This blog expands on the meaning and importance of recording the scope of work for a doctor’s appraisal.
The GMC describe: “Scope of Work. This will include the organisations and locations where you have undertaken work as a doctor. You will also need to provide a comprehensive description of the scope and nature of your practice”. (GMC, 2012b, p3)
The AoMRC, 2014, recommend that: “The doctor should record the scope and nature of all of their professional work carried out to ensure that the appraiser and the responsible officer understand the doctor’s work and practice. This should include all roles and positions for which a licence to practise is required, and should include work for voluntary organisations, work in private or independent practice and managerial, educational, research and academic roles.
Types of work may be categorised into:
ll clinical commitments
ll educational roles, including academic and research
ll managerial and leadership roles
ll any other roles.
Although the supporting information brought to appraisal for revalidation should cover the whole scope of a doctor’s practice, this coverage does not have to take place every year of the five year cycle. It is permissible for a doctor to concentrate on specific areas of practice each year, and then to discuss with their appraiser how and when the remaining areas will be covered during the five-year cycle.”
As a dr, you need to clarify your scope of work, because you are required to provide supporting information to demonstrate the quality of your work against the standards in Good Medical Practice (GMC, 2013) for the scope of work that you actually do, not what you historically qualified for.
Any separate role which requires a licence to practise, paid or unpaid, for a different organisation, employer, or as an individual, needs to be included so that the responsible officer (RO) knows where to seek assurance that you are fit to practise. It is best practice to include the contact details, where applicable, for each organisation or employer, to facilitate the transfer of information to the RO, and to be aware of the clinical governance arrangements in place. The RO may request confirmation, from each part of your scope of work outside the designated body, that there are no outstanding clinical governance issues, concerns or investigations, or request an up-to-date status report on any progress made, before making your revalidation recommendation.
In those circumstances where you have had a separate internal in-post review or ‘appraisal’ for a specific part of your scope of work, it is normal to include the outputs from this review, and your reflection on those, where appropriate, as ‘additional supporting information’ in your main annual medical appraisal for revalidation.
Where you have several different responsibilities within the same part of your scope of work, such as the various lead responsibilities that a GP partner might take on for the practice, it is appropriate and reasonable to reflect on these elements of your ‘job description’ with your appraiser, but they do not need to be declared as separate “scopes of work”. They do not require separate supporting information, or clinical governance review, because they are not provided for a different organisation, or independently. In determining the level of detail that is appropriate in declaring scope of work, you may find it helpful to consider whether the RO will need to have separate contact details to determine that the clinical governance arrangements are robust. Reflection on appropriate supporting information over the five year cycle needs to take place at the level of separate posts for different employers, or independently, not every responsibility that you may have.
Over the five year revalidation cycle, you do need to reflect on how you keep up-to-date, review what you do and what feedback you have had, as well as declaring all GMC level Significant Events and Complaints, for every post that forms a separate part of your scope of work.
For further information and support for a doctor appraisal, please visit: https://www.medicalappraisals.org.uk