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Practice managers to carry out GP appraisals, under new NHS scheme

Exclusive GPs could have their performance appraised by a practice manager as NHS bosses threw open recruitment to non-medical applicants, Pulse has learnt.

An advert from NHS England South for Surrey and Sussex encourages anyone who is ’a practice manager or a GP who has found your own appraisals interesting and have contemplated taking on the role previously’ to ‘respond to this article and send your CV’.

NHS England confirmed that GPs who did not wish to be appraised by non-medical professionals could demand to be appraised by a doctor, but said that it needed to ensure it had a sufficient number of trained appraisers.

The GPC said it had ‘heard of’ such schemes being piloted elsewhere in England but that GPs could and should refuse to have their appraisals led by non-clinicians.

The advert comes as some areas of the country are failing to recruit enough medical professionals into appraiser roles. NHS England introduced a new £500 flat fee for appraisals in 2013 that the GPC said may mean some GPs no longer consider it worthwhile to be appraisers and encourage some to ‘walk away’.

But this new scheme would mean GPs potentially having their revalidation decided on appraisals carried out by non-medical professionals.

GPC executive member Dr Dean Marshall said: ’I heard that the scheme had been piloted in different parts of the country [but] you do not have to agree to have non-GPs appraise you. Practice managers, nurses, or anyone else for that matter, will simply not understand what the needs of a GP are. Appraisals should have a supportive function and there has never been a more important time for GPs to have this support.’

NHS England could not confirm or deny reports that it was hiring non-medical professionals as GP appraisers for revalidation in other areas of the country at time of publication.

A spokesperson said: ’Any GP who does not wish to be appraised by a trained appraiser from a non-medical background can ask to be appraised by someone with a clinical background. We liaised in advance with the local LMC, who confirmed that this approach was acceptable. All our appraisers undergo full training in order to fulfill the requirements of their role, including completing regular training and undergoing reviews of their performance.’

But GP appraiser Stephanie di Giorgio, a GP in Kent and co-founder of Resilient GP, said that this could lead to current GP appraisers becoming even busier. She said: It means that employing [practice managers and non medical appraisers] and training them is potentially a massive waste of time and money.’

Revalidation – a longstanding bugbear of busy GPs

The revalidation process – including appraisals – has come under fire from GPs since it was introduced, with some calling it a ‘bureaucratic nightmare’ and saying it can take over 70 hours to complete. Last year, GP leaders branded revalidation as ‘a waste of time’ as official data revealed that less than 1% of all doctors actually needed remediation.

After the first year of the scheme, more than one in ten GPs have had their revalidation deferred by the regulator and critics say that the process is less about ensuring patient safety and more about enforcing tighter constraints on doctors.

But the GMC has commissioned an independent review of revalidation to ‘refine the system’ once every doctor has been through it.

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