e-Appraisal: A Guide for Primary Care PDF
Preview e-Appraisal: A Guide for Primary Care
e-Appraisal A guide for primary care Paul Robinson and Louise Simpson Foreword by Professor Sir Liam Donaldson Chief Medical Officer Radcliffe Medical Press Radcliffe Medical Press Ltd 18 Marcham Road Abingdon Oxon OX14 1AA United Kingdom www.radcliffe-oxford.com The Radcliffe Medical Press electronic catalogue and online ordering facility. Direct sales to anywhere in the world. © 2003 Paul Robinson and Louise Simpson All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photo- copying, recording or otherwise without the prior permission of the copyright owner. British Library Cataloguing-in Publication Data A catalogue record for this book is available from the British Library. ISBN 1 85775 961 3 Typeset by Acorn Bookwork, Salisbury, Wiltshire Printed and bound by TJ International Ltd, Padstow, Cornwall Contents Foreword vi Preface viii About the authors ix Acknowledgements x List of abbreviations xi 1 About e-appraisal 1 Who is this book for? 2 How to use this book 2 2 Introduction to e-appraisal 3 Informatics and appraisal in primary care 3 What do people think about appraisal? 4 What is informatics and what can we find in it to support appraisal? 5 Why you still don't need to worry about the stuff in the grey box of wires 6 The role of individual and organisational learning 7 Self-managed learning 8 Appraisal and clinical governance 9 Some final thoughts 10 3 What and where is appraisal? 13 Appraisal in the spectrum 13 Experience in and of appraisal 14 Dimensions of appraisal 15 Situating GP appraisal 18 4 Appraisal and the educational framework 23 A beginner's guide to appraisal 23 iv • Contents So why aren't we doing it already? 24 An educational framework for appraisal 25 How e-appraisal helps define learning needs 27 5 The art of appraisal I 29 Appraisal offers a structured and sequenced process 29 Appraisal offers the opportunity to reflect 30 Appraisal offers someone to talk to 31 The Johari window 31 Roles in appraisal 32 Roles in the appraisal meeting 33 Roles after the appraisal 34 How e-appraisal helps 34 6 The art of appraisal II 37 The art of appraisal 37 Bringing two worlds together 38 Personal learning and development plans (PDPs) 39 More on the Johari window 41 Confidentiality, openness and trust 42 Confidentiality in e-appraisal 43 The appraisal meeting 44 Communication in the appraisal meeting 44 e-Appraisal and the appraisal meeting 47 Preparing for the e-appraisal meeting 48 How to reflect 49 7 Reporting and demonstrating - reflecting and showing 51 It depends how you look at it... 51 Shop windows 52 The NHS Appraisal Toolkit: developing the appraisal statement 53 The advantages of a dynamic electronic appraisal record (EAR) 54 The NHS Appraisal Toolkit: the appraisal questionnaire 55 Using information and the appraisal statement in the appraisal meeting 56 Signing off after the appraisal 57 Using the personal learning and development plan throughout the year 57 Some final thoughts 58 8 GP appraisal and the practice team by John Bibby 61 Development plans, the individual and the practice 62 Out with the old ... 62 Contents • v Nurse education leading the way 63 ... and the administrative team? 63 Practice planning 63 PCTs and practice planning in partnership 65 External influences 65 Organisational development facilitation 65 Practice professional development planning 66 A look at appraisal and revalidation 69 The role of computers 70 Some final thoughts ... 73 9 Focus on informatics for e-appraisal 75 Why and how informatics has a role in appraisal 75 Training and personal development 76 Using the GP clinical system 76 The world wide web 77 Accessing the NHS Appraisal Toolkit 78 Patient surveys and consumer health informatics 79 The value of the e-community 79 10 Training and resources 81 Primary care informatics training 81 Web-based resources 83 Some useful addresses 84 Further reading and resources 85 Additional reading 92 Lessons from industry 94 Index 99 Foreword Appraisal is a positive and developmental process for individual clini- cians, aimed at supporting good patient care and high standards of clinical practice in the NHS. It forms an important building block in the strategy to ensure high clinical standards that doctors, and all people working in the NHS, can be proud of. It is a part of clinical governance; to work well it has to be something that every doctor takes part in, which is why it will be a condition of contract in the future. It is a process to give GPs feedback on their past performance, to chart their continuing progress and to identify development needs. It is a forward-looking process, essential in identifying the developmental and educational needs of individuals. The primary aim of appraisal is to help GPs consolidate and improve on good performance, aiming towards excellence. In doing so, it will identify areas where further development may be necessary or useful. The prospect of appraisal is new to many clinicians and it is important that they are comfortable with the concepts and have the access and knowledge to use resources that support appraisal as a formative, reflec- tive and useful part of both the quality and personal development agenda. Informatics tools are available to facilitate the appraisal process itself, but also the ongoing reflection and development activity before and after the appraisal meeting. By reflecting in the context of day-to-day work in general practice, much of the preparation for appraisal can be a by-product of existing activity. Thus, the appraisal process will not of itself result in the generation of significant amounts of new evidence or information, rather it will capture the information that already exists. I welcome the work that SCHIN have done on the development of the electronic NHS Appraisal Toolkit. To me, the Toolkit demonstrates how appraisal for general practitioners is important for the individual as well Foreword • vii as for the wider quality context. It also demonstrates the value of an on- going reflection in the context of day-to-day practice and general practice. This book, a guide for primary care, covers the underpinning principles to appraisal, and also demonstrates how clinicians, both appraisers and appraisees, can exploit their informatics resources to enjoy excellence in appraisal - a benefit to the quality and the personal development agendas. Appraisal is an opportunity for general practitioners to reflect on their work and to consider how their effectiveness might be improved. It is also a sign of commitment to professional and personal development within primary care. The Toolkit will mean that an informatics resource will be available to support both the individual and the organisation in developing appraisal. Professor Sir Liam Donaldson Chief Medical Officer October 2002 Preface This book is about appraisal and the role that today's information technology can play in making appraisal more effective and easier for both the appraiser and the appraised. The idea for the book grew from our previous book, e-Clinical Governance: a guide for primary care (Radcliffe Medical Press, 2002) and our work on the NHS Appraisal Toolkit. The links between appraisal and clinical governance are considered in detail in the book. Clinical governance is about co-ordinating the planning, management and delivery of healthcare and appraisal is the cornerstone that involves the practitioner in this process. The NHS Appraisal Toolkit is a web-based electronic resource that provides background guidance for appraisees and appraisers and a comprehensive appraisal record for the practitioner. It has been developed for GP Principals, for whom the first round of appraisal will be completed by April 2003. The focus of the book is therefore appraisal of general practitioners in the UK, and we have drawn on the NHS Appraisal Toolkit as an instance of the application of information technology to appraisal. In Chapters 9 and 10, in particular, we show how a wide range of electronic resources can be used in appraisal and in Chapter 8 John Bibby shows how appraisal of individual practitioners relates to work in teams. We feel that this approach, although it builds on specific contexts in the domain of primary healthcare in the United Kingdom, is applicable to appraisal in many other contexts and within other parts of the health services, and beyond. Paul Robinson Louise Simpson October 2002 About the authors Paul Robinson is a GP in Scarborough and GP educational consultant to the Sowerby Centre for Health Informatics at Newcastle (SCHIN). Paul is a key member of the NHS Appraisal Toolkit project team, drawing on his expertise as a VTS course organiser, lecturer and educationalist. Paul is author and co-editor of e-Clinical Governance: a guide for primary care (Radcliffe Medical Press, 2002). Louise Simpson leads the SCHIN education and communications team, developing and implementing initiatives for primary care including the NHS Appraisal Toolkit. She has worked in health informatics since 1992, with experience as a GP computer facilitator in Nottinghamshire and with EMIS National User Group. Louise is author and co-editor of e-Clinical Governance: a guide for primary care (Radcliffe Medical Press, 2002) and she successfully achieved an MBA with a thesis entitled Organi- sational Learning in General Practice. Caroline Rickard and Laura Bond are contributing authors from SCHIN and provided many of the web links and resource lists for this guide. John Bibby is a GP in Shipley, near Bradford, and a GP tutor in Yorkshire. He has worked extensively in GP education, clinical govern- ance, appraisal and revalidation. He is the author of Chapter 8 GP appraisal and the practice team.
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