Transcript Revalidation Workshop: Collecting Supporting Information

Revalidation Workshop for Sessional
GPs:
Collecting Supporting Information for
Appraisal and Revalidation
Dr Sahar Hassan
GP Tutor, St Peter’s PGEC
4th December 2012
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
INTRODUCTION
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December 2012 start date, notification of
revalidation year
Responsible officers RO (role is to
recommend you to the GMC for revalidation)
first to be revalidated in first 4 months, April
2013 roll out to all doctors
SOME OF US REVALIDATED from our
appraisal 2012-2013
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
INTRODUCTION
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Revalidation requires
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RO shown you have participated in an annual
appraisal of ALL your medical practice (GPwSI,
teaching, etc), AT LEAST ONE APPRAISAL
SIGNED OFF BY YOUR APPRAISER with good
medical practice as focus
Relevant Supporting information brought to
appraisal
No unresolved concerns regarding your
performance as a doctor
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
INTRODUCTION
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General Information
Keeping up to date
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Review of practice
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CPD
Quality improvement activity QIA- audits, SEA,
other examples
Significant events
Feedback on practice
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Colleagues, patients, complaints/ compliments
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
The Must Do
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Register with GMC online and confirm your
designated body and your responsible officer
Identify and start the dialogue with your
appraiser, find out by contacting
[email protected]
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
GPs in “non standard practice”
to maintain your licence to practise
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Contact the GMC if you unsure who is your
designated body and responsible officer
Must take into account ALL your work when
providing supporting information
Examples- peripatetic locum, OOH/ walk in
centre, rural GPs, GPs in Defence Medical
Services and secure environments, extended
career breaks, non clinical roles
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
GPs in “non standard practice”
to maintain your licence to practise
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If “non standard practice” may have difficulty
accumulating supporting information in a “standard
portfolio” and may have to produce “equivalent portfolio”
in discussion with appraiser so speak to your appraisers
SOONER RATHER THAN LATER if experiencing
difficulties with collecting supporting information
Include in exceptional circumstances rationale for
“equivalent portfolio”
Equivalent portfolio reflects working environment of the
doctor and should still fit the attribute of each area of
supporting information
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
Supporting Information
Other considerations- RCGP
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Part time and private GPs need to maintain skills at the
SAME level as full time/ NHS colleagues
Salaried, retainer, long term locum fixed practice
expected to produce “standard portfolio”
Can include notes in portfolio of special circumstances
such as ill health or maternity leave which have
affected amount information collected or other
difficulties
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
Other considerations RCGP
Career breaks
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Clinical standard portfolio- Can only take out 2
years of a 5 year revalidation cycle, 50 CPD
credits per year in the remaining 3 years,
demonstrate 200 half day clinical sessions (1/7
per week), 100 in 2 years prior to revalidation
Further guidance page 9 http://www.rcgp.org.uk/revalidationand-cpd/~/media/Files/Revalidation-andCPD/Guide%20to%20Revalidation%20v70.ashx
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
Supporting information
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We are all doing CPD, most of us lack the
time or space to document our reflective
learning
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
How can we collect supporting
information?
Register
RCGP eportfolio or clarity appraisal toolkit- start
collecting supporting information
Practical tips to collecting supporting information “on the
hoof”- some suggestions
phone app (evernote, microsoft one note), laptop/ ipad
USB card – word document include reflective log,
PUNS/ DENS, open documents during surgery and add
reflections in real time/ after the surgery
Try to document reflective learning during/ evening of
the event
Sessional GPs Collecting Supporting Information for Appraisal and Revalidation
Reflective learning
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key to success as it underpins appraisal
process
Plato’s directive “know thyself”- self
knowledge as an outcome of learning
John Dewey “we do not learn from
experience…we learn from reflecting on
experience”
Jenny Moon’s grades of reflective learning
Reflection can be before, during or after the
event
Collecting Supporting Information for Appraisal and Revalidation
Reflective learning
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What did you want to learn?
What did you learn?
How will this change what you do?
Has this highlighted any other learning needs?
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4 domains of good medical practice
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Knowledge, skills and performance, Safety and
quality, Communication, partnership and teamwork,
Maintaining trust
Collecting Supporting Information for Appraisal and Revalidation
Supporting Information- General
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Personal details
Scope of practice- clinical/ non clinical
Record of annual appraisals
PDP and their reviews
Probity-honest, trustworthy, acting with integrity
Health- register with a GP, Immunisation,
serious medical conditions
Collecting Supporting Information for Appraisal and Revalidation
PDP- keep it fun + don’t make a
rod for your own back
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SMART (Specific, measurable, achievable,
realistic, time scaled)
5 Ps (personal, patient, practice, population,
problems)
No limit but keep it to 2 or 3
Goals - clinical , leadership, managerial, teaching
Statement of development, how this will be
addressed, date of completion, intended
outcome, review by appraiser
Collecting Supporting Information for Appraisal and Revalidation
Continuing Professional
Development – continuous learning process
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GMC
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Personal, reflects scope of practice, REFLECTION,
outcomes, needs based, clinical governance processes
RCGP
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50 credits / year, “1 hour of education accompanied by
a reflective record” = 1 credit, if learning implemented in
practice with positive benefit (you/patient/ practice)claim 2 credits
Credits SELF ASSESSED and verified at appraisal with
your appraiser
Collecting Supporting Information for Appraisal and Revalidation
Continuing Professional
Development – examples
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Reflect ALL working life- GPwSI, teaching,
commissioning etc.
VARIETY educational activity- local/ national
lectures, on line learning modules (BMA, e-GP),
reading, learning new skill (IUDs, joint injections),
reflective log, PUNS/DENS, discussions with
colleagues
http://www.rcgp.org.uk/revalidation-andcpd/~/media/Files/Revalidation-and-CPD/Credit-Based-System-forCPD-2nd%20version-10110.ashx
Collecting Supporting Information for Appraisal and Revalidation
QIA
Significant Event Audits/ Case reviews
(any event which you can learn from)
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2 SEA each appraisal year, directly involving you
Serious incident/ significant event/ serious
untoward event – actual or potential effect on
patient safety must be included
Headings for writing up event- anonymous
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title, date, date discussion and roles of team present,
description of event, what went well, what could have
been done differently, reflections (4 domains good
medical practice), agreed changes, implemented
changes and their effect
Collecting Supporting Information for Appraisal and Revalidation
SEAs- sessionals
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Peer group – chambers, educational group,
forum to exchange/ discuss SEAs, support,
learn from each other
Regular locum cover GP practice- ask to
attend their SEA sessions
SEA in an Ad hoc session in GP practice ask practice if consider holding SEA session
including you
Collecting Supporting Information for Appraisal and Revalidation
Quality Improvement ActivityAudit
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Audit, separate hand out, during this early phase of
revalidation can state you’ve started a 2 cycle audit
and plan to complete full cycle in PDP for next year
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RCGP “can be a team audit if individual clearly shows
how they contributed properly to the choice of topic,
standards set, directly involved in care delivery in first and
second cycle, states changes made and effects of
changes”
RCGP- if not possible to do audit must at least have 2
SEAs/ year (page 8 http://www.rcgp.org.uk/revalidation-andcpd/~/media/Files/Revalidation-andCPD/Supporting%20information%20for%20appraisal%20and%20revalidation%20for%20GPs.ashx
Collecting Supporting Information for Appraisal and Revalidation
Quality Improvement Activity- Audit
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Standard audit and the sessional GP- often
not feasible or appropriate
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Constant moving between practices- thus not able
to follow changes through
Dr’s role does not include the ability to influence
or improve systems outside their own personal
practice (locums, most salaried GPs)
Unable to access medical records outside
consultation time (locums, OOH)
Collecting Supporting Information for Appraisal and Revalidation
Sessionals – ideas for audit and
other options for QIAs
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Audits for non clinical work- use same headings
Based in a practice-easier to utilise guidelines from
a standard audit
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QOF, NICE guidelines, NHS Surrey Medicines
Management
Options for peripatetic/ OOH/ walk-in GP
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SOAR examples antibiotic prescribing, analgesia
prescribing, investigations
List provided- topics in admin, referrals, antibiotic/ COC
prescribing, febrile child
Collecting Supporting Information for Appraisal and Revalidation
Other QIAs for sessional GPs
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Reviews- Surgery cases, referrals, referral
letters, challenging cases, follow up patients
and reflective learning of outcomes
Random Case analysis/ Action auditreview 20 cases (random or defined clinical
nature), assess (clinical decision making,
record keeping, standards of care) with peer
group / experienced colleague- document
reflections, agreed improvements,
demonstrate change
Collecting Supporting Information for Appraisal and Revalidation
Other QIAs for sessional GPs
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Records Audit- review record keeping in a series of
consultations, highlighting key elements of information which could be
improved, e.g. safety netting/ red flags/ READ coding, RCGP can not
use this as only evidence of QIA
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Condition based review- choose clinical area which
learning need (e.g. from PUN/DEN, SEA- which common and has
evidence based guidelines, e.g. asthma- collect 10 prospective cases,
assess management in context guidelines, learning points, aspects of
diagnosis/ care omitted or needs improvement
Collecting Supporting Information for Appraisal and Revalidation
QIA
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MUST BRING ANY INFORMATION ON
CLINICAL GOVERNANCE THAT YOU
HAVE BEEN ASKED TO BRING TO YOUR
APPRAISAL
Commissioning
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Demonstrate cost aware, efficient use of
resources
Our role through referrals and prescribing
Collecting Supporting Information for Appraisal and Revalidation
Feedback- colleague and patient
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GMC- 1 every 5 year revalidation cycle
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Questionnaires
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http://www.gmc-uk.org/colleague_questionnaire.pdf_48212261.pdf
http://www.gmc-uk.org/patient_questionnaire.pdf_48210488.pdf
On line RCGP or clarity or manually collate via colleague/buddykeep anonymous
Written summary in portfolio
Reflect on the feedback- implement
changes+ PDP, CPD opportunities, cover whole
practice, results benchmarked – compare to peers similar
scope of work
Collecting Supporting Information for Appraisal and Revalidation
Feedback
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Colleagues- distribute
20 – hope to have 15
responses
Junior peer, senior
peer, nurse,
receptionist,
pharmacist, admin staff,
practice manager,
consultant, sessional
support group
Reflect multiple roles
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Patients- distribute
45 – hope to have
37 responses
Reflect multiple
roles
Collecting Supporting Information for Appraisal and Revalidation
Feedback – issues for sessionals
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Colleagues- Inform appraiser of difficulties
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On line if possible, manual may be only option
peripatetic
Rural practices- insufficient number
Walk in / OOH/ peripatetic – not known for a length of
time
Think broadly on who can give feedback
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Collecting Supporting Information for Appraisal and Revalidation
Feedback – issues for sessionals
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Patients- inform appraiser difficulties
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On line may not be option- OOH, walk in centres
Less able to develop long term patient relationship
Think broadly on who can give feedback (carers, families,
customers, suppliers)
Inform practice/ nurse manager – ask for support, receptionist
role (handing out questionnaires, pens, collecting forms)
Keeping anonymous- ideas, buddy system to formulate results
Patient groups- e.g. secure environments may not be suitable
Collecting Supporting Information for Appraisal and Revalidation
Review of Complaints and
Compliments
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Reflection discussed appraisal- lessons learnt,
changes made, future implications
GMC- Another type of feedback, aware complaint procedures, GMC
good medical practice advice, actions taken (personal/ practice),
opportunities, MPS guide handing complaints- add to CPD
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RCGP - description event, assessment, resulting actions, outcome,
reflection
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Sessionals- Difficulty access, log of verbal
complaints, compliments, if none- declare in portfolio
Collecting Supporting Information for Appraisal and Revalidation
Avoiding isolation  peer support
keeping up to speed with your
revalidation
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Working environments (GP practices, walk in
centres, OOH organisations) should support the
conduct of patient surveys, inform you of any
complaint/ SEA relating to your work, access to
patient records for audit/ QIA
Educational groups – GP Lunch Club, ASPH
meetings, locum groups, St Peter’s sessional
GP support meetings (term time, monthly), peer
group support
Professional organisations NASGP
Collecting Supporting Information for Appraisal and Revalidation
Resources for Sessionals
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SOAR Scottish On Line Appraisal Resource
http://www.scottishappraisal.scot.nhs.uk/appraisalpreparation/sessional-gps.aspx
SOAR OOH GPs
http://www.scottishappraisal.scot.nhs.uk/appraisalpreparation/ooh-gps.aspx
NEPCSA guidance on supporting information for non
standard GPs http://www.gpappraisals.nepcsa.nhs.uk/nepcsa-guidancefor-sessional-gps/
Collecting Supporting Information for Appraisal and Revalidation
Questions? Future Topics?