FAQ

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Who will undertake GP appraisal?
The person carrying out the appraisal will be another GP, in order to be able to have an understanding of the working conditions of the appraisee. The appraiser will have been properly trained in carrying out appraisal.

How long will a GP appraisal last?
The actual times are obviously likely to differ according to each individual taking part in appraisal. However research commissioned by the Department suggests that the average time commitment for appraisal is a minimum of 4.5 to 6.5 hours. This includes between 2 and 4 hours for preparation. However we recognise that in the first year of appraisal the time commitment may be higher as PCTs and individual doctors adapt to the new system.

How will the GP appraisal process be funded; locum cover, protected time?
It is important that PCTs make appropriate provision for supporting appraisal in consultation with their LMC. PCTs will be responsible for ensuring that resources are in place to fund the GP appraisal system. Initial guidance on PCT funding of GP appraisal was included in the Health Authority Revenue Resource Limits 2002/03 Circular (HSC/2001/024) issued on 6th December.

Nigel Crisp has also written to PCT Chief Executives highlighting the importance of making financial provision to support appraisal and providing further guidance. His letter emphasised that to be successful, the appraisal scheme must also be introduced with an appropriate level of support to appraisers and appraisees. Adequate time should be allocated for the preparation and appraisal meeting, both for the appraiser and appraisee. PCTs should recognise that preparation time and time for carrying out appraisal are instead of, rather than additional to a GPs existing duties and workload and should therefore take place during usual working hours.

Recognising that time will be required to prepare for and undertake annual appraisal, and for fulfilling educational and development needs identified through the process, PCTs should therefore have a funded policy on the provision of locum cover. Precise arrangements will vary according to local circumstances. PCTs should consult with the Local Medical Committee and other interested parties when developing their appraisal policy.

What if a GP does not like his/her appraiser? Will the doctor have a choice in who appraises him or her?
Where there is a recognised incompatibility between the proposed appraiser and appraisee, the PCT Chief Executive will be responsible for nominating a suitable alternative.

Is appraisal in addition to what GPs already do for CPD?
Key development objectives for the following year and subsequent years should be set in the PDP. These objectives may cover any aspect of the appraisal such as personal development needs, training goals and organisational issues, CME and CPD. CPD activities are what will result from the appraisal discussion and resulting PDP. Thus, CPD will not be in addition to appraisal, it will be an outcome from it.

What will happen to PGEA?
The PGEA will continue to be available for supporting continuing professional development in the usual way.

What will be the role of the PCT?
Formal responsibility for appraisal will rest with the PCT. The responsibilities of the PCT should be as follows:

To ensure that an appraisal scheme is in place that covers all doctors working in general practice within the span of the organisation and that commands the confidence of the profession and their representatives locally (i.e. the LMC and usual professional channels).
To ensure that all doctors undergo annual appraisal in line with the scheme.
To establish workable arrangements for identifying, appointing and training appraisers.
To ensure that appropriate mechanisms are in place to quality assure appraiser and appraisee training; to regularly review the appraisal process in the light of participant experiences and changing circumstances; and to take the necessary action to redress any concerns with the process.
To ensure that robust processes are in place to deal with worries or complaints from individual GPs about the process or outcomes of appraisal.
To ensure that action is taken as far as possible to address the education and development needs of GPs and service development requirements identified and agreed in the course of appraisal.
To make adequate financial provision to support the appraisal process. This should include a funded policy on the provision of locum cover. Examples might include 1 to 1 cover, locum cover through a practice, or locums provided by a co-operative or an Out of Hours’ service provider.

If PCTs are expected to resource appraisal, won’t this take much needed money away from patient care. How can this be a good thing?
The primary aim of appraisal is to help doctors consolidate and improve on good performance, aiming towards excellence. In doing so, it will identify areas where further development may be necessary or useful: the purpose is to improve performance right across the spectrum, from the best to the worst. Ultimately, this will lead to an overall improvement in the quality of healthcare that patients receive.

What training is the Government putting in place for GP appraisal?
The Government has identified £2 million over two years to support GP appraiser training. The Department, in conjunction with the National Clinical Governance Support Team, supported an initial national GP appraiser training programme to train 900 GP appraisers. Around three GPs per PCT were trained via this programme. PCTs are now responsible for arranging further training locally according to their needs.

How many GP appraisers will each PCT have?
The number of appraisers within each PCT will depend on how appraisal is arranged locally.

What if there are not enough GP appraisers. I’ve heard that the Department is having difficulty recruiting GP appraisers?
The Department is not responsible for recruiting GP appraisers. It is the responsibility of PCTs to identify appropriate individuals to be trained as GP appraisers.

What support mechanisms has the Department put in place for appraisal?
The Department, in conjunction with the National Clinical Governance Support Team, supported an initial national GP appraiser training programme in 2002.

In addition, a series of regional workshops to support the appraisal process were held in the summer of 2002.

A CD-ROM has been produced by the English Department of Health to provide helpful information about the appraisal process. The CD-ROM is intended to demonstrate the right and wrong ways to conduct an appraisal and is aimed at both the GP being appraised and the appraiser. It is available from the NHS Responseline on 08701 555455, quoting reference 28027.

An electronic Toolkit is available, commissioned by the English Department of Health from the Sowerby Centre for Health Informatics at Newcastle (SCHIN). The Toolkit provides a single on-line resource to support appraising and appraisee GPs in the NHS. It also brings together advice, guidance, best practice, practice tools and access to a community of peers in the appraisal domain. The Toolkit is now being developed for use by hospital consultants in England.

Who will pay for any remedial training a GP needs as a result of appraisal? Who will organise the remedial training? How will the GP practice cope while doctors are being retrained and are not working?
Formal responsibility for GP appraisal will rest with the PCT. This responsibility will include ensuring that action is taken, as far as possible, to address the education and development needs of GPs and service development requirements identified and agreed in the course of appraisal. It will also include making adequate financial provision to support the appraisal process. This should include a funded policy on the provision of locum cover. Examples might include 1 to 1 cover, locum cover through a practice, or locums provided by a co-operative or an Out of Hours’ service provider.

Appraisal seems to be partly based on information about a practice. What will happen if a practice doesn't have the necessary data systems to provide this information? What support will be provided to help a doctor get this information?
If supporting information is not available via a practice, PCTs should be able to provide GPs with some of the material they are required to submit in support of their statements in the appraisal documentation.