Revalidation Support Unit Annual Report Revalidation Support Unit Annual Report

Transcription

1 Revalidation Support Unit Annual Report

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3 Contents Page3 Part 1: The Revalidation Support Unit Part 2: Overview of Work Undertaken l Revalidation Workstream l MARS Workstream l GP Appraisal Workstream l CPD Workstream l Medical Appraisal Workstream l Quality Management Part 3: The Revalidation Support Unit Stakeholders Part 4: Appendices 3

4 Foreword I am delighted to write the foreword for the Annual Report of the Revalidation Support Unit (RSU) of the Wales Deanery. This Annual Report covers the first full year of GMC revalidation for Doctors in Wales, where 20% of doctors were due to be revalidated. As the Chairman of the All Wales Revalidation and Appraisal Implementation Group (RAIG) and a member of the Wales Revalidation Delivery Board (WRDB) I have seen first hand the tremendous hard work, enthusiasm and professionalism the RSU has brought to bear on the tasks needed for successful implementation. We are extremely fortunate in Wales to be able to use the on line MARS system to facilitate annual appraisal and development of the Revalidation Progress Scorecard really enhances the ability of the Responsible Officer to ensure the correct recommendation to the GMC is made in a timely fashion. The RSU was also given the honour of being the first place in the UK that Sir Keith Pearson, Chairman of the GMC Revalidation Implementation Advisory Board, visited in June His complimentary comments about the work of the RSU can only echo my opinions in this foreword to the Annual Report. Finally I would like to express my congratulations to Professor Malcolm Lewis of the School of Postgraduate Medical and Dental Education (Wales Deanery) who has been awarded an OBE for services to medical education, having made this year s Queen s Birthday Honours list. His leadership of the RSU has been pivotal in the successful implementation of Revalidation in Wales. Peter Durning Chairman, Revalidation and Appraisal Implementation Group. 4

5 Preface Welcome to the Wales Deanery s eleventh Annual Report of the Revalidation Support Unit. Regular readers will notice a change in the layout with clear demarcation of the various work streams of the Unit, including MARS, appraisal, CPD and revalidation. I hope it is easy to navigate. I am grateful to Mr Peter Durning for agreeing to write this year s Foreword and for his generous comments. The integration of medical appraisal and revalidation has certainly been a surprisingly smooth ride for doctors in Wales during this first year of revalidation and I am sure this will continue. The success has been dependent on significant collaboration between a range of key organisations and Peter s chairmanship of the Wales Revalidation and Appraisal Implementation Group has been a central component to the consistency we are enjoying. I hope that this report makes for interesting reading. Professor Malcolm Lewis OBE LLM FRCGP 5

6 dsfd Part 1 The Revalidation Support Unit 6

7 The RSU is commissioned by the Welsh Government to provide support for the revalidation process. This is achieved through supporting the online system for appraisal for all doctors in Wales, providing appraisal for all GPs in Wales and, through CPD and management processes supporting doctors and the revalidation process itself. In order to deliver these strategic priorities, the Unit has identified strategic aims and objectives, which are referenced throughout the report, and fully captured in the appendix Who and what is the Revalidation Support Unit? The Unit manages the online Medical Appraisal Revalidation System (MARS) for both Primary Care and Secondary Care doctors in Wales. Professor Malcolm Lewis GP Director Katie Laugharne Organisational Lead Julie Nallon Deputy Organisational Lead Sian Parker-Hornsey GP Appraisal and MARS Manager Stacy Lloyd GP Appraisal Officer Dr Chris Price Deputy Director Rhian Jones MARS Support Officer Steffan Biggs GP Appraisal and CPD Training Manager Kelly Connell CPD and Training Administrator Kerry Wiltshire GP HR Administrator Sarah Holmes Quality Management Officer Katie Leighton Medical Appraisal Manager The GP Director and Deputy Director provide medical leadership for the Unit, they provide support and pivotal input across the Deanery and contribute to the wider University and activities of NHS Wales. Additionally, they ensure policies are implemented and communicated which reflect the overall agreed strategy. 7

8 wdefe Part 2 Overview of Work Undertaken 8

9 MARS QUALITY MANAGEMENT We provide an online platform which revalidation ready appraisal enables all doctors in Wales to realise positive appraisal and revalidation experience GP Appraisal We facilitate doctor development through delivery of high quality Revalidation Support Unit Maintaining, supporting and improving professional standards through appraisal and CPD CPD We support, deliver and quality assure a wide portfolio of CPD and training opportunities for all Medical Appraisal We support the establishment and evolution of appraisal for secondary care QUALIT Y MANAGEMENT QUALITY MANAGEMENT 9

10 Revalidation Workstream Name: Julie Nallon / Katie Laugharne Job Title: Deputy / Organisational Lead Work Stream: Revalidation Mission Statement: Maintaining, supporting and improving professional standards through appraisal and CPD Page10 Work undertaken over the past 12 months Our objectives for were: To provide programme and project management support to RAIG and WRDB We have continued to support regular meetings of the Revalidation and Appraisal Implementation Group (RAIG) and to progress its work. In particular the Clinical Academic Joint Appraisal Pilot, Responsible Officer Appraisal Pilot, Evaluation of MARS Roll Out Year, Revalidation Progress Report analysis and Appraiser training support for Designated Bodies. To evaluate the effectiveness of the Wales revalidation communication strategy, including the Revalidation Wales Website and the Revalidation Roadshows We have evaluated the communication strategy, which was shown to be successful and has now been integrated into the ongoing work of the RAIG group. A comprehensive review of the Revalidation Wales website was carried out and resulting improvements implemented. To seek feedback from doctors regarding the support they have received relating to revalidation and any additional support they require We have evaluated feedback received via the MARS service desk, and the online survey, which all doctors are asked to complete after their appraisal. Comments included: The website is maturing well but the calendar often confuses me, fortunately the helpdesk are there to assist with my queries Had some difficulty navigating the site at first, as this is my first year being appraised in Wales. I contacted the helpdesk who guided me through the process The administration as always is excellent. I had difficulty obtaining a GP Appraiser within my locality so I had to contact the admin team who recommended appraisers out of the area who were available. This process was good, the administrators I ed were helpful but it was frustrating as there appears to be a shortage of GP Appraisers Additionally GPs are being asked again about the support they have received relating to revalidation in the current research project evaluating the impact of revalidation on GP appraisal. 10

11 To collate and evaluate lessons learned from the first year of revalidation We have analysed recommendations and where applicable, shared these with RAIG. Lessons learned include; the importance of reviewing doctor s evidence early in the 4 month under notice period and contacting them proactively where there are gaps, and issues around the timing of appraisal in relation to revalidation. Milestones and achievements The support of 5 Revalidation and Appraisal Implementation Group (RAIG) meetings across South Wales Development of a single Quality Management Framework (QMF) for Wales, which is currently in implementation stages. Production of a number of key papers, including: Responsible Officer Information Flows Form, Routes to Revalidation and Communications with Responsible Officer Guidance for Appraisers The successful distribution and analysis of the Revalidation Progress Report The Revalidation Progress Report is designed to enable designated Bodies in Wales to report relevant appraisal and revalidation figures relating to , to carry out a self-assessment of the systems and processes they have in place to support medical revalidation and to provide assurances to their boards and to others that appropriate systems are in place. A similar assessment has been undertaken previously known as ORSA, this focussed on Designated Bodies readiness for revalidation. The Revalidation Support Unit has analysed the report returns on behalf of the Wales Revalidation Delivery Board (WRDB). The data has been analysed in two ways, firstly statistical analysis of appraisal rates, number of appraisers and revalidation recommendations among other areas. Secondly the governance of revalidation, via a red, amber, green (RAG) status, has been analysed with key themes identified from action plans, some of these may form the basis of an All Wales action plan if appropriate. The full analysis of the Revalidation Progress Reports can be found here: Overall the analysis of the Revalidation Progress Reports was encouraging as appraisal rates in Wales for all NHS doctors has risen to 75% from 53% in the previous year. There is still work to be done regarding this and the RSU has been working closely with Designated Bodies to support them in implementing robust appraisal processes. Objectives over the coming 12 months The Revalidation Progress Report exercise will be repeated in April/May To support a further 6 RAIG meetings To support 2 Responsible Officer Support Network meetings To facilitate and analyse the Revalidation Progress Report by May 2015 To facilitate the process of appraisal for ROs 11

12 MARS Workstream Name: Sian Parker-Hornsey / Julie Nallon Job Title: GP Appraisal and MARS Manager / Deputy Organisational Lead Work Stream: MARS Mission Statement To provide an online platform which enables all doctors in Wales to realise a positive appraisal and revalidation experience Page12 Work undertaken over the past 12 months i Our objectives for were To ensure there is appropriate, up to date guidance for all users of MARS We have provided a suite of guides for all users of MARS which are accessible at These are updated with each new release of MARS to ensure they remain up to date. In addition to the written guides there are interactive tutorials and a range of Frequently Asked Questions. Daily support to doctors with queries about MARS is provided by the RSU via a MARS Service Desk. MARS SERVICEDESK: Monday to Friday 09:00 16:00 Tel: e: marswales@cardiff.ac.uk 12 Members of the RSU assist doctors with technical and user queries about MARS and wider queries about appraisal and revalidation. We are delighted with the 100% resolution rate for service desk queries and the positive feedback we continue to receive from our users. To develop the interface between MARS and GMC Connect We have released MARS version 2.4 in March 2014 and included the GMC synchronisation to MARS. It was agreed the site will talk to GMC connect on a 24 hour update basis. This means doctors accounts are updated to reflect their completed revalidation date. This allows MARS to reset their account for their current cycle of appraisals for their next revalidation period. Responsible Officers have access to view the doctors with prescribed connections in their Designated Body. To ensure processes for ongoing management and continuous improvement of MARS are established We have achieved this through a computerised change management process and externally governed through the Service Management Board (SMB). Improvements may be informed by any MARS user through feedback. User Guides are frequently produced in order to proactively engage users. To provide and support a version of MARS for doctors in Severn Postgraduate Medical Education We have. delivered ongoing support to Severn Postgraduate Medical Education in the use of MARS and upgraded MARS specifically to suit their business requirements.

13 MARS Workstream Milestones and achievements Service Desk have a 100% response rate to 5503 telephone and or queries received since July Migration of MARS from NTT to IOMART Service Providers (data hosting) was undertaken. This has increased security of the site, and enables reliable back up regimes and provides excellent value. Two upgrades have been undertaken within year, taking MARS to Version 2.4. Some of the technical developments have included; Development of a live interface between MARS and GMC Connect Development of a single landing page for all doctors Download button for easier retrieval of summaries Improved access to archived material Revalidation Progress Page has a number of enhanced features Doctors professional activities details made available to Appraisers Appraisers can now directly influence the appearance of the scorecard, which is a vital component of the revalidation process in Wales Severn Postgraduate Medical Education have also received regular version releases of SAT under their previous MOU and have renewed their MOU with the Deanery for From 1st April 2014 Business Shared Services Unit (BSSU) has secured the appointment of an additional programmer to provide support for the Enhancement Project. MARS Enhancement Project (MEP) To augment its success, the system is undergoing a suite of enhancements as part of a long term project which began in January Over the next 18 months this project will focus on improving the user experience as well as ensuring its sustainability. Progress to date includes completion of the initial business scoping process to map out existing core functionality, development of a communication and engagement plan and a data management strategy. 13

14 MARS Workstream Objectives over the coming 12 months MARS To achieve MARS registration of 95% of all doctors in Wales with a prescribed connection Development of a new management system to support the change request process and technical development work programme Continue to provide one online system for the delivery of appraisal for doctors in Wales MEP Establishment of a new User Development Group composed of representation from all user groups to provide feedback and consult on changes Launch first project communication campaign Completion of the Analysis Phase business scoping, process definitions and reporting Completion of the Design Phase software and database modelling Initiation of the Development Phase software and database coding Begin mock up demonstrations to user groups to gather feedback as part of the development process 14

15 GP Appraisal Workstream Name: Sian Parker-Hornsey Job Title: GP Appraisal and MARS Manager Work Stream: GP Appraisal Mission Statement To support doctor development through delivery of high quality appraisal underpinning the revalidation process Page15 Work undertaken over the past 12 months Our objectives for were: To continue to deliver high quality appraisal despite appraisal capacity issues We have achieved this thanks to the commitment and hard work of our Appraisers, their willingness to undertake appraisals over and above their contracted number, we were consequently able to offer an appraisal to every GP in Wales on request. We were pleased to be able to recruit to our Appraiser vacancies in 2013 and in 2014 and to provide high quality training to all new Appraisers. The New GP Appraiser Training has been evaluated and found to be of a high standard. In order to continue to deliver quality we were able to recruit to our GP Appraiser vacancies. Out of a pool of 28 applicants nine were appointed to the role of Appraiser. We continued to work in partnership with the Health Boards to monitor GP engagement with the appraisal process, and to manage exceptions to the process. To review the Whole Practice Appraisal (WPA) pilot and refine the processes accordingly We have reviewed the Pilot as part of National Training Day The policy was amended accordingly and implemented across Wales. The WPA policy has now been incorporated into the Appraisal Exceptions Management Protocol. The Protocol has been developed based on a fundamental review of the Appraisal Governance Protocol, which describes communication lines between the RSU and the Health Boards. The Protocol is supported by detailed Operating Procedures which provide standard templates for correspondence. To evaluate whether GP appraisal meets the requirements of revalidation, and the impact of revalidation on appraisal We have commissioned a project, where a questionnaire has been disseminated to all GPs in Wales in February 2014 and early analysis of findings is being undertaken. It is anticipated that the project will report in September

16 GP Appraisal Workstream Milestones and achievements Number of GP appraisals completed: Completed Appraisals Abertawe Bro Morgannwg Aneurin Bevan HB Betsi Cadwaladr HB Cardiff & Vale HB Cwm Taf HB Hywel Dda HB Powys HB Prescribed Connections Complete Appraisals In 2013 eight GP Appraisers were recruited. In 2014 nine Appraisers were recruited, which maintains a set number due to natural staff attrition Appointment of new Appraisal Co-ordinator for North West Wales and Powys Whole Practice Appraisal policy agreed and implemented Internal QA Day 2013 evaluating the extent to which revalidation requirements were being met Successful National Training Day 2013 focussing on revalidation 16

17 GP Appraisal Workstream GP Constraints and Learning Needs Data - All Wales 2014 GPs are encouraged to identify any factors constraining their personal or professional development and to agree their learning objectives for the coming year at every appraisal. This data is collated through analysis of the appraisal summary and Personal Development Plan (PDP) and aggregated at the HB and All-Wales level. A summary of the aggregated data for is provided below: Learning Needs All Wales Clinical Learning Needs - Graph Cardiovascular Women s Health Mental Health Orthopaedics Endocrine Paediatrics Neurology Respiratory Sexual Health Uro-genital Dermatology Gastro-intestinal Therapeutics Care of the elderly Public Health ENT Nephrology Palliative care Ophthalmology Haematology Unscheduled care Other QI processes Miscellaneous i The top four learning needs in Wales have changed slightly from last year s results; 1. Cardiovascular 2. Women s Health 3. Mental Health 4. Orthopaedics/Rheumatology The order of the top 2 remain the same with Mental Health remaining in the top 4. Orthopaedics/Rheumatology has risen a few places as a learning need. i The top 4 non-clinical learning needs have changed slightly compared to last year. 1. Audit and Feedback 2. Practice Management/Development 3. Teaching & Training 4. Communication & Consultation Skills 17

18 GP Appraisal Workstream Constraints The most significant personal constraints for GPs were reported during as Job Issues and Employment Status followed by time, life changes and educational issues. For practice level constraints, Demographics is highlighted as the major constraint, followed by Doctor related issues, mirroring the results from last year. These are followed by premises issues and staff related issues. At the service level, chronic secondary care is clearly a significant constraint for a large number of doctors, along with acute secondary care and followed by primary / secondary care interface and political. This is identical to last year s results. All Wales Practice Constraints - Graph Demographics Doctor related issues Premises issues Staff related issues Attached staff issues Other Other (practice) not listed All Wales Service Constraints - Graph Chronic Secondary care Acute Secondary care Primary / Secondary care interface Political Out of hours Other (service) 18

19 GP Appraisal Workstream Recommendations Learning needs data is used to inform and evaluate planning of CPD. HBs are encouraged to use the constraints data to review any systemic or service level issues within their local area. In terms of those areas which fall under our remit, we propose the following actions to address issues identified: Pilot GP CPD Clinical Update Days which will cover specific topics highlighted in the learning needs reports. Improved links to GP CPD website to raise awareness about the resources we have available to GPs. Continue to develop the GP CPD website and inform GPs about new developments through targeted communication. Further information A full report can be accessed at: Further breakdown of the results, including numbers and sub categories, is available separately. 19

20 CPD Workstream Name: Steffan Biggs Job Title: Appraisal & CPD Training Manager Work Stream: CPD Mission Statement We will support, deliver and quality assure a wide portfolio of CPD and training opportunities in Wales. Page20 Work undertaken over the past 12 months i Our objectives for were: To seek user and stakeholder views regarding the impact of the reduction in CPD for GPs delivered by the Deanery since 2012 We have sent surveys to users and stakeholders to assess the impact on GP CPD in Wales. In a survey targeted at GP Appraisers, 55% of respondents had noticed a difference in the appraisal interview since the CPD network was disbanded. However, only 29% of respondents had personally had difficulty accessing CPD information since To evaluate the changes to the retainer scheme We have implemented an annual review to record any changes to personal details or circumstances. To evaluate the 3D Programme We have produced an Annual Report for 2013/14. The results have been very positive in terms of feedback and content. Milestones and achievements The Unit has organised a large number of CPD events across Wales over the past 12 months. These include: GP Appraiser National Training Day (NTD) NTD 2014 was held in June in Wrexham. This was the 10th year it has been held. The event covered various topics including an update on revalidation in Wales, as well as quality management, impact of revalidation on GP appraisal and a MARS system update. 75 delegates attended the event including 61 appraisers. It was noted that 2205 appraisals were completed during April 2013-March 2014 and over 20,000 appraisals completed in Wales since the introduction of the first online appraisal system. 20

21 CPD Workstream Feedback for the event was very encouraging: This year was one of the best! Great networking opportunity, useful to look back at the last 10 years and forward to the next 10 hopefully! More information can be found here. For information on the next NTD, please contact Revalidation Roadshows roadshows were held across Wales in February and March, open to all doctors. These were held in Llanelli, Newport, Bridgend, Llandudno and Wrexham. The roadshows were split in two during each of the days. The morning included a number of presentations and updates on relevant information such as revalidation requirements, CPD resources and a question & answer session. Alongside this, a local update was given by Local Health Board Revalidation Managers. Rachel Podolak, Head of Welsh Affairs from GMC, also gave a presentation to the attendees. The afternoon consisted of 4 workshops. Supporting information for Revalidation; Quality Improvement Information; Patient and Colleague Feedback and Whole Practice Appraisal. A total of 178 doctors attended the roadshows with 75% of them currently working in secondary care. The amount of attendees for South Wales Roadshow more than doubled in size compared to the Roadshow in Very useful information in context of upcoming appraisal & revalidation A good overview as to what is required from the doctor. Good to learn that there is plenty of support available Overall the feedback was excellent: More information can be found here. For information on upcoming roadshows please contact cpdadmin@cf.ac.uk Developing Doctors to Deliver (3D) Programme The 3D Programme is a free educational programme that is made available to all doctors. It is designed to address the educational requirements of doctors who wish to extend their abilities in engaging with and influencing the service improvement agenda in NHS Wales. The programme consists of six one day modules. All six have been delivered in South Wales (Bridgend) and three in North Wales (Wrexham) over the last 12 months. Each morning session includes a Project Clinic, which is a structured session utilising group approach to problem-solve individual projects. The afternoon session is a Skills and Knowledge session, which is a combination of programme facilitators and outside speakers. The D Programme attracted the highest number of applications in the last four years. The majority of doctors in this year s cohort were from secondary care but there are also doctors who work within Public Health Wales, and for the first time we had a participant from Dentistry. 21

22 CPD Workstream The programme has been opened up to all doctors working within Wales. The aim of broadening the access beyond just GPs was to maximise the numbers of participants and therefore increase the impact on service improvement, and to magnify educational gains for clinicians in primary and secondary in learning about service improvement together. Feedback overall was excellent for the programme: The 3D programme helped me to solve problems, predict barriers, helped provide solutions, provided me time to think, and kept me going! The 3D programme will undoubtedly affect my future vision as a doctor in a very positive way. I now feel more prepared and informed about how to manage future challenges in my professional life. For more information on 3D Programme please click here. For information on the next round of recruitment for 3D Programme please contact cpdtraining@cf.ac.uk GP CPD website The Unit is committed to developing a large number of CPD online resources. These include our GP CPD website which was launched in September The Unit is actively involved in producing, providing and updating CPD resources. These online modules cover both clinical and non-clinical topics, such as Motivate to Move, Return to Work, Veterans Health, Hip & Knee and Significant Event Audit. Since its launch in September 2013, the site has generated over 41,000 views. 18 modules have been created so far, with more in development. Feedback received has been very positive: It s excellent that the modules are freely available. It s great to have the facility to leave comment on the resources and it s super that the references are hyperlinked. If you have any feedback or would like to suggest a topic to be covered, please contact cpdtrainingmanager@cf.ac.uk Objectives over the coming 12 months: Review the feedback on the 2014 revalidation roadshows and explore with doctors and partner organisations what is needed for 2015 Maintain the CPD web pages and add a further 4 online modules Pilot delivery of GP CPD clinical update days on a project basis by March 2015 Provide regional events for sessional GPs in the autumn and spring Conclude and evaluate the 3D programme for ; recruit to and deliver the 3D programme for Develop online clinical leadership resources to support the 3D programme and widen access to its resources 22

23 Medical Appraisal Workstream Name: Katie Leighton Job Title: Medical Appraisal Manager Work Stream: Medical Appraisal Mission Statement We are supporting the establishment of appraisal systems for all doctors in Wales Page23 Work undertaken over the past 12 months The objectives for were: To continue to deliver and evaluate the MARS training programme for appraisers, and demonstrations for appraisees as required We have provided training sessions for medical appraisers in both the MARS website and Appraiser Skills. To roll out MARS to all doctors in Designated Bodies within Wales We have been working hard to support designated bodies in their use of MARS and developing appraisal systems, this was formally recognised by the Wales Revalidation Delivery Board decision in May 2013 that MARS is to be the only appraisal and revalidation system to be used by all NHS and Public Health doctors in Wales from 1st April To evaluate the roll out of MARS and identify any required improvements We have... completed the official roll out of MARS to all doctors in Wales in July 2013, at which point the Unit undertook an evaluation of the project. The evaluation report and recommendations were presented at the WRDB and RAIG. The full evaluation report can be found here: Key highlights from the report include: RO Appraisal Evaluation MARS Training Review Guidance and Support Clinical Academic Joint Appraisal Pilot Review of Roll Out Against Hospital Appraisal Pilot Objectives/Recommendations 23

24 Medical Appraisal Workstream Recommendations Table from MARS Roll Out Evaluation Ref Recommendation Responsible Organisation/s Progress (as of 1st April 2014) 1.1 Develop programme for annual appraiser training refresher days 1.2 All appraisers to be trained in skills and on MARS before being made an approved appraiser 1.3 Local models of training to be developed for sustainability 2.1 Develop reporting functions on MARS for ROs regarding revalidation Unit, Designated Bodies Designated Bodies Designated Bodies Unit, ROs Agreed at RAIG to take forward plans to facilitate 3 regional days in Autumn Included in All Wales Appraisal Policy training programmes being reviewed currently to ensure they are fit for purpose Large number of Designated Bodies now provided some form of training themselves 2.2 All ROs to have access to MARS training Unit Training sessions run monthly and ROs are able to attend these. Bespoke sessions could also be provided by Unit if required 2.3 Finalise and implement MARS and GMC Connect interface 3.1 Joint management of clinical academic staff to be considered via job planning rather than joint appraisal 4.1 Review key functionality areas of MARS for usability 5.1 Doctors not registered on MARS to be targeted by Designated Bodies communication needed regarding MARS as sole facilitator of appraisal Unit WRDB, Designated Bodies Unit Designated Bodies MARS now facilitates a sync with GMC Connect WRDB and RAIG agreed that joint job planning would facilitate joint management effectively. MARS still offers joint appraisal facility if requested Feedback gathered and will be incorporated into MARS EP MARS sole facilitator of appraisal from 1st April Registration rates very high on MARS 24

25 Medical Appraisal Workstream Milestones and achievements During the number of doctors registered on Medical MARS has increased dramatically which is reflected in Table (number). Designated Body (DB) Approx. No. of Doctors (excluding GPs) in DB No. of Doctors (excluding GPs) Registered on MARS No. of Appraisers Registered on MARS Abertawe Bro Morgannwg Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cwm Taf Hywel Dda Powys Public Health Wales Velindre Ludlow Street Healthcare St Josephs and St Annes Hospital Welsh Government Objectives over the coming 12 months: To contribute to the development of the All Wales Appraisal Exceptions Protocol To contribute to the review of the All Wales Appraisal policy and implement its standards To support Designated Bodies in delivering Appraiser training locally 25

26 Quality Management Name: Sarah Holmes Job Title: Quality Management Officer Work Stream: Quality Management Mission Statement Quality management is the overarching and underpinning influence that guides our work. We aim for excellence in the appraisal experience and its outputs. Page26 Quality Control Quality Assurance Quality Improvement Work undertaken over the past 12 months: Our objectives for were: To deliver Quality Management which underpins all areas of our work We have. Produced a Quality Management Framework which will be implemented in all Designated Bodies in Run the first Internal Quality Assurance event, which incorporated analysis of both Primary and Secondary Care appraisal summaries. To encourage and continue research, evaluation, Quality Improvement and publication activity We have Reviewed recommendations put forward by attendees of Internal Quality Assurance event. Produced a number of publications on the CPD website, through Quality Improvement projects. We are currently evaluating the impact of revalidation on GP Appraisal, a research paper on this will be released in the latter half of Appraisal Insight Monitoring process updated in the RSU and plans for implementation in Secondary Care Appraisal 26

27 Quality Management Milestones and achievements 2014 Internal Quality Assurance Event The 2014 Quality Assurance event took place on 11th April in Cardiff. This event was the first to Quality Assure both Primary and Secondary care summaries. The aims of the IQA process were: To undertake Quality Assurance of appraisal summaries To generate useful analysis for future action planning To provide best practice for all delegates, developing their understanding of the quality of appraisal output To determine areas where training is required To unite Primary and Secondary care Appraisers To seek feedback on the process and on any themes identified Methodology The 2014 IQA event was run over a full day. The QA criteria were used to analyse a summary (purposefully constructed to illustrate both strong and weak entries) as part of an initial calibration exercise. Following this attendees were split into pairs, and asked to consider individual summaries. Where possible, GP Appraisers and other Appraisers in the same Health Board were paired together, enabling networking in the same geographic area. Summaries were randomly selected from both MARS and MARS (GP). A total of 5% of summaries were evaluated. Quantitative Data While the summaries were selected at random and anonymised, to ensure individuals could not be identified, summaries were coded with a key which enabled us to review the scores specifically for summaries completed on MARS and MARS (GP): Primary Care Data Qualitative Data Highest Scoring Summary 100% Lowest Scoring Summary 33% Average Scoring Summary 83% The qualitative data was largely collected from the delegate feedback form. Below are some of the comments which appeared as themes from the day: What were the best features of the appraisal summaries and PDPs that you reviewed? Generally professionally completed When present professional context & revalidation at end make it much easier to read & understand summary in context Do you have any comments about the organisation of the Quality Assurance Review? Well organised Good to interact with consultants Excellent event. I learnt a great deal from both the summaries and interacting with fellow appraisers 27

28 Quality Management The comments suggest that the event was beneficial to attendees, and provided an opportunity to share ideas and learn from both strong and weak summaries. The comments also largely reflect the quantitative data with reference to training requirements, such as summary construction, and signposting revalidation progress. Further details on IQA and the results from the day can be found in the Quality Management Report here: For information on IQA please contact Projects Current Projects: We have a formal project planning process, in which the Project Board initiate, approve, monitor and evaluate all projects completed on behalf of the RSU. No Project Title Synopsis Action/Objective QIP027 Appraisal Summary Guidance To produce suggestions for guidance on appraisal summaries in the context of revalidation QIP029 AIMS We now intend to produce a paper on publication outlining the process and learning to date. Produce a guidance paper for Appraisers on completing the Appraisal Summary. Final document will be applicable for both PC and SC appraisers. Produce a paper on process and case examples of AIMs (Appraisal Insight Monitoring) QIP030 Evaluating the impact of revalidation on GP Appraisal To evaluate the initial impact of revalidation on key aspects of the GP appraisal process and those involved in it To identify any actions or improvements required to produce a paper for publication Produce paper on impact of Revalidation on GP Appraisal. QIP039 Detecting Acute Kidney Injury Acute Kidney Injury Online module to be produced and uploaded onto the CPD pages. QIP043 Parkinson s Disease General Overview of Parkinson s Disease. Paper containing educational resources for Parkinson s disease. 28

29 Quality Management Completed Projects: No Project Title Synopsis QIP024 Review of auto s To review auto s send through MARS including text, links and spelling QIP031 Child Protection Training Level 3 To review the scope of information currently available for CP Level 3 (Possible follow up project) QIP032 Review of Support Pack - Prescribing Production of updated Support Pack - Prescribing QIP033 Review of Support Pack - Practice Evidence Production of updated Support Pack - Practice Evidence QIP036 Review of Appraisal Guide for NQ GPs Production of updated Appraisal Guide for NQ GPs QIP034 Review of Support Pack - Out of Hours Production of updated Support Pack - Out of Hours QIP035 Review of Support Pack - Referrals Production of updated Support Pack - Referrals QIP041 Genetic Susceptibility to Breast Cancer Production of online paper on genetic breast cancer QIP040 Development of On-line learning resource on doctor reflection Provide support for doctors to structure reflection and to demonstrate how to record this in the MARS templates. Live web page QIP042 Fibromyalgia Project Project on Fibromyalgia. Live on web page 29

30 Feedback in figures MARS Feedback Survey All doctors who complete an appraisal on MARS are asked to complete a feedback survey. The survey asks the appraisee to rate their experience in the following areas: The Appraiser, the appraisal process and MARS. 1 The Appraiser was supportive 2% 21% 77% 0% Very Poor/ Strongly Disagree 0% Poor/ Disagree 2% Average/ Neutral 21% Good/ Agree GP MARS Feedback Results: Charts 1 and 2 show the highest scores. The Appraisers ability to conduct the appraisal always scores highly. This is evidenced again in the results, which show Appraisers are engaging with, and supporting their appraisees. 2 The Appraiser s ability to listen 1% 14% 77% Very Good/ Strongly Agree 0% Very Poor/ Strongly Disagree Chart 3 is the weakest score of the survey. This reflects the data from the IQA event, which also highlighted a training requirement for challenge. As a consequence of this, the Quality Management team arranged a training session at the 2014 NTD on challenge. 0% Poor/ Disagree 1% Average/ Neutral 85% 14% Good/ Agree 85% Very Good/ Strongly Agree The Appraiser challenged me to think about my practice 3 3% 32% 0% Very Poor/ Strongly Disagree 0% Poor/ Disagree 65% 3% Average/ Neutral 32% Good/ Agree 65% Very Good/ Strongly Agree 30

31 Feedback in figures 4 5 The Appraiser was supportive 1% 17% 82% The Appraiser s ability to listen 1% 20% 79% 0% Very Poor/ Strongly Disagree 0% Poor/ Disagree 1% Average/ Neutral 17% Good/ Agree 82% Very Good/ Strongly Agree 0% Very Poor/ Strongly Disagree 0% Poor/ Disagree 1% Average/ Neutral 20% Good/ Agree MARS Feedback Results: Charts 4 and 5 show the highest scores. Interestingly these are the same as those scoring highest for GP MARS. It is also reassuring to see that such a high percentage of appraisee s find their appraiser both able to listen and support them throughout the appraisal discussion. Chart 6 shows the weakest score from the survey. While challenge to think about practice has scored most poorly, the percentage of those disagreeing with the statement entirely is only 6%. In justification of ranking lowest, it could be suggested that as many MARS appraisals are undertaken as cross-specialty appraisals, the ability of the Appraiser to challenge the appraisee s practice is diminished. The survey also provides an opportunity for the appraisee to leave comments and suggestions. Some of the comments and suggestions from the survey were: 79% Very Good/ Strongly Agree 6 The Appraiser challenged me to think about my practice % Very Poor/ Strongly Disagree 13 13% Poor/ Disagree 16% Very Good/ Strongly Agree My Appraiser was earnest, thorough and had clearly prepared a lot beforehand. I liked the open manner and felt they knew my folder well enough to have deduced the areas I need to work on. I have only positive comments - keep up the good work! 30% Average/ Neutral 30 35% Good/ Agree Recommendations Quality management processes to ensure that the requirements of doctors, the HBs and the GMC are met and that service delivery is continuously reviewed and improved. Each year the RSU collates recommendations and where practicable, acts upon the recommendations to improve all facilities and services provided. For the full list of recommendations that we have acted upon. Please see the full Quality Management Report here: 31

32 Quality Management Your objectives over the coming 12 months: Fully integrated Primary and Secondary Care Quality Assurance event in 2015 Manage, report on and implement the recommendations of the annual Quality Assurance event Ensure all Designated Bodies receive regular feedback reports on their appraisers from July 2014 Review and report on the feedback received from doctors, highlighting recommendations for improvement Secure sign off of the Quality Management Framework for appraisal in Wales and support implementation, ensuring that all Designated Bodies are working toward its implementation Manage a programme of Quality Improvement and support completion of quality improvement projects 32

33 Revalidation Wales Deanery Support Annual Unit Annual Report Report Page33 Part 3 The Revalidation Support Unit Stakeholders 33

34 The GP Appraisal Co-ordinator team Job Title: Appraisal Co-ordinator (AC) Employer: Cardiff University Geographic Location: Each Appraisal Co-ordinator (AC) manages a team of Appraisers which cover areas across Wales. These areas may cross health board boundaries, due to geographical, managerial and population considerations. Dr Rosie Preece: Carmarthenshire, Ceredigion, Pembrokeshire Dr Lynne Rees: Neath Port Talbot, Swansea Dr Chris Mellor: Vale of Glamorgan, Bridgend, Rhondda Cynon Taf, Merthyr Tydfil Dr Roger Morris: Cardiff Dr Pete Rowlands: Newport, Torfaen, Monmouthshire, Blaenau Gwent and Caerphilly Dr Martin Thomas: Anglesey, Gwynedd and Powys Dr Mark Rowlands: Denbighshire, Flintshire, Wrexham, Conwy Please provide a brief description of your role including and main responsibilities What has been your biggest learning point over the past How has the RSU supported you in this role over the last What part does quality management play in your work? What support would you like to receive from the RSU over the next The AC role is broad and varied. We meet regularly with our regional team of Appraisers, with RSU staff, with Appraisal Board and with local HB MDs and Revalidation Managers. We all work as GPs and also carry out some GP appraisals. A major part of our role is to facilitate communication to our regional Appraisers. We are also a go-between the appraisal team and the Health Boards, advising on local issues and monitoring engagement with the appraisal process. We line manage our regional team, and are the first port of call for appraisers in difficulty. Special responsibilities and project work may be collaborative, shared, or one AC may take the lead. We are a tightly knit team and aim to promote consistency across Wales. With revalidation the area of greatest learning and development relates to the write up and structure of the Appraisal Summary document. The AC group has been the working towards an increasingly concise and focused document suitable for interpretation and decision making by the Responsible Officer. This has centred on the ready identification and validation of the 6 strands of supporting information required by the GMC. The RSU provides support at many levels. The Exceptions Management protocol produced by the unit has played a key role in ensuring consistency in the management of a wide range of issues relating to appraisal and revalidation. The RSU has played an important role in the effective administration of the appraisal process in Wales. The RSU s focus on quality through its quality management processes has enabled the Appraisal Coordinators, as a team to adopt a robust approach to the maintenance of quality in our respective regions. Quality management is part of our day to day work as an Appraisal Co-ordinator. The aim is to assure a quality appraisal for all Doctors in Wales whether they re in Caernarfon, Cardigan or Cardiff. Quality Management starts with appointing the right people as Appraisers, giving them the initial training, then reviewing their work regularly to ensure that the appraisals meet the standards we set ourselves, and also the standards set by the GMC. As well as regularly reviewing the appraisal summaries in our area, we are involved with national quality assurance once a year. This all ensures we have a robust, quality assured appraisal system that patients, Drs and Responsible Officers can be confident is of a consistently high quality and fit to support the revalidation process. Continue to receive support in the following ways: 1. IT support 2. Help desk queries 3. MPL / MARS reconciliation reports 4. Locality work load reports to discuss with AMD 5. Organisation support for regional meetings, National Training Day and new Appraiser training 6. Organisational support in recruitment of new Appraisers 7. HR and contract advice. 34

35 Professor Peter J Barrett-Lee Job Title: Consultant Clinical Oncologist and MD Employer: Velindre NHS Trust Geographic Location: Cardiff Please provide a brief description of your role including and main responsibilities I am a Medical Director and Responsible Officer for the whole Trust including the Cancer Centre and Welsh Blood Service. What has been your biggest learning point over the past That generally my consultants have been anxious about revalidation but surprised how well it went for them. How has the RSU supported you in this role over the last RSU support is vital for MARS to advise on all aspects of the process. Revalidation would not have worked without their support. What part does quality management play in your work? Quality management is centre in our organisation. What support would you like to receive from the RSU over the next RSU should continue to develop MARS and the quality agenda. 35

36 Peter Durning Job Title: Assistant Medical Director Employer: Cardiff and Vale UHB Geographic Location: Cardiff Please provide a brief description of your role including and main responsibilities I am the Revalidation lead for 1100 Doctors in the UHB. I also train all the appraisers in secondary care (180) and I also Chair the All Wales Revalidation and Appraisal Implementation Group and the MARS Service Management Board. What has been your biggest learning point over the past The scale of doctors lack of preparation for revalidation! How has the RSU supported you in this role over the last They are like the rarest of gems I could not manage without them! They have assisted in the implementation of revalidation with great professionalism. What part does quality management play in your work? I believe it is key to demonstrating too the regulatory authority that we in Wales comply not just with the letter of the law but the spirit and intention for Revalidation to create a culture of continuous improvement and putting patient care at the centre of everything we do. What support would you like to receive from the RSU over the next More of the same is the obvious answer but also increased engagement in managing the RO group. 36

37 Sarah Holmes Job Title: Quality Management Officer Employer: Cardiff University Geographic Location: Cardiff Please provide a brief description of your role including and main responsibilities My role, within the RSU, is to oversee and report on aspects of work associated with Quality Management. My responsibilities are diverse, ranging from supporting our Organisational Lead in the development of an All Wales QMF, to running the annual IQA event, and producing the Unit s annual report. In addition, as part of the Quality Improvement process, I manage projects undertaken within or for the Unit. What has been your biggest learning point over the past As our work revolves around an adapting subject it is fair to say every day is a learning curve, and I often feel new ground is being broken. However, the greatest learning point has been with regard to revalidation, and the changes this has brought about in the world of medical appraisal. How has the RSU supported you in this role over the last As an internal member of the RSU, I receive support from the Unit on a daily basis. It is motivating to work in a department where everyone is approachable and there is so much knowledge at hand (ranging from high level clinical procedures to how to get the photocopier to work). To deliver outputs, and realise our strategic aims there are a host of individuals in the RSU supporting one another so we can achieve the highest standards. What part does quality management play in your work? Quality management is the essence of my role. The ever running cycle of Quality Standards, Quality Assurance and Quality Improvement are the underpinning and overarching factors which dictate the work I am involved with. What support would you like to receive from the RSU over the next A continuum of that which I have received over the past twelve months. 37

38 Charlotte Jones Job Title: GPC Wales chair Employer: Variety Uplands & Mumbles Surgeries, Swansea; Cardiff University; British Medical Association / GPDF, BMA House, Tavistock Square, London. Geographic Location: Swansea (home base) then Cardiff & London for BMA work Please provide a brief description of your role including and main responsibilities What has been your biggest learning point over the past How has the RSU supported you in this role over the last What part does quality management play in your work? What support would you like to receive from the RSU over the next Chair of GP Committee, Wales (elected statutory committee representing GPs) the committee has sole responsibility for negotiating terms and conditions of service for GPs. GPC Wales also represents GPs on many local / regional and national committees (e.g. other branches of practice, national workforce groups, remediation steering group), liaising with other key partners (e.g. RCGP Wales, RCN) as well as undertaking pastoral and support work to individual GPs and Local Medical Committees. This role also affords me a position on the GPC UK negotiating committee and am involved in English QOF negotiations, English vaccinations & immunisations as well as dispensing issues. GPs across UK are experiencing lower morale and under increasing levels of stress managing demand and complexity which is affecting their willingness and ability to engage in strategic development and have time to look at the sustainability of their practices. Current support systems available to GPs remain inadequate learning point has been around additional support services available. But equally, frustration that WG and DH seem oblivious to the need to look after our workforce (despite the rhetoric given about valuing General Practice), increase investment and resources into General Practice and address the significant problems facing the profession. A positive has been that I remain passionate about our profession and hope this comes across when representing the profession and GPC Wales / BMA. The guidance around whole practice based appraisal has been very helpful as it is clear and pragmatic. Where doctors have unusual portfolio careers not covered in the guidance, the advice from my appraisal co-ordinator and leads at appraisal unit has been prompt and helpful. In addition, the documentation has been helpful in my separate role sitting on the remediation steering group for Wales and also when discussing appraisal and revalidation with colleagues in other branches of practice within Wales and with GP colleagues at UK level. I have an annual appraisal with the GPC UK chairman as well as informal feedback from the BMA Cymru chair this includes colleague feedback. All formal papers and strategic documents produced are cross-referenced by the secretary and assistant secretary from BMA Cymru and feedback given where appropriate. Informal feedback comes from professionals am involved with on various committees. The above feeds into my individual GP appraisal to ensure I meet the whole practice based requirements for revalidation. Just to continue having read access to up to date guidance and personnel within the dept. as needed. 38

39 Julie Keely Job Title: GP Appraiser Employer: Wales Deanery Geographic Location: Powys Please provide a brief description of your role including and main responsibilities I am a grass roots Appraiser of ten year standing, undertaking approximately 50 appraisals per year. This enjoyable role is primarily to promote education and support colleagues in their personal and professional development and more recently to support them through revalidation. This work gives me the opportunity to visit many practices, steal their good ideas, support peers and improve my geography of Wales. What has been your biggest learning point over the past I am so glad to be a GP as my revalidation proved straightforward having participated in the highly organised, efficient and quality assured GP appraisal system in Wales Despite the current political and financial climates and the looming recruitment crisis in primary care, individuals and practices in Wales still strive to provide high standard individual patient care with enthusiasm and kindness. How has the RSU supported you in this role over the last There is always a kind word, a friendly face and regular updated information to help us to cope with all the changes to appraisal since the introduction of revalidation. No question is treated as a daft question and is unfailingly followed by a prompt response. What part does quality management play in your work? Quality Assurance of the Appraisal process is essential to ensure consistency and that the system of peer appraisal remains fundamentally educational, supportive and developmental and is not reduced to a tick box, Revalidation requirements list. We have all worked hard to achieve this and maintain this approach which is valued by GPs. Each appraiser receives regular feedback on the quality of their appraisal summaries from the Appraisal Unit and also from Appraisees which is vital to improve performance. Having recently attended the National Appraisal QA Day where for the first time both primary and secondary care summaries were reviewed, I am pleased to be a GP and proud of what the Deanery and GPs have achieved through appraisal in the last ten years. Our secondary care colleagues were envious and willing to learn from our experience and identified that they have a lot of catching up to do. What support would you like to receive from the RSU over the next The same as in the last ten years-essentially, keep up the good work and continue to maintain the same highly supportive approach with empathy and a sense of humour. 39

40 Paul Kirk Job Title: BSSU Manager Employer: Wales Deanery Geographic Location: Cardiff Please provide a brief description of your role including and main responsibilities I manage the team responsible for development, maintenance, delivery and quality assurance of the MARS software. What has been your biggest learning point over the past How valuable good quality leadership is in terms of motivation, direction and engagement. How has the RSU supported you in this role over the last The RSU team is very well organised, focused and professional. We have had a great deal of clarity around processes and functions linked to MARS, provided in a very supportive way. This has helped us to model additional functionality for MARS users, enhance the system and maintain system quality. What part does quality management play in your work? Quality in my role is related to identifying industry standards and best practice in software analysis, design and development. We ensure from an organisational perspective that MARS is informed by best practice and is compliant with the Information Commissioner s Data Protection Standards. What support would you like to receive from the RSU over the next We are currently working on the MARS Enhancement Project and we work closely with RSU and stakeholders on that. Just to continue our high standard professional interactions would be great. 40

41 Brendan Lloyd Job Title: Medical Director Employer: Powys Teaching Health Board Geographic Location: Powys Please provide a brief description of your role including and main responsibilities Usual MD Wales responsibilities, which includes Responsible Officer role. I also oversee the Appraisal process and chair our Clinical Education Group, which includes provision of PLTS in Powys. What has been your biggest learning point over the past Understanding the Responsible Officer role with regard to revalidation, including getting information off MARS and conditions for deferral. How has the RSU supported you in this role over the last Excellent support through RAIG and attendance at local Revalidation Panel meetings. Good sharing of information and updates at MDs meetings. What part does quality management play in your work? Quality management very important. Getting robust approach to quality assurance of appraisal and revalidation is difficult in a small organisation. What support would you like to receive from the RSU over the next More of the same please! Ongoing support for local meetings and support for Quality Assurance process on an all-wales basis. 41

42 Colette McNally Job Title: GP Associate Dean Employer: Cardiff University Geographic Location: National Please provide a brief description of your role including and main responsibilities Most of my time is spent delivering appraisal training to secondary care doctors. I undertake approval visits to GP practices who have expressed an interest in employing a GP retainer. What has been your biggest learning point over the past I have been delighted to see the enthusiasm of secondary care doctors for appraisal. How has the RSU supported you in this role over the last The RSU supports me in several ways. Kelly organises all my appraisal skills teaching sessions. I confess Kelly also oversees version control of my teaching package, something I should manage myself! Katie, Julie and Steff meet with me periodically to keep me updated on changes afoot and review changes I ve made to the appraisal skills teaching package. Katie and Sarah keep me informed about QA processes and outcomes in secondary care. Finally, Rhian organises my retainer visits. What part does quality management play in your work? We collect feedback on the training and periodically review the package in light of the data. It has been really helpful to see the quality data from the recent QA day regarding secondary care doctors appraisal summaries. It helps doctors to see the template that informs the quality assessment of their appraisal summaries. What support would you like to receive from the RSU over the next More of the same, please! 42

43 Stephen Monaghan Job Title: Consultant in Public Health Medicine and BMA Representative Employer: Public Health Wales Geographic Location: Cardiff Please provide a brief description of your role including and main responsibilities I am an elected member of the BMA Welsh Council and its nominee on the Welsh Revalidation Delivery Board, The Revalidation and Appraisal Implementation Group and the Appraisal Policy subgroup. What has been your biggest learning point over the past The level of quality assurance which has already developed fostered by the RSU. How has the RSU supported you in this role over the last All these roles involve liaison with the RSU. What part does quality management play in your work? Quality management is central to all the work on revalidation and appraisal systems. What support would you like to receive from the RSU over the next To undergo appraiser training myself. 43

44 Christopher Price Job Title: Deputy Director RSU Employer: CU Geographic Location: Cwmbran/Cardiff/all Wales remit Please provide a brief description of your role including and main responsibilities I am involved in the strategic planning for the Revalidation Support Unit. My role is wide and varied and could include writing a strategic paper, policy setting, problem solving, employment issues, financial planning to writing an educational website. I am also involved in the development of MARS and the implementation of Revalidation with respect to appraisal. What has been your biggest learning point over the past Where there is a will there s a way. I have been involved this year (and previously) with the roll out of appraisal to all doctors in Wales through the MARS system. In the main people have worked their way around various hitches the biggest one was initially the IT infrastructure only one person has shouted at me so far (yes it s all my fault!) How has the RSU supported you in this role over the last I am continually impressed by the productivity, energy, humour and resilience of my colleagues in the central office. They also all know that I never have the right papers for the meeting (or a pen!) What part does quality management play in your work? The whole work of the RSU is anchored by quality management. I can confidently say that our appraisers do a quality job within an infrastructure that not only supports that quality but also actively seeks to improve. What support would you like to receive from the RSU over the next If I receive half the support I have had this year that would still be good, however I am confident that we can continue as we are. 44

45 Dr Anton Saayman Job Title: Consultant & Lead Clinician, Adult ICU Employer: Cardiff & Vale UHB Geographic Location: Cardiff & Vale UHB Please provide a brief description of your role including and main responsibilities Lead Clinician, Adult ICU, Associate Dean (PGES), Wales Deanery and Appraiser (Writing in the capacity of Appraiser). What has been your biggest learning point over the past Reflection on activities is a cornerstone of the appraisal process. How has the RSU supported you in this role over the last The RSU has been available for telephonic, help and advice around appraisal and revalidation issues. What part does quality management play in your work? Quality Management is an integral part of the daily activity of my ICU role. What support would you like to receive from the RSU over the next Updates on new developments with appraisal & MARS Feedback on the appraisals done by me. 45

46 Sarah Tyler Job Title: Revalidation Manager Employer: Betsi Cadwaladr University Health Board Geographic Location: North Wales Please provide a brief description of your role including and main responsibilities I oversee the secondary care appraisal process and facilitate 360 and Revalidation for all non-training grade doctors in North Wales. What has been your biggest learning point over the past Development of QA process and bringing quality of hospital appraisal in line with Primary Care. Need for further Appraiser training. How has the RSU supported you in this role over the last Advice as and when required always received in a timely manner. Appraiser training sessions held in North Wales. What part does quality management play in your work? This is one of my main objectives for the current appraisal year. What support would you like to receive from the RSU over the next As before and continued support with Appraiser training sessions in North Wales. 46

47 Helen Williams Job Title: Revalidation and Appraisal Manager Employer: Hywel Dda University Health Board Geographic Location: West Wales Across the three counties of Carmarthenshire, Pembrokeshire and Ceredigion Please provide a brief description of your role including and main responsibilities I work as part of the Medical Director s Department team and am accountable on a day to day basis to the Assistant Medical Director for Workforce. I am responsible for the management of the Secondary Care Appraisal process throughout the Health Board and for developing and implementing robust systems for monitoring and managing the Revalidation process for doctors, across both the Primary and Secondary Care sectors. What has been your biggest learning point over the past There has been so much to learn over the past year but I think my biggest learning point has definitely been in relation to quality assurance. Learning about the importance of evaluating current systems and practices has helped me to look at the areas of appraisal and revalidation that need to be developed further within the Health Board. Revalidation brings together so much information that not only does the direct management of Revalidation itself need to adhere to high standards of quality assurance, the process consequently has a knock on effect with relation to other departments within the Health Board, such as the Clinical Governance Departments, Medical Staffing, Clinical Audit Department, Medical Education Department and so on. The Responsible Officer needs to feel confident with submissions made to the GMC and consistent quality assurance is key. How has the RSU supported you in this role over the last The RSU are a constant support with all aspects of appraisal and revalidation. The team are always at hand to provide guidance and clarity and the training and development opportunities provided have been of great value. I have bombarded the MARS team with queries over the last year and they are always quick to respond. Polite, helpful and very patient. What part does quality management play in your work? Since the introduction of revalidation there has been a constant need to raise standards through monitoring and assessing the underpinning systems and processes. Quality management ensures that there is meaning to Appraisal and Revalidation. Where models of good practice are developed and implemented, these exercises prove to be important developmental tools that will raise standards for Patients and their families, Doctors and their Colleagues. If a sustained faith in the process of revalidation is to grow quality management is essential. What support would you like to receive from the RSU over the next I would be grateful to receive the same kind of support that has been provided by the RSU over the past year, in the ways of guidance, information and invitations to your events please. 47

48 Paul Myres Job Title: Professional Lead, Primary Care Quality Employer: Public Health Wales Geographic Location: Mamhilad Please provide a brief description of your role including and main responsibilities Team Lead for advising the NHS on Quality Assurance, Quality Improvement in Primary Care and Primary Care Development. What has been your biggest learning point over the past Limit the number of interventions you would like primary care to make to five or less or they are likely to be ignored. How has the RSU supported you in this role over the last It hasn t. Our programmes can support GPs to ensure effective governance systems and to revalidate. What part does quality management play in your work? Our work includes helping practices and practitioners to apply quality management principles. What support would you like to receive from the RSU over the next To identify our products and personnel as supporting revalidation. 48

49 Dr Janet Badger Job Title: General Practitioner Employer: ABHB Geographic Location: Cwmbran Please provide a brief description of your role including and main responsibilities 5 session partner in a 7 partner Practice in Cwmbran for 14 years. I have been a GP Registrar trainer since 2002 and trainer for sexual health since I have taken part in the appraisal process for the past 10y and was revalidated in June What has been your biggest learning point over the past How has the RSU supported you in this role over the last What part does quality management play in your work? What support would you like to receive from the RSU over the next In the past year I have spent a lot of time learning about newer anti-coagulants, stroke risk, atrial fibrillation etc. This learning need was identified following my last appraisal and through discussion with my appraiser. He helped me plan my learning and also gave some ideas for good resources. In the past year I have also been revalidated. To be honest, it happened so seamlessly I did not realise it had happened until I received the letter. The regular appraisals have meant that all the relevant information has been in place and I really did not need to worry about the process. I now have had 6 different appraisers and they have all been very helpful and encouraging, easy to talk to, but also supportive. They should be congratulated on how well they help us develop our learning and minimise any stress around revalidation. Previously I took part in the Organisational Effectiveness Program (I think now known as 3D?). This was a superb opportunity which came at the right time in my career. It helped me grow in confidence within the practice team. It also equipped with me skills to deal with management issues better, as well as the ability to work within teams with very different personalities and skill mixes. Every Doctor should do this course. More recently I have been made aware of the GP CPD section of RSU. I have competed a few modules to date including eating disorders, veterans health and fibromyalgia. I find the site easy to navigate and the case scenarios are very relevant to real life. The resource lists are excellent to have, both for the GP and the patient/their families. I think I need to remind myself to access this section more often as I appreciate there are more and more topics being added all the time. Since the introduction of revalidation there has been a constant need to raise standards through monitoring and assessing the underpinning systems and processes. Quality management ensures that there is meaning to Appraisal and Revalidation. Where models of good practice are developed and implemented, these exercises prove to be important developmental tools that will raise standards for Patients and their families, Doctors and their Colleagues. If a sustained faith in the process of revalidation is to grow quality management is essential. I would be grateful to receive the same kind of support that has been provided by the RSU over the past year, in the ways of guidance, information and invitations to your events please. Part of daily life. Forever trying to improve the quality of care given to patients and their families through audit, significant event analysis, training, educational meetings, review of referrals, cancer diagnoses, complaints etc. To continue with reminders about what is going on within appraisal, revalidation and GP education. I would like to know what CPD events are available. 49