Being good

Appraisal

Although the annual appraisal for GP registrars may seem like another burden, you should already be collecting most of the information you will need as part of your training. Appraisals continue annually throughout your career, and completing an appraisal this year allows you to develop a personal career development plan. The appraisal consists of five forms:

Form 1 – personal details

Form 2 – current medical activities

Form 3 – information for the appraisal, based around the headings of Good Medical Practice (this form will take the most time to complete). As mentioned, though, you will probably have already collected most of the information you need. Examples include:

• Good clinical care, eg, audits, out-of-hours log.
• Maintaining good medical practice, eg, reflective diaries, course certificates (day release, CPR, Advanced Life Support), personal development plan.
• Teaching, training, appraising, assessing – not likely to be much at this stage in your career, but might include any presentations you have done, perhaps for your summative assessment or audit.
• Relationships with patients, eg, thank-you letters, Christmas cards, complaints, patient surveys.
• Working with colleagues, eg, feedback from practice team and others.
• Probity, eg, gifts received.
• Health.

Form 4 – the formal summary of the appraisal, and form 5, the optional, confidential record of the appraisal discussion, are completed during and after the appraisal.

Good Medical Practice specifies that “you must maintain a folder of information and evidence, drawn from your medical practice” and “reflect regularly on your standards of medical practice in accordance with GMC guidance on licensing and revalidation”.

Performers list

GP registrars have to apply to join the medical performers list of the local PCT before starting training. If your training is arranged late, and your application has not yet been approved, you can work for two months to allow the paperwork to go through. However, you must have applied before the training started, otherwise this grace period is not allowed. See the GMC’s section on Registration for Doctors for further information.

At the end of your training, you must show your PCT your JCPTGP vocational training certificate as soon as you get it. If you want to stay in the area, tell the PCT and you can stay on as a fully-fledged GP. If you get a job somewhere else, it will probably be best to apply to leave your training PCT list and join the list of your new PCT. Let both PCTs know what you are doing and they should be able to sort it out between them (but check that they have). You must let your PCT know in writing, within seven days, if you are convicted of a criminal offence (including being bound over or receiving a caution), or are investigated for professional conduct by the GMC or another Trust.

You must also tell the GMC “without delay” if you have accepted a caution, or been charged with, or found guilty of, a criminal offence anywhere in the world. This excludes road traffic offences where you accept the option of paying a fixed penalty charge, or fixed penalty notices issued by the local authority. However, Penalty Notices for Disorder at the upper tier penalty level and Fixed Penalty Notices under the Anti-Social Behaviour etc (Scotland) Act 2004 must be reported to both the GMC and your PCT.

Gifts

It is not uncommon for patients to approach their GP with a gift, whether that is money or a bottle of wine or spirits. There is no problem with accepting small gifts, but bear in mind that the patient is "rewarding” you for care that has probably involved the rest of the practice, at least to some extent. Larger gifts can create more problems, particularly, for example, in the case of a legacy in a will. It is best to try and discourage these, without causing offence.

However, if the patient is insistent, you could thank them for the offer, and suggest that the money could go towards some new equipment or improvement for the surgery. GPs should keep a gift register for gifts with an actual or estimated value of more than £100. The PCT can inspect this register at any time.