Training and Recruitment

Contents

TRAINING & RECRUITMENT

TRAINING AND RECRUITMENT OF MEDICAL APPRAISERS

Medical Appraiser training courses in 2015/2016

2015/2016 has been a busy year for the team as we completed the Phase 4 Medical Appraiser Training programme and moved onto the Phase 5 schedule (August 2016 to June 2017).

We carried out 12 training events this year across Scotland:

2-day New Appraiser Training (x6)
1-day Refresher Training (x4)
1-day RO Training Day (Responsible Officers)
1-day Tutor Training Day

From the six New Appraiser Training courses, a total of 78 new Secondary Care Appraisers (out of 79 participants) and 24 new Primary Care (GP) Appraisers were successfully trained.

In Scotland, it is a Revalidation requirement for all appraisals to be completed by a NES-trained Appraiser. For a number of Secondary Care Appraisers, the Refresher Medical Appraiser training offered a necessary opportunity to attend NES training; to develop and refresh their skills and allow them to continue in their role as an appraiser. For others, the Refresher courses enabled them to refresh and review their skills as an appraiser, particularly a number of Primary Care Appraisers who had originally trained more than five years ago. In total, 66 Secondary Care Appraisers and 11 Primary Care Appraisers have attended our Refresher Training events.

We have also successfully trained 17 new tutors who joined the existing panel to increase and refresh our training capacity; and 12 of Scotland’s Responsible Officers attending the RO Training Day. (See sections at bottom of page for details)

We also recognise the valuable work that takes place at a local level and is led by local Lead Appraisers to support the appraisal workforce in their own health board.

Training course format

As before, the 2-day New Medical Appraiser Training Courses have a maximum of 18 participants while the 1-day Refresher Medical Appraiser Training Courses are run with a maximum of 24 participants per course. With the exception of one training course (R10), most of the training courses ran close to (if not at) full capacity.

For information on how a New Appraiser application is processed and what is covered at the training course, please download our posters:

The New Appraiser Training Courses are assessed. The tutors observe the participant in a number of roles during the course of the two days (a week apart), and assess them against criteria linked to Communication, Empathy, Challenge and Professional Integrity. Although rare, there have been occasions over the years where participants failed to meet the criteria requirements and subsequently have not been recommended at that time for the Appraiser role.

The Refresher training courses are NOT assessed. But any significant concerns raised by the tutors would be shared with the appraiser’s Appraisal Lead so these can be addressed.

The ‘mini’ Appraisal sessions on both training courses are video recorded, which are then transferred onto DVDs and sent out to the course participants by NES. These DVDs offer the participants a further opportunity to reflect and learn at their leisure.

As part of our continuous review of the training courses, we identified an area of improvement with the post-training DVD videos. We began exploring options to post the grouped recordings online via secure video hosting. This was piloted for the R10 event in March 2016 and proved to be a success. The transfer time is significantly reduced (almost halved) and the access is almost instantaneous. We have since invested in our own secure online video hosting service and all videos uploaded are password protected, so only the participants and course tutors will have the links to the videos – which are split into groups, meaning Group A participants cannot access Group B etc – and the videos are deleted 6 weeks after the training. We will continue to monitor progress and user feedback on this.

Extra Medical Appraiser training during Financial Year 2015/16

NES continues to be proactive in responding to local Health Board requirements. In order to meet the continual requests for New Appraisers, one of the relatively undersubscribed Refresher courses (R9) was cancelled to allow an additional New Appraiser training course (N25a) to be held.

With the participants’ goodwill and help, those on R9 were successfully moved onto other Refresher courses.

Unused places from the Appraiser Training Courses

During the Financial Year 2015/16, there were 15 unused spaces on the New and Refresher Medical Appraiser Training Courses – a significant reduction from last year’s 34. However, it should be noted that one of the courses (R10) ran at a reduced capacity of only 15, due to restricted facilities offered.

The 15 unused places were caused by unfilled capacity and late cancellations that we were unable to then reallocate to another participant, or participants who did not attend (DNA) on the day of the courses.

Substantial increase in Medical Clinician workforce

This year we have had additional requests for New Appraiser training courses. It was not immediately obvious why there was an increased demand for additional appraisers until we reviewed the number of Appraisees across Scotland compared to this time last year (see appendix A).

Overall there has been an increase in numbers of 444 doctors in Secondary Care, and together with the loss of 45 appraisers, it is clear why there was a demand for new Appraisers in 2015/2016.

However, it should be noted there are now 1321 Appraisers covering 7606 Appraisees. Although the CMO recommendation is that every appraiser should ideally undertake 10 appraisals, the statistics indicate that if they each did an average of 6 appraisals, that would meet demand.

For GPs it’s a slightly different scenario where the SOAR figures (captured on 24th May 2016) indicate there are 52 GPs less in Scotland. Fortunately, the Appraiser workforce in primary care has remained steady.

With the exception of a minority of health boards, the appraisal completion rate has remained steady with either a rise or fall of 1-3% compared to last year (see Appendix B).

"Building confidence in the role and honing interview skills to meet the specific requirements of this role. Really enjoyed meeting other participants and hearing about their jobs. Practical role-playing absolutely central to this learning experience. Great that we were all put at ease and made comfortable enough to participate in this fully - felt safe to immerse self in various roles. Thank you.”

There was very positive feedback from participants at the New Medical Appraiser Training Courses. When asked ‘What was the most valuable aspect of the course?’, there were a lot of positive comments, perhaps best summed up by the following feedback from an N26 participant:

New Medical Appraiser Training Courses

Of the 79 Secondary Care participants who attended New Medical Appraiser training courses, 78 were successfully trained and, along with 24 Primary Care participants, went on to become Appraisers. Rigorous chasing up of Participants by NES and good use of training course Waiting Lists ensured that there were only 5 unused places. We had 2 drop-outs, both on days 2; one of them successfully attended a later course, the other candidate withdrew from the training.

The following table illustrates the attendance at the courses.

* R9 was cancelled and N25a was created to meet the continuous demand for New Appraisers recruitment.

R6 and R7 were close to full capacity (max capacity 24). Unfortunately, due to unexpected circumstances a few people had to drop out on the day, raising the combined unused spaces for all Refresher courses to 10.

R8 ran successfully with only one DNA on the day; but R9 was cancelled and was replaced with a New Appraiser course (N25a).

* Due to limitation with facilities offered, R10 was run at a reduced capacity of 15 instead of the normal 24. DNAs on the day (x2) reduced the number of participants further, but we still managed to successfully train 13 Appraisers on the day.

There was once again very positive feedback from the participants at the Refresher Medical Appraiser Training Course. When asked ‘What was the most valuable aspect of the course?’, the overwhelming response was the roleplay / mini appraisal sessions and the feedback received. Some of the other replies included:

Personal learning: Not getting into argument - use "consequences" as a way to unlock impasse. Leaves responsibility with appraisee. Good mix of appraisers - primary and secondary care.”

Regaining enthusiasm for appraisal! Discussions about difficult issues. Learning how others are getting on. Doing the role play was very useful to deal with challenging issues.”

Seeing that the same problems exist across all specialties.”

Reinforcing current practice, also learned some new tips.”

Refresher Medical Appraiser Training Course

We successfully trained 11 GPs and 66 Secondary Care doctors (6 DNAs in total.) The following table sums up the attendance at the courses.

Secondary Care Appraisers

During Financial Year 2015/16 we have successfully trained 145 Secondary Care doctors; 79 of whom attended the New Appraiser courses (78 went on to become Appraisers), and 66 attended the Refresher courses. The spread across the Health Boards is summarised below:

The number of appraisals carried out by Secondary Care Appraisers per year – whilst improving – is a topic that we are looking to engage in dialogue with the Territorial Health Boards in the coming year.

Primary Care Appraisers

We trained 24 new GP Appraisers, and 11 GP Appraisers attended a Refresher course this year. The distribution over Health Boards is shown below:

We continue to maintain the required supply of new GP Appraisers to the Health Boards. We are now training established GP appraisers on the Refresher Medical Appraiser Training courses to augment their appraisal skills, as it may be a few years since these GPs attended their original training.

GP Appraisers undertake around 22 Appraisals per session. The number of appraisers, appraisees and appraisals undertaken, per Health Board, is summed up for GPs and Secondary Care doctors in tables under Appendix A and B.

Tutors Induction Day

An Appraisers Tutor Training Day was organised on 9th September 2015 at the NES Edinburgh office (102 Westport), the aim of which was to recruit and expand our existing Tutors Panel.

The format is similar to the one-day Refresher training, but instead of focusing on the Appraiser role in the mini appraisal sessions, the emphasis was on providing feedback in the Observer role.

18 new Tutors were successfully trained and 17 have joined the existing panel to increase and refresh our training capacity (1 has since left NHS Scotland).

RO Training Day

On 6th May 2015, a special Responsible Officer (RO) Training Day was organised at the request of the Scottish Government, and was attended by 12 of Scotland’s ROs. The one-day event was held at the Queensferry Hotel, Fife, and the design was similar to our Refresher Training courses. More management-specific supporting information was collated and used for this event, which was also attended by Dr Catherine Calderwood, the Chief Medical Officer (CMO).

The event was a success and we are working with the Scottish Government to organise further similar events in 2016/2017.