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Hot Topics and Key Learning - December 2019

For consideration: Vacancy for a new Locality Lead

Will Liddell is resigning as Senior Appraiser for Fareham & Gosport and East Hants Appraiser Support Groups with effect from 31st December. He has brought his unique perspective and high level of challenge to the role, along with a huge amount of common sense, charm, good humour, and pragmatic decision-making - he will be greatly missed.

The vacant role will be advertised and open to all existing Wessex appraisers on TRAC and NHS jobs once the HR processes are complete. It is a very flexible one-session-a-week role and we would encourage anyone interested in getting more involved in appraisal leadership to apply.

URGENT REMINDER For action: Please return signed and witnessed Terms of Engagement

Without a proper signed Terms of Engagement for 2020-21, HEE will not allow us to allocate any appraisals to you. This is now urgent for those of you who have not yet returned a properly signed and witnessed ToE if you wish to continue to appraise next year.

It is legal to have a witness related to you if they have no financial connection to you (ie not a spouse but a grown up and independent child, living at a different address).

REMINDER: you cannot facilitate an appraisal in the evening if you have worked all day

The ToE and Code of Conduct are clear: appraisers cannot expect to be engaged to facilitate appraisals on a day when they have already done a full day’s work. They will not be sufficiently fresh. Nor can the appraisee discharge their professional responsibility to engage fully with their annual appraisal on a day when they are doing a full day of clinical or other work. If any such appraisal comes to light, the appraiser will no longer be engaged to perform appraisals on behalf of the Service. The reputational risk of being double-paid for a day of work is a potential probity issue, and the appearance of collusion and a cosy chat could not be avoided.

Appraising when fresh is essential to doing it well. Sometimes an allocation is a complete mismatch in terms of time available. Ultimately, if no mutually convenient day/time can be arranged, please hand back the appraisal(s).

REMINDER For action: You must use secure email for appraisal work

This is a further reminder that, if you are not currently using nhs.net secure e-mails, you should be, and to please let us know if you have any difficulty in getting an appropriate nhs.net address to use for appraisals. It is a pain to have multiple emails, but it would be worse to be part of a Significant Event about the misuse of personal and sensitive information.

For information: the minimum number of Appraisals required by NHS England has increased from 6 to 8 per annum. This will be applied from 2020-21

For Wessex Appraisal Service purposes, Hants/IoW and Dorset are considered one area, because the allocations are on postcode and work across areas to minimise travel and stay ‘green’. Where the appraiser undertakes work for WAS under other SLAs, they must be completing at least 8 in NHS England. In exceptional circumstances, appraisers can do fewer on a case by case basis.

REMINDER For action: Revalidation dates

Doctors’ accurate revalidation recommendation due dates are included in your notifications and those to your doctors. The dates feed straight from the GMC and so reflect the correct date on the date of the email. GMC Online provides the definitive Revalidation Date and it is best practice for the appraisee to check this. Please check the date your doctor gives you in their paperwork, as there have been incidents of the wrong date being entered and misleading the doctor and appraiser. When this meeting is the last before their revalidation, ALL EVIDENCE needs to have been presented through appraisal by the time of this meeting, including MSF and PSQ surveys, otherwise you must sign a Disagree Statement about appropriate supporting information having been presented. Please also let us know via email, copying in the doctor. We will follow up with the doctor and with the relevant designated body about the situation.

REMINDER For action: Feed the Beast to avoid recorded delivery ‘Final Reminder’ letters about appraisals with no date set

Do take responsibility for setting an appropriate appraisal date well in advance and PLEASE when you have set the date for an appraisal meeting let us know! It doesn’t just save time for the office team, but it saves money not having to send out final reminders which inevitably come over badly, especially if the date is in fact already set. By just copying us into your email, confirming the date, you are really helping us and your appraisee out. Gill will be monitoring this in future and we will be feeding back to the Senior Appraiser when an appraiser has failed to set a date. If you cannot get in touch with your appraisee or they are proving difficult to pin down, let us know and we can help.

REMINDER For action: ‘Disagree’ Statements should be explained in the first comments box to the RO below the appraisal output statements

For action: How can we reduce the ecological footprint of appraisal?

This is important to examine this question given the climate emergency. Simple steps include:

  • Minimising the use of paper for our meetings and training as far as possible
  • Using iPads during appraiser training with digital sign in and feedback options
  • Choosing the location of the conference to minimise travel and facilitating car sharing and use of public transport
  • Using teleconference and video conferencing facilities where appropriate
  • Checking the policies of our venues regarding single-use plastics, food sourcing, etc
  • Encouraging appraisees to choose a QIA that impacts the green-ness of their practice (addressing overprescribing, buying a practice bike, recycling, turning off PCs, becoming a park run practice, etc)
  • Grouping appraisals in remote venues together as far as possible
  • Reducing travel with our postcode-based allocations (so make sure your address is up to date)
  • Initiate two “Wessex Green Awards” (Dorset and HIoW) for the best QIA around becoming ‘greener’ or more sustainable in some aspect of practice

For information: Feeding back soft concerns about appraisees

Please do use the post-appraisal feedback forms, as well as talking to your Senior Appraiser and the Service Lead/RO (depending on the level of concern). Presently, appraisal and revalidation queries are handled by the team here in liaison with the Area Office administrative team. Specific RO queries may go in the first instance to Susi as she has completed relevant RO training, then on to Shahed Ahmed (HIoW) and Vaughan Lewis (HLRO Hants/IoW), and Caroline Gamlin (Dorset) and Michael Marsh (HLRO Dorset).

For information: Team news

Rory Molloy resigned after a period of sick leave on 31.10.2019

Tara Whittington is due to return from her Maternity Leave around the beginning of February 2020

Karen Gregory shared the great news that her tumours are responding well to treatment, she has already completed the New Forest marathon and the Florence marathon, and been accepted for the London 2020 marathon (which will enable her to meet her goal of three marathons in the first 12 months on treatment). She has become Sports Ambassador for her charity AgainstBreastCancer and will be starting a blog very soon. Watch this space!

For action: Support Group Highlights

All Senior Appraisers have been asked to bring examples of things that have gone particularly well in their Support Groups to our Feb Whole Team Meeting, so that ideas can be shared and cascaded out to other groups. Things to share include top tips from appraisees, peak support group experiences (and of course anything that has not gone well and should be avoided). Can the groups generate ideas to support their Senior Appraiser?

For information: Low Volume of Clinical Work Structured Reflective Template

Some appraisers are not yet aware that there is an NHS England / RCGP / BMA LVCW SRT which should be completed by ALL appraisees doing fewer than the threshold of 40 sessions of NHS clinical work/any clinical work per twelve months in work. GPs doing more than 40 sessions may also find it a useful prompt to reflect on the governance around their role. It is embedded in FourteenFish and available on our website. There is no reason to contact ROs if the LVCW SRT has been completed unless there are concerns. The second comments to the RO box in the appraisal documentation should be used to highlight where a doctor is working less than 40 clinical sessions and say that they have reflected on the factors that keep them safe using the LVCW SRT.

The version on our website has had some issues and will shortly be revised to ensure it is easy to open and complete. There is no need for the appraiser to fill anything in on the LVCW SRT  – the discussion should be in the summary as usual.

For information: Leaving well

Going forward, Leads will ask any outgoing Appraisers if they would like to share the reason(s) for their decision so that we can get an overview of when and why appraisers stop and ask whether there are any lessons the Service can learn.

On a similar note, an appraisee recently felt they did not need a PDP at their last appraisal as they were retiring. To fully celebrate their career as a GP and to plan for their retirement are very appropriate PDP goals and will avoid a disagree statement in their last appraisal outputs. Not having a PDP is inappropriate.

For information: Clarity glitch

Following an issue for an appraiser logging into to Clarity to prepare for an appraisal, Clarity revealed that there is a potential to be unable to log in if the appraiser also uses other Clarity products (such as Teamnet). If these are under different email addresses, this completely confuses the system. This is a reminder to everyone to put all Clarity-related products on one secure email address – preferably nhs.net. It will affect both appraisees and appraisers.

For information: Pensions update

All contributions owed by HEE to the Pensions Agency have now been paid. Allocations to the individual doctors should be completed soon by the Pensions Agency as they have the required information. Good News: from October 2019, only one SOLO form is required per annum.

For information: Retreats for GPs – Acacia/Wiltshire retreat

Retreats for doctors/GPs are becoming more popular and information about these two will be included in the next Newsletter and on the website if you or your appraisees would be interested.

For information: Wessex Appraisal Service successes

FMLM Leaders in Healthcare Conference 4-6th November 2019 – two posters

NHSE appraisal leads event – one poster

DEMEC 2-3rd Dec 2019 – one presentation

Ottawa Conference, Kuala Lumpur, Feb/Mar 2020 – one workshop, four presentations (all shortlisted for the IMU-RHIME award) and one poster accepted.