Summary of an Appraisal: Form 4

If you experience a problem viewing the above video, please visit:  https://vimeo.com/1060912534

Slides used on the day is available for downloading below, along with the sample Form 4s used in the breakout group discussions.

In this workshop, participants were asked to review and discuss the anonymised examples of Form 4 in small groups as outlined below.  The recording above includes snippets of some of the breakout room discussions.

Breakout 1:  Focus on Domains 1 and 2

Consider for Domain 1:

• What additional information do you add? (work the doctor does? additional roles?)
• What about learning? (reflections on the learning? Type of learning?)
• What comments do you usually make with regards to PDP?
• How do you summarise QIA activity?
• Do you use the actions/Agreed outcomes box?

Consider for Domain 2:

• What do you normally highlight/ Record from PSQ? anything particularly good or areas to improve?
• For complaints or critical incidents, what do you normally include when writing the Form 4?

Breakout 2:  Focus on Domains 3 and 4

For Domain 3:

• What aspects of your conversation do you record on this area?
• Do you add detail on the actions/Agreed outcomes?
• If MSF was submitted? what areas do you highlight?
• What comments do you normally write around health?

For Domain 4:

• What aspects of the discussion do you record in here?
• Do you mention GMC good medical practice?
• Do you record if the doctor is registered with a GP?

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This page was last updated on: 26/03/2026