Pre Appraisal Checklist

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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
HINT



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
Good Medical Care


Clinical activity data relating to
individual and team.

Outcome measures or National
Registry Information



Number of patients operated –
major minor, details of
complications
Outpatients – numbers seen of
old/new
Provide comparators of these
within directorate (anonymised)
and also college benchmarks.
Copy of legible notes
Maintaining Good Medical Practice

CPD activity


Programmes, notes and certificates
and evidence that is relevant to
your practice. Include CPD for all
your roles.
State College minimum
requirement.

Audit

Lists of audits undertaken
(minimum of one example per year)
and topics discussed in
departmental audit meetings and
how this has changed your
practice.

Mandatory Training

Evidence of completion of e
learning programmes (Child
Protection, Equality and Diversity
etc)

Clinical Governance

Documentary proof of attendance
at mortality and morbidity meetings
e.g. forms, minutes together with
attendance rates.
November 2010
1

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
Working relationships with
Colleagues


Colleague feedback 360 MSF
Evidence of Team work
Relations with Patients

Details of complaints



Teaching and Training

What has been delivered



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
Management Activity

Current posts

Aspirations for the future
Research

Details of abstracts, publications
etc
Probity

Self declaration
Health
November 2010
2
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