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Making recommendations: colleague feedback

You should consider colleague feedback when you make revalidation recommendations.

In this scenario, we consider:

  • how much feedback a doctor should gather
  • whether in your recommendations you should compare how much feedback different doctors gather
  • how to use feedback to inform your judgement.

Scenario: considering colleague feedback

Dr Cardiff and Dr Monmouth are consultants at the same NHS hospital. They have both collected all six types of supporting information, which was generally of a high standard. You are content their appraisals were in line with relevant policies.

Dr Cardiff, who works in a small department with a heavy research focus, collected colleague feedback from six colleagues. Dr Monmouth got feedback from 32 colleagues across his busy A&E department and several other teams.

You are concerned about the large difference in sample size, and are unsure whether to recommend Dr Cardiff for revalidation.

Key points: considering colleague feedback

Key issues are:

  • revalidation is not a benchmarking exercise
  • each doctor must meet revalidation requirements on his or her own
  • your recommendation must take into account all types of supporting and clinical governance information
  • revalidation should encourage reflection.

In more detail: considering colleague feedback

You should consider your recommendations for Dr Cardiff and Dr Monmouth separately. To make a recommendation to revalidate, you must agree with all criteria in the recommendation statement for each doctor. 

Colleague feedback is one source of supporting information. You shouldn't consider it in isolation from other types of evidence, such as clinical governance information.

Our Guidance on supporting information for appraisal and revalidation emphasises that the doctor’s insight, reflection and understanding of potential improvements to their practice are more important than sample size.

Dr Cardiff may also have less colleague feedback for a number of reasons – most obviously that she has fewer colleagues.

While a smaller sample may not give the same statistical reliability as a larger sample, you must merely be confident that the amount of feedback gathered is appropriate to the doctor’s practice.

If gathering feedback from immediate colleagues and managers is challenging, doctors should be encouraged to think creatively and seek feedback from clients, suppliers or non-medical colleagues.

Our colleague and patient feedback case studies give more potential sources of feedback. It's also worth recording the reason for the smaller sample and considering whether alternative sources should be encouraged for future exercises.

If Dr Cardiff fulfilled the same feedback requirements as Dr Monmouth, and gathered feedback of the same standard, you can consider Dr Cardiff’s revalidation in the same way as Dr Monmouth’s.