Final Report > Chapter 25: Competent Healthcare Professionals > The systems for assuring competence > Appraisal

Appraisal

55 Appraisal is a common feature in most large organisations. The annual appraisal of all healthcare professionals should, in our view, be the norm. For most, it is. For hospital consultants and general practitioners, however, it is the exception. This must change. We are pleased to note from `The NHS Plan' [22] that the Government has agreed in principle with the British Medical Association (BMA) that annual appraisal and effective job plans will be made compulsory in the new consultants' contract. We believe this commitment must be kept and be implemented in full as soon as possible.

56 We see annual appraisals as an essential part of an overall strategy aimed at maintaining competence and thereby securing safe care and improving the quality of care in hospitals. The obligation to participate in appraisal is of such importance that we take the view that it should apply to all NHS employees and be incorporated into employment contracts, including, as we have said, consultants' contracts with the trust. Indeed, we regard appraisal as sufficiently important that it should extend to GPs and a requirement to undergo periodic appraisal should therefore be incorporated into the terms of service of GPs' contracts with the NHS. Some doctors have expressed concern at what they see as a mechanism for judging or even victimising them. But this is to misunderstand the exercise. Appraisal itself is a neutral activity: what matters is the principle on which the appraisal proceeds. We believe that appraisal in the NHS should be constructive and facilitative, with a particular emphasis on what the employer can do to enable healthcare professionals to do their job well and to fulfil themselves in the workplace. For this reason, it is vital to distinguish between appraisal and revalidation. They are separate exercises with different purposes, even though appraisal may well inform the process of revalidation. Appraisal should focus on past performance, on the maintenance and development of skills as they touch on competence, and on job fulfilment. Revalidation, by contrast, is concerned with ensuring that the appropriate levels of skill necessary for continued competence have been and are maintained.

Footnotes

[22] `The NHS Plan'. London: Department of Health, 2000. Para 8.21