Guidance
Use the links below to see more information on each mandatory evidence type as stipulated by the GMC:
CPD
What is it?
Continuing Professional Development (CPD) is a continuous learning process that maintains and develops competence and performance. CPD enables you to maintain and improve across all areas of your practice.
Why do I need to include it?
Good Medical Practice requires you to keep your knowledge and skills up-to-date and states “You must take regularly take part in activities that maintain and develop your competence and performance” (paragraph 9).
What should I include?
Documentation of CPD events should include a reflection on the learning gained and the likely effect on your professional work. You should present a summary of your CPD events through the year for your annual appraisal, together with a certificate from your college or faculty if this is available. For revalidation a cumulative 5 year record of your CPD events should be provided.
For more information, please see:
- NHS England - further guidance and information on appraisal and revalidation
- GMC - Good Medical Practice
Quality improvement
What is it?
Quality Improvement activities can take many different forms depending on the role you undertake and the work that you do. These activities should be robust, systematic and relevant to your work. They should include an element of evaluation and action and, where possible, demonstrate an outcome or change.
There are a vast number of activities you can undertake as part of quality improvement, some examples include:
Please Note: If you work in a non-clinical area you should discuss options for quality improvement activity with your appraiser, college or faculty.
Audit and other quality improvement activity should reflect the full breadth of your professional work over each five-year revalidation period.
Why?
Paragraph 14 of Good Medical Practice states you must:
- (b) “reflect regularly on your standards of medical practice in accordance with GMC guidance on licensing and revalidation”
- (c) “take part in regular and systematic audit”
- (d) “take part in systems of quality assurance and quality improvement”
- (e) “respond constructively to the outcome of audit, appraisals and performance reviews, undertaking further training where necessary”
For the purposes of revalidation, you will have to demonstrate that you regularly participate in activities that review and evaluate the quality of your work.
Clinical audits
How often?
You should participate in at least one complete audit cycle (audit, practice review and re-audit) in every 5 year revalidation cycle. If audit is not possible then other ways of demonstrating quality improvement activity should be undertaken.
These can include local/personal audits and non-local/national audits.
What should I include?
You will need to demonstrate that you have actively participated in a clinical audit relevant to your work and then evaluated and reflected on the results. You will also need to demonstrate that you have taken appropriate action in response to the results (e.g. a development plan/a change in practice) and that improvement has occurred or good practice has been maintained.
Case reviews
How often?
The AORMC’s Supporting Information for Appraisal and Revalidation - Core Guidance Framework states that:
“If you are unable to provide evidence from clinical audit or clinical outcomes, documented case reviews may be submitted as evidence of the quality of your professional work. You should then provide at least two case reviews per year, covering the range of your professional practice over a 5 year revalidation cycle.”
You should consult guidance from your College or Faculty for their specification on how frequently you are required to include case reviews.
What should I include?
For appraisal and revalidation you will need to demonstrate that you have actively participated in case reviews and then evaluated and reflected on the results. You will also need to demonstrate that you have taken appropriate action in response to the results (e.g. a development plan/a change in practice) and that improvement has occurred or good practice has been maintained.
Please Note: Some specialties or subspecialties may recommend case reviews routinely, and a number of different approaches will be acceptable, including documented regular discussion at multidisciplinary meetings or morbidity and mortality meetings.
For more information about Quality Improvement Activities, please see:
- Pages 7-8 of GMC’s Supporting Information for Appraisal and Revalidation
- Pages 11-12 of Supporting Information for Appraisal and Revalidation - Core Guidance Framework
- Good Medical Practice
Significant events
What is it?
A significant event (also known as an untoward or critical incident) is any unintended or unexpected event, which could or did lead to harm of one or more patients. This includes incidents which did not cause harm but could have done, or where the event should have been prevented.
Why do I need to include it?
As a doctor you have a responsibility to log incidents and events according to the reporting processes in your organisation. These events should be reflected upon and any learning that occurred as a result should be discussed with your Appraiser.
What should I include?
It is the content and what you have learned from the experience rather than the number of events that should be the focus in your appraisal.
You should include a description of the event and a reflection on the actions you took and how it has affected your practice.
You should be able to demonstrate that you are aware of any patterns in the types of incidents recorded about your practice during your appraisal.
For more information, please see:
- Page 9 of GMC’s Supporting Information for Appraisal and Revalidation
- Page 13 of Supporting Information for Appraisal and Revalidation - Core Guidance Framework
- Good Medical Practice
Multi-source feedback
What is it?
For the purposes of appraisal and revalidation you should seek feedback from colleagues and patients and review and act upon that feedback as appropriate.
Feedback will usually be collected from colleagues and patients using standard questionnaires that comply with GMC guidance (such as the Clarity MSF Questionnaires) and is intended to help inform further development.
Why do I need to include it?
Feedback from colleagues and patients is a required aspect of revalidation. Seeking feedback in this way enables the views of colleagues and patients views about your behaviour to be gathered in a systematic way and provides the opportunity for patients, non-medical co-workers and medical colleagues to reflect on your professional skills and behaviour.
How often do I need to include it?
At least one complete colleague and one complete patient feedback “cycle” should be presented every revalidation cycle.
The amount of feedback you are required to collect is dependent on your organisation and you should consult your Organisation’s appraisal policies or your Appraisal Administrator for more information.
Which colleagues should I contact for feedback?
You should contact a wide variety of colleagues to receive feedback. You should seek feedback from both non-medical colleagues and medically trained colleagues to ensure a varied perspective of your practice.
Colleagues to contact could include:
- Other doctors
- Doctors in training
- Nurses
- Health visitors
- Midwives
- Pharmacists
- Administrators
- Secretarial staff
- Allied healthcare professionals
Who you contact is dependent on the roles you perform – you should choose colleagues that will give a fair and varied assessment of your practice.
What should I include?
For revalidation you need to include:
- At least one cycle of colleague feedback
- At least one cycle of patient feedback
Some organisations may also require you to complete a self-assessment form to compare and contrast your results.
You should obtain your feedback results report with enough time before your appraisal to review and consider the feedback you have received before discussing it with your appraiser.
For more information regarding MSF, please see:
- Pages 10-11 of GMC’s Supporting Information for Appraisal and Revalidation
- Page 14 of Supporting Information for Appraisal and Revalidation - Core Guidance Framework
Complaints and compliments
What is it?
A complaint is a formal expression of dissatisfaction or grievance. It can be about an individual doctor, the team or about the care of patients where a doctor can be expected to have had influence or responsibility.
Why do I need it?
A review of complaints and compliments is required for revalidation. Complaints should be seen as another type of feedback, allowing doctors and organisations to review and develop their practice and make patient-centred improvements.
What should I include?
Details of any formal complaints should be updated annually in your appraisals. You required to included any complaints made by patients, carers, colleagues or staff (either employed in your clinical area or any other area in which you work).
It is the content and how you dealt with the complaint that you should reflect upon in your appraisal. You should use complaints to highlight areas for further learning within your PDP.
It is useful to include compliments as well as complaints. Reflecting on your successes and how they have affected your professional practice, relationships and learning is a beneficial aspect of the appraisal process.