FAQs for Medical Appraisal

A range of Frequently Asked Questions about Medical Appraisal

What is Appraisal?

The Medical Appraisal scheme for doctors working in Scotland ensures that all doctors participate in a system where they reflect on and consider their current and future professional practice and, from this, identify objectives and educational activities which will enhance their professional and personal development. It provides the opportunity to identify and share any concerns at an early stage.

Appraisal provides an opportunity for you to speak with another doctor who has been trained in appraisal skills. You will be able to discuss your achievements, identify some of your development needs and form your own personal development plan. It is a continual process and part of a learning culture. Participation in appraisal should be a positive and supportive process.

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Who is it for?

Medical Appraisal is for ALL doctors working in Scotland.

GPs in Primary Care (regardless whether you are a GP Principal, Sessional Locum, Retainee etc), and doctors in Secondary Care (regardless of specialty or locum) are all required to undergo annual appraisals as part of your contractual obligation.

Non-participation may affect your Licence to Practice.

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How is it managed?

Medical Appraisal in Scotland is managed at Board level by Medical Directors and Local Appraisal Advisers (Primary Care) and Appraisal Leads (Secondary Care), and supported centrally by NHS Education for Scotland (NES).

There is a central Medical Appraisal team at NES made up of the Project Team Manager, Appraisal Scheme Manager, Information Manager, Information Technician and an Administrator. There is also a NES National Appraisal Adviser.

In each Health Board, Local Appraisal Advisers / Leads oversee the appraisal process in Primary and Secondary Care respectively, and are supported by separate Local Administration staff.

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Is it compulsory?

Annual appraisal is a contractual obligation for ALL doctors employed by, or contracted with, the NHS Board.  ALL doctors are required to have an annual appraisal if they hold and wish to retain a Licence to Practise.  Non-participation will be referred to the Health Board's Medical Director. 

For GPs, participation in annual appraisal is part of the GMS contract.  Non-participation may affect inclusion on the Performers List.  A GP must maintain their status on the current Performers List to provide a clinical service in General Practice regardless of being a salaried, sessional or out of hours doctor.

Appraisal is not a contractual obligation for doctors in training as it is subsumed within their ongoing educational supervision and assessment as trainees.  

Failure to participate may lead to ineligibility for pay progression. It will also mean the Responsible Officer will be unable to recommend the doctor for relicensing.

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Who does the appraisals?

Appraisals are carried out by doctors who have been trained to undertake the Appraiser role.

NHS Education for Scotland (NES) offers a programme of national appraiser training.  It has been agreed at Scottish Government level that all new appraisers in Scotland will be recruited and trained by NES, to ensure that all doctors are appraised by Appraisers trained to a uniform standard, and that the appraisals are meaningful and of high quality.

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How do I arrange my appraisal?

Appraisals are arranged locally with your appraiser or local administrative team.

If they have not contacted you before it is time for your appraisal, take the initiative and make contact with them for further assistance.

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Where will my appraisal interview be held?

The interview should be held at a mutually pre-agreed location.  For GPs, this is often (but not always) in your own surgery premises.

For all interviews, it is important that you have somewhere to meet where you can be sure of privacy and no interruptions for the length of the interview. It can be helpful to have access to a computer to finalise the forms at the end of the meeting.

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How long will my appraisal interview take?

The interview is likely to last between 2 and 3 hours.

Your appraiser should agree an agenda with you, between receiving your appraisal documentation and the agreed appraisal date.

At your appraisal you should expect to discuss your job and clinical workload, and information you have provided regarding your involvement in Quality Improvement activities (for example Clinical Audit, Significant Event Analysis, Case Study, Multi-Source Feedback debrief, Patient Survey).  You will also be expected to discuss your learning in the year gone and your plans for learning (Personal Development Plan) for the year ahead. Declarations regarding continued Probity and good Health (in keeping with GMC Good Medical Practice) are also required.

You should allow at least one hour (or two) for essential matters; after that it can take as long as you want. It is your appraisal - your opportunity to discuss your achievements, concerns, hopes and aspirations.  Do not hold back if there are things that you want to discuss with your appraiser.

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Will I have a choice of appraiser for my appraisal?

You will NOT be allowed to choose your own appraiser.  Appraiser/Appraisee allocation is organised locally by the local admin teams, guided and supported by the Local Appraisal Adviser (Primary Care) and Appraisal Lead (Secondary Care).

If for some reason you do not wish to be appraised by a particular appraiser (e.g. you used to work together, socialise outside of work, are neighbours etc), you can ask to be allocated to another appraiser.

The appraisee is entitled to request one alternative choice of appraiser. If the appraisee has legitimate reason not to accept the second appraiser then the Appraisal Adviser/Lead or Committee will appoint another trained appraiser, and that decision will be final.

It is recognised that there are both advantages and disadvantages in having continuity of appraiser throughout the 5 year appraisal cycle, however, you should NOT be appraised by the same appraiser for more than 5 times.

It is recommended that an appraisee should have two different appraisers during each five year revalidation cycle.

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Should I be worried about my appraisal?

Appraisal provides an opportunity for a doctor to reflect on his or her professional work life through a structured dialogue with a fellow doctor who has been trained to undertake this kind of intervew.  Doctors will be able to discuss achievements, identify learning and development needs and form their own personal development plans.

Annual appraisal, and 5 yearly Revalidation, should be easily achieved by the vast majority of doctors simply by documenting the professional development and quality improvement activities already being undertaken by them.

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What do you mean when you say that appraisal is formative?

Formative is an educational term. A formative assessment is intended to give appraisees feedback on their learning and to give the appraisers an indication of where appraisees have done well, and areas of difficulty. Appraisal is a formative process of review - a developmental approach to performance, non-judgemental but challenging, which helps to inform and shape the educational process.

An alternative to formative is summative. A summative assessment has a significant element of pass/fail, testing knowledge and skill against clear and explicit markers - it sums up how you have performed against set standards. Formative appraisal is a learning process. A summative assessment is a test of how you measure up to set standards.

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All the appraisal forms are online, are there paper versions?

As of 22nd April 2013, we ceased support for paper versions of appraisal forms to coincide with the updated version of the Good Medical Practice 2013.

The new version of Good Medical Practice is configured around the 4 Domains established for appraisal and revalidation, the same as our redevelopment of the Appraisal Forms (1,2,3 & 4) at the time as we had anticipated.  We have not, and will not be providing paper copies of the appraisal forms.

Usage of SOAR and its online forms for all GPs in Scotland have been agreed with all NHS Scotland Health Boards.

Secondary Care users might be able to retrieve PDF copies of the appraisal forms from the Scottish Government website, but liaise with your Appraiser and/or Appraisal Lead first - most Health Boards have mandated the compulsory use of SOAR for appraisal and may not accept paper appraisal forms.

For further (or more technical) queries on using SOAR, please review the User Guides provided, or check out the SOAR FAQ section.

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I work in both Primary and Secondary Care, do I need to be appraised twice?

No. You should only have one annual appraisal.

If you are on the Primary Care Performers List for the Health Board you work in, then you should do your appraisal in Primary Care, and utilise that process to cover the entirety of your work. Your designated body (for Revalidation) would be the Primary Care Health Board (as well as Responsible Officer).

You do not do 2 appraisals. If you have a meeting to talk about your work with the Clinical Lead / Associate Medical Director etc in your Secondary Care setting, you can agree a note of this and take it to your GP Appraisal.

For further clarifications, please consult with your local Appraisal Leads/Advisors.

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What about Revalidation?

Revalidation started on 3rd December 2012 and the GMC expects to revalidate the majority of licensed doctors in the UK for the first time by March 2016.

Licensed doctors will have to revalidate every five years (usually), and to do this they will need to participate in annual appraisals.  The portfolio of supporting information for your annual appraisals should meet the standards described by the GMC in Good Medical Practice, and demonstrate that you provide an acceptable standard of clinical care and service to your patients.  (Most GPs will have already been collecting this kind of information for a number of years for their annual appraisals.)

The Responsible Officer will recommend you for Revalidation if there have been five satisfactorily completed appraisals, and there are no other issues they are aware of that could impact on your fitness to practise.  (If there are serious concerns, the GMC may be asked to review these to determine whether you can still be revalidated.)

For detailed information about the GMC Domains, please visit the Good Medical Practice homepage.  We recommend that ALL doctors should NOW be collecting supporting information for their portfolio across these domains and that material presented at appraisal should be retained in a revalidation portfolio.

There are provisions for doctors who have missed annual appraisal because of illness, maternity or sabbatical leave.  In this situation your revalidation date would usually be deferred for a year. If you think this may apply to you, discuss this at the earliest opportunity with your Local Appraisal Adviser (LAA).  Please visit the Contact Us section for contact details of the local appraisal offices administrators and LAAs in Scotland.

The supporting information that the GMC requires for Revalidation is not prescriptive.  In general terms the five year cycle of appraisal must demonstrate supporting information in relation to each of the four domains of "Good Medical Practice", but you do not have to provide material for all of them every year.  The appraisal forms will guide you through the frequency with which they must be covered.

Please also review our section on Revalidation for further information.

 

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Anything else for revalidation?

If you have been consistently appraised in Scotland as a GP in the past, probably not.

The Scottish GP Appraisal Scheme has been running since 2003 and although the format and content have changed slightly to fit the GMC domains of Good Medical Practice (2013), the significant changes to the supporting information required for appraisal are:

  • Multi-source feedback (MSF)
  • Patient surveys
  • Changes to the scope of Quality Improvement Activities that may be undertaken.

For Revalidation (a process that happens in the background), provided that you have maintained your annual appraisals under the Scottish system and you have provided sufficient supporting information to meet the guidelines, you will not need to do anything else - unless contacted by the Responsible Officer with a question or request for additional information relating to particular aspect(s) of your work.

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Where can I get the Appraisal forms?

The Medical Appraisal forms are integrated into SOAR. To complete the Appraisal Forms simply login to SOAR, and you will see the forms listed on the menu on the left.

Since the GMC's release of Good Medical Practice 2013, we have ceased support for paper appraisal forms.

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Do I need a password?

To login to SOAR, you will need a login name and password.  If you are new to SOAR or you have forgotten your login details, submit a SOAR Login Request as your first port of call.  Alternatively you can contact your Local Administration team for assistance.

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Timescales for appraisal interviews

A table of suggested timescales is available from the Help me with... Appraisal section on the website.

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What if I don't work in a fixed practice setting?

Doctors are encouraged to provide supporting information for their appraisal that is appropriate for the job(s) they do. Appraisal will be much more rewarding if you discuss the most relevant and challenging issues of your work, rather than trying to fit a hypothetical model of mainstream general practice. For example you may work as:

  • a sessional doctor (locum);
  • work entirely in the out of hours services; or
  • undertake a variety of work in different settings, with no fixed GP base

There are Toolkit templates and suggestions to cover these situations. The Sessional Doctors Toolkit and the Out of Hours Toolkit provide suggestions for these types of work. If you are not sure, ask your appraiser for guidance.

Please visit the GMC website for further information about special circumstances; or contact your LAA for advice.

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What if I have additional jobs?

Doctors in this category might include those who:

  • work in a paid external post in addition to mainstream general practice
  • have a major management role
  • hold an academic post
  • are a trainer or undergraduate tutor

Your appraisal and revalidation need to cover all aspects of your work as a doctor. It may be more difficult to keep up to date in a job that is a smaller part of your work, and the potential risks of becoming deskilled may be higher.

For this reason we advise that you:

  • provide an in-depth review of an aspect of your additional job once in each five year cycle.
  • ensure that your PDP includes learning needs for all your jobs.
  • provide supporting information that is appropriate to this work.
  • If you are not sure how to do this, ask your appraiser or the Local Appraisal Adviser for advice. Others will probably have been in your situation and there are various examples that they can share with you.

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Is there a Glossary of Terms?

A Glossary of Terms is available on the NES website.

We have also supplied a Glossary of Terms and Acronyms used in the Medical Appraisal Scotland website and SOAR here.

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This page was last updated on: 15/05/2015