Introduction Phyllis Tuckwell Hospice Care (PTHC) is an independent hospice and a Designated Body (DB) for medical revalidation. We will outline the approaches taken at PTHC to assure and improve the quality of the medical appraisal process in a voluntary hospice.

Quality assurance processes Individual appraisals

• The Responsible Officer (RO) reads every doctor’s appraisal in its entirety The RO also works closely with the Director of Patient Services who reviews all complaints and incidents. Feedback and learning is shared by the Director of Patient Services and incorporated into medical appraisal, providing further oversight of doctor’s practice.

Appraiser support

• The work of the appraisers is supported by a clear job description

• All appraisees provide feedback on their appraiser which is collated by the RO and fed back as part of appraiser development

• PTHC appraisers also undertake appraisals for doctors from a local NHS Trust. This arrangement maintains and enhances the skills of the appraisers.

Organisational oversight and external review

• An appraisal quality audit was undertaken in 2017. The results demonstrated good compliance with appraisal requirements supported by evidence of reflection from the doctor and the appraiser

• Prior to revalidation, appraisal paperwork is reviewed by a Revalidation Decision Making group. This provides assurance for robust revalidation recommendations

• The appraisal system was externally assessed through a Higher Level Responsible Officer Quality Review in January 2018. The report highlighted a range of examples of good practice including strong support from the CEO and Board of Trustees.

Conclusion The model of medical appraisal developed at PTHC demonstrates that a voluntary-funded hospice can deliver a robust revalidation process within a supportive appraisal environment. The quality assurance process has been developed and implemented without an expensive electronic database or extensive team of staff, which is essential for a cost-conscious charitable organisation.