Annual appraisal should always consider a doctors whole practice, the GMC describes whole practice appraisal within their guidance on Supporting Information.
Whole scope of practice: You must declare all the places you have worked and the roles you have carried out as a doctor since your last appraisal. You must collect supporting information that covers the whole of this practice. It’s important you identify your whole scope of practice so you can make sure your supporting information covers all aspects of your work. Your supporting information must cover any work you do in:
A - clinical (including voluntary work) and non-clinical (including academic) roles
B - NHS, independent sector and private work.
To meet the requirements of revalidation the GMC requires all doctors to present supporting information covering all aspects of their professional duties. This will require information being presented at an annual appraisal. Doctors often undertake multiple roles - cross specialty, manager, education etc. All of these roles will be covered by revalidation requirements and will need to be represented at an appraisal discussion.
Supporting doctors with independent roles and whole practice appraisal
Many different roles that doctors undertake sit under the umbrella of Whole Practice Appraisal (WPA) and for most roles a letter of sign off/appraisal once in a revalidation period from a GMC registered doctor who has some oversight of the practitioner is sufficient. However, some doctors undertake medical roles part time and work completely independently. Examples would include:
- Working as a touchline doctor at sporting events (mainly at non-professional level)
- Cosmetic interventions (e.g. Botox, fillers etc.)
- Ad Hoc occupational health work
- Online prescribing
- Private work (not as part of a recognised institution)
When considering WPA as part of a doctor’s appraisal, an Appraiser would need the reassurance that:
- The doctor is qualified and trained to undertake the role
- The doctor keeps up to date in that role
- The doctor provides a good and safe standard of care when compared to accepted standards in that role
- The doctor reflects on their role and undertakes quality monitoring/improvement/development in that role
In standard UK practice there are mechanisms external to the doctor that would normally undertake this monitoring, however, in the case of independent practice, the doctor themselves may be the only professional involved. The Responsible Officer needs to be assured that the doctors under their umbrella are indeed performing to acceptable standards and that some sort of external governance or mechanism for the like is in place. The role of appraisal in these cases is diverse. It should celebrate excellence and development, it should give the doctor the opportunity to “validate” this practice, it should offer developmental challenges and should be the place where quality in this role is demonstrated and recorded.
MARS template for recording independent practice
A template has been developed for the MARS system facilitating the recording of the information required for appraisal and revalidation
Add Information > Category ‘Whole Practice Appraisal’ > Type ‘Independent Practice’