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It is obligatory for all NHS GPs to undergo the annual appraisal process in order to stay on the performers list. The aim of the appraisal is to allow GPs to reflect on their practice, and to identify their strengths and weaknesses, and any related training needs.

GPs will normally be given two months notice of their appraisal, to allow time to prepare the pre appraisal forms including a personal development plan (PDP), this should be completed during protected time. The appraisal process only applies to NHS work, but a note of non-NHS work should be included in the appraisal paperwork to enable the appraiser to gather a fuller picture of the GPs outside commitments.

Appraisers are employed by the PCT and will be trained GPs. The appraisal interview normally lasts for around 1½ hours, after which an appraisal summary will be agreed and signed by the GP and the appraiser.

Six months after the appraisal, the appraiser and GP will conduct an appraisal review (although it is preferable for this to be a face-to-face discussion, it can be conducted over the phone). The aim of the review is to establish what progress has been made with the PDP and any additional training required.

Should the GP undergoing appraisal have any areas of special interest that the appraiser does not feel that they are able to discuss fully then it may be necessary for the GP to participate in a peer review with a colleague who has more specific knowledge.

The appraisal summary will be shared with the Medical Director and the Chief Executive Officer of the Primary Care Trust and will also feed into the 5 yearly revalidation process.

More information about GP appraisal can be found on the Department of Health website.


The NHS Pensions Scheme for GPs is complex, and the process varies significantly for GP Partners, Sessional GPs and GP Locums. In many cases practitioners can find themselves having undertaken a variety of these roles in any give financial year. Further increasing the complexity is that earnings from each impact of the contribution rates for others. 

The LMC and BMA strongly recommend that GPs should seek professional advice from an accountant to ensure that their pensionable income is being calculated correctly as this not only impacts on pension benefit calculations but also affects tax liabilities.

Further information and advice can be accessed on the BMA website.

BMA Members should contact the Pensions Department:

Pensions Department
BMA House
Tavistock Square

Telephone: 020 7383 6138 or 020 7383 6166
Fax: 020 7383 6484
Library Documents Include:



Management of GP performance is a continuous process enabling identification of any issues in a timely manner to enable any training or support to be implemented before any problems become serious. All NHS bodies need to have procedures in place to handle serious concerns where patient care has been affected, for less serious matters an informal process can be followed.

The Department of Health, NHS Confederation, BMA and BDA (British Dental Association) have developed a Doctors' and dentists' disciplinary framework which includes:

  • Guidance on the actions to be taken when a concern about a doctor or dentist arises
  • The procedure for considering whether there need to be restrictions placed on a doctor or dentist or a suspension
  • Guidance on conducting hearings and disciplinary procedures
  • Procedures for dealing with issues of capability and arrangements for handling concerns about a practitioners health.

There are 4 key elements that the framework builds on:

Appraisal and Revalidation - the appraisal and revalidation processes encourage reflection on performance, facilitating early recognition of weaknesses and training needs and promoting continuing professional development.

The advisory and assessment service of the NCAA - aimed at enabling fair and timely handling of cases.

Tackling the blame culture  - recognising that many failures in standards of care result from system weaknesses rather than individuals

Abandoning the "suspension culture"

The intention of the framework is not to weaken accountability or disciplinary action where required, but to promote a culture of tackling performance issues through training or other remedial action.

More information about Performance Management can be found on the Department of Health website.

Library documents include:


Expected to begin in 2012, Revalidation is a national process that is being implemented jointly by the GMC and the four Departments of Health. In conjunction with Clinical Governance and Appraisal, the aim of Revalidation is to enable doctors to demonstrate to the GMC (and patients), that they have up to date training and are fit to practice. The process is intended to be relevant to daily practice and should not present an additional burden to busy GPs. 

Implementation of the Revalidation process began in November 2009, when GPs were issued with a license to practice. This will become an assessment of competence once Revalidation is introduced.

Library documents include:

The Revalidation process will require GPs to maintain a portfolio of supporting information to demonstrate that they are meeting the principles set out in Good Medical Practice, including general information providing context about work completed, keeping up to date, an evaluation of the quality of professional work and feedback from colleagues and patients.

The BMA recommend that GPs should start considering what information they might include in their portfolio, including and CPD activity, details of any complaints and resolutions and clinical audit data relating to individuals and departments. This information will be utilised in annual appraisals, which are a requirement of the revalidation programme. Based on this information, and information drawn from the clinical governance system, the Responsible Officer will make a recommendation to the GPC about the doctors' fitness to practise, normally every 5 years.  The GMC will then make a decision about whether to revalidate a doctor according to this recommendation.

The GMC Website provides comprehensive information on all aspects of revalidation and appraisal.

BMA guidance on the Revalidation process can be found on their website including their 3 monthly Revalidation updates and an email address for any revalidation queries.

Revalidation: Guidance for GPs (England) April 2016

The RCGP has approved a new Guide to Supporting Information for Appraisal and Revalidation (March 2016) that aims to reduce inconsistencies in interpretation and simplify and streamline the recommendations.


It is designed to ensure that any areas where there has been a lack of clarity are better understood. The guide confirms that:

  • all time spent on learning activities associated with demonstrating the impact of learning on patient care, or other aspects of practice, can be credited as continuing professional development (CPD)
  • Quality over quantity - GPs should provide a few high quality examples that demonstrate how they keep up to date, review what they do, and reflect on their feedback, across the whole of their scope of work over the five year cycle
  • Only incidents that reach the GMC level of harm need to be recorded as Significant Events in the portfolio. Reflection on all such Significant Events is a GMC requirement and must be included whenever they occur
  • GPs only need to do a formal GMC compliant colleague survey once in the revalidation cycle (like all doctors)
  • there are many forms of quality improvement activity and they are all acceptable to demonstrate how you review the quality of what you do, and evaluate changes that you make. There is no requirement for GPs to do a formal two cycle clinical audit once in the five year cycle.

The RCGP recognises that GPs need to be supported by their College in resisting inappropriate additional bureaucracy and is working with key stakeholders such as the BMA GP Committee, GMC and Responsible Office3r networks to look at reducing the regulatory burden.


The guide is available on the RCGP website.

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