Appraisal reappraised

 

Back in May 2018, when we were blissfully unaware of what was around the corner I did a little exercise working out how much time the process of appraisal takes, and what this means in the broader view of impact on clinical services. I did the same, separately, for mandatory training.

Then Covid came along. With the workload clinicians were taking, and the stress we were under it became accepted, even by the GMC,  that a requirement for appraisal would be unnecessarily burdensome on hard pressed doctors. Trusts also felt the same about mandatory training. Tacit admissions that both appraisal and mandatory training can be shelved when it suits them.

Covid has not gone away! The UK seems to be in yet another wave, with 25,000 new cases on June 15 2022. In addition the waiting lists for treatment have ballooned. There are now 6.5 million people awaiting treatment. Also it is estimated that the UK is understrength by 10,000 doctors.

So I decided to recalculate, but combining both processes. I assumed, as before that appraisal takes 40 hours to prepare for and endure. And 20 hours mandatory training. I also assumed, as before that a doctor works 44 weeks of the year. In may 2018 there 240,000 fully registered medical practitioners. There are now 300,000.

I’m not going to go through the arithmetic. The bottom line is that, if appraisal, and mandatory training were abolished, and the time saved devoted to clinical work it would generate extra work equivalent to employing an extra 10227 full time doctors. At zero cost. That would address the shortfall at a stroke. I believe that the benefits would actually be greater. These calculations assume that doctors would be prepared to do an extra 15 sessions a year if the requirement for appraisal and mandatory training, both utterly worthless exercises, were lifted. I would be perfectly prepared to permanently change an SPA to a clinical session if this were offered, and I’ve no doubt many of my colleagues would feel the same. In addition we know that these processes are demoralising. They contribute to doctors emigrating and retiring early.

They are both, in the current circumstances, and for the foreseeable future, unwanted luxuries we can not afford.