Menu Home Search

Hot Topics and Key Learning - February 2020

End of year

If you have any appraisals due before 31st March for which you don’t have a date recorded, you should already have heard from Gill. Numbers are far fewer than they have been in previous years, so “thank you” for getting the dates agreed with your doctors and notified to us. If you are already in touch with Gill, please keep her updated on any progress with your doctor. If you do have an appraisal in March, please try to get the documentation and your invoice in before the end of March to help with the year-end reporting.

Do you facilitate training for us?

If you do, then you will shortly be sent new Terms of Engagement (ToE) for the role. This is something that we are introducing to ensure our contractual arrangements are formalised for your benefit and ours (and the auditors). When you get them, please complete and return them soonest and definitely before 31st March 2020 as we will not be able to continue to engage facilitators (or appraisers) without signed ToE.

NHS ENGLAND pilot to reduce pre-appraisal documentation:

Our apologies that the NHS England pilot was announced with such short notice that it was not in the last Hot Topics or Appraisers Newsletter. 56 doctors with appraisals in February signed up. Doctors who have completed their appraisals have been followed up to ensure they complete the survey. As an appraiser, you do nothing differently apart from completing the appraiser survey afterwards. Any feedback directly to the team would be welcomed. Email Susi Caesar.

COVID-19

We are sure you are all watching the Public Health England announcements about the Coronavirus health situation globally. It has already affected us, as Drs Susi Caesar, Karen Gregory, and Majid Jalil will no longer be travelling to participate in the Ottawa ICME conference in Kuala Lumpur on 2nd-4th March. Instead, we have videoed their presentations and poster discussion to send to the conference organisers; once the conference is concluded, we will have new resources on the Wessex Appraisal website.

The implications of COVID-19 for appraisal are not yet clear, but we want to remind you that we have a process for approving a remote telecommunications-assisted appraisal, so if you are self-isolating for any reason, this is an option to consider.

Introduction of the Medical Performers List Refresher Route

Please find attached Info Sheet 6 which relates to the introduction of the new NHS England Medical Performers List Refresher Route, enabling those doctors who have been out of the workforce for more than 24 months but who have managed to remain on the Performers List (usually following a prolonged period of ill health) an easier route back to general practice, supported by NHS England. Susi has said in response: "What fabulous news. A bursary supported refresher scheme for people who have been out of UK GP for more than two years without having to come on and off the NPL.” Effectively, such doctors link into the I&R scheme but without having to come off and back on the Performers List in order to access the bursary funding. This good news will be in the next Appraisee Newsletter too.

Inspires

Following discussion at the Annual Conferences and a review of the new specifics that need to be included in appraisal summaries that are not reflected in PROGRESS, our new QA tool “INSPIRES” will be rolled out across Wessex from 1st April 2020. You will recognise the focus on the formative elements of support, challenge and encouraging excellence, reflecting a good appraisal discussion, and the summative specifics have been gathered together so that it should be easier to learn to incorporate them in every summary.

Learning from complaint

Unfortunately, we have had two recent complaints, one of which is still being investigated, in which the relationship between the doctor and the appraiser appears to have broken down leading to the complaint. Learning points from the first complaint include:

  • A reminder that it is important to allow sufficient time after the appraisal is due to end for the doctor to go away and reflect, but also as run-over time if something comes up during the appraisal discussion so that there is time to complete the appraisal. A doctor who has patients waiting in surgery will not be able to engage fully with the end of the appraisal. Rescheduling additional time may be wiser than rushing to finish without due discussion. [Note: A half day is allowed for the appraisal meeting so allowing 3.5 hours should be sufficient but, even at the end of this length of time, a hard deadline can be difficult to manage.]
  • A reminder that it is important not to leave the appraisal without agreeing the PDP together with the doctor so that they have ownership of the goals and do not feel that something has been imposed on them
  • A reminder that it is important not to leave the appraisal without agreeing any Disagree Statements before they are made. The reason why a statement has to be ‘disagree’ should be explained to the doctor and the wording in the box to the RO agreed
  • If an appraisal has to be aborted before it is completed, it is reasonable to discuss the circumstances with the Appraisal Service and consider rescheduling to finish it properly. Although there is no formal funding for a second appraisal for the same doctor, we have a contingency fund for these exceptional circumstances to offer an entirely new appraisal or pay for the time for an additional meeting.

Disagree to Statement 5

Learning from an FAQ: If a doctor declares that they are under investigation or have restrictions on their practice, then statement 5 must be a ‘disagree’ because something has been presented that raises a concern about the doctor’s fitness to practice. You can then comment to the RO that it has been ‘openly and honestly discussed and appropriate safeguards are in place’ (or whatever else is appropriate).

Documents Due

Learning from an event: Top tip - it is really helpful if you let the doctor know the exact date two weeks before their appraisal date when their documentation is due and suggest that they put it in their diary as well as as the date of the meeting. Appraisers using this technique have found that it has worked in dramatically reducing the doctors who present their information late. At least, it means you usually get an apologetic e-mail and an explanation if the documentation is going to be delayed by a few days which can pre-empt a need to chase.

Learning from MSF/PSQ Issues 

Learning from incidents: NHS England have had a few instances recently where a doctor could not have a positive revalidation recommendation on the due date because they had not reflected on their MSF/PSQ and discussed it at their annual appraisal. Please, as appraisers, ensure that the doctor knows that the discussion at appraisal is required by the GMC, and document your discussion and recommendation to do this before the end of the revalidation cycle in the appraisal summary/PDP goals so there is no doubt that the doctor was well-informed in good time to do what they needed to do. We strongly recommend postponing any final appraisal before revalidation if the MSF/PSQ are not ready.

Internal News 

Staff and Office Reorganisation

Tara Whittington is now officially back from maternity leave but using up her annual leave before coming back into the office on Monday 16th March. Tara will be reducing from full time to four days per week. This will lead to some organisational changes within the Administration Team as we work out how to share out the workload of supporting doctors and appraisers most appropriately. Watch this space!

Senior Appraiser to cover East Hampshire and Fareham & Gosport

Due to delays within the HEE recruitment system, interviews for Will Liddell’s replacement will take place on Tuesday 24th March. Three candidates have been invited for interview and we hope to have someone in post very soon thereafter.

We have adopted the title Senior Appraiser so that the role (formerly called Locality Lead) is understood across NHS England.

NHS ENGLAND/IMPROVEMENT Reorganisation

20 months after the initial merger of NHS England and NHS Improvement, the changes are still making slow progress.

Dorset:

Dr Caroline Gamlin is once again the RO for SW (Dorset). The revalidation support from the NHS England Area Office for Dorset will be moving to Kate Barnes (based in Gloucester) from 1st April 2020, and the appraisal contract remains with the Wessex Appraisal Service for another year.

HIoW:

Dr Shahed Ahmad remains the RO for SE (HIOW). Naomi Sargeant (based in Southampton) remains the NHS England Area Office contact for HIoW, and the appraisal contract remains with the Wessex Appraisal Service for another year.

Annual Conferences

To confirm that the conferences are now scheduled as follows:

  • Hampshire: Friday 11th September 2020; Norton Park Hotel, Sutton Scotney nr Winchester
  • Dorset: Tuesday 29th September 2020; RNLI College, Poole

Please do pop those dates in your diary. Further details will be advertised in due course but if you want to reserve your place now please email appraisal.wx@hee.nhs.uk