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Fears over revalidation feedback as study reveals GPs already advised to censor appraisals

GPs are unlikely to give full and frank feedback on colleagues if their comments are included in assessments for revalidation, according to a GMC-sponsored study that raises serious concerns about the use of multi-source feedback to assess the performance of doctors.

The survey reveals some appraisers already advising GPs to omit certain information from their appraisals ahead of the expected start of revalidation in seven months' time.

GPs are likely to become more ‘guarded' in their comments after the introduction of revalidation, the study found, due to fears over souring working relationships with colleagues and whether the information could be used as legal evidence against them.

A recent study showed considerable ‘underlying resentment' over the inclusion of multi-source feedback in the GMC's plans for revalidation, which will involve collecting feedback from at least 15 colleagues and 34 patients.

This new study – published in this month's issue of the British Journal of General Practice –was based on interviews with 24 GPs and 24 appraisers and found support for using colleague feedback to guide development in appraisals.

But the researchers said most felt extending this to revalidation would undermine its worth, and compromise the value of appraisal.

Professor John Campbell, professor of general practice at the Peninsula College of Medicine and Dentistry in Exeter, said: ‘Concerns remain regarding aspects of the GMC multisource feedback methodology, which might undermine its credibility and also apply to other multisource feedback tools of similar intent.

‘Some doctors and appraisers may become more guarded regarding what is openly discussed and formally recorded in appraisal.'

The study quoted one appraiser who was already advising GPs to censor their appraisal feedback: ‘I'm advising people not to put anything in [appraisal documentation] that they might find a bit exposing, because the questions are a bit intrusive.'

Writing in the same issue of the BJGP, RCGP revalidation lead Professor Mike Pringle acknowledged that the processes around revalidation would need to be ‘refined', but said colleague feedback would remain an integral part of their plans.

‘A safe, effective doctor is continuously reflecting and learning, striving for improvement, and using colleagues and patients as a reference point to understand how and where they should refine their practice,' he said.

Meanwhile in a letter replying to recent concerns raised by the chairs of BMA Northern Ireland and BMA Scotland, GMC chief executive Professor Peter Rubin said he understood doctors might feel ‘a level of anxiety' over the use of multisource feedback, but that it was only one item of supporting information.

He said: ‘We are very clear that the purpose is not to use questionnaires as some kind of screening process to identify outliers. Nor is it to be used as a judgement tool. It is intended to provide doctors with information about their practice through the eyes of those they work with and treat.'