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I'm being denied an appraisal - for being a British GP working abroad

Dr Rory Johnston



I’m delighted to hear that the GP drought is over - somehow the government has found those pesky missing 5,000 GPs! No? Really? Oh, well then I must have misunderstood something…

I’m a British GP. I went to medical school in the UK, trained at an excellent practice in rural Essex and worked in the country, but am currently living and working in New Zealand. I had planned to stay on the UK appraisal system and performers list, but am being declined a video appraisal and a postponement on my appraisal. So, I’ve started the process of working out how these Byzantine procedures work, and will probably end up having to come off the list.

If you want to stay on the NHS performers list, you must have your appraisal with an NHS designated body. The responsible office for an area can ignore any appraisal guidelines, and there seems to be no right or process for appeal. As GPs, we are familiar with the idea that guidelines are not law. Google ’NHSE Appraisal Logistics Handbook’, and you’ll find that scenario B on page 27 is exactly me - the recommendation is for a video appraisal.

Video appraisal isn't my responsible officer's ‘preferred option’ - so the answer is no

I have an appraiser who was willing, but he did warn me that the responsible officer declines all requests for video appraisals. And so it’s true - video appraisal is not ‘the preferred option’ - so the answer is no. Postponement was also separately declined - so unless I manage to pull some rabbit out of a hat, come September I will be off the performers list, and might as well stop paying my GMC fees as well.

I did my best to comply with what I understood were the rules (which appears to be technically one session per year, although most areas are moving to 40 sessions per year). I’ve done 150 GP sessions in the UK since my last appraisal in September 2018. I had planned to do another set in the UK, but apparently the services of British-trained GPs, working with hoards of other British GPs, following essentially NICE guidance, and complying with all the portfolio rules, we are just not wanted.

As I drive the short commute to work over the Auckland Harbour Bridge and look at the SkyTower gleaming in the sun, I wonder why this bothers me. We have 15-minute appointments, virtually no home visits (so far one in the last five months), we pretty much work 9-5, and we have fantastic pharmacists and physios, plus the Accident Compensation Corporation scheme, which gives us very low indemnity. My next trip to the UK can be just a holiday.


 NHS England Medical Appraisal Logistics Handbook

 Dr Rory Johnston is a GP in New Zealand who previously practised in Essex

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Readers' comments (26)

  • If you have done 150 sessions in UK since 2018 then I don’t understand why you are not still with the responsible officer you were connected with.
    I suggest trying another agency as the advice isn’t right unless you haven’t done any U.K. work and do not intend to do any.
    If you are on sabbatical then you can take a break ( akin to a female doctor having maternity leave) just continue to collect CPD and keep things on track. Then when you are back hook back into the appraisal system.
    The only problem is when your Revalidation date falls when you are away. It seems that the system hasn’t an answer to this except to go via the GMC directly ( costly and requires you to undertake a Micky mouse exam)
    Officially the advice of you are away for over a year is to come off the GMC register but going back on is a bureaucratic headache.
    It is worth going to the GMC directly for advice. ( possibly)

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  • Please go to UK on holiday before deciding if you want to return for good. We didn't and it made a mess. Should have stayed abroad. Going back now.

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  • Azeem Majeed

    Not allowing appraisals is a very luddite approach. Yet, NHS England is pushing video consultations, a mode of consultation where there is a lack of data on their safety.

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  • NHS feels it is safe to video consult patients.

    NHS feels it is unsafe to video appraisal staff.

    The whole world is likely laughing at us whilst they work for a public health care system which actually benefits both parties.

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  • I had a similar experience:- A British National, Edinburgh Graduate working in Canada but doing locums in UK from 2008 - on Sussex & Weald Performers List - recommended Appraisals and Revalidated until 2018 - but kicked off the Performers List because of not having worked in the region for 12 months. When challenged, reason given was 'administrative reasons' - I could 'always re-apply'. Right.

    Prior to that I had a 4 yr battle, ending with the NHS Litigation Authority, to obtain a Certificate to Practice. Despite being a Principal in UK General Practice for 5 years before leaving for Canada, followed by 35 yrs as a fully certified Canadian GP, I was deemed ineligible to practice and would have to go back into training for 6 months. Right.

    If I had been trained elsewhere in the EU, the Certificate would have been granted automatically (and at that time without any need to show English language ability).

    My 40 yrs of total GP experience was deemed not 'Equivalent' to the 2 year GP vocational training program - which did not exist when I qualified.

    Anyway, the NHS Litigation Authority ruled in my favour and instructed the various GMC Committees to (get a life and) issue the Certificate.

    I'm now retired!!!!!

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  • If in NZ, do your 'appraisal' there (called 'annual general pversight meeting', and have the overseer's report sent to you RO in UK as proof! easy.

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  • Is there a list somewhere documenting all these stories? No wonder there is a crisis!

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  • He could always have a private appraisal and pay for it.

    I have a long and updated blog about this issue.

    I was based in Australia for 7 years and kept up my appraisals every year, working one or more days in the UK when on my travels. After this I walked back into UK practice. I am not sure why GMC, which used to be so pragmatic has recently followed the RCGGP and medical Educational industry line that working abroad is a sabbatical...when we are short of doctors discouraging anyone to come back.

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  • So we are desperately short of GPs and need 5000 more and at the same time we put upall sorts of obstacles that make it difficult for British GPs working abroad to come back and help.

    Sadly not surprising from the GMC CQC NHS England etc.

    What will it take to get them to pull their fingers out and do something? Presumably one of their family members will have to die because of the shortage to make them wake up.

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