The LMC is regularly involved in representing and supporting doctors who have been identified as having “performance” issues.  The LMC has identified a number of themes which recur, and this regular feature will highlight these, so that our members can avoid these pitfalls.

Recently there was an update to the appraisal tool Fourteen Fish which read:

"Disclosing your information

We may pass on your personal information if we have a legal obligation to do so, including exchanging information with government departments for legal reasons."

This echoed concerns following the suspension of Dr Hadiza Bawa-Garba: "the manslaughter conviction had been based partly on evidence from her own self-appraisal, including - controversially - reflective notes containing details of the incident..."

As such, useful advice regarding the content of your appraisal reflections would be that an appraisal portfolio should not contain patient-identifiable information nor anything that would be personally or commercially sensitive for the GP.

Appraisers have been advised to describe to a GP at appraisal that confidentiality is qualified and relative, not absolute, such that information that might put patients, the doctor’s or colleagues at risk or bring the reputation of the profession into disrepute will have to be shared appropriately.  This would preferably be with the consent of the GP, but do be aware that Duty of Care outweighs confidentiality in the same way that the confidentiality of a consultation must sometimes be breached.

Identifiable information in your appraisal record may not require the full name or initials of the person for the case to still be identified so it would be sensible to only record very general entries and to discuss them in your appraisal in more detail if required.

For the vast majority of appraisals, it is a positive experience, but this guidance may help avoid difficult situations related to the information you record.