Appraisal Documentation

Appraiser: Dr Helen Carter

Appraisee: Dr Marcus Vance

Date and Time: 14/05/2024 14:00

Summary of Last Year's Appraisal and Agreed Objectives

During last year's review, Marcus was commended for his smooth transition into the salaried GP role at Oakwood Surgery and his management of acute on-call duty lists. The main improvement area identified was time management during complex multimorbidity clinics. We established three core objectives for the past year: completing a two-cycle clinical audit on DOAC prescribing in AF, attending a regional dermatology update course, and assuming lead responsibility for the practice's QOF hypertension register.

How This Year Has Gone

This year has gone well overall, though winter pressures and staff shortages presented significant workload challenges. Marcus successfully met his QOF objective, increasing the practice's BP monitoring target achievement from 72 % to 84 % by working closely with the HCA team to streamline recall protocols. He also completed the DOAC audit, which highlighted three patients on suboptimal doses of apixaban (Eliquis®) 2.5 mg PO BD due to outdated renal function weights; these were appropriately adjusted to 5 mg PO BD.

Patient and colleague multisource feedback (MSF) was highly positive, noting his calm demeanour and clear communication. However, the dermatology course was postponed due to study leave clashes during the January surge, meaning this objective remains outstanding. Clinic running times have improved significantly since implementing a 15-minute slot buffer mid-morning.

Training and Development

Marcus still requires completion of the primary care dermoscopy and skin lesion update course to support the practice's minor surgery and rash clinics. Additionally, following a recent significant event analysis (SEA) involving a delayed cauda equina syndrome referral within the PCN, Marcus identified a learning need around musculoskeletal red flags and plans to complete the RCGP e-learning module on acute back pain. His Basic Life Support (BLS) and Level 3 Safeguarding certifications are due for renewal in October.

Future Career Planning

Over the next two to three years, Marcus is keen to explore a GP Trainer role and potentially transition from a six-session salaried post to partnership within the practice. To prepare for educational supervision, he will look into the local deanery's Postgraduate Certificate in Medical Education (PGCert) intake for next autumn. He also expressed interest in shadowing the current practice finance lead to better understand partnership accounts and PCN service specifications.

Other Points and Ideas

Marcus suggested trialling an automated SMS recall system for routine DMARD monitoring bloods, noting that the current manual letter system creates unnecessary administrative burden for the reception team and occasional delays in methotrexate prescribing. He also raised the possibility of adjusting his Wednesday afternoon session start time by 30 minutes to accommodate childcare commitments, which appears feasible given current room availability.

Objectives Set

For the upcoming appraisal period, Marcus will complete the rescheduled RCGP dermatology and dermoscopy course and integrate lesion triage into his routine clinical sessions. He will lead the implementation and 6-month evaluation of the new automated SMS recall protocol for high-risk drug monitoring. Finally, he will attend the introductory prospective GP Trainer workshop hosted by the local deanery to begin his pathway toward becoming an educational supervisor.

Agreed Actions

For the Appraiser (Dr Helen Carter)

• Raise the Wednesday afternoon session time adjustment at the next partners' business meeting on 28/05/2024.
• Introduce Marcus to the PCN Educational Lead to discuss the upcoming trainer pathway and study budget allocation.
• Approve study leave request for the autumn dermatology course once dates are confirmed.

For the Appraisee (Dr Marcus Vance)

• Book and complete the rescheduled dermatology course and upload reflection notes to the portfolio by 30/11/2024.
• Draft the protocol for the automated DMARD blood monitoring SMS recall with the Practice Manager by 31/07/2024.
• Renew mandatory BLS and Level 3 Adult and Child Safeguarding certificates prior to 15/10/2024.