To maximise your Q&A interaction with the panel on the day, please watch this video above or read the key notes below prior to attending the webinar.
Registration Status
- Whilst it may be acceptable to the GMC, should the appraiser have a licence to practise as well as being on the medical register in order to have credibility with appraisees.
- Should it be deemed acceptable, then at the very least there should be status transparency.
- There are potential problems with the GMC requiring ‘adequate & appropriate indemnity’ with a distinction between cover for a possible claim and any support an appraiser might require if subject to a regulatory referral.
Failure to Identify Concerns About Fitness to Practise
- If the appraiser overlooks, minimises, or fails to escalate concerns (e.g. health, probity, clinical competence), they may later be criticised if the doctor goes on to cause harm to patients or themselves.
- Example: Ignoring repeated complaints or evidence of poor outcomes.
Overstepping the Role of Appraiser
- The appraiser should not act as investigator, performance manager, or disciplinarian. Blurring boundaries may expose them to legal challenge or professional complaints.
- A degree of coaching may be inherent within the arrangement, especially over a 3-year period but mentorship probably goes beyond that.
Inadequate Documentation
- Poorly written or incomplete appraisal summaries may cause problems if the appraisal record is later scrutinised in GMC/HR/legal proceedings.
- Lack of clarity or factual accuracy could compromise both the appraiser and the process.
- Is there adequate auditing of the record produced?
Breach of Confidentiality
- Sharing appraisal information inappropriately (outside agreed governance structures) could amount to a confidentiality breach. Need to give advance notice of this possibility and the warning recorded about exceptional circumstances where may need to do this.
- Conversely, failing to disclose relevant information when a serious risk to patients is identified may also create legal exposure - same duty as all RMP although mindful of proportionality and justification for any actions taken.
Conflict of Interest
- Appraising a colleague where there is a personal, professional, or financial conflict may undermine impartiality and could be challenged legally. Should be obvious in advance but may require to withdraw from process if this becomes apparent on the day.
Failure to Support Revalidation
- If the appraiser does not adequately (man on the Clapham omnibus) i.e. reasonableness - test supporting information or accepts weak/false evidence, it could compromise the responsible officer’s revalidation recommendation.
- They may later be criticised if problems with the doctor’s practice emerge that should have been appreciated earlier.
Inconsistent or Biased Approach
- Treating some doctors more leniently or harshly than others can open the appraiser to accusations of unfairness, discrimination, or bias - perception of actions. Also, should have training about and awareness of unconscious bias.
- Equality Act obligations apply.
Not Escalating Health Concerns
- If an appraiser becomes aware of significant health issues that may impair safe practice but fails to advise appropriate disclosure/occupational health referral, they could be implicated if harm occurs. Significant or chronic illness may not equate to patient risk - also require to consider whether there is insight with mental health issues.
Misrepresentation of Appraiser Role to the Appraisee
- If the appraiser gives the impression appraisal is entirely ‘safe space’ but later disclosures must be escalated, the appraisee may claim they were misled. It's never entirely safe.
- Has the appraiser received NES enhanced training and is this up to date.
Negligence in Advice Given
- While appraisal is not meant to be advisory in a prescriptive sense, if an appraiser makes recommendations that are unsafe (e.g. advising on clinical practice changes beyond their expertise), there could be liability. Adequacy of generic medical knowledge i.e. sphere of competence and up to date.
This page was last updated on: 27/10/2025
