Making an objective assessment of a colleague's performance

Historically, assessment of good medical practice has focused on clinical skills and knowledge. However, performance assessments and appraisal today encompasses the review of both non-clinical, or behaviourial skills and the assessment of clinical practice.

There is an increasing trend towards the systematic, multifaceted assessment of doctors' performance. For doctors in training this has facilitated the earlier identification of performance concerns as they arise. Doctors in training have clear goals and accept regular assessments as a requirement of their progression through medicine. This is perhaps not quite the same for more senior colleagues where, for some, the introduction of performance assessments based upon appraisals and revalidation may have historically been uncharted territory.

Skilful peer assessment is not easy, and the boundaries between roles, responsibilities and relationships when managing senior colleagues can often feel blurred. Performance issues are often complex, multifactorial, and include both clinical and behavioural issues. To make an objective assessment of performance requires a comprehensive understanding of the problems raised. This includes the collection of appropriate detailed information alongside clarity of the local and national processes involved in assessing and managing performance issues.

The provision of local, specific support for more senior colleagues is at present not well formulated. This in turn leads to concerns very often being ignored until they have become a disciplinary issue. With the introduction of revalidation there is a need to address training around the management of performance issues to improve the experience for both the appraiser and the appraisee.