Management and Structure of Appraisal

Medical Appraisal is managed at both a national and local level

National Level

NHS Education for Scotland (NES) is responsible for the development and internal quality assurance of the Medical Appraisal process in Scotland. The Medical Appraisal Team and the National Appraisal Adviser co-ordinate the development and monitoring of the scheme.

The work of the Medical Appraisal Team at NES is informed by the National Revalidation Delivery Board which meets regularly to oversee the delivery of Medical Revalidation in Scotland. This group includes representatives from all the key stakeholders namely SGHD, GMC Scotland, the Medical Royal Colleges, the BMA, Directors of Postgraduate Medical and Dental Education, Medical Directors, Chief Executives of Primary Care Divisions and lay representatives. Healthcare Improvement Scotland (HIS) externally quality assures appraisal in Scotland.

The Medical Appraisal Scotland website and SOAR are provided, and supported, by NES to facilitate the administration and monitoring of the scheme.

Local level

Appraisal is delivered at local Health Board level and is the responsibility of the Medical Director(s) of the Board.

Appraisers in each Health Board are managed by Local Appraisal Advisers (LAA) in Primary Care and Local Appraisal Leads (LAL) in Secondary Care,  who are trained appraisers themselves. LAAs and LALs coordinate the development and monitoring of the scheme at a local level and are supported by the Medical Appraisal Team at NES. The Health Boards provide local administrative support for LAAs, LALs and Appraisers to ensure the efficient running of the scheme.

LAAs, LALs and Appraisers are contracted through the Health Boards and are accountable to the Chief Executive, through the Board's Medical Director. Appraisers are required to operate within the agreed framework of the appraisal scheme, which is monitored by NES.

National Revalidation Delivery Board (NRDB)

The NRDB is the successor to the National Revalidation Implementation Group (NRIG) which was set up in 2012 by the Scottish Government Health Directorates. Its primary role is to ensure the delivery of appraisal and revalidation in NHS Scotland to a high standard, across all career grade doctors in all specialties, sectors and NHS Boards.

It should be noted that trainee doctors in numbered posts are not appraised by Territorial Boards but are under the supervision of NHS Education for Scotland.

For governance purposes, NRDB reports to the Scottish Government Health Directorates and then the Cross-Professional Fitness to Practise Group. 

Governance of Appraisal within NHS Boards

Under the legislation, the Responsible Officer (RO) is liable for the system of revalidation in an NHS Board. In addition, the RO is responsible to both the NHS Board and to the GMC.

It is necessary for the RO to ensure that in each NHS Board a structure is developed to deliver enhanced appraisal. Although the RO has a degree of flexibility with regard to the organisation of enhanced appraisal at the local level, two important principles must be included in the system in all Health Boards:

  • All appraisers must have satisfactorily completed a NES approved training course. It is recognised however that this may take up to 2015 to achieve.
  • The appraiser must be allocated to the appraisee. The appraisee will no longer be able to self-select their appraiser.  There should, however, be a system to allow an appraisee to object to the first allocated appraiser.

It is envisaged that the Responsible Officer will delegate the management of the system to the Appraisal Adviser / Lead, but will retain overall responsibility for the system of enhanced appraisal.

Currently most geographical NHS Boards have an Appraisal Adviser and Appraisal Lead for Primary and Secondary Care respectively.

Local Appraisal Steering Group

It is advised that the RO and Appraisal Adviser/Lead should set up a local Appraisal Steering Group, chaired by the Appraisal Adviser/Lead.

This group should include - as a minimum - representatives from the following groups: AMD/clinical directors, Human Resources, Non-clinical management, Local Negotiating Committees, GP Subcommittee of the AMC, Staff and Associate Specialist doctors, Universities (where appropriate) and at least one lay member.

It will be helpful to include the Appraisal Adviser from Primary Care on the group in Secondary Care, and likewise, include the Appraisal Lead from the Secondary Care group in Primary Care.

The responsibility of this group should be to oversee the appraisal process and to ensure internal quality assurance. (This may require a link to be developed with the Boards' clinical and staff governance committees.)  The minutes of these meetings should be made widely available and posted on the Boards' websites.



This page was last updated on: 02/08/2017