As an extension of the 2025/26 Appraisers Conference, this lunchtime webinar, delivered by Drs Iain Jamieson (NES) and George Fernie (NSS), explored common medico-legal challenges faced and risks that appraisers could encounter during the appraisal process, including confidentiality concerns, documentation standards, conflict resolutions and handling sensitive disclosures.
Participants were asked to review a pre-session presentation prior to attending the webinar. Below are summaries of the presentation and the subsequent discussions during the session.
Drs Iain Jameson and George Fernie discussed the importance of appraisers having both a license to practise and being on the medical register. George emphasised that while it is technically acceptable to be on the register without a license, having a license adds credibility and comfort among peers.
Iain and George talked about the necessity of transparency regarding appraisers' licenses and the importance of adequate indemnity. George highlighted the need for openness about one's status and the distinction between cover for claims and support for regulatory referrals.
Iain and George discussed the potential issues arising from failing to identify concerns about fitness to practise. George emphasised the importance of thorough appraisals and documenting rationales to avoid criticism if harm occurs to a patient.
Iain and George addressed the risks of appraisers overstepping their roles by becoming investigators or disciplinarians. George advised appraisers to maintain boundaries and focus on coaching and mentorship within the appraisal process.
Iain and George discussed the importance of well-written and complete appraisal summaries. George stressed that documentation should be clear, factually accurate, and appropriately detailed to avoid compromising the appraisal process.
Iain and George talked about the importance of maintaining confidentiality during appraisals. George noted that while most information should remain confidential, there are exceptional circumstances where patient safety concerns may require breaching confidentiality.
Iain and George explored the concept of conflict of interest in appraisals. George explained that conflicts could be personal, professional, or financial, and appraisers should withdraw from the process if a conflict arises.
Iain and George discussed the importance of supporting revalidation with adequate evidence. George emphasised the need for reflective learning and insight, rather than just ticking boxes, to ensure the appraisal process is meaningful.
Iain and George talked about the importance of addressing health concerns that may impair safe practice. George advised appraisers to encourage doctors to seek help and take appropriate actions if patient care is at risk.
Iain and George discussed the potential issues arising from appraisers misrepresenting their roles. George emphasised the need for clear communication about the appraiser's role and the importance of maintaining professional boundaries.
Iain and George addressed the potential liability of appraisers providing unsafe advice. George highlighted the importance of staying up to date with medical knowledge and ensuring that any advice given is appropriate and safe.
Drs Iain Jamieson and George Fernie recapped on the pre-session recording and discussed the importance of understanding medical legal aspects for appraisers, addressing gaps in knowledge, and ensuring rigorous appraisal processes.
Iain explained that appraisers can hold a license to practise even if their practice is restricted to being an appraiser. He also discussed the possibility of obtaining insurance without a license to practise.
Iain and George highlighted the importance of acting responsibly during appraisals and discussed potential professional complaints and their ramifications.
Iain and George addressed various questions from participants, including tips for engaging with Medical Defence Organisations (MDOs), the importance of transparency, and the need for calibration in appraisals.
George emphasised the importance of having support from MDOs and the British Medical Association (BMA), especially in cases of professional complaints or GMC hearings.
The below message was shared by colleagues who raised this in England:
The confusion here relates to the difference between indemnity cover (which the MDO no longer cover at all; it all comes from NHSEI whether for appraisal work or clinical) and professional/licence/legal cover, which is what doctors pay MDOs to support them if there is a challenge to their licence or if they want to challenge a case where NHSEI wants to settle.
There are therefore situations where an MDO will charge for covering an appraiser for professional cover (for example if the appraiser is not otherwise professionally active), but it is important to be clear about what they are covering (i.e. not for damages pay outs). At the end of the day they may choose whether to pay for the cover being offered or insure their professional licence some other way. Also, I sense some inconsistency between call handlers, even of the same MDO, in the stories I hear.
Generally I would signpost the doctor to the ROAN 31.
Iain and George discussed the importance of calibration sessions to ensure that Form 4s meet the required standards and provide adequate documentation. Appraisers can reach out to their Appraisal Leads for support.
A participant raised concerns about the financial burden of maintaining a license to practise. Ian acknowledged the issue, emphasising the need for transparency and potential support.
Although in most instances valid cover at the time of membership will suffice, George explained the importance of enquiring about any requirement for run-off cover for retired appraisers and the need to check with MDOs to ensure continued support is available.
This page was last updated on: 31/10/2025
