How to get the best out ofHow to get the best out ofHow to get the best out of i l d lid tiappraisal and revalidationappraisal and revalidation

D Al SDr Alan SwannClinical Director for Revalidation and AppraisalClinical Director for Revalidation and Appraisal, 

Cumbria Partnership Foundation TrustCumbria Partnership Foundation Trust

Outline of the SessionOutline of the Session

I t d ti t lid ti h ?• Introduction to revalidation – where are we now?H lid t d?• How are you revalidated?y

Role of the doctor in appraisal• Role of the doctor in appraisalppO i f GMP• Overview of GMP

• Supporting Information what you need to collect• Supporting Information – what you need to collect

• Improving the quality of your reflective practice andImproving the quality of your reflective practice and PDPyour PDPy

I t d d L i O tIntended Learning Outcomesg

B th d f thi k h ti i t ill bBy the end of this workshop participants will bey p p pable to:able to:-• Describe the types of Supporting Information they• Describe the types of Supporting Information they

need to collect for their appraisalneed to collect for their appraisal• Describe the GMC’s Good Medical Practice• Describe the GMC s Good Medical Practice

frameworkframework • Prepare for a high quality appraisal• Prepare for a high quality appraisal

U fl ti t l t• Use a reflective templatepC• Create a high quality PDPCreate a high quality PDP

Purpose of RevalidationPurpose of Revalidationp

‘T ti t d th bli l d‘To assure patients and the public, employers andp p , p yother healthcare professionals that licensed doctorsother healthcare professionals that licensed doctors

are up to date and are practising to theare up to date and are practising to the appropriate professional standards’appropriate professional standards

GMC R lid ti Th W Ah d 2009GMC: Revalidation – The Way Ahead 2009y

Two Main Themes on Core PurposeTwo Main Themes on Core Purposep

• To improve the quality and safety of patient care• To improve the quality and safety of patient careT t th f i l d l t• To strengthen professional developmentg p p

f f• An additional theme is to reinforce systems to identifyAn additional theme is to reinforce systems to identify those doctors who require supportthose doctors who require support

Delivering revalidationDelivering revalidation

Th lid ti lThe revalidation cycleThe revalidation cycle

R lid tiR lid tiRevalidation Revalidation

• Doctor recommendationrecommendation • General• Doctor • General • Appraiser • Responsible Medical• Appraiser • Responsible

OffiMedical C ilOfficer CouncilOfficer Council

Cycle of appraisal Cycle of appraisal Revalidation Revalidation y pp& review

y pp& review decisiondecision& review& review decisiondecision

6

Delivering revalidationDelivering revalidation

R d tiRecommendationsRecommendations

RevalidationRevalidation

Responsible Officer Request for moreResponsible Officer d ti

Request for more ti (d f )recommendation time (defer)o da o (d )

F il tFailure to engageg g

Concerns about Fitness to PractiseConcerns about Fitness to Practise must be raised when they arisemust be raised when they arise

77

Delivering revalidationDelivering revalidation

Wh t d d f l t ?What do deferral requests mean?What do deferral requests mean?

Providing supporting informationProviding supporting information

P ti i ti i l l ti lParticipating in a local or national process

I ffi i tInsufficient informationinformation

HR or Participating in a GMC processHR or investigation

p g p[revalidation placed on hold]g [revalidation placed on hold]

Information Fitness to PractiseInformation gaps Performance

di tiFitness to Practise

g por remediation

88

Some MilestonesSome Milestones

• All RO’s and ‘medical leaders’ to be revalidated byAll RO s and medical leaders to be revalidated by A il 2013April 2013p

1/3 f di l kf i i ti t b• 1/3 of medical workforce in organisations to be grevalidated by April 2014 and 1/3 in each followingrevalidated by April 2014 and 1/3 in each following

2 ears• 2 yearsy

All currently licensed doctors revalidated by 2016• All currently licensed doctors revalidated by 2016y y

Additional things to knowAdditional things to know….g

• GMC connect• GMC connect • 4/12 ‘doctors given notice’• 4/12  doctors given notice• The role of the Employment Liaison AdvisorThe role of the Employment Liaison Advisor (ELA)(ELA)( )

• ‘Managing concerns log’ and remediation• Managing concerns log  and remediation• ‘fitness to practice’ and ‘fitness for purpose’fitness to practice  and  fitness for purpose

What are the goals of a goodWhat are the goals of a goodWhat are the goals of a good i l?appraisal?appraisal?

Small groupsSmall groupsg p

An opportunity topp ylisten value andlisten, value and 

k l dacknowledge

Personal andPersonal and professionalEnsure doctors are fit to professional 

d l iEnsure doctors are fit to practice and up to date development timepractice and up to date ( i i(review supporting 

What are theinformation) What are the )

goals of agoals of a goodgood 

i l?appraisal?pp

A t it f Create an opportunityAn opportunity for  Create an opportunity f d t t fl tappropriate  for doctors to reflect on pp p

challenge the previous years workchallenge p y

An Effective Revalidation Appraisal is PossibleAn Effective Revalidation Appraisal is Possible ppWhenWhen…..

Effective Appraisal SystemEffective Appraisal System

AppraiseeAppraisee S b itAppraiser is Well Prepared Submits Appraiser is Well Prepared Supporting pp g

InformationInformation

Appraisee InAppraiser in Well Run Appraisee In Appropriate

Appraiser in Appropriate Excellent ‘Soft’  Well Run 

Appraisal Appropriate d

Appropriate  Skills Appraisal Mind‐SetMind‐Set Skills Meeting

Heidi Ashley HackerHeidi Ashley Hacker

TASK : The Doctor’s RoleTASK : The Doctor s Role

• In small groups discuss the doctor’s role in the• In small groups discuss the doctor s role in the g pprocessprocess

The Role of the DoctorThe Role of the Doctor

• Collects and organises Supporting Information over• Collects and organises Supporting Information over th f th f ALL t f th i lthe course of the year for ALL aspects of their role.the course of the year for ALL aspects of their role. (scope of practice)(scope of practice)

• Provides written reflections on their learning• Provides written reflections on their learning• Ensures they have achieved the previous years PDP• Ensures they have achieved the previous years PDP

Are open to challenge and have a constructive• Are open to challenge and have a constructive p gapproach to their appraisalapproach to their appraisal

• Contributes to problem solving• Contributes to problem solving

GMC G id S ti I f tiGMC Guidance on Supporting Informationpp g

‘The supporting information that you will need to bring toThe supporting information that you will need to bring to your appraisal will fall under four broad headings:your appraisal will fall under four broad headings:

1 G l i f i idi b h1.   General information – providing context about what you p g ydo in all aspects of your work Scope of Practicedo in all aspects of your work – Scope of Practice2 Keeping up to date – maintaining and enhancing the2.   Keeping up to date – maintaining and enhancing the quality of your professional workquality of your professional work3 i f i l i h li f3.   Review of your practice – evaluating the quality of your y p g q y y

f i l kprofessional work4 Feedback on your practice how others perceive the4.   Feedback on your practice – how others perceive the quality of your professional work’quality of your professional work

GMC G id S ti I f tiGMC Guidance on Supporting Informationpp g

There are six types of supporting information that you will beThere are six types of supporting information that you will be t d t id d di t i l t l texpected to provide and discuss at your appraisal at least once p p y pp

in each five year cycle They are:in each five year cycle. They are:

1. Continuing professional development1.    Continuing professional development2 Q li i i i2.    Quality improvement activityQ y p y3 Significant events3.    Significant events4 Feedback from colleagues4.    Feedback from colleagues5. Feedback from patients (where applicable)5.    Feedback from patients (where applicable)6 R i f l i d li6.    Review of complaints and complimentsp p

Good Medical Practice:Good Medical Practice:  Domains and AttributesDomains and Attributes

Domain 1: Knowledge, skills and  Domain 2: Safety and qualityg ,performance

y q yperformance

1.1 Maintain your professional performance 2.1 Contribute to and comply with systems to 1.2 Apply knowledge and experience to  protect patientspp y g ppractice

p p2.2 Respond to risks to safetypractice

1 3 Ensure that all documentation (including2.2 Respond to risks to safety2 3 Protect patients and colleagues from any1.3 Ensure that all documentation (including 

clinical records) formally recording your work2.3 Protect patients and colleagues from any risk posed by your healthclinical records) formally recording your work 

i l d l iblrisk posed by your health

is clear, accurate and legible

D i 3 C i ti t hi d D i 4 M i t i i t tDomain 3: Communication, partnership and k

Domain 4: Maintaining trust teamwork

3 1 Communicate effectively 4 1 Show respect for patients3.1 Communicate effectively3 2 Work constructively with colleagues and

4.1 Show respect for patients4 2 Treat patients and colleagues fairly and3.2 Work constructively with colleagues and 

d l ff i l4.2 Treat patients and colleagues fairly and i h di i i idelegate effectively without discrimination

3.3 Establish and maintain partnerships with  4.3 Act with honesty and integritypatientsp

ExerciseExercise

• What Supporting Information (SI) can the• What Supporting Information (SI) can the pp g ( )i ti id f thi d i ?organisation provide for this domain?organisation provide for this domain?

• What SI should the doctor provide?• What SI should the doctor provide?p• Different colour Post Its• Different colour Post Its

Tea/coffee breakTea/coffee break/

P ti f th M tiPreparation for the Meeting -p ga Suggested Appraisal Time Linea Suggested Appraisal Time Line

C l tAgree Agree Submit Complete Agree time &

Agree agenda

Submit portfolio documentationtime & agendaportfolio documentation

and sign offdate and sign offAppraisaldate Appraisal interview

6 months 3 weeks 2 weeks 2 /526 months 3 weeks 2 weeks 2 /52 before before before after

Pre Appraisal Contact / Agenda SettingPre-Appraisal Contact / Agenda Settingpp g g

O t it t t d• Opportunity to set agendapp y g

• Clarify doctor’s goals/issues• Clarify doctor s goals/issues

M k ti f d t ti i 360 f db k &• Make time for documentation review, 360 feedback & ,PDPPDP

• Ask doctor to decide on time balanceAsk doctor to decide on time balance

• Ask how ‘challenging’ s/he wants you to be• Ask how challenging s/he wants you to be

How to best use MSF?How to best use MSF?

• Keep it in perspective• Keep it in perspectivep p p• Look at the self/others mismatches• Look at the self/others mismatches• Any surprises?Any surprises?H i h d l i ?• How might you deepen your learning?How might you deepen your learning?Wh t thi h l d?• What new things have you learned?What new things have you learned?

• Prepare a written reflection for your portfolio• Prepare a written reflection for your portfoliop y p

Quality improvement activityQuality improvement activityQ y p y

• Case based Discussion (CbD)• Case based Discussion (CbD)( )• Clinical Audit (minimum 2 per 5 year cycle)• Clinical Audit (minimum 2 per 5 year cycle)• Documentation audit (1 per cycle)Documentation audit (1 per cycle)

ReflectionReflection………

• “ I am unable to find any evidence showing that• …I am unable to find any evidence showing that experience has any benefits unless people payexperience has any benefits unless people pay

tt ti t f db k d dj t ”attention to feedback and adjust.”jAnders Ericsson 2011Anders Ericsson 2011

• “ a process of reviewing an experience of practice in… a process of reviewing an experience of practice in d t d ib l l t & i forder to describe, analyse, evaluate & so inform , y ,

learning about practice “learning about practice.

Reid 1993Reid 1993

Exercise using Reflective Template (2 mins)Exercise using Reflective Template (2 mins)g p ( )

• Think of a recent CPD activity or a serious incidentThink of a recent CPD activity or a serious incident

• Capture your learning on the appropriate Structured• Capture your learning on the appropriate Structured Reflective TemplateReflective Template

• Feedback in pairs what helps you to reflect• Feedback in pairs what helps you to reflect….

Looking at the Personal Development PlanLooking at the Personal Development Plang p(PDP)(PDP)( )

Personal Development PlanningPersonal Development Planningp g

Development need Agreed action Date Outcome EvaluationDevelopment need Agreed action Date Outcome Evaluation

Keep up to Go on an 12 Know more I will be moreKeep up to d t

Go on an d t

12 th

Know more b t h t’

I will be more fid tdate update course months about what’s confident

new

Be S M A R TBe S.M.A.R.T.

• S ifi• S pecificp

M• M easurableM easurable

A• A chievableA chievable

R• R elevantR elevant

• T ime framed• T ime framed

Exercise Preparing your PDPExercise – Preparing your PDP p g y

S lit i t i ( ith d t k• Split up into pairs (with someone you do not know p p p ( ywell)well)

• Choose a real non work issue that you want to• Choose a real non-work issue that you want to develop or get better at in the coming year (e g learndevelop or get better at in the coming year (e.g. learn French start a regular exercise routine )French, start a regular exercise routine….)

• The person who is not the issue holder will act as theThe person who is not the issue holder will act as the Sappraiser, helping the doctor to create SMARTappraiser, helping the doctor to create SMART

bj tiobjectivesjS d 5 i t h ti SMART bj ti f• Spend 5 minutes each creating SMART objectives for p g jyour development needyour development need.

I t d d L i O t i it dIntended Learning Outcomes - revisitedg

B th d f thi k h ti i t ill bBy the end of this workshop participants will bey p p pable to:able to:-• Describe the types of Supporting Information they• Describe the types of Supporting Information they

need to collect for their appraisalneed to collect for their appraisal• Describe the GMC’s Good Medical Practice• Describe the GMC s Good Medical Practice

frameworkframework • Prepare for a high quality appraisal• Prepare for a high quality appraisal

U fl ti t l t• Use a reflective templatepC• Create a high quality PDPCreate a high quality PDP