What is appropriate?

The practice evidence section has been designed to help doctors prepare evidence about the functioning of their practice. Appraisal quite rightly focuses on individual development. It is relevant however, how that development is used within the team and also relevant that development takes place according to team priorities. It may also help you demonstrate your role in an environment that is safe and effective in delivering patient care (a clinical governance requirement).

Quality improvement templates are already available on the appraisal web site under the Revalidation Template tab when entering information under ‘My Appraisal Information’ and will not be duplicated here. These are for individual activity rather than practice activity and are listed below:

  1. Audit/Monitoring of a teaching programme
  2. Case Review or discussion
  3. Clinical Audit
  4. Evaluation of Impact of a Health Initiative
  5. Review of Clinical Outcomes
  6. Significant Event analysis

29037148When considering practice evidence however, the templates included in this support pack will provide the doctor with a structure in which to provide evidence of the common situation where you may be involved in the work of others, perhaps in the activities one to five above, or in other practice based activities where you work as a member of a team or in support of another colleague. In these situations, you will not be the lead individual for the activity but will nevertheless play a significant role and this should be recognised at appraisal. The following templates may be used to aid you in recording and analysing your involvement.

The list is by no means exhaustive and the templates do not cover for example, areas such as contributing to the Quality and productivity (QP) domain of QOF, practice meetings, consortia projects, establishing a new enhanced service etc. The standard appraisal web site template should suffice for such entries.

Examples of “practice work” that would be appropriate to use in your appraisal folder                

  • Much of the work we do as GPs involves a team approach. We work with others to deliver healthcare to our patients, this team approach is sometimes difficult to document for the purposes of appraisal. An example would be a colleague in the practice is auditing lithium monitoring, the initial data collection show only 40% of patients on lithium have a blood level within therapeutic range in the last 6 months. You sit down with your colleague and work out a strategy to improve this; you then work to that plan. Your colleague finishes the audit there is an improvement in-patient care however it is difficult for you to include that audit in your appraisal folder, as it was not you that “did” the audit.
  • Significant event audit does not always directly involve an individual, it is imperative that a practice has a significant event system in place and this should be demonstrated at appraisal. An individual’s contribution to SEA can be demonstrated and a template and example is included in this document.

An individual may wish to demonstrate at appraisal that their development is helped (or hindered) by the system in which they work.

  • Practice skill mix is an important factor when considering personal development. If there are 4 GPs within the practice providing minor surgery then another individual may consider it as a low developmental priority however if no other GPs in the practice are trained then the priority obviously changes. A template for examining the skills mix of the practice can be found here.
  • You may wish to consider your own skills in realation to the needs of your practice. This template may be helpful.
  • Practice development – a practice may be planning to move premises, become a training practice, take on medical students or to change appointments system. Large developments could affect an individual’s development plan for that appraisal year.
  • QOF – many practices are achieving high QOF points, the goalposts are ever shifting. An individual may like to highlight how they have contributed to the practice in this area and either identify learning needs falling out of this or highlight development or teamwork that has helped in achieving success.