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I’m being denied an appraisal – for being a British GP working abroad



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