Appraisal funding


November 2004

The English Department of Health has now issued its guidance on appraisal funding.
  • General medical services (GMS) practices will receive an appraisal premium (26 pence) to their global sum. This is for the appraisal (including preparation) of GP providers and their salaried GPs.
  • where GMS practices have already received a contribution (prior to 1 July 2004) to cover appraisee costs, primary care trusts (PCTs) should as a minimum honour existing appraisal payment arrangements
  • where GMS practices had not received any appraisal funding in the first quarter of 2004/05 then a local adjustment will be needed (eg paying an additional quarters payment before the financial year end or uplifting monthly payments by a third).
  • locum GPs should receive a contribution towards their costs (and this is specified in the Department of Health (DoH) guidance). Ideally locum GPs should not be out of pocket as a result of participating in appraisal and therefore their loss of income should be covered. The guidance specified that PCTs will need to agree the precise details of payments to locums in the case of their appraisee costs, and notes that PCTs will wish to consult with their local medical committees (LMCs). We therefore recommend that LMCs consult with their PCTs on the level of locum funding as soon as possible. Again, if PCTs have previously agreed a level of payment then this should as a minimum be honoured.
To give you an indication of how much time the whole appraisal process of time will take, as we stated in our original appraisal guidance and based on our independent research on the likely preparation time for a first appraisal, we estimate the following minimum times for appraisal per GP:

Preparation time
Completing the pre-appraisal forms (and reflection time) - 3.25 hours
Identifying and collating the documentation required for the forms - 2 hours
Preparing an outline personal development plan - 1 hour
Total preparation time - 6.25 hours
Appraisal interview - 1.5 hours as previously agreed by the DoH
[Possible peer review - 1 hour]
Appraisal review preparation - 1 hour
Appraisal review interview - 0.5 hours as previously agreed by the DoH
Total - 9.25 hours [10.25 hours with possible peer review]

These estimates are higher than the Department of Health's. The Department previously estimated that appraisal will only take between 4 ½ and 6 ½ hours. We believe that our estimates are a much closer match to the true requirements. Indeed, the Chief Medical Officer's letter of 1 March 2002 to all GPs stated that, in the first full year of appraisal, the time commitment may be higher as everyone adapts to the new system.
  • The payment/reimbursement for GP appraisers will be set by the PCT, and should be agreed after consultation with their LMC. It is therefore likely that there will be regional variations. Previous payments should, at least, be honoured. We recommend (as previously) that GP appraisers should be fully reimbursed for any out-of-pocket (including locum) expenses that they incur and also receive proper remuneration for their time, commitment and skills while training and appraising. We strongly suggest that appraisers contact their PCT before undertaking any training or appraisal work to check what reimbursement and payments they will receive. We advise that GPs should only undertake this work if they are fully reimbursed and remunerated.
To give you an idea of the amount of time required for appraisers to prepare for and undertake an appraisal, we have estimated the following minimum times:
Preparing for each appraisal - 1 hour
Appraisal interview - 1.5 hours as previously agreed by the DoH
Preparing for appraisal review - 0.5 hour
Appraisal review - 0.5 hour as previously agreed by the DoH
Total estimated time for appraisers - 3.5 hours

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