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Appraisal 2020 will focus on ‘Support not Paperwork’

On the 3rd September 2020 Professor Stephen Powis, National Medical Director NHS England and NHS Improvement, wrote to all Responsible Officers and Medical Directors in England announcing a new way forward for medical appraisals. The letter explains that this year’s appraisals will focus on ‘support not paperwork’. What does this change mean in reality for doctors and appraisers? And are there benefits to this new approach that we should maintain going forwards?

The emergence of COVID-19 and its impact on the NHS will be one of the most significant events in most doctors’ careers. From the peak of hospital admissions to the public gratitude expressed to the NHS, 2020 has been a tumultuous year for us all in the healthcare industry. As the pandemic took hold, many trusts had to halt their appraisals to free up clinical time and those doctors had their revalidation postponed.

But this time has taken its toll on the medical profession and data from the BMA’s COVID-19 tracker released on 18th May 2020 found that during the pandemic, more than 45% of doctors said they were suffering from any of depression, anxiety, stress, burnout, emotional distress or other mental health conditions relating to, or made worse by, their work. The additional burden on doctors over recent months means that taking time for reflection, support and wellbeing during a doctor’s next appraisal is more important than ever.

Appraisal has been ‘reset’ in light of Covid-19

The new guidance from NHS England details how appraisal has been reset in light of COVID-19. The balance of appraisals will now be weighted more towards professional development and wellbeing. The approach allows for flexibility with local ‘creativity’, and there are simplified expectations around supporting information. The guidelines include:

  • Using appraisal as an “opportunity to help doctors reflect on their health and wellbeing to the extent that this is relevant to their ability to provide high-quality, safe care.”
  • An “Increased emphasis on the role of the appraiser to prompt sufficient reflection during the appraisal discussion”
  • That “Appraisers should be trained and encouraged to explore questions about maintaining health and wellbeing with the doctor during the discussion and be able to signpost doctors to appropriate resources”

What do the changes mean for appraisers?

Whereas in the past, the appraisal was based around pre-work, documentation and statements, the new format brings focus the mental and physical health and wellbeing of the appraisee, meaning appraisers may need to develop new skills or refresh their current skills. As we see it, new format tasks appraisers with:

  • Taking a coaching approach
  • Challenging and supporting appraisees
  • Focussing on developmental opportunities
  • Making the conversation a worthwhile experience for the appraisee

The skills required for this more nurturing and supporting format include empathy, listening and coaching skills. Appraisers need to be able to sign post or highlight if they think there are issues. In response to these changes, we at Miad Healthcare have launched two refreshed online courses:

New Appraiser Training
Appraiser Refresher Training

Two new courses for appraisers

We have moved to an online environment including e-learning and live webinars for both of these courses. Recognising the way in which the appraisal is developing, and the associated learning required, we have extended the length of our courses and included new scenarios to reflect the different types of conversations that appraisers are having with doctors at this time. To find out more about what the changes mean for appraisers and how you can keep your skills up to date, get in touch with the Miad Healthcare team here.

The NHS recommends that responsible officers adopt a flexible approach, aiming to begin reinstating appraisals by 1st October, with a view to resuming normal levels of activity by 1st April next year. The new format will change the way we appraise in the future and is perhaps a step we should welcome as a positive outcome from the current situation. More than 250,000 doctors across the UK are subject to revalidation. Appraisal is one tool we have through which we can nurture the professional growth of doctors who are in need of reflection and support as well as revalidation.

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