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My annual angry appraisal blog

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December is upon us, and with it the annual indignity of my appraisal, as inexorable as a bout of recurrent herpes and about half as welcome. It seems like only yesterday I was writing an angry blog about appraisal, but here we are again. I know what you’re going to say: I should do little bits of my angry appraisal blog throughout the year, so it’s nearly complete when I come to need it, and in fairness I swear each year to do that next time, only to inevitably find myself staring down a deadline in the wee small hours, shoehorning vaguely-remembered bits and bobs into some semblance of order.

Appraisal is a scandalous squandering of the most precious resource in the NHS

While recent high-level research shows most GPs find appraisal worthless, some people say they enjoy it, and I suppose I can understand that. I certainly get a mild sense of elation when it’s over for another year, like that experienced on leaving an exam hall, or relievedly jettisoning a particularly tenacious poo. If nothing else, it’s a few hours’ respite from the daily grind of withholding my secret cure for the common cold from people who’ve explained how they really need to be better in time for Christmas.

But that doesn’t excuse the fact that appraisal is a scandalous squandering of the most precious resource in the NHS: GPs' time. Each appraisal represents six combined appraiser-appraisee hours away from direct patient contact; multiply by 40,000 GPs and suddenly one and a half million appointments are up in smoke. And that’s even before you consider the innumerable hours of scanning, linking, and general fretting spent in pointless preparation, let alone the phantom clinics that will remain forever unfilled after frustration with appraisal encourages many colleagues into early retirement.

In years gone by, I used to keep my head down, tick the boxes, and pretend to reflect through gritted teeth, like Mark Corrigan doing expressive dance. Unfortunately, to the powers that be, this kind of mute compliance appears identical to enthusiastic endorsement. So nowadays I give ‘em the bare minimum name-rank-and-serial-number 50 credits, use the white spaces to delineate why it’s a total waste of time, and harangue my unfortunate appraiser about how I wish everyone else who hates appraisal would do the same. 'If you feel so strongly about this, why don’t you write about it in your blog?’, he suggested this time, in what I now suspect was a jaded attempt to get me to leave. Well, I was going to anyway, but now that he’s told me to, I can put it in my PDP as well.

Two points down, 48 to go. See you next year. 

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson

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Readers' comments (33)

  • Couldn't agree more!!
    Will definitely stop me doing locum work after my early retirement!!

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  • Phil Yates

    Couldn't agree more. I've got a very busy year most of which I love. I have boundless energy for things I believe in and no energy at all for things I hate.

    And I hate the box-ticking waste of time that appraisal represents. It adds no value and serves no useful purpose. I don't need it to convince myself to stay updated and reflective. If I ever feel that's in jeopardy I'll hang up my stethoscope - I don't need appraisal to persuade me (& it wouldn't identify it anyway). Total waste of medical resource.

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  • Well said, although surely worth more than 2 points :)

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  • only the appraisors enjoy appraisal .... its supposed to be helpful and supportive ... but its just highly bearocratic .... Asked what local support and education there is .. reply its not our job to help with cpd .. its our job to check its demonstrated

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  • yeah what happened to anonymous.. the number of postings is gouing to drop significantly .. either that or lots of cool code names expected

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  • It's the "reflections" and "SMART" garbage that I can't bear.

    "Look, mate, I'm a GP, I need to know about diabetes, so I went to an accredited meeting about diabetes, then used that knowledge in my diabetic clinic. Is that not enough? ARE YOU NOT ENTERTAINED???"

    Sarcasm was my weapon of choice when reflecting on my learning........
    "It was a glorious sunny morning the day I drove to my Diabetic Education Day. The M6 was a cruel mistress as always, but plentiful parking meant I arrived just in time for coffee, biscuits and some jovial banter with fellow GPs freed from the yoke of the daily grind of repetitive surgeries........'"

    She stopped asking for reflections after that.

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  • A very reflective piece! Ideal to put into your appraisal 😂 will try something like this myself methinks...

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  • A virtual nobody

    "It was a glorious sunny morning the day I drove to my 3:57pm
    'Diabetic Education Day. The M6 was a cruel mistress as always, but plentiful parking meant I arrived just in time for coffee, biscuits and some jovial banter with fellow GPs freed from the yoke of the daily grind of repetitive surgeries........'

    Glorious! I'm scratching round for reflections for my upcoming appraisal ...can I copy and paste?

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  • Knowledge is Porridge

    My favourite appraisal reflection this year:
    I wanted to review the updated RCGP appraisal guidelines, published March 2016, to check I was approaching appraisal appropriately. I was interested to reflect on the 30 page guideline containing the follow word frequencies
    Reflect 109
    GMC 72
    Learn 57
    Doctor 44
    GP 32
    CPD 32
    Workload 1

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  • Up and down the land A&Es are closing down, Social care is falling apart, GP surgeries are shutting their doors, the nightmare of CQC (now THERE'S a tick box exercise!)whom we PAY for the privelage of being superficially scrutinised and judged according to meaningless criteria The entire health and social care system is being run into the ground. And we moan about appraisal? Sure it has its downsides, but I get 2 hours paid to talk about just me, a bit of time off from the daily grind, in the grand scheme of things, appraisal is really NOT the problem!. Please colleagues expend all this energy on something REALLY important. (COI I am and appraiser but I have to have appraisal just like everyone else, and they challenge me too).

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