e-Appraisal: A Guide for Primary Care

122 Pages·2003·5.52 MB·English

by  Paul Robinson

e-Appraisal
A guide for primary care
Paul Robinson
and
Louise Simpson
Foreword by
Professor Sir Liam Donaldson
Chief Medical Officer
Radcliffe Medical Press
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© 2003 Paul Robinson and Louise Simpson
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
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British Library Cataloguing-in Publication Data
A catalogue record for this book is available from the British Library.
ISBN 1 85775 961 3
Typeset by Acorn Bookwork, Salisbury, Wiltshire
Printed and bound by TJ International Ltd, Padstow, Cornwall
Contents
Foreword vi
Preface viii
About the authors ix
Acknowledgements x
List of abbreviations xi
1 About e-appraisal 1
Who is this book for? 2
How to use this book 2
2 Introduction to e-appraisal 3
Informatics and appraisal in primary care 3
What do people think about appraisal? 4
What is informatics and what can we find in it to
support appraisal? 5
Why you still don't need to worry about the stuff
in the grey box of wires 6
The role of individual and organisational learning 7
Self-managed learning 8
Appraisal and clinical governance 9
Some final thoughts 10
3 What and where is appraisal? 13
Appraisal in the spectrum 13
Experience in and of appraisal 14
Dimensions of appraisal 15
Situating GP appraisal 18
4 Appraisal and the educational framework 23
A beginner's guide to appraisal 23
iv • Contents
So why aren't we doing it already? 24
An educational framework for appraisal 25
How e-appraisal helps define learning needs 27
5 The art of appraisal I 29
Appraisal offers a structured and sequenced process 29
Appraisal offers the opportunity to reflect 30
Appraisal offers someone to talk to 31
The Johari window 31
Roles in appraisal 32
Roles in the appraisal meeting 33
Roles after the appraisal 34
How e-appraisal helps 34
6 The art of appraisal II 37
The art of appraisal 37
Bringing two worlds together 38
Personal learning and development plans (PDPs) 39
More on the Johari window 41
Confidentiality, openness and trust 42
Confidentiality in e-appraisal 43
The appraisal meeting 44
Communication in the appraisal meeting 44
e-Appraisal and the appraisal meeting 47
Preparing for the e-appraisal meeting 48
How to reflect 49
7 Reporting and demonstrating - reflecting and showing 51
It depends how you look at it... 51
Shop windows 52
The NHS Appraisal Toolkit: developing the appraisal statement 53
The advantages of a dynamic electronic appraisal record (EAR) 54
The NHS Appraisal Toolkit: the appraisal questionnaire 55
Using information and the appraisal statement in the
appraisal meeting 56
Signing off after the appraisal 57
Using the personal learning and development plan
throughout the year 57
Some final thoughts 58
8 GP appraisal and the practice team by John Bibby 61
Development plans, the individual and the practice 62
Out with the old ... 62
Contents • v
Nurse education leading the way 63
... and the administrative team? 63
Practice planning 63
PCTs and practice planning in partnership 65
External influences 65
Organisational development facilitation 65
Practice professional development planning 66
A look at appraisal and revalidation 69
The role of computers 70
Some final thoughts ... 73
9 Focus on informatics for e-appraisal 75
Why and how informatics has a role in appraisal 75
Training and personal development 76
Using the GP clinical system 76
The world wide web 77
Accessing the NHS Appraisal Toolkit 78
Patient surveys and consumer health informatics 79
The value of the e-community 79
10 Training and resources 81
Primary care informatics training 81
Web-based resources 83
Some useful addresses 84
Further reading and resources 85
Additional reading 92
Lessons from industry 94
Index 99
Foreword
Appraisal is a positive and developmental process for individual clini-
cians, aimed at supporting good patient care and high standards of
clinical practice in the NHS. It forms an important building block in the
strategy to ensure high clinical standards that doctors, and all people
working in the NHS, can be proud of. It is a part of clinical governance;
to work well it has to be something that every doctor takes part in, which
is why it will be a condition of contract in the future.
It is a process to give GPs feedback on their past performance, to chart
their continuing progress and to identify development needs. It is a
forward-looking process, essential in identifying the developmental and
educational needs of individuals. The primary aim of appraisal is to help
GPs consolidate and improve on good performance, aiming towards
excellence. In doing so, it will identify areas where further development
may be necessary or useful.
The prospect of appraisal is new to many clinicians and it is important
that they are comfortable with the concepts and have the access and
knowledge to use resources that support appraisal as a formative, reflec-
tive and useful part of both the quality and personal development
agenda. Informatics tools are available to facilitate the appraisal process
itself, but also the ongoing reflection and development activity before and
after the appraisal meeting. By reflecting in the context of day-to-day
work in general practice, much of the preparation for appraisal can be a
by-product of existing activity. Thus, the appraisal process will not of
itself result in the generation of significant amounts of new evidence or
information, rather it will capture the information that already exists.
I welcome the work that SCHIN have done on the development of the
electronic NHS Appraisal Toolkit. To me, the Toolkit demonstrates how
appraisal for general practitioners is important for the individual as well
Foreword • vii
as for the wider quality context. It also demonstrates the value of an on-
going reflection in the context of day-to-day practice and general practice.
This book, a guide for primary care, covers the underpinning principles
to appraisal, and also demonstrates how clinicians, both appraisers and
appraisees, can exploit their informatics resources to enjoy excellence in
appraisal - a benefit to the quality and the personal development
agendas.
Appraisal is an opportunity for general practitioners to reflect on their
work and to consider how their effectiveness might be improved. It is
also a sign of commitment to professional and personal development
within primary care. The Toolkit will mean that an informatics resource
will be available to support both the individual and the organisation in
developing appraisal.
Professor Sir Liam Donaldson
Chief Medical Officer
October 2002
Preface
This book is about appraisal and the role that today's information
technology can play in making appraisal more effective and easier for
both the appraiser and the appraised. The idea for the book grew from
our previous book, e-Clinical Governance: a guide for primary care (Radcliffe
Medical Press, 2002) and our work on the NHS Appraisal Toolkit. The
links between appraisal and clinical governance are considered in detail
in the book. Clinical governance is about co-ordinating the planning,
management and delivery of healthcare and appraisal is the cornerstone
that involves the practitioner in this process. The NHS Appraisal Toolkit
is a web-based electronic resource that provides background guidance for
appraisees and appraisers and a comprehensive appraisal record for the
practitioner. It has been developed for GP Principals, for whom the first
round of appraisal will be completed by April 2003.
The focus of the book is therefore appraisal of general practitioners in
the UK, and we have drawn on the NHS Appraisal Toolkit as an instance
of the application of information technology to appraisal. In Chapters 9
and 10, in particular, we show how a wide range of electronic resources
can be used in appraisal and in Chapter 8 John Bibby shows how
appraisal of individual practitioners relates to work in teams.
We feel that this approach, although it builds on specific contexts in the
domain of primary healthcare in the United Kingdom, is applicable to
appraisal in many other contexts and within other parts of the health
services, and beyond.
Paul Robinson
Louise Simpson
October 2002
About the authors
Paul Robinson is a GP in Scarborough and GP educational consultant to
the Sowerby Centre for Health Informatics at Newcastle (SCHIN). Paul is
a key member of the NHS Appraisal Toolkit project team, drawing on his
expertise as a VTS course organiser, lecturer and educationalist. Paul is
author and co-editor of e-Clinical Governance: a guide for primary care
(Radcliffe Medical Press, 2002).
Louise Simpson leads the SCHIN education and communications team,
developing and implementing initiatives for primary care including the
NHS Appraisal Toolkit. She has worked in health informatics since 1992,
with experience as a GP computer facilitator in Nottinghamshire and
with EMIS National User Group. Louise is author and co-editor of
e-Clinical Governance: a guide for primary care (Radcliffe Medical Press,
2002) and she successfully achieved an MBA with a thesis entitled Organi-
sational Learning in General Practice.
Caroline Rickard and Laura Bond are contributing authors from SCHIN
and provided many of the web links and resource lists for this guide.
John Bibby is a GP in Shipley, near Bradford, and a GP tutor in
Yorkshire. He has worked extensively in GP education, clinical govern-
ance, appraisal and revalidation. He is the author of Chapter 8 GP
appraisal and the practice team.