Appraisal, wellbeing, and pandemics: why a focus on wellbeing is always warranted

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Doctors are human beings, with personal and professional needs.¹ Many have spent the pandemic supporting others with little support for themselves. The restart of appraisals offers protected time to have a confidential reflexive conversation with a well-trained peer. The rebalanced ‘Appraisal 2020’ process² minimises the pre-appraisal paperwork and recognises the impact of the pandemic. We urge doctors to seize this opportunity to make their appraisals valuable and ensure that their investment of time delivers maximum benefit to themselves and their patients.

A focus on wellbeing in appraisal is always warranted. In the World Medical Association Declaration of Geneva, doctors pledge: ‘I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard.’ A doctor who is unwell cannot give their best care to patients — yet many doctors do not prioritise maintaining their own health and wellbeing. The risk of burnout for doctors was high even before the pandemic. Appraisal, as a process reaching all, is a proactive way to offer a safe place to discuss any concerns and be signposted to resources as needed.

Doctors should understand the code of conduct that defines the limits of professional confidentiality in any setting. If a doctor discloses a risk to personal or patient safety, appropriate action must be taken immediately to protect the vulnerable. An appraisal would be stopped — but so would a casual coffee-room conversation. Sensitive topics are frequently discussed at appraisal without being recorded. The written summary should always be mutually agreed before being signed off. The training for Appraisal 2020 reminds appraisers of this and emphasises the importance of creating a confidential safe space for support.

The core purpose of appraisal is not to revalidate. Appraisal cannot be ‘failed’. Its published purposes^2,3 are clearly supportive and developmental. Most doctors re-license without difficulty by demonstrating their continued competence through appraisal. An absence of concerns has been positively confirmed through appropriate clinical governance but they remain unaware of this aspect of the regulatory process.

• © British Journal of General Practice 2020