Surrey and Sussex Area Team Appraisal Output Aide Memoire September 2014 AREA 1. Scope of practice NOTES • • • • • 2. Achievements/ aspirations/challenges • • • 3. CPD • • • • • All roles, for which a licence to practice is required, must be described. Make comments regarding evidence of supporting information/CPD/competency etc in the summary for each role. This also relates other roles within the practice such as safeguarding lead etc. For toolkits and platforms that not have a specific section for this, it is worth adding before knowledge + skills section. Be clear which roles the supporting evidence submitted/credits being claimed for, support bearing in mind that some supporting evidence/ credits may overlap roles. If other roles have been appraised separately, please describe what evidence you’ve seen to be able to state that this is the case. If relevant, declare in the summary “there are no other roles for which a license to practice is required, beyond what is described above.” We all ask about these but rarely record them. It sets a good tone at the outset of an appraisal You can add after “scope” or in the general summary The “Excellence” tool looks to see if appraisers are exploring these themes. We interpret that the minimum number of CPD credits required to support the role of a GP is 250 over 5 years, averaging 50 per year. As a guide,for a doctor with who works solely as a general practitioner we want to see 50 credits per year relating to the GP role, with at least 40 relating directly to clinical GP credits, 10 can be non-clinical but for the GP role. In order to demonstrate competency in each extra role, there needs to be sufficient related CPD credits in the portfolio. There may be some roles which genuinely only require a small amount of annual CPD, others may require more, so establish what would be reasonable and appropriate and assess against this. Again, some CPD may overlap roles and therefore could count towards each role. IMPACT-Whilst many doctors provide far in excess of 50 CPD points (including any impact you choose to claim), a small number are using a higher proportion of impact credits to reach 50 CPD points. Whilst Impact is supported by the RCGP and has a role in measuring CPD, it is EXAMPLE COMMENTS Dr X is a full time GP Principal with no other roles for which a licence to practise is required. Surrey and Sussex Area Team Appraisal Output Aide Memoire September 2014 4. Quality Improvement Activity viewed that those that rely on this to reach 50 points are unlikely to have embraced enough professional development that the broad general practice curriculum requires. Appraisers will look critically at how Impact is used, and challenge this if there is not sufficient evidence that it has had a significant impact on your clinical practice. It is also recognised that some GPs will have already prepared portfolios for their next appraisal relying on impact credits to reach a minimum of 50. In agreement with the LMC, for all appraisals completed before October 2014, the Area Team will accept up to 10 well evidenced impact credits in this circumstance, as long as it is the appraiser’s professional judgement that you have covered enough of the GP curriculum to keep yourself up to date’. After October 2014, impact will not be recognised in the CPD credit tally. Impact can only be scored where learning HAS effected a change AND it can be evidenced. Some doctors may wish to have impact acknowledged, once they have reached the threshold for minimum recommended CPD credits per role. • Reflection, reflection, reflection. Absolutely clear from the GMC that this is required and so please say so when and whether or not it has occurred The following are deemed to be acceptable:1. A first or second cycle clinical audit (group or personal) which you have reviewed, evaluated and described/reflected your personal learning and how this has changed your practice. 2. Case reviews presented in a structured way (such as using an SRT) which promote learning outcomes and reflection. Could also be an SEA. 3. Clinical data collection exercises from which learning points and reflections relevant to your practice can be derived. 4. Reviews of clinical outcomes which are relevant to your practice.’ See GMC guidance on supporting information "For the purposes of revalidation, you will have to demonstrate that you regularly participate in activities that review and evaluate the quality of your work. Quality improvement activities should be robust, systematic and relevant to your work. They should include an element of evaluation and action, and where possible, demonstrate an outcome or change." In order to assure an appraiser that QIA is undertaken regularly, there should be some form of QIA included in the portfolio on an annual basis. Surrey and Sussex Area Team Appraisal Output Aide Memoire September 2014 http://www.gmcuk.org/doctors/revalidation/revalidation_information.asp We would like to see a doctor’s portfolio containing one substantial piece of QIA per five year cycle (e.g. audit or series of case reviews) with a small example of QIA in each of the other years (eg a case review). 5. Significant Event Analysis Any SUI type/threshold event that occurs is expected to be described, reflected upon and discussed at appraisal. Inclusion of lower level SEAs provide opportunities to demonstrate patient led learning and provide a degree of assurance that a doctor is undertaking a reflective approach to their work. For this purpose, a doctor may choose to include these too. 6. MSF + PSQ 7. Complaints See GMC guidance on supporting information http://www.gmcuk.org/doctors/revalidation/revalidation_information.asp • DATES of both. RMS will not let you save the revalidation summary unless dates are added. If you don’t have the actual date, add the date of the appraisal • The number of responses required depends upon the Toolkit used, as each toolkit has different requirements. The tool you use must adhere to GMC guidance. (personal but not administered or collated personally and with a benchmarked sample size). As a guide, the numbers of feedback forms required for PSQ varies between 30 and 50 and for MSF is between 15 and 20. • See GMC website for guidance of acceptable first cycle MSF/PSQ. • • • • If present must be declared, written up, reflected upon Some toolkits include an “absence of complaints” box for doctors to tick. Worth writing “no declared complaints” Add that the doctor declares that they have not Surrey and Sussex Area Team Appraisal Output Aide Memoire September 2014 • 8. Probity • • 9. Health • • • • • 10. Authenticity of documents provided 11. Adherence to GMP principles 12. Last years’ PDP • Simply YES or NO • Again, simply YES or NO – but worth confirming in the summary section as a fail safe A brief summary of key achievements, non achievements and why Some portfolios allow you to sign off in the PDP section – but this is not always visible to Lead Appraisers/Area Team when cross checking for revalidation. Also often just recorded as “achieved” with no narrative This must be referred to in the summary Should be SMART There should normally be between 3 and 5 elements of the PDP. These should reflect the doctor’s GP needs and if there are other needs above and beyond a General Practice role these should be included as additional elements. Origin of PDP item – this is scored in the “Excellence” tool. A useful technique is to ask – “What will you bring next year that will show you have achieved this goal? We should be expecting to cover the whole scope of practice in the PDPs over a 5 year cycle One option would be to become familiar with the Surrey and Sussex CCGs’ local priorities as • • 13. This years’ PDP been asked to bring anything to discuss at appraisal by the Area Team/GMC etc. Failure to declare a complaint at appraisal is a probity issue Do discuss probity issues. The Leicester structured reflective template provides a good aide memoire to inform the conversation. Although most portfolios ask you declare adherence to “probity”, check their understanding of its meaning and adding a comment to that effect Probity must be referred to in the summary We expect you to ask if there are any health issues that affect the doctor’s ability to practise safely. Add a brief comment in the summary regarding the doctor’s response, even if they state that there are no issues. Doctors are under no obligation to discuss other health matters though. The Leicester structured reflective template provides a good aide memoire • • • • • • • We went through the Leicester probity SRT and identified X as an issue. Dr X stated to me that there he/she had no health issues that would impact on patient care. We identified some key learning from the complaint “x” therefore has been put into Dr X’s PDP for the coming year The evidence you will provide therefore next year will be….. Surrey and Sussex Area Team Appraisal Output Aide Memoire September 2014 these may help to frame some objectives.