ro training day organisational structure for the delivery of enhanced appraisal in scotland ian g...
TRANSCRIPT
RO Training Day
Organisational Structure for the Delivery of Enhanced Appraisal in
ScotlandIan G Finlay
Scottish Government Health Directorates
Regulation of Doctors
• Reserved power• Appointment of ROs• Revalidation will be a
UK process• Scottish Context• Remediation is a
devolved matter
Revalidation based on Enhanced Appraisal
• An annual enhanced appraisal over a 5 year cycle
• Patient and peer feedback (MSF)
• Based on evidence already present in the workplace for clinical governance
• Evidence – fulfil the framework of Good Medical Practice
Appraisal of Doctors in NHS Scotland
Primary Care
• Robust• Appraisers NES trained• Appraisers allocated• SOAR (e-system)
Secondary Care• Variable
National Appraisal Leads Group
• Leads - 14 Health Boards
• Developed an appraisal form- draft
• E-form SOAR• Appraisal Handbook -
draft
Basic Principles of the structure for Enhanced Appraisal
in 2011/2012
• Training of appraisers standardised to deliver enhanced appraisal
• All appraisers must be trained (NES)
• Appraisers allocated to appraisee
• Align appraisal in primary and secondary care
Appraiser selection and training
• NES have provided appraiser training for primary care since 2002
• NES funded by SGHD to deliver appraisal training for secondary care (circa 650) over two years (100 now trained)
• One day or two day courses• Consistent standard across Scotland• Board level- select appraisers for training
Allocation of an Appraiser
• The appraiser will be allocated to the appraisee• Local System to allocate appraisers• Primary care – Local appraisal adviser• Secondary care – ?Appraisal lead, ?CD/AMD• Appraiser from same specialty (not guaranteed)• Appraisee allowed one objection
Who should have an enhanced appraisal?
• All doctors who hold a licence to practice
• Consultants and SAS doctors
• Employed non standard doctors
• ?HR and the Pay Roll
• Compile a local list
Doctors who hold a national training number not included
Timing of the Appraisal
• Primary care – throughout the year
• Secondary care –
Align with job planning and pay progression
Help if throughout the year (10 appraisals/ appraiser)
Urgent tasks at Board level
• Compile a comprehensive list of all licensed doctors who will require to be appraised
• Compile a list of all “old style” trained appraisers• Select appraisers for NES enhanced appraisal
training program• Develop a structure to allocate the appraiser to
the appraisee• Ensure that every doctor has an appraisal and
form 4 in 2011
NALG - Appraisal steering group
• Appraisal lead/Appraisal advisor• AMD/CD, HR, LNC,SAS doctors, Universities
and lay member• Allocate appraisers to appraisee• Minutes provide governance• Responsible for an annual report• AMD/CD free to deal with remediation issues
Structure for the delivery of enhanced appraisal in NHS Boards
RO Appraisal Steering GroupAppraisal Lead
CD/AMD
Select appraisersList trained appraisers
Allocate appraisers
APPRAISAL
Structure for the delivery of appraisal using CD/AMD
RO CD/AMD
Select appraisersList trained appraisers
Allocate appraisers
APPRAISAL
Supporting evidence for enhanced appraisal
Now• Proportionate• Meaningful• Cost effective• Deliver “fit to
practice”
Evidence of quality of practice for specialists
• Colleges and Faculties
• Menu of suggested suitable evidence
• Appraisee and appraiser discuss and agree nature of evidence
Provision of supporting evidence for enhanced appraisal at Board
level
Incremental process
• Description of practice
- patient numbers
• Provision of record of complaints
NALG -MSF Sub Groupproposals
• Single MSF Scotland – colleague feedback• Patient feedback will be separate and may be
specialty specific• Ideally should contain narrative• Feedback by a trained person• Focus on the administrative structure (cost
effective)
Outstanding issues relating to the organisational structure of MSF
• Should the appraisee see the unedited MSF before the appraisal?
• What happens if the comments are especially negative?
• What tool do we chose?
Output from appraisal
• Form 4 to CD/AMD• Analysis• SOAR – the final common pathway• Satisfactory list to RO• Unsatisfactory - MSF (colleague or patient) - Tacking concerns locally
Quality Assurance
• Feedback from selected appraisees
• Feedback from selected appraisers
• Annual report
• QIS Tool (pilots Tayside, Forth,Highland)
• GMC
Actions in 2011
• Identify and list at local level all doctors in NHS Scotland who require an enhanced appraisal
• Ensure that they are all appraised in 2011• List all current appraisers - select for NES
training • Develop the local structure for allocation of
appraisers and organisation of enhanced appraisal