Medical Appraisal for Locum Doctors: A Practical UK Guide

If you’re undertaking locum work during an FY3 year, picking up ad hoc shifts or locuming full time, you will need to undertake an annual appraisal, just like in any other medical job. The difference when locuming is that you often need to be self-motivated about organising your appraisal, rather than having someone chase you to arrange a date.

Your designated body will usually be linked to the organisation you work for most of the time, although the appropriate connection depends on your working arrangements. It is worth contacting the organisation if you are not already connected to it on your GMC account.

If you work through multiple agencies, only one can be your designated body. This will usually be the agency through which you undertake most of your work, subject to the rules about your connection.

It is important to declare all the places you have worked and all the agencies you have worked through in the scope of work section of your appraisal form.

If you work through an NHS bank, the trust may support you with arranging your appraisal, or it may ask you to undertake a private appraisal.

If you work through an agency, the private company supporting its appraisal arrangements will usually work with you to organise a date.

If the trust arranges and funds your appraisal, there is no cost to you. If you arrange a private appraisal or have one through an agency, you will normally need to pay. Some recruitment agencies contribute towards the cost if you have undertaken a significant number of locum hours with them.

You can check your designated body and Responsible Officer details on GMC Online. If you are not connected to the organisation through which you undertake most of your work, contact it to check whether it should be your designated body.

The organisation can help you arrange the connection, or you can update your details through GMC Online as appropriate.

If you are locuming, you will usually have a designated body through either an NHS trust or an agency. However, working in a very small hospital or having unusual working arrangements can sometimes mean that there is no designated body.

In this situation, my recommendation is to arrange an appraisal and confirm with the GMC how to submit your appraisal information, including whether a REV12 form is required, so that your record can be updated.

You normally need an appraisal every year. If you are an FY3 doctor who finished FY2 in August, you would generally plan for your first appraisal around the following August, confirming the timing with your designated body.

If you are new to the UK, check your first appraisal date with your designated body or the GMC rather than assuming it will automatically be one year after full registration.

Otherwise, your next appraisal will usually be around one year after your previous appraisal.

Please see the appraisal guide for information on preparing your portfolio. The main areas include relevant mandatory training, BLS or other appropriate resuscitation training, CPD and quality improvement activity.

Around 50 hours of CPD is a common benchmark, rather than a fixed GMC minimum. Quality improvement evidence might include two or three case-based discussions, provided these demonstrate reflection on and evaluation of your practice.

Appraisal software is often used to upload evidence shortly before the appraisal meeting. After FY2, you may miss having a portfolio such as Horus to record learning and workplace-based assessments as you go.

Often, this means keeping files, screenshots, certificates and workplace-based assessments in a folder on your computer.

We have built appraisal tools to help with this. You can record CPD on the go and upload evidence in the portfolio tools section of Medical Appraisal Hub.

There are several options for the quality improvement section, including an audit, a quality improvement project, teaching evaluated through feedback or case-based discussions that help you review your practice.

If you are in a department for a few months, it is helpful to complete your project during that placement. If you are doing ad hoc shifts, you might complete one case-based discussion at one hospital and two more at another.

Despite the transient nature of locum work, particularly if you are doing ad hoc shifts, it is important to declare and reflect on significant events and complaints in which you have been personally involved. This includes relevant matters brought to your attention by an organisation you have worked for or an agency.

In an appraisal, complaints and significant events are usually discussed as learning exercises: you review what happened and identify learning points and any changes to your practice. Often, no further action is needed through the appraisal process. However, concerns such as significant patient safety issues or a pattern of unprofessional behaviour may need to be raised with the Responsible Officer.

As with any appraisal, aim for targets that are appropriate to your scope of work. For example, if you undertake a lot of acute work and currently only have BLS, you may want to complete ALS.

If you are doing a lot of locum work in gastroenterology, you might want to complete relevant modules or read around common gastroenterology presentations.

You get the idea: these should be targets that will aid your development and be relevant to the year ahead.

If you have undertaken very little clinical work during the appraisal year, discuss this with your appraiser or designated body so that the appraisal can reflect your circumstances. Be honest about gaps and don’t exaggerate your experience.

The appraisal meeting covers your scope of work, CPD, quality improvement, complaints and significant events, and setting a PDP for the year ahead. The length of the meeting will depend on your circumstances and how much there is to discuss.

After the meeting, the appraiser will prepare a report, and the appraisal software will usually generate a final PDF. It is important to keep a copy for your revalidation records.

Use this checklist to prepare your portfolio and keep track of the extra details involved in working across different locum roles.

• Confirm your designated body and Responsible Officer details on GMC Online.

• Check your appraisal due date and GMC revalidation date.

• Confirm who will organise your appraisal, who pays and whether your agency contributes towards the cost.

• Book your appraisal and confirm which software or forms to use.

• If you have no designated body, confirm your appraisal and revalidation arrangements with the GMC.

• Check your GMC number and personal details are up to date.

• List every NHS trust, private hospital and other organisation you have worked for.

• Include all agencies and staff banks you have worked through.

• Record your job titles, specialties, dates, responsibilities and average number of shifts per month.

• Include other medical roles, such as teaching, management, private or voluntary work.

• Explain any career breaks or periods of limited work.

• Record your CPD across the appraisal year, covering your whole scope of work.

• Aim for around 50 hours of CPD, using any relevant specialty or designated body guidance. This is a common benchmark, rather than a fixed GMC minimum.

• Include a mix of workplace and external learning, such as departmental teaching, case reviews, courses, webinars and online modules.

• Reflect on what you learned and how it has influenced your practice.

• Include relevant, up-to-date mandatory training.

• Include BLS, ALS or other resuscitation training appropriate to your roles.

• Gather certificates and learning records from different placements in one place.

• Include suitable quality improvement activity relevant to your work, with reflection on the findings and any changes made.

• Consider an audit, QI project, review of cases or teaching evaluated through feedback.

• If using case-based discussions, explain the learning and how this helped you evaluate or improve your practice.

• Collect evidence and feedback before leaving a placement where possible.

• Declare significant events and complaints in which you were personally involved, or confirm there have been none.

• Reflect on your involvement, learning and any resulting changes to practice.

• Check for relevant information from the trusts or agencies you worked through.

• Include relevant compliments and reflect on positive feedback.

• Check when formal patient and colleague feedback is due within your revalidation cycle.

• If due, arrange collection early enough to allow time for responses across locum placements.

• Follow the requirements of your chosen feedback tool, including its recommended response numbers.

• Upload the anonymised feedback reports and reflect on the results.

• Include other relevant feedback received during the year.

Formal patient and colleague feedback is normally required at least once per revalidation cycle, rather than at every annual appraisal.

• List each previous PDP objective.

• Explain how each objective was achieved, including relevant evidence.

• If an objective was not achieved, explain why and whether it remains relevant.

• If this is your first appraisal after FY2, include your latest training PDP or development objectives where available.

• Prepare a few suggested objectives to discuss with your appraiser.

• Choose goals relevant to your locum work and career plans.

• Consider how you will achieve them while moving between placements.

• Complete your health and probity declarations.

• Declare relevant issues for discussion.

• Include indemnity or medical defence cover details where requested, and check that cover reflects your whole scope of work.

• Upload an up-to-date CV and any employment documents required by your appraisal provider.

• Remove patient-identifiable information from your evidence.

• Submit your portfolio by the agreed deadline.

• Note any career, wellbeing or workplace concerns you would like to discuss.

• After the meeting, review your appraisal summary and agreed PDP.

• Complete the sign-off process and save your appraisal documents.

Medical Appraisal Hub offers a lower-cost appraisal. Your designated body may be happy for you to arrange a private appraisal with another provider, but it is best to check with it first.