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PRE APPRAISAL CHECK LIST FOR APPRAISEE
Information for Appraisal Portfolio
EVIDENCE REQUIRED
General
GMC Registration Number
Evidence of Licence to Practice
Medical Qualifications
Previous years Form 4 and PDP
Description of Practice
Title
Role
Job Summary including responsibilities and activities over the last 5 years
Job Plan
Good Medical Care
 Clinical activity data relating to individual and team.
 Outcome measures or National
Registry Information
HINT
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Have review meeting with Clinical
Director and sign off current Job
Plan, and Reporting Form A.
Discuss draft PDP for following year at meeting with CD
Advise appraisal administrator of date agreed for appraisal
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Number of patients operated major minor, details of complications
Outpatients old/new and also college benchmarks.
Copy of legible notes
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– numbers seen of
Provide comparators of these within directorate (anonymised)
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Maintaining Good Medical Practice
 CPD activity
Audit
Mandatory Training
Clinical Governance
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Programmes, notes and certificates and evidence that is relevant to your practice. Include CPD for all your roles.
State College minimum requirement.
Lists of audits undertaken
(minimum of one example per year) and topics discussed in departmental audit meetings and how this has changed your practice.
Evidence of completion of e learning programmes (Child
Protection, Equality and Diversity etc)
Documentary proof of attendance at mortality and morbidity meetings e.g. forms, minutes together with attendance rates.
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Working relationships with
Colleagues
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Colleague feedback 360 MSF
Evidence of Team work
Relations with Patients
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Details of complaints
Teaching and Training
 What has been delivered
Probity
 Self declaration
Health
Management Activity
 Current posts
Research 
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Attendance at discrepancy meeting, significant events review
Five yearly cycle
Committee minutes/letters details of projects
Significant events or cases review and ACI’s
Anonymised example of reply
Thank you letters
Example of letter to patient
Feedback Forms, log of lectures given, details of who taught and how often.
Copy of presentation
Educational Supervisors Form
Interests and gifts
Written consent
Confirmation of registration with GP
Aspirations for the future
Details of abstracts, publications etc
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