Published 7 August 2019
If you are incurably curious, motivated by wanting to help and support your fellow professionals, have sufficient experience in clinical practice to be credible and keen to develop your own reflective practice skills, then becoming a medical appraiser for revalidation may appeal to you.
It can also be a way to boost income, depending on the practice agreement.
There should be a transparent and fair recruitment process that will start with an open advert saying that more appraisers are required in your area.
Consider carefully what you say in your application. The aim is to weed out at shortlisting those people who do not have the compassion or capacity to do the job well. Do your best at interview; this is a professional role so take it seriously and don’t make jokes that could backfire on you.
You will only be appointed if you believe that appraisal can be a valuable intervention that supports doctors and can demonstrate that you have something to offer. You will also have to demonstrate that you are in good standing with your regulator and up to date with your information governance training.
Being appointed through the recruitment and selection process in primary care is only the start of becoming an appraiser. You will be required to attend a competency-based two-day appraiser training programme. The training is summative; you can fail at this stage if you are not able to communicate effectively in the appraisal exercises.
Most doctors find that their transferable skills from their main roles are exactly what they need in appraisal. The main difference is the privilege of having two to three hours to spend discussing things in confidence with a colleague (the acceptable range is 90 minutes to four-and-a-half hours, depending on the complexity of the appraisal).
The first three appraisals are usually probationary and well supported. You will be assigned a buddy or senior appraiser who will be available by phone or email to answer your queries. You will get feedback on the way you have written up your summary of discussion as this really is best learned on the job. Don’t expect to get it right first time. The two golden rules for appraisers are:
You will be part of an appraiser support group with local leadership and have opportunities to learn on the job, discuss difficult appraisals and calibrate your professional judgment with your peers. With a ratio of approximately one appraiser to 10 to 12 appraisals nationally in primary care, roughly one in 10 GPs are appraisers at any one time.
Appraisers are paid £515 per appraisal, which is superannuable income if you are part of the NHS pension scheme. According to your practice agreement, partners can pool the income, or be paid as an individual through the practice as a vehicle.
Salaried doctors have to complete a GP SOLO form if they are in the NHS pension scheme.
Locums have to complete Locum Form A and B and can only superannuate 90% of the income as the other 10% is deemed to be expenses. Locums also have a choice about whether to count this as pensionable income, even if they are in the pension scheme, whereas partners and salaried GPs have no option: if they are in the scheme, they cannot opt out just for their appraisal work.
The number of appraisals undertaken each year varies but NHS England guidance suggests that five is the minimum you need to do to maintain your skills, and 20 the maximum you should do for one designated body (to avoid being overly dependent on any one appraiser). Some appraisers are engaged by more than one designated body, or do independent appraisals too.
Each appraisal is supposed to take, on average, two sessions of your time; one to conduct the appraisal and roughly one in total to prepare and write up. Of course, only the appraisal meeting needs to be in practice time, and you will rapidly become slick at preparing beforehand and summarising the appraisal afterwards. You are entitled to claim exceptional travel expenses in addition if the appraisal is more than 45 minutes’ travel away but except in remote and rural areas, this is rarely the case, and you can often agree a mutually convenient venue half-way.
Extra income is rarely the main motivation for becoming an appraiser, as the ‘soft’ benefits for your practice are even more significant.
Learning from the doctors you appraise and bringing back ideas that you can use in your own practice is invaluable. Meeting other doctors forges connections that can help to identify potential additions to your practice team. Having your ear to the ground locally boosts your ability to become early adopters of good ideas (and teaches you to avoid some that are not). After 16 years of appraising, I still learn something new from every appraisal that I facilitate.
You will also become part of a team through your local appraiser support group, and develop the ability to signpost resources that may help others. Being able to make a positive difference for other doctors at a time of great stress on the profession is very rewarding.
Dr Susi Caesar is RCGP Medical Director for Revalidation
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