Annual appraisal will continue to be the core component providing evidence to the revalidation process.
- Annual appraisal has been a contractual requirement for all consultants in NHS Scotland since 1st April 2001 ( PCS(DD)2001/2).
- It was extended to all secondary and community care doctors (including locums in post for more than 2 months, and doctors in non-standard posts, but not in substantive training posts) on 25th October 2002 ( PCS(DD)2002/7).
- Doctors in substantive training posts (e.g. Foundation Year 1 and 2 or Specialty Trainees) are covered by separate arrangements under the auspices of the Postgraduate Medical Education & Training Board and NHS Education Scotland.
- Annual appraisal became a contractual requirement for all general practitioners on 1 April 2004.
The Scottish Government asked Medical Directors to assess the state of appraisal of doctors within their Boards in spring 2008, looking at management processes and quality assurance. This has highlighted action required to improve the quality of appraisal, which is now being addressed. NHS QIS have recently performed External Quality Assurance of appraisal in primary care doctors, and those reports will be available in the near future.
Content of Annual Appraisal
The content of appraisal will change over the coming years. The General Medical Council has produced a framework for appraisal consisting of 4 domains (broken down into 12 attributes) which map closely to Good Medical Practice. There is ongoing work to establish the types of evidence which would objectively prove adequate performance in those domains. In collaboration with the GMC, and using the same framework, the UK Academy of Medical Royal Colleges is also currently working to establish the types of evidence which could be used for recertification of specialists and general practitioners. Development of new content and new approaches will be underpinned by evidence, will not be demanding of individual clinician's time and will be implemented incrementally. The type of evidence which could be used in appraisal might include:
- evidence of satisfactory and appropriate continuing professional development
- audit (both participation in, and outcome of)
- clinical incident reports
- patient complaints
- colleague and patient feedback
It is clear that much of the evidence will derive from clinical governance systems, rather than involving the individual doctor in data collection.
In collaboration with the General Medical Council and the Scottish Academy of Medical Royal Colleges, the Scottish Government is currently supporting a pilot in one NHS Board examining the types of evidence which could support appraisal using existing resources