Is the appraisal discussion confidential?
The appraisal discussion is confidential to the extent that a clinical consultation is confidential.
For example if a doctor discloses that he/she is a perpetrator of child abuse, or the appraiser thinks patient safety is at risk, then the appraiser is obliged to disclose this to the proper authorities.
Appraisers are keen to make the discussion a safe place to discuss the doctor's practice and performance and will strive to protect the confidential nature of the discussion.
It is not unusual to discuss personal problems, illness, conflict with colleagues and stress in the appraisal, and the appraiser will take steps to support the doctor in dealing with these matters.
The appraiser will give the doctor an opportunity to comment on the written summary of the discussion before it is submitted, so no inadvertent disclosures are made.
For example if a doctor discloses that he/she is a perpetrator of child abuse, or the appraiser thinks patient safety is at risk, then the appraiser is obliged to disclose this to the proper authorities.
Appraisers are keen to make the discussion a safe place to discuss the doctor's practice and performance and will strive to protect the confidential nature of the discussion.
It is not unusual to discuss personal problems, illness, conflict with colleagues and stress in the appraisal, and the appraiser will take steps to support the doctor in dealing with these matters.
The appraiser will give the doctor an opportunity to comment on the written summary of the discussion before it is submitted, so no inadvertent disclosures are made.
Who can view the appraisal documents?
The documents you submit, the personal development plan and the summary of the appraisal discussion can all be seen by staff on the appraisals team each of whom is bound by a confidentiality clause in their contracts of employment.
However, these documents can be used by the responsible officer for different purposes and may be submitted to the GMC or other investigators in certain circumstances.
However, these documents can be used by the responsible officer for different purposes and may be submitted to the GMC or other investigators in certain circumstances.
NHS England lists the following people who, in certain circumstances MAY have legitimate access to your appraisal documents:
- Appraiser
- Appraisal lead
- Senior appraiser
- Responsible officer
- Lead appraiser
- Members of the responsible officer’s decision support group (known as the Revalidation Advisory Group, RAG).
- Administrative/support staff
- Medical director
- CEO
- HR director
- Persons with clinical governance responsibility for the doctor in all the places where they are working
- Other persons involved with the investigation and handling of the matter in hand
- GMC personnel
- Legal personnel, including courts
- Police
- Clinical Director
- The Director of Postgraduate Education
ROAN Info Sheet 33: Disclosure of appraisal information to third parties contains advice to Responsible Officers as to when or whether to disclose confidential information to third parties.
Could my reflections be used against me in court?
Yes. Although to date it is believed this has never happened (January 2019).
Any document could be subpoenaed by a British court, so documents submitted as part of the appraisal process are not exempt.
GPs are advised to continue to reflect but to anonymise those reflections to minimise the risk they may be used against them at any time.
Any document could be subpoenaed by a British court, so documents submitted as part of the appraisal process are not exempt.
GPs are advised to continue to reflect but to anonymise those reflections to minimise the risk they may be used against them at any time.
This briefing (NHSE, 15 02 2018) is a letter to provide clarification over the use of written reflective practice in appraisals.
See also Confidentiality of appraisal reflection (ROAN sheet 8).
See also Confidentiality of appraisal reflection (ROAN sheet 8).
The rapid review report into gross negligence manslaughter was published on 11th June 2018.
In a statement to parliament, Jeremy Hunt, Secretary of State for Health and Social Care, said, “I accept the recommendations in full”.
In a statement to parliament, Jeremy Hunt, Secretary of State for Health and Social Care, said, “I accept the recommendations in full”.
Examples of good, brief, anonymous reflection
Reflection on a significant incident (NHS SSW, March 2018)
Reflection on a prescribing issue (NHS SSW, March 2018)
Reflection on a complaint (NHS SSW, March 2018)
Reflection on a prescribing issue (NHS SSW, March 2018)
Reflection on a complaint (NHS SSW, March 2018)
Can I name people in my appraisal documents?
An appraisal portfolio must not contain personally identifiable information (whether patient, colleague or any other person). To do so is a breach of information governance rules.
The RCGP says, about compliments and complaints,
"You should include a reflective note, rather than original material, in your submitted appraisal portfolio, due to the difficulties with anonymising data, and keep any original cards or letters, if you wish, securely in a paper portfolio.
Such original data, if shared with your appraiser, can be referenced in the appraisal summary to preserve the anonymity of the sender without defacing the source material."
"You should include a reflective note, rather than original material, in your submitted appraisal portfolio, due to the difficulties with anonymising data, and keep any original cards or letters, if you wish, securely in a paper portfolio.
Such original data, if shared with your appraiser, can be referenced in the appraisal summary to preserve the anonymity of the sender without defacing the source material."
The limits of confidentiality of appraisals and revalidation are set out in the NHS England's Medical appraisal access statement (NHSE, December 2016).
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"There are a number of circumstances when persons other than the appraiser may need access to appraisal documentation, including the inputs.
This [document] sets out these circumstances and the access arrangements for each". |
Information flows to support medical governance and responsible officer statutory function.(NHS England, August 2016).
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This guidance sets out the main channels along which information about a doctor’s medical practice may need to flow, in support of good medical governance and the statutory duties of the responsible officer and in support of patient safety and quality of care.
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The use of information about patients is essential to the education and training of medical students, doctors in training and other healthcare students and trainees. This explanatory guidance sets out how the general principles in our guidance Confdentiality apply in the particular context of education and training.
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