appraisal for nhs consultants: ccsc proposals
March 2000
Introduction
Preamble
Appraisal is a process of constructive dialogue, in which the doctor being appraised has a formal structured opportunity to reflect on his/her work and to consider how his/her effectiveness might be improved. The CCSC supports the definition of appraisal offered in the Chief Medical Officer's document 'Supporting doctors, protecting patients', that:
"Appraisal is a positive process to give someone feedback on their performance, to chart their continuing progress and to identify development needs. It is a forward looking process essential for the developmental and educational planning needs of an individual….it is not the primary aim of appraisal to scrutinise doctors to see if they are performing poorly but rather to help them consolidate and improve on good performance aiming towards excellence. However, it can help to recognise at an early stage developing poor performance or ill health which may be affecting practice". ('Supporting doctors, protecting patients', paragraphs 5.13-5.14).
The following sets out the elements that the CCSC believes that an appraisal system for consultants working in the NHS should contain, and how this will ensure safe practice.
The conversations and documents which form part of the appraisal process will remain confidential, unless any concerns about patient safety arise, in which case they would need to be made available to the medical director.
Content of appraisal
- Clinical activity
Evidence based discussion of clinical activity, with reference to data generated by audit, outcome data and recorded complications, where these have been shown to be robust and valid sources of information. Discussion of factors influencing activity, including the availability of resources and facilities.
Outcome of investigated complaints.
Review of outcome of any available patient survey information
Confirmation that the doctor being appraised has striven to develop and maintain successful professional relationships with all of his/her patients; that any problems have been resolved or are in the process of resolution; and if a satisfactory relationship has proved impossible, that suitable alternative arrangements have been made.
Professional relationships and teamworking.
- Fulfilment of obligatory professional requirements
Review of continuing professional development, including confirmation of participation.
Confirmation of participation in clinical governance activities, and in particular audit, and consideration of any factors which may have prevented full participation, eg lack of resources.
Confirmation of participation in any training in emergency treatment, eg resuscitation, where appropriate
- Teaching
Where appropriate to the professional practice of the doctor being appraised, review of teaching activity in the preceding year.
- Research
Where appropriate to the professional practice of the doctor being appraised, review of any research activity in the preceding year, ensuring that necessary procedures for ethical approval have been followed.
- Management
Where appropriate to the professional practice of the doctor being appraised, review of performance of any management duties in the preceding year.
- Discussion of professional development
Discussion of career/professional development needs and longer term goals
- Job plan review
Discussion of the job plan for the preceding year
Review in the light of the discussion under items i-v, of whether the workload of the doctor being appraised is manageable, and adequately reflected by the job plan.
Discussion of factors which may have changed the workload, or affected the ability to fulfil duties, in particular resources or facilities.
Agreement of job plan for the coming year, and any consequent requirements which will be necessary for its fulfilment.
Discussion of allocation of intensity supplements for the forthcoming year]
- Objective setting
Setting of objectives, particular tasks etc for the coming year that have not been covered by the job plan review, and discussion of resources and staffing needed to deliver the objectives. The achievement of any tasks that are agreed should be reviewed at the next appraisal meeting.
- Any other business
Discussion of any other matters which either the appraiser or the doctor being appraised may wish to raise.
Participation in the managerial aspects of the appraisal scheme would be a contractual obligation (ie job plan review, confirmation of participation in CPD, confirmation of participation in audit), and therefore written into the terms and conditions of service.