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Nursing staff conduct GP appraisals

GPs' performance is being

appraised by health visitors, school nurses and practice managers under a controversial scheme backed by the GMC.

Practice staff who conduct the annual GP appraisals get the same £150 fee and training as GP appraisers under a system operated by Slough PCT.

With many cash-strapped trusts struggling to fund appraisals and recruit GP appraisers, a prominent GP member of the GMC warned that some would seize on the idea as a way of doing appraisals 'on the cheap'.

A GMC spokeswoman confirmed that appraisals by non-GPs would be accepted for GP revalidation folders as long as the appraisal process met formal guidelines.

But the Department of Health cast doubt on the validity of the system. Government guidance suggests GPs must conduct appraisals.

So far seven GPs out of 29 have chosen to have their appraisal conducted by non-medical staff.

Dr David Martin, a department adviser on appraisals, said: 'You have to ask why those GPs are choosing not to be appraised by another GP.'

Dr Martin, principal GP research fellow at Sheffield University's school of health, said GPs would have to show the quality of debate about clinical processes was as good with a health visitor or practice manager as a GP.

Slough GP Dr Neil Coleman, who chose to be assessed by a clinical tutor with a social science background, said he had wanted his appraisal to have an educational focus.

Dr Coleman said the tutor 'did a better job' than a GP would have done but he would probably opt for a GP next year. 'I wouldn't want to be seen to be avoiding


Dr Krishna Korlipara, former chair of the disbanded GMC GP consultative group on revalidation, said: 'The GMC good medical practice headings on appraisal were based on the appraisal being done by another GP. If other trusts cotton on to this as a way of meeting costs on the cheap it will throw the whole process into disarray.'

Dr Korlipara added: 'I wouldn't want to be appraised by a non-member of the medical profession. Nurses have been trained to be angels of compassion. Now they're used for all kinds of positions.'

GPC member Dr Charles Simenoff said only fellow GPs understood the job. 'I wouldn't expect to appraise nurses or practice managers.'

GPC negotiators were unavailable for comment.

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