The RCOG aims to facilitate the completion of the NHS Executive's consultant appraisal documentation. The following should provide Fellows and Members and their trusts with information to undertake the appraisal/performance review against personal and organisational objectives.
Appraisal forms and guidance for completing them can be downloaded here.
RCOG guidance for implentation of the NHS executive's consultation appraisal documentation, issued April 2001
1. Introduction
The annual appraisal documentation has been agreed between the NHS Executive and the Central Consultants and Specialists Committee (CCSC) of the British Medical Association (BMA). Information under the same headings is to be collected by all consultants within the NHS. We believe that the information will be relevant for all UK consultant obstetricians and gynaecologists - both within the NHS and independent practice, as well as for non-consultant career grades (NCCGs) and trainees. The documentation will provide most of the information on which the General Medical Council (GMC) will base its decision on revalidation. All doctors wherever they are employed or practise will need to undergo this process. The NHSE introduction on appraisal for consultants is available on their website (www.doh.gov.uk) and should be read in conjunction with the College suggestions.
2. Background
The appraisal documentation is aimed to serve two purposes. Firstly to provide you and your trust with information to undertake the appraisal/performance review against personal and organisational objectives and to confirm satisfactory participation in clinical governance. Secondly, to collate information under the GMC's Good Medical Practice headings, the information which summated over a five year period will provide the evidence for revalidation. We believe that the processes of assessment regarding clinical governance participation, the formal annual appraisal and the revalidation process are all part of a continum and it is appropriate that they are viewed as such. Satisfactory participation in these processes will ensure that you remain up-to-date and competent in your clinical practice, a goal to which we all strive.
3. Collating the information
At first glance the processes may seem rather daunting and complex and require endless data collection. Inevitably, to ensure robustness of the process, evidence will need to be accrued to inform the processes and act as confirmatory evidence for the summary statements contained within the résumés of sections 1-4 of the documentation provided by the NHSE. These are required by the NHSE to be forwarded each year to the chief executive of your trust, or for non-NHS consultants to the chair of your medical executive committee (or equivalent) in the private sector.
You will be aware that our College over the years has produced a vast amount of information related to clinical governance, audit, good medical practice, evidence-based guidelines, green-top guidelines and working party report recommendations. Many of these will be of relevance for completion of this documentation, depending upon your range of specialty practice. The College will continue to update and expand the range of these documents, as well as providing service and professional standards on an ongoing way.
The purpose of this guidance is to make this process easier and specifically produced with generalist consultants in obstetrics and gynaecology in mind, but equally will be of value for subspecialists. You will appreciate that as each consultant's practice is unique and individual, it is impossible to provide precise guidance for each individual and for all specific instances. We hope that we have covered the majority of the general components.
I should emphasise that the guidance notes for our specialty (green), and the sample completed forms (white) are the College's suggestions on completing the NHSE consultant appraisal documentation and on information collection for GMC's revalidation process. To aid the whole process, we are also providing you with an appraisal/ revalidation folder as an aide-mémoire and a mechanism for collating and storing the relevant documentation.
An electronic version of the forms can be downloaded to allow for individualisation of the forms.
4. A changing process
In many instances the data required at annual appraisal will not change from year to year and will not need to be repeated. If the process is approached in a manner whereby you collect and collate the information on an ongoing basis throughout the year then this will enhance your preparation for the annual appraisal meeting. Inevitably preparing and collecting data will involve time, effort and commitment. It is our belief that as lessons are learned from the initial rounds of the annual appraisal and the assessment reviews process, and ultimately the first cycle of the revalidation reviews, modifications to the processes are inevitable and hence this guidance as now promulgated will need updating.
In addition, the development of the information technology systems within hospital trusts will ease acquisition of much of the data necessary to undertake effective work place assessments - that is clinical outcomes data, critical incident reports, etc. The establishment of effective agreed national clinical standards will also assist in comparing your performance fairly.
The key to the success of this whole process is adequate preparation by both you, who are going to be appraised, and your appraiser. This requires time and it is essential that employers agree to allocate this time in our contracts - AL(MD)5/2001 states it is essential therefore that adequate time is allocated for preparation, both for the appraiser and appraisee. A joint goal for all of us is to provide the best patient care we are able and to ensure the best outcomes for our patients - setting and applying standards to improve women's health.
It is important that you collate evidence against the wide range of activities which may be required of senior medical staff:
- Clinical activities and outcomes
- Audit of personal and team work
- Educational and professional development
- Management roles
- Research undertakings
5. Setting the agenda (RCOG concept)
It will not be possible to look at every facet of someone's job at each appraisal interview, nor is this thought to be desirable. Inevitably, like any other form of assessment it is a process of sampling weighted to areas which are of high importance (clinical risk) or which have been selected at a national or local level as specific topics for audit currently.
Such topics should be listed by your appraiser within a draft agenda circulated six weeks or more in advance of your appraisal date for agreement. The list should contain an acceptable number of items - we would suggest between four to six items. In addition, one or two items your appraiser specifically wishes to discuss with you as an individual may be added. This process should establish a final agenda, agreed and understood between the appraisee and the appraiser, before the interview. This allows time to collect other relevant information for discussion at the meeting.
6. Personal development plans
It is essential that individuals are appraised against their job plans and previous personal development plans. A well written and relevant job plan gives you a clear picture of the job purpose, objectives and what outcomes are expected!
In preparing for the discussions within the appraisal and the establishment of your personal development plan it will be essential that you reflect around the following issues:
- what have I achieved over the last 12 months?
- what do I wish to achieve over the next few years?
- what training or resources would this require?
- would this necessitate a change in my job plan?
- have there been any weaknesses in my performance?
- if so, why was this? (lack of resource, personality issues, failure of management to respond?)
- how could this/these be remedied?
- do I need guidance or help?
The personal development plan you agree to is a performance agreement against which you will be appraised the following year. It is essential that the expectations it defines are:
- specific
- measurable
- achievable
- relevant
- timely
It will also define skills and competencies that are necessary, together with any training required. Your personal development plan may require the utilisation of considerable resources and these may have to fit a particular time scale and fit in with your trust's priorities and business plan.
7. Conclusion
In conclusion, the processes are for the annual appraisal/performance review and the GMC's requirements for revalidation, which will inevitably evolve with time and experience. This guidance is your College's view of current developments and we would envisage future updates to be produced by the College's Professional Standards Committee.
This documentation takes cognisance of feedback received from the Chief Medical Officer for England, the CCSC and the GMC.
We hope that this will assist you as an individual in collating your information and we would welcome your comments on how you find the documentation, as well as suggestions for future refinements. These should be sent to Mrs Charnjit Dhillon, Head of Clinical Governance and Standards, RCOG.
Professor Robert Shaw FRCOG
President
August 2001