Medical Appraisal
The Shipman Enquiry highlighted that the fitness of Doctors to practice was poor following qualification. To ensure public faith in Medicine they strengthened the process of Medical appraisal in the NHS, Doctors were seen to be fit to practice, remaining up to date and with any concerns dealt with appropriately. Appraisal became a component of GMC Revalidation in 2010-11.
I have been an Appraiser since 2002, when I was in a full time clinical role. I undertook regular ‘in house’ appraisals until 2009; I retrained in 2020 and again in 2026 under the guidance of Wessex Appraisal Services.
What Is Appraisal?
Medical appraisal is described by NHS England as ‘a process of ‘facilitated self-review supported by information gathered from the full scope of a doctors work’. It looks back at the achievements and challenges of the past year and looks forward to their career aspirations and development needs. Appraisal is a stand-alone activity but but it is also part of a wider safety net linked to the 5-yearly GMC revalidation cycle. Appraisal was seen by Doctors as mainly as a ‘tick box’ exercise involving a large quantity of documentation, but since 2022 it has changed into an annual opportunity for a Doctor to review their practice, reflect on evidence, and identify issues early. It is not designed to detect misconduct, but to support Doctors to where concerns can be raised, reviewed, and escalated if necessary. Primarily it is a reflective, developmental process with a reduced level of documentation. Appraisal provides a safe, confidential space to review achievements, challenges including the doctor’s health and wellbeing, and their aspirations, while still supporting revalidation.
Appraisal & Coaching
Appraisal supports personal and professional development. At its best, it uses coaching skills including active listening, open and curiosity-driven questioning and promotes self- reflection. It is a safe listening space to facilitate deeper reflection. Appraisers who use coaching approaches are more likely to discover wellbeing issues, ethical dilemmas and system pressures. The doctor will discover their own personal and career goals.
My appraisal Skill Set
As an appraiser in the NHS, I obtained a detailed knowledge of the GMC and AoMRC Appraisal guidance. I now work with Appraisal providers and receive regular supervision and training. This ensures that each appraisal generates a clear, actionable Personal Development Plan.
When undertaking an appraisal I aim to create a safe, respectful space for colleagues, to enable reflection on their current practice, personal wellbeing and career aspirations. These Coaching skills help the doctor to understand areas of strength and to take control of their career development.
Appraisal discussions are anchored in the 4 domains of Good Medical Practice, whilst recognising the pressures of working in the NHS and the negative effect these pressures may have on personal performance and wellbeing. I work collaboratively with Doctors to mitigate these pressures through their Development Plan, balancing these with the need to demonstrate patient safety. This process increases personal resilience through professional growth, and by signposting to other sources of help where appropriate.
Empathy is a Coaching skill which provides cues about stress or moral distress. It invites the doctor to talk about their personal wellbeing, so that I can respond supportively, without judgement, and within a confidential conversation.
Appraisal is mandatory but the ‘standard’ system is not suitable for all Doctors. It fits awkwardly around fragmented, multi-employer or non-clinical work. As a doctor with a portfolio career myself, I fully understand that appraisal for non-clinical and portfolio medical careers requires a more explicit, role-specific approach, with coordination across several organisations. It requires a clear recognition of non-patient-facing contributions. In my appraisal work I am able to understand the adaptations that can and must be made to ensure the process is both fair and complete.
I work exclusively though Appraisal providers such as Wessex Appraisal Services, please get in touch with them if you’d like me to undertake your next appraisal.
