Appraisal and RevalidationDr Mike Walton

Harvey Group Practice, St AlbansHerts Valleys CCG

#NUG13

Who Needs Revalidation?

• Nurses:– NMC ‘proportionate and effective model by end

2015, which enhances public protection’– 3-yearly registration renewal (450h+)– CPD activity and feedback from patients, service

users, carers, colleagues– Performed by ‘3rd party’ (eg manager/employer)

at time of registration renewal– Formal Consultation Jan to March 2014

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Who Needs Revalidation?

• Doctors– Licenced Doctors must remain up-to-date and fit

to practice– RV is periodic renewal of License– Check by employer/contractor and GMC – gives

public confidence– Commenced Dec 2012– Annual Appraisal process; RV 5 yearly– All docs Revalidated by March 2016

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Annual Appraisal for GPs (1)

• RCGP led• 2002 (E); 2003 (NI&S); 2004 (W)• Central to the Revalidation process• To enable GPs continually to improve the

quality of their practice• To help with early identification of doctors in

difficulty

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Annual Appraisal for GPs (2)

• Prev PCTs – now Area Teams• Designated Bodies – oversee Appraisal

process and Revalidation• Designated Body signs off the Revalidation

and informs the GMC re. successful process ‘Responsible Officer’ makes a recommendation

• GMC revalidates

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Useful RCGP links

• RCGP website:Principles of GP Appraisal (Mar 2008) http://tinyurl.com/qxeb39p RCGP/CoGPED Joint Statement (Sep 2008) http://tinyurl.com/omqaqbyRCGP Core Appraisals Paper (Sep 2008) http://tinyurl.com/ow9pf69

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Personal Development Plan (PDP)

• A menu of things to learn/do over the next 12 months

• Fuelled by the annual appraisal and reflection upon gaps and development needs

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Collecting and Storing for Revalidation

• Increasing chaos around paperwork• PC and intranet – organisation• iDevice – always there• Cloud storage – anytime, anyplace• 2002 – mainly paper-based,

electronicprinted, memory stick, emailed to appraiser

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ePortfolio Tools

• RCGP and BMA GPC agree a ‘choice of portfolios’

• ePortfolio “A collection of electronic evidence assembled and managed by a user”

• Some examples

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Six Areas

• 1. Continuous Professional Development• 2. Quality Improvement Activity• 3. Significant Events• 4. Feedback from Colleagues• 5. Feedback from Patients• 6. Review of Complaints and Compliments

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Personal Development Plan

• Agreed plan of action for the following 12m

• SMART

• What it is (the need)• How I’ll Do It (the method)• When I’ll finish it by (the timeframe)• What it will mean for me (the outcome)

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Continuing Professional Development (CPD)

• Minimum of 50 credits needed per year• 250 credits per 5y RV cycle – covering a ‘broad

range’ of GP experience• Self-assessed – verified at appraisal• Time Spent with Reflection• Demonstrate +ve Change in Practice = double

this• RCGP v3.0 Guide to CPD (Aug 2013) at

http://tinyurl.com/phrq7g2#NUG13

Clarity Informatics Appraisal Toolkit

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RCGP Appraisal ePortfolio

Revalidation Support Team MAG

Osmosis.me

patient.co.uk

GPTools

Review of Practice

• Significant Event Analysis (SEA)

• Clinical Audit

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SEAs

“Success does not consist in never making mistakes, but in never making the same one a second time” George Bernard Shaw

Significant Event AnalysisSignificant Event AuditingLearning Event AuditsCritical Incident Analysis

Interchangeable names Any of these CAN be included

Serious Incidents

(patient-safety concern or event)Any of these MUST be included

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SEAs

• expectation is for analysis of at least two Significant Events in which you have been directly involved for each appraisal.

identify reflect change improve

team/colleagues/peers group

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SEA ProformaTitle of event No patient identifiable infoDate of event Date of event discussed Include who present at the discussion and their roles

GP involvement in event What went well What could have been done differently

Reflections

Include issues such as knowledge, skills, performanceSafety and qualityCommunication, partnership, teamworkMaintaining trust

Agreed changes For me personallyFor the Team/Processes etc

Review of changes afterwards Appropriate review timeframe, consider effect

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SEAs – locums and others

• Locum info – practice has duty to feed back SEAs

• Locums/OoH – can use ‘Case reviews’ and discuss with peer group

• NHS Institute for Innovation and Improvement ‘PC Trigger Tools’ http://tinyurl.com/qgonm54

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Clinical Audit

• Quality Improvement Activity– Clinical Audit– Care Pathway Review– Prescribing Review– New Service Introduction– Hazardous Drugs Review– Educational or Research Initiation– Condition-based Case Review Series

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Audit Process

• Title• Criteria• Standards with rationale• Data collection – measure against standard• Discussion and changes agreed• Implementation• Repeat data collection• Outcome and Reflection son process

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The IT-savvy Appraisee

• Be Aware of requirements• Familiar with an ePortfolio tool• CPD savvy – web-browser harvesting• Share SEAs and Audit – intranet, Cloud-based• Reflections – immediacy – mobile device?• Searches and reporting – system tools

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Mastering Appraisal

Unconscious Incompetence“don’t know – don’t care” : state of denial

Conscious Incompetence“I know I can’t do it” : state of worry

Conscious Competence“I know I can do it” : state of struggle

Unconscious Competence“second nature” : state of success

Thank You

Go Forth and Revalidate!

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