Doctors criticise appraisal data and IT

Doctors say NHS trusts are unable to provide them with enough data on their performance to carry out appraisals and have heavily criticised an IT toolkit for revalidation.

A BMA survey of almost 4,000 GPs and consultants looked at doctors’ experience of the current appraisal process and also sought views from those in pathfinder sites testing revalidation before it is introduced across the UK in 2012.

The survey found that more than two-thirds of doctors (68%) said their trust was unable to generate sufficient data relevant to their performance for appraisal. 

And three quarters (76%) of appraisers said they did not have access to information to independently corroborate statements made by appraises.

Reasons given for lack of relevant data included information being generated at departmental level than at personal level, difficulty getting outcomes data and poor quality data.

Three out of four GPs said they had access to enough IT to complete appraisals but only just over half of consultants (54%) said the same.

Of those who took part in the survey, 258 were involved in the revalidation pathfinder pilots.

The majority said they had access to sufficient help, advice and support during the pilot but were highly critical of the IT they had to use. The BMA said comments on the revalidation pilot toolkit were “overwhelmingly negative”.

It added: “Respondents found the toolkit difficult to navigate and time consuming. They felt that it dominated the appraisal process rather than supported it, [that it was] not user friendly, unreliable and prone to losing data, and many had experiences of glitches and being logged out unexpectedly.”

One respondent said: “IT computer software system very time consuming and cumbersome to use."

Another said: “absolutely dreadful, the computer system is bespoke, poorly designed and poorly implemented."

While a third said “most of the time was spent trying to cope with the poor design of the toolkit which had nothing to do with my clinical performance.”

Dr Hamish Meldrum, chair of BMA Council, told BMA News that he was concerned by the issues raised in the survey which he said must be addressed before revalidation is introduced next year.

Niall Dickson, the chief executive of the GMC, said the survey results were a wake-up call.

He added: “Every employer has a duty to provide appraisals and with responsible officers now in place across the UK, there is a statutory duty to make this happen.

"We are going to work closely with the four UK health departments and with responsible officers to make sure doctors have what they need by the time revalidation is introduced.

“We also recognise that if revalidation is to work, the systems that support it must be easy to access, simple and straightforward to use. The findings from the pilots suggest that some of the IT support was clunky and that does need to be addressed.

“At the GMC we have streamlined and simplified our proposals in light of what doctors have told us, and next month we will publish updated guidance on what appraisals need to cover, including the information doctors will need to bring along to their appraisal discussion. With good will and common sense we can all make this work.”

The BMA survey was carried out in November and December last year and received 3,863 replies, with respondents evenly split between consultants and GPs. Almost 90% of those questioned had undergone an appraisal since April 2009.