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At the heart of general practice since 1960

I decided to be appraised by a non-GP

s a non-GP the right person to conduct a GP's appraisal? I opted for a non-GP, and I'm more than satisfied with the result.

It is true that most GPs I know who have been appraised chose another GP to do the job. On the other hand, it seems that among those GPs with strategic roles within general practice, such as myself, there was a preference for a non-GP appraiser.

Let me set the scene. I am a 43-year-old GP, the senior partner in a 7,000-patient practice in a very deprived area in Slough. I developed the practice into a training practice some seven years ago and just prior to my appraisal I had been approved for the maximum three years as a trainer.

We have tried to develop a multi-professional team-based approach to patient care in our practice. We also have a learning culture. I am the education lead for Slough, I have kept my own personal development plan since February 1997, and in November 2001 I completed a masters degree at our local university in collaborative leadership in health and social care.

I am prevented from undertaking fellowship of the RCGP by assessment due to high consultation rates and disease prevalence significantly above national average in my practice, but I have facilitated certain developments from looking at this option. I have been a course organiser on the local vocational training scheme.

Slough, where I practise, is a busy and under-doctored area trying to recruit and retain the whole range of health care workers. In response, Slough started a protected learning time programme in June 2000. Its aim was to be 'a multi-disciplinary forum for learning....underpinned by the principle of equality'.

Against this background, Slough PCT set up a system of appraisal ahead of any Department of Health directive. Because we learn multi-professionally, it seemed natural to have a multi-professional appraisal system. All appraisers, whether GPs or not, have undergone a training course as an essential requirement for admission on to the list of appraisers.

GPs are able to choose whom they wish to undertake their appraisal from the list, and this therefore gives them a right to one of the many GP colleague appraisers if they want.

However, I decided to be appraised by our local primary care tutor. She is not a doctor but has a background in social science and health care education. She now has a role that incorporates assessing GP learning needs, and GP appraisal is part of this role. I chose her to undertake my appraisal as I wanted it to incorporate elements of my varied roles as GP, trainer and GP educator within one appraisal.

My appraisal was a very positive experience, with refreshing insights. It was the holistic approach to my varied learning needs that I most valued. I do not believe there is a GP in Slough who would have been more appropriate. The system of appraisal in Slough is about positive development of professionals. It is not primarily designed to identify poorly performing doctors. There is a separate established system for this.

Clearly poor performance will appear as an issue in some circumstances nationally, but I believe a trained appraiser who is not a doctor can conduct GP appraisal backed up by a robust system of clinical governance.

I believe Slough PCT has done a good and innovative job in appraising its staff. But I now find myself with a dilemma. I would like my next appraisal to also be conducted by our primary care tutor. This would provide continuity and would best suit my continuing development.

However, I don't want people to think I am avoiding clinicians!

GPs with strategic roles preferred a

non-GP to

carry out their appraisal~

Dr Neil Coleman had his appraisal conducted by a

non-GP, and found the experience entirely positive

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