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The critical success factors in internal and external GP appraisal

Lookup NU author(s): Professor Jan Illing, Dr Diana Jelley, Professor Tim Van Zwanenberg OBE


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All NHS general practitioners (GPs) are now required to undergo an annual appraisal with a fellow GP. GP appraisal cannot be wholly modelled on existing systems in the public sector because of its non-hierarchical structure and lack of clinical 'line management'. A variety of models of implementation have emerged in Northumberland and Tyne and Wear. There is little published research on how the stated aims of GP appraisal are best delivered. The study aims were to: determine the potential strengths and weaknesses of internal and external appraisal see whether there were critical success factors regardless of model. The main method of data collection was via 44 interviews with a stratified random sample of GP appraisers and appraisees, and primary care trust (PCT) appraisal leads. A patient reference group was established to provide the steering group with a patient's perspective on key questions to address. Data analysis was conducted using principles from grounded theory - comparative analysis of the cases to identify common concepts within the topics/themes discussed. Internal appraisal can be robust. Either model can be cosy. GPs' goals for their appraisals varied, e.g. to be stimulating, a tick box exercise, or identifying poor performance. Success factors included a shared view of the purpose of appraisal between appraiser and appraisee. Appraisee's preparation and reflection, and the appraiser's ability to facilitate these also contributed. This study reviewed outcomes from the first year of what is an evolving process and whose function was never initially clearly defined because of its linkage to revalidation. As a tool to aid personal and professional development it has been largely welcomed by the profession despite early reservations. Emerging post 'Shipman', it is possible that appraisal will be used as a tool to also identify indicators of underperformance; if so, this will raise many additional issues about its successful delivery. © 2006 Radcliffe Publishing Limited.

Publication metadata

Author(s): Adams R, Illing J, Jelley D, Walker C, Van Zwanenberg T

Publication type: Article

Publication status: Published

Journal: Education for Primary Care

Year: 2006

Volume: 17

Issue: 6

Pages: 607-616

ISSN (print): 1473-9879

ISSN (electronic): 1475-990X

Publisher: Radcliffe Publishing Ltd.