There were 35 out of 100 reviews which identified sub-standard quality of surgeon appraisal.

We routinely request appraisal documentation as part of our preparation for invited reviews. In a significant proportion of reviews we found that that the standard of appraisal of consultant surgeons was poor.

Examples of shortcomings with appraisal processes include:

  • Documentation being out of date. Upon following this up there were instances where we discovered that some consultants had not been appraised for several years.
  • Appraisals being superficially completed or demonstrating little to no evidence of any reflective practice.
  • Appraisals lacking effective challenge of under-performance or simply not addressing this at all.

Appraisal was not often a primary feature in our sample of invited reviews.  At times, however, they have been an important secondary factor, with interviews highlighting:

  • Disagreement between parties about the selection of an appraiser by an appraisee.
  • A general attitude towards appraisals that remained dismissive of their significance.

Revalidation was launched during the period within which our sample of invited reviews took place. This has the capacity to drive improvements in this area.  Our experience in this area reinforces the extent to which improvements are required.