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GPs call on RCGP to back the suspension of appraisals

RCGP president

Around 200 GPs, including members of the RCGP, have signed an open letter urging the Council to overhaul GP appraisals and revalidations.

The GPs sent the letter ahead of the Council meeting held tomorrow (21 November), calling on the College to withdraw support for the current appraisal process.

They call on the RCGP to put pressure on the GMC to adapt its policy.

Lead author of the letter Dr Heather Ryan said she hopes that appraisals will be suspended while the Covid crisis continues, but also that they will become more simplified in the future.

The letter was sent to Council chair Professor Martin Marshall and honorary secretaries Dr Victoria Tzortziou-Brown and Dr Jonathan Leach earlier this week (18 November).

It reads: ‘Appraisal should not ever have been restarted, least of all at the beginning of the second wave of a pandemic, especially as GPs are also re-escalating chronic disease management work and facing renewed demand from patients including being asked to take on Covid vaccination.

‘We call upon RCGP to withdraw its support for appraisal and revalidation during the pandemic with immediate effect. This should include insistence that the GMC develop the least burdensome system possible, to be implemented only after the pressures of the coronavirus pandemic have passed, until such time as any relevant statutory instruments can be revised.’

Dr Ryan, a GP in Warwickshire, told Pulse: ‘It’s not right that hardworking GPs, battling Covid alongside usual winter pressures, should have to take time away from clinical care to participate in an appraisal process which many GPs find stressful and which is poorly-evidenced.’

While acknowledging that some GPs find their appraisal ‘helpful and supportive’, Dr Ryan said that the mandatory aspects should be ‘stripped back to a bare minimum’, with additional support ‘optional’ only.

She stressed that the College changing its stance would have the capacity to ‘heavily influence’ the GMC.

Similarly, current Council member Dr John Cosgrove added: ‘I’m hopeful for change, and clearly there has been a fair amount of movement on appraisal already.

‘But I think our concern is that it doesn’t really fit in that way.

‘It would be nice to see coaching or mentorship as an offer, rather than something that is mandated.’

In response, chair Professor Martin Marshall told Pulse: ‘We’ve received this letter and thank the signatories for taking the time to write.

‘This is an important issue and the College will be responding in due course.’

Earlier in the Covid pandemic, NHS England ‘strongly recommended’ that appraisals were suspended, and then simplified the process behind them – decisions welcomed by the letter authors as ‘liberating’ and ‘a move in the right direction’.

The BMA also supported this, and concluded that pausing appraisals and revalidation did not affect patient safety.

NHS England subsequently announced in August that appraisals would return in October, albeit in a more relaxed format. But when the second spike of the virus gained momentum across the country, it admitted that this would no longer be possible in many areas.

Last month, the GMC postponed the revalidation of another 9,000 doctors, in addition to that of the previous 50,000 earlier this year.


John Glasspool 20 November, 2020 8:33 pm

Appraisal has never been fit for purpose. But for now, it all needs to be suspended for a year. This will also free up time for appraisers and the people who administer them, as well as ROs, to get back, roll up their sleeves and see some patients.

Ben Thurlow 20 November, 2020 9:21 pm

In my experience it’s the doctors who take such a disappointing closed loop approach to professional development that may well need to reflect on whether they are fit for purpose (rather than the system). Hobby job Appraiser x 1 session, Undergrad Lecturer x 1 session…..sleeves rolled up coal face GP x 8 sessions .

Dave Haddock 21 November, 2020 3:08 pm

Perfectly competent GPs from my cohort have retired early, to both their own and the NHS’s detriment. Appraisal has been repeatedly sited as smaller or larger part of their reasons for leaving.

The assumption that because a small minority find the process helpful, that those who do not are somehow incompetent or otherwise unfit for the job is remarkably arrogant. It would be surprising if people so utterly lacking in insight were actually competent for the job of GP.

Those who support this process need to seriously examine their conscience.

Dave Haddock 21 November, 2020 5:12 pm

Dr Thurlow’s comment above is actually very helpful; far from being the supportive process claimed by the GMC and RCGP, Appraisal is actually a wonderful opportunity for the self-appointed Stasi. Perhaps one of his victims may feel emboldened to complain?

John Graham Munro 21 November, 2020 9:27 pm

The ”appraisals process” is the only time in my medical career that i feel I can joyfully lie and cheat

Hussain Noordeen 22 November, 2020 2:57 pm

It will never stop. Appraisal and Revalidation has become an industry feeding many jobsworths with income and several NHS /RCGP/GMC Suits content in their ivory towers.

Slobbering Spaniel 22 November, 2020 7:28 pm

Appraisal and revalidation have nothing to do with professional development.

Edmund Willis 22 November, 2020 7:33 pm

? Maybe A chance to change appraisal back to what it started as. I.e. A supportive coaching discussion with an experienced fellow GP.

John Williamson 23 November, 2020 9:25 am

Appraisal is one of the many things about UK Medicine that convinces me that I was right to move abroad when I did. The response of my Government in NZ to Covid compared to the UK Government is another. Looking at the attempts to reintroduce Appraisal in the middle of an accelerating Pandemic demonstrates how bonkers these people are. We on the other hand are keeping services running as a priority, swabbing every patient with any kind of sniffle and chasing up every possible contact of a positive case. The idea of taking time out to navel gaze at such a time is probably why you are having such trouble getting the manpower to manage this.

Relaxed GP doing 6-8 sessions, hobby farmer in a Country with regulator who requires practical CPD.

Dave Haddock 23 November, 2020 10:00 am

The only way to ensure Appraisal is supportive is to make them voluntary. Compulsory appraisal traps victims into an abusive system.

Aman Samaei 23 November, 2020 11:20 am

Before having appraisal , what happened that now could happen, absolutely none sense this appraisal, wast of time and resource

Decorum Est 23 November, 2020 12:49 pm

Being a ‘hobby farmer’, seems commendable for many personal and communal reasons but being a ‘hobby appraiser’ is quite the opposite!

David Turner 23 November, 2020 4:39 pm

The whole appraisal/revalidation system was set up, let us remember,to ‘ stop another Shipman’ an aim most agree, it would not succeed in, as Shipman was knowledgeable and popular with his patients.
It has morphed into something very different, a clumsy system, heavy with bureaucracy, with spin off benefits for those running update courses you pay good money to attend.
When people are making a lot of money out of something, they are not going to give it up without a fight.

Sonia Chester 24 November, 2020 7:33 pm

Going into the hardest winter of our collective careers it is at this point indefensible to still have appraisal on the table. It should be suspended at the very least. It should also be objectively reviewed & cost/benefit ascertained before reintroducing. No other country has adopted appraisals- there must be very good reasons why…. I suspect it is a factor in many GP’s retiring early & not doing part time work or locums as semi retirement option. I know I find it an onerous box ticking exercise that I resent doing in my precious free time.

Dave Haddock 27 November, 2020 9:00 am

200 Doctors signed; shame not distributed more widely and it would have been thousands.

John Williamson 27 November, 2020 11:01 am

As a further comparison, here in NZ our CPD submissions have been suspended for 9 months due to COVID, (remember we are now functioning reasonably normally but just playing catchup compared to yourselves) because the Royal Colleges argue that we are learning so much in terms of new ways of working with remote communication and having to manage COVID that this is better learning than any formal CPD sessions.

Their thoughts and suggestions not ours.