Significant events and complaints for appraisal

Significant events, and complaints and compliments, are two of the six types of supporting information the GMC expects. Both ask you to declare what happened and reflect on what you learned. This guide sets out what the GMC says.

The GMC defines a significant event as any unintended or unexpected event which could or did lead to harm of one or more patients, including incidents where the event should have been prevented. Your organisation may call these something else, such as serious incident, adverse event or patient safety incident. To meet the GMC’s requirements, you should focus on your learning from any events and incidents that have or could have harmed your patients.

• Declare and reflect on every significant event you were involved in since your last appraisal. Involvement includes being part of the team providing treatment where the event occurred.
• Focus your appraisal discussion on events that led to a change in your practice or to system improvements, or that show your insight and learning. Discuss your part in logging incidents and in clinical governance meetings where they are reviewed.
• Focus your reflection on insight and learning, rather than the facts or the number of events. You must be able to explain to your appraiser, if asked, why you chose those events.
• If you have not been involved in any, you must declare that. You should either reflect on your local significant event or serious incident process, or on what you have done to reduce the risk of one happening.

Show patterns

You should be able to show you’re aware of any patterns in the types of events recorded about your practice, and discuss what you’ve done and changed to prevent them recurring.

Where the information comes from

If you are employed or contracted by an organisation, it should collect significant events routinely. If you are self-employed, the GMC says you should make a note of any such events or incidents and review them.

Duty of candour

The GMC says you must be open and honest with patients, colleagues and employers, and that you have a responsibility under the duty of candour to log incidents and events through your organisation’s reporting process.

• Declare and reflect on all formal complaints made about you or your practice since your last appraisal. The GMC defines formal complaints as those about you or your team that have been formally acknowledged or recorded by you or the organisation it was sent to.
• Also reflect on compliments, and on complaints received outside formal procedures, where they give you useful learning.
• Focus your discussion on those that show insight and learning, or led you to change your practice. You must be able to explain to your appraiser, if asked, why you chose those over others.
• If you have none in which you are named, you can reflect on other relevant local complaints or compliments that helped you change or confirm your practice.

Where they come from

The GMC says that for each appraisal you should collect, reflect on and discuss:

• complaints you resolved informally, without formal escalation;
• complaints investigated by regulatory bodies, such as ombudsmen, inspection agencies in the four UK countries, or the GMC;
• feedback received through other channels, such as online feedback platforms or informal feedback from a colleague; and
• feedback about your team or the wider environment where you practise, where it affects your individual practice.

Why the GMC asks for it

To identify and build on good practice, to identify areas for improvement and lessons learned, and to show you value patients’ and others’ concerns by making changes as a result.

• List every significant event you were involved in since your last appraisal, and be ready to say why you picked those you’ll discuss.
• Collect your complaints and compliments from every place you work, including informal ones.
• Write short reflections on what you learned and what changed.
• Remove names and details that could identify patients or colleagues.

See our revalidation checklist, and how online appraisals work, and patient and colleague feedback.

You still declare events and complaints from every placement. See locum doctor appraisal.

GMC, Guidance on supporting information for revalidation: Significant events; Compliments and complaints.