How to get the best out of How to get the best out of appraisal appraisal and revalidation i l and d revalidation lid ti Dr Alan Swann D Al S Clinical Director for Revalidation and Appraisal Clinical Director for Revalidation and Appraisal, Cumbria Partnership Foundation Trust Cumbria Partnership Foundation Trust Outline of the Session • IIntroduction t d ti to t revalidation lid ti – where h are we now? ? • How H are y you revalidated? lid t d? • Role of the doctor in appraisal pp • Overview O i off GMP • Supporting Information – what you need to collect • Improving the quality of your reflective practice and yyour PDP I t d d Learning Intended L i g Outcomes O t Byy the B th end d off this thi workshop k h pp participants ti ip t will ill b be able to: to:• Describe the types of Supporting Information they need to collect for their appraisal • Describe the GMC’s GMC s Good Medical Practice framework • Prepare for a high quality appraisal • Use U a reflective fl ti template t pl t • Create C a high quality PDP Purpose p of Revalidation ‘To assure p ‘T patients ti t and d the th p public, bli , employers pl y and d other healthcare professionals that licensed doctors are up to date and are practising to the appropriate professional standards’ standards GMC Revalidation GMC: R lid ti – The Th W Way y Ah Ahead d 2009 Two Main Themes on Core Purpose p • To improve the quality and safety of patient care • To T strengthen t gth p professional f i l development d l p t • An additional theme is to reinforce f systems to identify f those doctors who require support Delivering revalidation Th revalidation The lid ti cycle l • Doctor • Appraiser Cycle y of appraisal pp & review 6 R Revalidation lid ti recommendation • Responsible Offi Officer • General Medical C Council il Revalidation decision Delivering revalidation R Recommendations d ti Revalidation Responsible Officer recommendation o da d tio Request for more ti time (d (defer) f ) F il Failure to t engage g g Concerns about Fitness to Practise must be raised when they arise 7 Delivering revalidation Wh t do What d deferral d f l requests t mean?? Providing supporting information P ti i ti in Participating i a local l l or national ti l process I Insufficient ffi i t information HR or g investigation Information gaps g p 8 Performance or remediation di ti Participating p g in a GMC process p [revalidation placed on hold] Fitness to Practise Some Milestones Some Milestones • All RO’s RO s and ‘medical medical leaders’ leaders to be revalidated by Ap il 2013 April • 1/3 off medical di l workforce kf iin organisations g i ti tto b be revalidated by April 2014 and 1/3 in each following • 2 years years • All currently y licensed doctors revalidated byy 2016 Additional things Additional things to know…. g to know • GMC GMC connect connect • 4/12 4/12 ‘doctors doctors given notice given notice’ • The role of the Employment Liaison Advisor The role of the Employment Liaison Advisor ( ) (ELA) • ‘Managing Managing concerns log concerns log’ and remediation and remediation • ‘fitness fitness to practice to practice’ and and ‘fitness fitness for purpose for purpose’ What are the goals of a good What are the goals of a good appraisal? i l? Small groups Small groups g p An opportunity to pp y listen value and listen, value and acknowledge k l d Ensure doctors are fit to Ensure doctors are fit to practice and up to date practice and up to date ( i (review supporting i information)) An opportunity for A t it f appropriate pp p challenge Personal and Personal and professional professional d l development time i What are the What are the goals of a goals of a good good appraisal? pp i l? Create an opportunity Create an opportunity f d t t for doctors to reflect on fl t the previous years work p y An Effective Revalidation Appraisal is Possible An Effective Revalidation Appraisal pp is Possible When….. When Effective Appraisal System Effective Appraisal System Appraiser is Well Prepared Appraiser is Well Prepared Appraiser in Appraiser in Appropriate Appropriate Mind‐Set Excellent ‘Soft’ Skills Well Run Well Run Appraisal Appraisal Meeting Appraisee Appraisee S b it Submits Supporting pp g Information Appraisee In Appraisee In Appropriate Appropriate Mind‐Set d Heidi Ashley Hacker Heidi Ashley Hacker TASK : The Doctor’ss Role TASK : The Doctor Role • In In small groups discuss the doctor small groups g p discuss the doctor’ss role in the role in the process The Role of the Doctor The Role of the Doctor • Collects and organises Supporting Information over th course off the the th year for f ALL aspects t off their th i role. l (scope of practice) • Provides written reflections on their learning • Ensures they have achieved the previous years PDP • Are open p to challenge g and have a constructive approach to their appraisal • Contributes to problem solving GMC Guidance G id on Supporting S pp ti g Information I f ti ‘The The supporting information that you will need to bring to 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. General information – 1 G li f i p idi g providing context about what you b h y do in all aspects of your work Scope of Practice do in all aspects of your work – Scope of Practice 2 Keeping up to date – maintaining and enhancing the 2. Keeping up to date – maintaining and enhancing the quality of your professional work quality of your professional work 3 3. Review of your practice – i fy p i evaluating the quality of your l i g h q li y f y professional work f i l k 4 Feedback on your practice how others perceive the 4. Feedback on your practice – how others perceive the quality of your professional work’ quality of your professional work GMC Guidance G id on Supporting S pp ti g Information I f ti There are six types of supporting information that you will be There are six types of supporting information that you will be expected to provide and discuss at your appraisal at least once p t d t p id d di ty pp i l t l t in each five year cycle They are: in each five year cycle. They are: 1. Continuing professional development 1. Continuing professional development 2 Q li y i p 2. Quality improvement activity i iy 3 Significant events 3. Significant events 4 Feedback from colleagues 4. Feedback from colleagues 5. Feedback from patients (where applicable) 5. Feedback from patients (where applicable) 6 R i 6. Review of complaints and compliments f pl i d pli Good Medical Practice: Good Medical Practice: Domains and Attributes Domains and Attributes Domain 1: Knowledge, skills and g , performance Domain 2: Safety and quality y q y 1.1 Maintain your professional performance 1.2 Apply knowledge and experience to pp y g p practice 1 3 Ensure that all documentation (including 1.3 Ensure that all documentation (including clinical records) formally recording your work clinical records) formally recording your work i l is clear, accurate and legible d l ibl 2.1 Contribute to and comply with systems to protect patients p p 2.2 Respond to risks to safety 2.2 Respond to risks to safety 2 3 Protect patients and colleagues from any 2.3 Protect patients and colleagues from any risk posed by your health risk posed by your health Domain 3: Communication, partnership and D i 3 C i ti t hi d teamworkk D Domain 4: Maintaining trust i 4 M i t i i t t 3.1 Communicate effectively 3 1 Communicate effectively 3 2 Work constructively with colleagues and 3.2 Work constructively with colleagues and d l delegate effectively ff i l 3.3 Establish and maintain partnerships with p patients 4.1 Show respect for patients 4 1 Show respect for patients 4 2 Treat patients and colleagues fairly and 4.2 Treat patients and colleagues fairly and without discrimination ih di i i i 4.3 Act with honesty and integrity Exercise • What What Supporting Information (SI) can the Supporting pp g Information ((SI)) can the organisation organisation provide for this domain? i ti provide id for f this thi domain? d i ? • What SI should the doctor provide? What SI should the doctor p provide? • Different colour Post Its Different colour Post Its Tea/coffee Tea/coffee break / break Preparation P p ti for f the th Meeting M ti g a Suggested Appraisal Time Line Agree time & date Submit portfolio 6 months before 3 weeks before Complete C l t documentation and sign off Appraisal interview Agree agenda 2 weeks before 2 /52 after Pre Appraisal Pre-Appraisal pp Contact / Agenda g Setting g • Opportunity Opp t ity to t sett agenda g d • Clarify doctor’s doctor s goals/issues • M Make k ti time ffor d documentation t ti review, i , 360 ffeedback db k & PDP • Ask doctor to decide on time balance • Ask how ‘challenging’ challenging s/he wants you to be How to best use MSF? How to best use MSF? • • • • • • Keep it in perspective Keep p it in p perspective p Look at the self/others mismatches Look at the self/others mismatches Any surprises? Any surprises? H might How How might you deepen your learning? i h you d deepen your learning? l i ? Wh t new things What What new things have you learned? thi h have you learned? l d? Prepare Prepare a written reflection for your portfolio p a written reflection for yyour p portfolio Qualityy improvement Q Quality improvement activity p activityy • Case Case based Discussion (CbD) 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) Reflection……… Reflection • “…II am unable to find any evidence showing that experience has any benefits unless people pay attention tt ti to t feedback f db k and d adjust.” djj t ” Anders Ericsson 2011 • “… a process of reviewing an experience of practice in order d tto describe, d ib , analyse, ly , evaluate l t & so iinform f learning about practice practice.“ Reid 1993 Exercise usingg Reflective Template Exercise using Reflective Template (2 mins) p (2 ( mins)) • Think of a recent CPD activity or a serious incident • Capture your learning on the appropriate Structured Reflective Template • Feedback in pairs what helps you to reflect reflect…. Looking at the Personal Development Plan Looking g at the Personal Development p Plan ( (PDP) ) Personal Development Personal Development Planning p Planningg Development need Keep up to d t date Agreed action Go on an update d t course Date 12 months th Outcome Know more about b t what’s h t’ new Evaluation I will be more confident fid t Be S M A R T Be S.M.A.R.T. • • • • • S M A R T p ifi pecific easurable chievable elevant ime framed Exercise Preparing your PDP Exercise – Preparing p g yyour PDP • S Split plit up p iinto t p pairs i ((with ith someone yyou d do nott kknow well) • Choose a real non non-work work issue that you want to develop or get better at in the coming year (e (e.g. g learn French start a regular exercise routine French, routine….)) • The person who is not the issue holder will act as the appraiser, helping the doctor to create SMART S objectives bjj ti • Spend Sp d 5 minutes i t each h creating ti g SMART objectives bjj ti ffor your development need need. I t d d Learning Intended L i g Outcomes O t - revisited i it d Byy the B th end d off this thi workshop k h pp participants ti ip t will ill b be able to: to:• Describe the types of Supporting Information they need to collect for their appraisal • Describe the GMC’s GMC s Good Medical Practice framework • Prepare for a high quality appraisal • Use U a reflective fl ti template t pl t • Create C a high quality PDP