Monday, 2 December 2013

The Transformative Potential of Doctors' Appraisals.

Since December 2012, in addition to being on the medical register of the General Medical Council, all doctors in the UK have to have a formal Licence to Practice. This has to be renewed every 5 years and this renewal will require an annual strengthened appraisal.

In a recent blog post, I may have struck a somewhat sceptical note about the whole process. 
Well, since I wrote those words, I carried out my first appraisal. It was while I was reading the online form and supporting documentation of the doctor being appraised that I had a lightbulb moment.  In a flash, I went from being sceptical to becoming a real fan of the whole enterprise of appraisal and revalidation 
Appraisal clearly have the intended roles of formative and summative assessments of the doctor's working life. The revalidation process of which appraisal is the predominant component should and will be reassuring for patients, fellow health workers and employers. 
Strengthened appraisals also have a transformative potential to bring about genuine quality improvement. There are 2 immediately obvious ways this could be achieved  - putting the need to carry out an audit and to fill in a critical incident form in the PDP or personal development form. Can you imagine the effect of having an increase in the number of useful consultant led audits as well as an increase in the logging of unsafe or potentially unsafe incidents by consultant doctors.
Within appraisal circles, there is a big debate about the use of appraisals as instruments of performance management. I imagine the British Medical Association may not be too happy about it. However the use of appraisals to change doctors' behaviour so as to bring about genuine quality improvement in patient care should not be challenged.