Formal vs Informal Feedback in Medical Appraisal

2 days ago

3 min read

Why feedback matters in appraisal

Feedback is a core part of medical appraisal because it helps doctors understand how their practice is experienced by patients, colleagues and teams. For appraisal purposes, it is useful to separate feedback into two broad categories: formal solicited feedback and informal or unsolicited feedback.

Formal feedback: PSQ, MSF and TAB

Formal feedback is the structured feedback exercise normally required at least once in each revalidation cycle. For patients, this is often called a patient satisfaction questionnaire, or PSQ. For colleagues, it is often called multi-source feedback, MSF, or team assessment of behaviour, TAB. Formal feedback should use a structured questionnaire, collect enough responses to be meaningful, and produce a report that can be discussed at appraisal.

For patient feedback, reliability improves when enough responses are collected. Many appraisal systems work on the principle that around 34 patient responses provide a useful level of reliability. The questionnaire should ideally be distributed and collected in a way that reduces bias. For example, a receptionist, administrator or colleague may hand out forms rather than the doctor selecting only patients they know well. Results should then be collated and presented in a report.

For colleague feedback, many systems aim for around 15 responses. These should normally come from a range of colleagues across the doctor’s scope of work. Depending on the role, this might include doctors, nurses, pharmacists, managers, administrators, allied health professionals, supervisors, clinical leads and other members of the wider team. If a doctor works across multiple settings, it is sensible to include respondents from more than one role or site where possible.

The GMC mandates that formal feedback should occur in a GMC-compliant fashion e.g. using a particular feedback tool, collected independently or semi-independently, certainly analysed and scrutinized interpedently, and ideally benchmarked against other data. Dr Appraisals feedback services meets these criteria.

Informal feedback

Informal feedback is different but still valuable. This might include a thank-you card, an email from a patient, a verbal compliment, a colleague’s comment, feedback after teaching, or themes from day-to-day work. Informal feedback is not a substitute for a formal PSQ or MSF where that is required for revalidation, but it can still provide useful annual appraisal evidence. Think of informal feedback as an annual appraisal expectation.

The GMC expects doctors to reflect on feedback from patients and colleagues. The purpose is not to prove that every response is positive. It is to identify themes. What do people value about your practice? What could be improved? Are there differences between how you see yourself and how others experience you? Have you changed your behaviour as a result?

Doctors with limited or no patient contact

Doctors sometimes ask what to do if they have no patients. This is common for doctors who are not currently working or for doctors in non-clinical roles e.g. work in pharma. The answer depends on the doctor’s circumstances and revalidation timeline.

If there is genuinely no patient contact, the doctor should explain this clearly at appraisal and discuss a plan for collecting patient feedback when they next have a suitable clinical role. Are there any substitutes for direct patient contacts? For example, in pharma, do they interact with patient advisory group?

Dr Appraisals feedback service options

Dr Appraisals offers feedback services for doctors who need GMC-compliant patient and colleague feedback for revalidation purposes. Options may include electronic feedback, paper-based feedback, or a combination depending on the doctor’s circumstances and working environment.

Electronic feedback can be easier for doctors working remotely, across different sites, or overseas. Paper feedback can be useful in face-to-face clinical settings where patients may prefer a physical form.

The key output is a feedback report. A good report should summarise responses, highlight themes, and allow the doctor to reflect on the findings. Where benchmarking is available, it helps the doctor understand how their results compare with relevant datasets. This can make the feedback more meaningful than a simple collection of individual comments.

For Dr Appraisals customers, the feedback service is designed to support formal revalidation feedback requirements. Doctors can use code FEEDBACK5 for £5 off our feedback services. The feedback report can then be discussed at appraisal and included as supporting information.

Reflection matters more than the score

The most important part of feedback is not the score. It is the reflection. A doctor with very positive feedback should still identify what they want to maintain or develop. A doctor with mixed feedback should avoid becoming defensive and should identify practical changes.

Feedback is most useful when it leads to better communication, safer systems, clearer documentation or improved teamworking.