Patient and colleague feedback for appraisal

Feedback from patients and from colleagues are two of the six types of supporting information the GMC expects. This guide sets out what the GMC says about each.

How often

At least once in each revalidation cycle you must collect feedback from patients using a formal, solicited feedback exercise, and reflect on it at appraisal. You should also reflect on any other relevant informal or unsolicited patient feedback, such as cards, letters, digital feedback, or feedback on your team or service, at each annual appraisal.

If you don’t have patients

The GMC says you should reflect on feedback from others you provide medical services to, for example students, customers or clients, suppliers or those who rely on your expert opinion. If you can’t collect such feedback, you must agree with your responsible officer, suitable person or PA/AA recommender that you don’t need to. See MSF with no patient contact.

How to collect it

The GMC’s four principles:

1. Choose a suitable mechanism. A structured questionnaire may be suitable. Other approaches include structured interviews, focus groups, formal comment cards or a digital tool such as an app. The organisations where you work, or your designated body, should help you with this.
2. Cover your whole scope of practice across the cycle, with enough feedback to reflect on. You don’t need a formal exercise for each role. Focus on the quality of the feedback and what it tells you. If you can’t reach the recommended number of responses, it can still be valuable, especially free-text comments, but discuss it with your RO, suitable person or appraiser.
3. Make it accessible. Offer feedback in a way that meets patients’ needs, with reasonable adjustments for disabled patients, and seek views from relatives, carers or advocates if patients can’t give feedback themselves. Those who respond should be broadly representative of your patients.
4. Tell patients the purpose. They should know how to give feedback, what it will be used for, that it is confidential or anonymous, and that they don’t have to take part.

If your workplace has no system in place

The GMC says that if you work in settings without systems, or don’t work in one setting regularly, you should not collect or collate responses yourself, and you shouldn’t ask your RO, suitable person, PA/AA recommender or appraiser to do it. Instead you should:

• use an independent provider to process your feedback and give you an anonymised report;
• minimise bias in who is asked, for example by asking a colleague to approach consecutive patients or a random sample; and
• consider settings where support staff might help.

Your RO or suitable person must be satisfied that your process meets the GMC’s requirements.

Reflecting on it

The GMC says you should reflect on feedback, act on it if appropriate, in a timely manner, and discuss at appraisal how it has informed your practice. Consider the context of your work and whether it influenced the feedback.

How often

At least once in your revalidation cycle you must collect, reflect on and discuss feedback from colleagues at appraisal.

Who to ask

• Colleagues must be chosen from across your whole scope of practice, with a range of roles, including people who are not doctors, AAs or PAs.
• You must choose them impartially and be able to explain to your appraiser why you chose them.
• Choose colleagues you feel will be honest and constructive. The GMC says this may include people you’ve worked with in difficult or challenging circumstances.

How to collect it

Wherever possible, use standard questionnaires that are validated and independently administered, consistent with Good medical practice. You must agree any alternative approach with your RO or suitable person. The independent provider can tell you how many responses you need for an accurate picture. A smaller sample may be acceptable if it suits your practice, but discuss the reason with your appraiser or RO.

If your organisation has other mandatory feedback processes, such as 360-degree feedback, the GMC says your RO or suitable person may agree in exceptional circumstances that you use those instead.

Keep it objective

Where possible, feedback should be anonymous. If you can identify who gave it, you must remain professional, especially if it isn’t favourable.

Reflecting on it

Reflect on what the feedback means for your current and future practice, including how your self-assessment compares with your colleagues’ views.

• Check when you last had a formal patient and colleague feedback exercise.
• If none is due, bring the results and your reflection.
• If one is due, start early, because it takes time. See responses needed for an MSF and MSF for locum doctors.

Our MSF service collects colleague and patient feedback online and gives you a report. Check with your RO or suitable person that it meets their requirements.

See also our revalidation checklist and writing reflections for appraisal.

GMC, Guidance on supporting information for revalidation: Patient feedback; Colleague feedback.