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CAMHS won't see you now

GP appraisal is a real professional plus

Dr Melanie Wynne-Jones overcame her initial unease to feel extremely positive about GP appraisal

y first reaction

when I heard about compulsory appraisal and revalidation was similar to many GPs' ­ more hoops to jump through, an outrageous slur on our ability to manage ourselves, and so on.

However, six months into becoming an appraiser, I have found the process much more worthwhile than expected. In Stockport, appraisal has been firmly interpreted as an aid to personal development, rather than a stick to beat doctors with. The contents of the appraisal are confidential between the appraiser and appraisee, but agreed summary and development plans are sent to the lead appraisal GP. These are used to develop an anonymous summary of GPs' learning needs to help plan educational resources provided by the PCT and GP tutor.

The first step towards being an appraiser was to be appraised myself. Despite reassurances, I was apprehensive about an outsider looking at the way I work. I started preparing two months in advance, downloading forms from the website11, and collecting the various supporting documents such as audits and PGEA records. I really struggled with some of the questions, and found myself letting off steam about the NHS. This was quite therapeutic, and I was then able to be more constructive.

I was surprised by how much I enjoyed the appraisal itself. It felt strange but liberating to

sit for three hours talking about my working life in detail to someone from outside the practice. I did feel able to talk freely because I knew the discussion was confidential, and because my appraiser was also a GP.

The appraisal format provides time out for both parties to collect their thoughts; the appraisee draws up a list of their own strengths which is then added to by the appraiser.

This was a pleasant surprise, and seems to be well thought of by most doctors, as even though we get positive feedback from colleagues and patients, hearing it from an outsider adds another dimension.

It certainly made me more favourably inclined towards drawing up a relevant and realistic personal development plan.

My appraiser made the whole process of my appraisal seem smooth and effortless, but at the training session to become an appraiser myself I felt like a medical student taking my very first history.

Many of the required skills and questions overlap with consultation and GP trainer skills, but it has taken a lot of practice to get the complete process at my fingertips. The training also provided another plus ­ the chance to learn from individual GPs, whom I didn't previously know, including non-principals.

The GPs on the appraisers' course started by appraising each other for practice, but I have now appraised several GPs 'for real' and have been impressed by their hard work and high standards. They too seem to have found appraisal a more positive experience than anticipated.

Regular interaction with colleagues is invaluable, but hard to maintain with today's workload in general practice, and this for me has been a welcome bonus of being an appraiser.

It has been very rewarding to learn about colleagues as individuals and members of their teams, what makes them tick, and the effort and care they put into providing services to patients, often in difficult circumstances. I have also learnt things that I can put to good use in my own practice.

So far my experience of appraisal has been entirely positive, but there are still concerns about the future implications for revalidation. It is vital that appraisal remains GP-led ­ a carrot and not a stick.

It is vital that appraisal remains

GP-led ­ a carrot

and not a stick~

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