All doctors working in NHS Wales have access to the Equiniti patient and colleague feedback tool. For most doctors this will provide the route to obtaining the minimum requirement of 1 colleague and 1 patient feedback exercise every 5 years. Some doctors may wish to use other tools - you should ensure that the method chosen is validated and accepted as an alternative by your Responsible Officer. It is good practice to obtain your feedback in the first two years of your revalidation cycle as, if changes are needed, you may choose to run the feedback again to demonstrate development. 

GMC Guidance on Colleague and Patient Questionnaires

The GMC has also released the following Central Resources;

Making it work – real examples

$1· We have six real case studies from doctors in roles and specialties where collecting feedback can be most challenging: multiple roles, locum posts, mental health, anaesthetics, palliative care and neonatology.

$1· The examples also illustrate broader principles – such as the most appropriate time to ask for feedback – so doctors in a range of roles will be able to benefit.

Encouraging useful feedback – new patient leaflet

$1·  Feedback from patient groups suggested that patients would be more likely to give their doctor feedback if they understood how to do so and how their feedback would be used. As a result, we have created a new leaflet for patients that sets out the process and how patients’ feedback can have a positive impact on care.

$1· The leaflet is short and easy to print. It is available in English, Welsh, easy read and large print. 

How does the Equiniti system work?

    • 1. Your Health Board has completed a spreadsheet for all doctors detailing when they should have access to the Equiniti system
    • 2. Equiniti issue invitation to doctors to participate in line with schedule
    • 3. You complete self-questionnaire, nominate 15 colleague raters (medical, nursing, administrative etc) and a Supportive Medical Colleague (SMC). The SMC will be a doctor who knows you and is willing to support you through the process. 

For GPs, the SMC is not your appraiser. This doctor should not be related to you but may be your partner or someone else with whom you work closely. 

For all other doctors, the SMC can be your appraiser. This doctor should not be related to you but may be someone else with whom you work closely. 

Guidance for avoiding Conflicts of Interest re: SMC's

Within Wales, a local system has been adopted and the GMC does not give specific guidance on this. The GMC guidance relates to the need to ensure that there is no conflict of interest  when the Responsible Officer is making the Revalidation recommendation.

The role of the Supportive Medical Colleague in the process, is to help the doctor make sense of, and reflect on, their feedback - both good and bad. A relative may find it difficult to be objective and balanced in their approach, and, as a consequence the doctor might not get as much out of the process of reflection as they otherwise would.

For this reason, it would suggest that it would be best practice for the SMC to not be a relative wherever that is possible. The same advice would apply to a relative who is considering the appropriatness of being a colleague rater, where it might be appropriate to consider requesting additional patient questionnaires to be completed.

In both situations, it is a requirement of Good Medical Practice that the doctor declares that there is the potential for a conflict of interest. 

     4.  The SMC approves the rater list and will act as the recipient of the completed report.

     5.  Equiniti then emails all selected raters to invite them to complete the online questionnaire

     6.  You will receive a pack of 30 patient feedback forms with sealable envelopes and you should make arrangements to distribute these in a manner compliant with GMC guidance. (i.e. distribution and collection is independent of you– this may be your receptionist or clinic clerk etc)

     7.   Once you have obtained 20 completed patient feedback forms you then mail them back to Equiniti as one batch still within the sealed envelopes. These are processed by Equiniti and released to the SMC – a process that may take up to two weeks.

     8.   Once 15 colleague raters have completed the online questionnaire the colleague report is released to the nominated SMC.

     9.   The SMC has to provide feedback and release the report to you (on line in downloadable PDF format).

    10.   You will then be able to upload to MARS and complete the appropriate reflective entry.

    11.    If less than 15 Raters have responded you can nominate more raters by contacting the Equiniti helpdesk.

If you have any further questions please contact: This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it.

In order to meet revalidation requirements the feedback must be taken to appraisal. If however your revalidation date falls between your Patient and/or Colleague feedback and your next appraisal, you should inform your RO. 

You and your Colleague should then fill in this template and forward to your RO before your date for revalidation as communicated to you by the GMC.

Being a Supportive Medical Colleague in the Feedback Process

How to analyse the report

In most instances scores are very high. However, no quick assumptions or conclusions should be drawn from low scores until reasons have been explored. Below is a list of possible reasons for low scores.

These have been provided for discussion and reflection. There may well be many other reasons for low scores not included in this list, but many of the more common reasons have been included.

Possible Reasons for Low Scores

These are listed with no particular weighting:
Workload Technical support
Team/Trust failure Suitability of selected raters
Staff shortages Specialty
Personality clashes Personal problems / illness
Patient case load Lack of training
Lack of skills/knowledge Lack of information
Lack of feedback Lack of awareness
Keeping up to date Job structure/job role
Honesty Equipment availability/failure
Cultural issues Confidence
Communication skills Awareness of own limitations
Attitude Other (investigate)

Supportive Medical Colleague (SMC) Feedback Notes

Feeding back the contents of the 360 report to your colleague

Introduce the feedback session and describe your role as a SMC to encourage reflection and personal development planning. If appropriate, consider setting some ground rules, such as confidentiality. The feedback interview should be held in private, avoiding interruptions. 

Seek doctor's views first - Ask questions rather than make statements

If your colleague has low scores in a particular area, do not make assumptions. There are many reasons for low scores some of which are detailed above. Low scores may be a result of workload or staff shortages. Of course, low scores may also be due to personal factors.

If there are clusters of raters scoring I have concerns/ below expectations, the appraiser should seek advice from the appraisal lead.

You could ask: -

    •  What went well and why?
    •  What didn't go so well? and why?
    •  What changes would you like to see in the future?
    •  How will these changes be implemented?
    •  What will happen to reassess / monitor improvements?
    •  Concentrate on specific areas which cause most concern e.g. high variance between self and colleagues assessments.

Then focus on specific items of behaviour.

Compliment on the areas where the individual scored highly as well as address areas for improvement. Encourage the individual to build on their strengths. The graphic quantitative feedback report allows you to discuss current, sensitive issues in a direct manner. The feedback interview should be held in private, avoiding interruptions.

Stick to the facts and always avoid becoming emotional or using emotional language. For example, if a doctors has a low score in communication skills you might say 'you have some lower ratings in the communication skills element, why do you think that might be?' instead of "you didn't do very well in communication skills did you?"

If in doubt about how to approach this feedback please contact the Appraisal Lead in your organisation or the available designated individual. If you are unaware who this is please contact the Responsible Officer for advice.

For further guidance please visit  http://www.equiniti360clinical.com/ or visit our FAQ section, there is one for GPs and one for all other doctors.