Making recommendations: barriers to engagement

This scenario looks at:

  • investigating the circumstances behind potential non-engagement
  • the need for doctors to have access to systems and processes to support them with revalidation.

Scenario: barriers to engagement

Dr Gainsborough joined the trust two years ago and works in the microbiology department. He isn’t under notice for revalidation, so you don’t need to make a recommendation about him yet.

However, most of his supporting information is missing from the appraisal system and he didn’t attend his annual appraisal, which should have taken place four months ago.

The appraiser claims Dr Gainsborough did not turn up to the appraisal meeting as arranged. Dr Gainsborough maintains that the meeting was cancelled weeks in advance.

Key points: barriers to engagement

Key issues are:

  • doctors must be given sufficient opportunity and support to engage
  • you should check whether a doctor has made efforts to engage, even if this has not been successful
  • you should consider whether there are reasonable circumstances that explain non-engagement
  • You are responsible for making sure there are robust systems of appraisal and clinical governance to support doctors with their revalidation.

In more detail: barriers to engagement

The microbiology department has suffered from disruptions to staffing and facilities, including difficulties with appraisal systems. Dr Gainsborough has compiled supporting information in his appraisal portfolio, but technical difficulties mean he’s lost access.

IT issues also have affected the appraisal booking system. The original appointment was cancelled in error.

Dr Gainsborough had no way of knowing that his appraiser also hadn't been notified about the cancellation. And he had trouble booking a new date in the system.

By investigating, you should be assured that Dr Gainsborough is willing to engage and that troubles are due to issues with the trust’s appraisal systems.

Dr Gainsborough could have raised concerns with his employer, or sought alternative information for his appraisal discussions. But as Dr Gainsborough’s responsible officer, you are responsible for making sure appraisal and other systems are in place to support his proper engagement in revalidation.

You can find more information about requirements for supporting information and recommendations of non-engagement in our guide, Making a recommendation about a doctor's revalidation.