5. Colleague feedback

NASGP AppraisalAidYou must gather feedback from a range of colleagues that cover the full scope of your work and reflect on this once in every 5 year revalidation cycle.

A key issue for the more peripatetic locum is having access to a suitable number and range of colleagues.

How to muster colleagues

Be identifiable

  • Kit yourself out with a name badge and name plate for your consulting room door; people can’t give you anonymous feedback if they don’t know who you are.
  • Insist on a unique, secure log in to the clinical IT system so that subsequent GPs can identify who’s been seeing each patient.
  • Chat to the practice staff - everything from social niceties (time allowing) to work-related matters.
    • Thank them for their help.
    • Learn their names as future potential colleagues. You will need a range of fellow GPs, nurses and admin staff.
    • Offering your feedback about the practice is a powerful tool as everyone is on the lookout for supporting information. Start with the positive. You’ll make yourself memorable for future employment and colleague feedback; even the most harassed and unsmiling practice member likes to know they’re doing something right. So it’s a win-win.
      • “Thank you for being so thoughtful and making sure my room was stocked. It makes such a difference.”
      • “Nice to meet you Dr Foster. I saw some of your patients today and I thought your notes were fantastic - really clear and easy to follow.”

Join forces with locum colleagues

  • Fellow locums are colleagues too. If you are in a learning group, locum chamber or meet at educational eventsthey will be able to comment on your commitment to patient care, and your efforts to keep up to date and reflect on your practise.
  • If it doesn’t already do so, get your chambers or group to organise name badges and doorplates for everyone, and make it a policy that all practices where you’re booked issue correct passwords and IDs.
  • If you have successfully insisted on having your own unique computer log in, your locum colleagues may also have worked in the same practices as you and be able to comment on your standard of care and note-keeping.

Take your time

  • Working across different settings and having brief, intermittent contact with colleagues, it is likely to take a locum longer to cultivate contacts with a sufficient number and range of colleagues.
  • Before parting with cash, talk to your questionnaire provider, explain your circumstances and make sure they are willing to give you adequate time to identify colleagues and gather responses.

Which questionnaire to use

Neither the GMC or RCGP now specify which questionnaire to use. Many questionnaires are provided by the various toolkit providers.

The GMC has developed their own questionnaire and instructions on how to administer it. Whilst these instructions are specific to their own survey, there are key features that all questionnaire providers have to note:

  • Questionnaires should be based on GMC principles of Good Medical Practice, follow GMC principles of good questionnaire design and have been piloted and validated.
  • They should be completed confidentially and anonymously by a range of medical and non-medical colleaguesfrom the full scope of your work.
  • Responses should be handled and collated independently of the doctor, appraiser or RMO.

The RCGP suggest checking with your RMO whether they recommend any specific colleague feedback questionnaires. Given the key role of your appraiser and RMO in your revalidation, it might make your life easier to use a tool that is not too alien. However, if you have used a questionnaire that has been designed and administered in accordance with GMC guidance, then you should be able to justify your choice.

Pitfalls in interpreting colleague feedback for locums

The GMC feedback surveys were piloted and researched by Professor John Campbell of Peninsular college of medicine in 2012. Appraisers should be familiar with his guidance on interpreting feedback surveys. Some of the key findings that pertain to locums:

  • Locums tend to receive less favourable feedback than doctors in permanent positions.
  • Colleagues who have contact with a doctor less than once a month tend to give less favourable feedback than they do about doctors they have contact with on most days.
  • Doctors who obtained their primary medical degree in a non-European country tend to receive less favourable feedback than those who qualified within Europe.
  • Beware benchmarking. Interestingly the GMC does not currently see comparison with other colleagues as an essential feature of the feedback process. Nonetheless, many survey providers do include benchmarking BUT it is rarely locum-specific. So for your own sanity and in preparation for your appraisal, it is good to be aware of the rating bias against locums.

The NASGP, with our experience of locum work, think that below the surface of these GMC findings there are probably more granular factors at play which affect how locums are perceived. Read here for some examples of patient and practice variables which could serve as talking points with your appraiser when reflecting on your feedback. Unless your appraiser is also a locum, they may not fully appreciate the context in which you work, so be ready to tell them!