Glossary

Annual appraisal
The process of preparation, collation and reflection on information, followed by a discussion with an appraiser at a formal, confidential meeting. The appraisal meeting between the appraisee and appraiser should take place every year. An appraisal is considered to be completed when the summary of the appraisal discussion and personal development plan (PDP) have been signed off by appraiser and appraisee, within 28 days of the appraisal meeting.

Appearance of bias
An apparent predisposition, prejudice or preconceived opinion that may prevent an impartial or objective evaluation.

AQMAR
Assuring the Quality of Medical Appraisal for Revalidation (AQMAR) was the precursor to ORSA (see below).

Business case
A business case captures the reason for initiating a project or task. The Department of Health (England) is currently developing the business case for revalidation. This will evaluate the costs and benefits of appraisal, assessing that the proposed model is proportionate and right for doctors, employers, patients and the public. It will be informed by the RST’s testing and piloting programme and overall assessment of organisational readiness of the health sector to introduce revalidation.

Clinical audit
The National Institute for Clinical Excellence (NICE) defines clinical audit as: ‘a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team, or service level and further monitoring is used to confirm improvement in healthcare delivery.’

Conflict of interest
A situation in which the responsible officer has competing professional or personal duties, loyalties, obligations or interests that would either make it difficult to fulfil their duties fairly, or would create an appearance of impropriety or a loss of impartiality that could undermine public confidence.

Deanery
A deanery, within healthcare in the UK, is responsible for the organisation and management of postgraduate medical and dental training.

Designated body
An organisation that employs or contracts with doctors and is designated in The Medical Profession (Responsible Officer) Regulations 2010.

England Revalidation Delivery Board
The England Revalidation Delivery Board (ERDB) is the governance body established to provide assurance to the Department of Health in England that the introduction of revalidation is being managed appropriately.

Good Medical Practice
Good Medical Practice sets out the principles and values on which good practice is founded; these principles together describe medical professionalism in action. The guidance is addressed to doctors, but it it also intended to let the public know what they can expect from doctors.

GMP framework for appraisal and revalidation
The Good Medical Practice Framework for appraisal and revalidation sets out the broad areas which should be covered in medical appraisal. The Framework will form the basis of a standard approach for all appraisals, in which licensed doctors must take part in order to revalidate.

Licence to practise
To practise medicine in the UK all doctors are required, by law, to be both registered and hold a licence to practise. This applies to practising full time, part time, as a locum, privately or in the NHS, or employed or self employed. Licences are issued, renewed and withdrawn by the GMC.

Medical Appraisal Guide (MAG)
MAG will produce clear and effective guidance for annual medical appraisal. Medical appraisal will help to determine whether a doctor is up to date, fit to practise and will support professional development.

ORSA
ORSA (Organisational Readiness Self-Assessment) is a self-assessment tool designed to help designated bodies in England determine whether they are ready for revalidation.

Organisational readiness
The purpose of the RST's organisational readiness project is to prepare healthcare systems and designated bodies in England for their role in delivering revalidation for doctors through appropriate training, guidance and tools.

Peer review
Peer review is the process of having a piece of work or data/information reviewed by colleagues in the same field to ensure its validity and relevance.

Personal development plan (PDP)
The personal development plan (PDP) is an agreement, between the appraisee and appraiser, on the learning and development needs of the appraisee, identified at the appraisal interview, with an outcome-based learning plan for the subsequent year.

Practising privileges
The agreement between an independent healthcare organisation and the doctor, allowing the doctor to practise within that organisation.

Prescribed connection
The prescribed connection is the formal link between a doctor and their designated body. It is the route by which doctors are able to find their responsible officer. Regulation 10 and 12 in The Medical Profession (Responsible Officer) Regulations 2010 set out the “prescribed connection” between designated bodies and doctors and these are explained in more detail in the responsible officer guidance.

Remediation
The overall process agreed with a practitioner to redress identified aspects of under performance. Remediation is a broad concept varying from informal agreements to carry out some re-skilling, to more formal supervised programmes of remediation or rehabilitation.

Responsible officer
A licensed doctor with at least five years experience who has been nominated or appointed by a designated body.

Responsible officer networks
Responsible officer networks are regional networks of responsible officers organised by the SHA responsible officers, providing development, peer support and advice.

RST
The NHS Revalidation Support Team (RST) works in partnership with the Department of Health, the GMC and designated bodies to deliver an effective system of revalidation for doctors in England.

This includes:

supporting healthcare organisations and responsible officers in preparing for medical revalidation
producing clear and effective guidance for annual medical appraisal, and
providing evidence of the costs, benefits and practicalities of implementation, to ensure that revalidation supports high quality care and is cost-effective and efficient.

For more information, please visit: www.revalidationsupport.nhs.uk

RST Pathfinder Pilots
The NHS Revalidation Support Team (RST) Pathfinder Pilot project ran from 1 January 2010 to 31 March 2011. Over 3,000 doctors from primary and secondary NHS healthcare settings participated across ten pilot sites in England.

The aim of the RST Pathfinder Pilots was to test whether the proposed components of medical revalidation, such as strengthened medical appraisal, are as practical and as efficient as possible, whilst supporting high quality care and providing confidence to the public.

The RST Pathfinder Pilots were phase two of a three phase piloting process. Phase one included preliminary small scale pilots. A third and final phase of piloting is taking place in 2011-12, testing specific components of the revalidation process and the Medical Appraisal Guide on doctors in a variety of healthcare settings and organisations.

Revalidation
Revalidation is the process by which doctors will have to demonstrate to the GMC, normally every five years, that they are up to date and fit to practise. A Statement of Intent was published by the GMC in October 2010, following the GMC’s consultation in early 2010 and the announcement by the Secretary of State to introduce an added year of testing and piloting.

It was agreed by the General Medical Council, the Chief Medical Officers for England, Northern Ireland and Wales, the Deputy Chief Medical Officer for Scotland and the Medical Director of the NHS in England and sets out the GMC and our partners' commitment to change the way doctors are regulated in the UK.

Second responsible officer
Designated bodies must nominate or appoint a second responsible officer where there is a significant conflict of interest or an appearance of bias. Where a second responsible officer has been appointed, that individual has the responsibilities specified in the legislation.

Supporting information

During their annual appraisals, doctors will use supporting information to demonstrate that they are continuing to meet the principles and values set out in the GMC's Good Medical Practice. The supporting information that will fall under four broad headings: general information, keeping up to date, review of your practice and feedback on your practice. For more information, please read the GMC guidance on Supporting Information.