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Quality Improvement Activities (QIAs) are a cornerstone of the UK's medical appraisal and revalidation process. Whether you're a GP, a locum, or a hospital doctor, demonstrating that you actively review and improve your clinical practice is not just a regulatory requirement — it's a mark of a committed and reflective practitioner. This blog breaks down what QIAs are, what forms they can take, and how to present them effectively as supporting information for your annual medical appraisal.

This Blog addresses the issue of quality improvement activities as supporting information for your medical appraisal.

From: https://www.bma.org.uk/advice/employment/appraisals/appraisal-tips-for-sessional-gps

What Are Quality Improvement Activities?

The RCGP recommends that doctors demonstrate the ability to review and learn from their medical practice by reflecting on representative Quality Improvement Activities relevant to their clinical work every year, with a spread of QIAs across all of their scope of work over a five-year cycle.

In the past, this typically meant two Significant Event Analyses (SEAs) each year and one clinical audit over a five-year cycle. However, current RCGP guidance no longer prescribes a fixed number of QIAs. Instead, the focus has shifted towards greater flexibility, acknowledging that some forms of QIA may be difficult to achieve in certain circumstances — for example, true peripatetic locum work.

Locum doctors in particular may also need to ensure they have an active Designated Body Connection to remain compliant with revalidation requirements.

What Forms Can QIAs Take?

The guidance recommends that you choose QIAs which are representative and appropriate to your scope of work. QIAs can take many forms, including:

• Large scale national audit
• Formal audit
• Review of personal outcome data
• Small scale data searches
• Information collection and analysis (Search and Do activities)
• Plan/Do/Study/Act (PDSA) cycles
• Significant Event Analysis (SEA) and reflective case reviews
• Outcomes of reflection on formal patient and colleague feedback survey results, Significant Events, and Complaints

How to Present Your QIAs for Appraisal

You are encouraged to submit good quality examples with appropriate reflection, making your personal involvement clear — without necessarily being involved in data collection yourself. Where organisational, regional, or national outcome data is used, you should provide a reflection on what it means for your personal performance and outline your response or actions taken.

Where you employ specific clinical skills such as minor surgery, joint injections, cervical smears, or IUCD/IUS insertions, a log of personal outcome data with reflection would be a suitable and strong example to include.

If reflecting on your QIAs has highlighted gaps in your professional development, career coaching can help you turn those insights into a structured and achievable growth plan.

Why QIAs Matter Beyond Compliance

Quality Improvement Activities are more than a tick-box exercise. They are an opportunity to genuinely reflect on your practice, identify areas for growth, and demonstrate your commitment to safe and effective patient care. When approached with the right mindset, QIAs can drive meaningful change — both for you as a professional and for the patients you serve.

If you are unsure how QIAs fit into the broader appraisal cycle, our Medical Appraisals & Revalidation service can walk you through every step of the process.

Conclusion

Whether you are completing a formal audit, a PDSA cycle, or a significant event analysis, what matters most is the quality of your reflection and its relevance to your clinical work. The move towards flexibility in QIA requirements is a positive step, but it places greater responsibility on doctors to choose activities that are truly representative of their practice.

Still unsure how to select or present your QIAs? Book an advisory call for personalised guidance tailored to your scope of work.

At Medical Appraisals, we support doctors across the UK in preparing meaningful, well-documented appraisals that meet GMC standards. If you need help structuring your QIAs or preparing for your next appraisal, get in touch with us today — we're here to make the process straightforward and stress-free.

Want to learn more? Watch our expert guidance on medical appraisals and revalidation on our YouTube channel.