next year.For the avoidance of doubt, a set of consistently low feedback scores, without evidence of reflection and understanding, will lead to a recommendation for deferral. On the other hand, a low feedback score, with evidence of reflection, and a plan to address any areas of concern is likely to lead to a positive recommendation.The RCGP now strongly recommend that the feedback tools are completed in the first 3 years of the revalidation cycle. This is because if significant changes are required as a consequence of feedback, then the survey is likely to need repeating prior to revalidation.
Any complaints should be investigated and reflected on, what actions were taken and changes made to practice if needed. The Complaint Report Structured Reflective Template can be used.
Further information about appraisal and revalidation
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