Key documents

All key documents referred to on the Revalidation Wales website can be downloaded here.

All Wales Medical Appraisal Policy

This high level policy document has been developed to support the implementation of local processes which are fit for purpose for revalidation, consistent and fair and add value in their own right.

Polisi Gwerthuso Meddygol Cymru Gyfan v12

All Wales Medical Appraisal Policy v12

View the completed Medical Appraisal Policy Equality Impact Assessment

A supplementary document has been developed by the Wales Revalidation and Appraisal Implementation Group (RAIG), which describes the operating standards to be achieved in order to deliver the policy, good practice guidance and templates.

Wales Medical Appraisal Toolkit - MARS

The WRDB decided in May 2013 that the Medical Appraisal Revalidation System (MARS) would be the only tool for appraisal for all NHS doctors in Wales from 1st April 2014.

MARS is designed to support organisations and individual doctors in ensuring that their current appraisal paperwork is fit for purpose in relation to GMC standards for revalidation.

Responsible Officers are given specific access to MARS to enable them to review appraisal and revalidation information for their doctors, this then enables Responsible Officers to make revalidation recommendations on GMC Connect.

Wales Appraisal Exceptions Management Protocol

The All Wales Appraisal Exceptions Management Protocol was agreed by the WRDB September 2014, it enables Designated Bodies to consistently manage doctors who do not engage in the appraisal process. The protocol outlines the key principles of the annual appraisal process in Wales, its links with revalidation and its management in this context. The document describes protocols which apply to a range of different exceptional situations. This will also be of interest to appraisers so they are aware of exceptional circumstances and how they will be managed and supported in Wales.

Making Revalidation Recommendations

The General Medical Council has published guidance to help Responsible Officers make revalidation recommendations about doctors.

The guidance - 'Making revalidation recommendations: the GMC responsible officer protocol' - explains what Responsible Officers should take into account when deciding what their recommendation should be.

Responsible Officers have the ability to make three types of recommendation at the point that a doctor's revalidation is due:

  • a positive recommendation that a doctor should be revalidated
  • a request for a doctor's revalidation date to be deferred (because the doctors needs more time to collect supporting information, for example)
  • or a notification of "non-engagement".

Responsible Officers can make a revalidation recommendation to the GMC once the doctor is in the ‘Under Notice’ period which starts 4 months before their revalidation date.

The guidance is available to download from the GMC's website. It is aimed primarily at responsible officers but will be of interest to doctors, employers, and patients and the public.

Guidance on the wider role and functions of responsible officers was published by the Department of Health which can be found here.

Revalidation Advisory Groups

Health Boards within Wales generally hold regular revalidation advisory group meetings in order to collate and review all relevant revalidation information regarding a doctor because the Responsible Officer makes a revalidation recommendation, such as annual appraisal evidence and clinical governance information.

A pro-forma has been developed by RAIG to assist revalidation advisory groups in Wales in establishing whether all supporting information for revalidation is present, it also enables Health Boards to keep an audit trail of reasons for recommendations made by the Responsible Officer:

Revalidation Advisory Groups Terms of Reference - This document has been provided as guidance for designated bodies in Wales.

Designated Bodies are encouraged to be pro-active regarding reminding doctors to include all strands of required supporting information in their appraisals. A template letter has been approved by RAIG which can be sent out approximately 6 months before a doctor’s revalidation date to remind them of what is required:

Prescribed Connections

The GMC outlines that nearly every doctor will have a prescribed connection to a designated body, for the majority of doctors this will be very straight forward. However some doctors may find it difficult to establish a prescribed connection with any existing designated body and should therefore contact the GMC for further guidance.

The GMC provides guidance on how to revalidate for doctors that are unsure of their prescribed connection.

For doctors who request to have a connection with a designated body or Responsible Officer, RAIG have developed a template letter which can be sent to the individual requesting further information, this can be used to establish whether there is a ‘connection’ between the doctor and the designated body:

If a doctor moves designated body it can be difficult for the new Responsible Officer to obtain enough information regarding that doctor for them to make a revalidation recommendation, particularly if the doctor moves fairly shortly before their revalidation date. A sub group of RAIG have developed a Responsible Officer Information Flow Form which needs to be completed by the doctor and the previous Responsible Officer. This form is then passed to the new Responsible Officer allowing them to become aware of any current issues etc.

Overseeing Revalidation

GMC Supporting Information
This guidance sets out the supporting information that you will need to provide at your annual appraisal and the frequency with which it should be provided. It also gives further details on how the information can be used or discussed during appraisal.
GMP Framework for Appraisal and Revalidation
The framework sets out the broad areas which should be covered in medical appraisal and on which recommendation to revalidated doctors will be based.

Resources for Employers & Responsible Officers

Managing conflicts of interest between doctors and ROs in Wales
This document outlines how to manage conflicts of interest between a doctor and an RO in the context of Revalidation.
Quality Management Framework Template
Effective Quality Management is crucial to the on-going success of medical appraisal in Wales, and its contribution to other quality improvement and governance processes including revalidation. The document has been developed by a sub-group of RAIG and distributed to DBs, this should enable DBs to evaluate the robustness of existing arrangements and assess the extent to which these are fit for purpose.
Appraiser Standards Framework
An overview of quality assurance indicators relating to the selection, training and performance management of medical appraisers.

Effective Governance to support medical revalidation                                                                                                            

A handbook for boards and governing bodies

Whole Practice Appraisal

With the advent of revalidation the GMC requires a doctor to present supporting information covering all aspects of their professional duties. To support doctors in Wales in meeting Whole Practice Appraisal requirements, the following guidance has been developed.

Revalidation for Trainees

Information for Doctors in Training
The GMC has recently published a leaflet on 'How doctors in training will revalidate', read it to find out more about the process.

Patient and Colleague Feedback

All doctors working in NHS Wales have access to the Orbit360 patient and colleague feedback system. For most doctors this will provide the route to obtaining the minimum requirement of 1 colleague and 1 patient feedback exercise once per revalidation cycle.

You can complete your patient and colleague feedback at any point in your revalidation cycle. It is good practice to obtain your feedback early in your revalidation cycle as, if changes are needed, you may choose to run the feedback again to demonstrate development. 

How does the Orbit360 system work?

Orbit360 is a dedicated end-to-end patient and colleague feedback system that integrates directly to the Medical Appraisal Revalidation System (MARS). It has been developed by the Revalidation Support Unit (RSU) in conjunction with the Digital Team within Health Education and Improvement Wales (HEIW). We also manage and develop the Medical Appraisal Revalidation System (MARS).

Orbit360 has been designed on an adaptable platform to allow the possibility of further professions utilising the system in the future. It also means we can be reactive to any changes to revalidation requirements introduced by the GMC. Orbit360 compiles patient and colleague feedback into a report that you can reflect upon during your appraisal.

As part of revalidation, the GMC require that a doctor collects formal feedback from colleagues and patients. Further guidance can be found on our Frequently Asked Questions.


A flowchart with the Orbit360 can be found here.

  1. You’ll need to register on Orbit360 and verify your email address. Please ensure the details, including your GMC number, are entered correctly
  2. Once you have verified your email you can login and initiate your survey(s) via the ‘manage feedback page’.
  3. Orbit360 will perform an automatic check against GMC Connect and MARS, should you meet the criteria your survey(s) will be automatically approved. If you do not meet the criteria, your Designated Body will manually review the survey request.
  4. You can then enter the details of your Supportive Medical Colleague (SMC), colleague list and download your patient forms simultaneously
  5. The patient feedback forms should be administered by a third party, this could be a receptionist or other clinical or non-clinical staff
  6. You’ll then see progress bars for each survey detailing the responses received and the time remaining. You have 8 weeks to complete your feedback. You can add additional colleague details or download additional patient forms at any point while the survey(s) is active
  7. Patient forms can be returned by email or post
  8. Your report will automatically be generated once you have received the minimum number of responses and reached the 8-week time period. Alternatively, you can request for your SMC to view the report early once you reach the minimum number of responses. You need a minimum of 15 colleague responses and 34 patient responses.

For GPs, the SMC is not normally your appraiser. You should select a clinical colleague; this doctor should not be related to you but may be your partner or someone else with whom you work closely.

For all other doctors, the SMC can be your appraiser. You should select a clinical colleague; this doctor should not be related to you but may be someone else with whom you work closely.

Guidance for Supporting Medical Colleagues (SMC)

The role of the Supportive Medical Colleague in the process, is to help the doctor make sense of, and reflect on, their feedback. Further information about the SMC role can be found here.

The SMC will;

  1. Verify the list of colleagues that a doctor has selected, ensuring that the list represents colleagues from across the whole practice
  2. Review the doctors report
  3. Provide feedback on the doctor’s report and release it back to them.

The Report

Your completed report will be available to download, go to 'completed reports' from the Orbit360 menu.

Once you have the completed report, you should create a ‘Feedback’ entry onto MARS, upload your report and reflect on the feedback you’ve received to ensure you meet the requirements for revalidation.

If you have any further questions, please contact



Quality Indicators

Quality Indicators for Appraisal Documentation to Support Revalidation in Wales
A set of quality indicators have been devised to guide both doctors and appraisers in ensuring the quality of that supporting information is sufficient.
Appraisal Discussion Assessment Method (ADAM)
The Wales Deanery has developed a tool for analysing recorded appraisal discussions. This is a formative tool used to assess the quality of the appraisal discussion that might also be used to self-assess or to provide feedback to appraisers to improve appraisal discussion skills. ADAM was developed as a tool to improve appraisal discussion skills and is applicable to both primary and secondary care for use in initial training and the development of more experienced appraisers.

Revalidation Support Unit Reports

Revalidation Quality Assurance Report

Revalidation Support Unit Annual Review 2018-19


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