As you approach the end of GP training, it may be a good time to think about preparing for next year's appraisal, your first as an independent practitioner.
This article highlights the type of information you need to collect, portfolios for collecting evidence and the questions your appraiser likely to ask. The article does not cover the GMC requirements, you can find more information on this from the RCGP here.
Start with your final ESR
Your final educational supervisor's report (ESR) gives you the opportunity to identify a few personal developmental plans (PDPs). It is a good idea to record these in the first four columns of the table attached below. Once signed off with your trainer, this form can be uploaded into next year's appraisal portfolio.
Choose an electronic portfolio
As a trainee, you collated evidence within your RCGP e-portfolio. As a GP, you need to find a suitable, preferably electronic, portfolio. There are several available, some free of charge and others at a cost. Look at the options available before you decide as some are easier to navigate than others.
- The Clarity & RCGP Appraisal Toolkit for GPs is very similar to the trainee eportfolio.
- NHS England’s medical appraisal guide model appraisal form (MAG Form) is useful and free of charge.
- The GMC offers a My CPD app – see here for more details.
- https://www.fourteenfish.com also offers online CPD recording.
Contents of the appraisal portfolio
Each portfolio must contain 'appraisal inputs', which fall under five headings:
- Personal information: name, contact details, GMC number.
- Scope and nature of work: the work you do in your capacity as a doctor, including NHS and non-NHS work.
- Supporting information: evidence of CPD, quality improvement, reflection on teaching/ management activities; comlaints, compliments, feedback from patients or colleagues.
- Review of previous personal development plan: what was achieved and if some items were not completed, the reasons for this.
- Achievements, challenges and aspirations, including the main developmental needs for the coming year.
Evidence worth collecting
When you have completed your training, you trainer will no longer be chasing you for at least two learning logs per week. However, it is important to be disciplined about collecting evidence throughout the year.
Remember to document and reflect on naturally occurring evidence, such as:
- Did any in-house protected learning events occur? What did you learn and how did your clinical practice change?
- Did you contribute to any practice protocols? If you had to write one again, what will you do differently?
- What aspects of QOF have you lead on and what changes have you made?
- Having read the quarterly summary of PACT prescribing data, what changes have you made?
- Having attended the referrals analysis meeting, what have you learnt?
- Have you reflected on some PUNs and DENs or undertaken a structured case review?
- What formal courses (study days/ diplomas/certifications) have you undertaken?
- If you have completed mandatory training such a safeguarding and resuscitation training, make sure you upload your certificate.
- Briefly reflect on journal articles/podcasts/YouTube learning events that have changed your practice.
- Comment on any personal or practice audits, significant event or complaint discussions.
- Reflect on feedback the surgery has obtained and on patient involvement group meetings.
- Reflect on any 'sticky moments' you may have had with colleagues or on what you gained from practice social events, such as away days.
Typical appraisal questions
When you attend your appraisal these are the types of questions your appraiser will ask, based on the evidence you present.
- How has this learning (personal study, local meeting, certification etc) changed your patients' care?
- How did you disseminate your learning to colleagues?
- Having reviewed your prescribing/referral behaviour etc, what do you feel you have done well and what could be done better? Should these insights be recorded in a PDP?
- Having reflected on these cases/significant events/complaints/patient feedback, how did this learning affect you personally?
- Having participated in the practice's audit program, what changes have you made to your practice? How can you objectively demonstrate this?
- Was last year's PDP completed? If not, why not?
- What are the strengths/achievements from last year?
- What you think your main development needs are for the coming year?
- Having had this discussion, what needs to go into this year's PDP?
- Is the proposed PDP SMART and does it contain 3-6 items?
- Does the PDP cover your whole scope of work?
- At what stage of the revalidation cycle are you? What needs to be completed (PSS; MSF) before the next revalidation?
- Use the PDP you agree with your trainer at your final ESR as your starting point for next year's appraisal.
- Collect the evidence in the portfolio of your choice, remembering to self-review your work. Remember to include the mandatory CPD.
- Be prepared for questions on how your learning and quality improvement activity changed patient care.
- Propose a PDP that is relevant to your scope of work.
- Submit your portfolio to your appraiser two weeks before your appraisal meeting.
Dr Naidoo is a GP trainer in Oxford. She has written three books on how to pass the CSA. The latest book CSA Practice Cases for the MRCGP Paperback was published in January 2016.
Further reading/useful resources
- RCGP guidance on CPD credits, appraisal and revalidation
- NHS England - What is medical appraisal?
- Bradford VTS online resources - appraisal tools and forms