Strengthened Medical Appraisal - Appraisee Clinical Governance Questions These questions are asked on behalf of the Responsible Officer to ensure that effective clinical governance is in place for the purposes of revalidation. Please answer all questions. The completed form should be uploaded to your PReP portfolio. Name: Date of appraisal: 1 Indemnity Yes No 1a Do you have adequate indemnity in place to cover all aspects of your scope of practice? 2 Clinical Governance Yes No 2 a Are you aware of your duty to raise concerns relating to gaps in clinical governance in the organisations or service providers with which you work? (You may wish to add supporting information of any action you have taken in this respect, or any information sought about clinical governance compliance from these organisations). 2 b Are your publications regarding services both factual and accurate? (GMP 2013 Yes No N/A Domain 4:Act with Honesty and Integrity; para 70) 2 c Do you maintain adequate occupational health clinical records? (GMP 2013 Domain Yes No N/A 1, Knowledge Skills and performance; para 19 - 20) 2 d Do you have an effective policy to control access to computerised data and to Yes No N/A prevent unauthorised access at all times? (GMP 2013 Domain 1, Knowledge Skills and performance; para 20)
Strengthened Medical Appraisal - Appraisee Clinical Governance Questions These questions are asked on behalf of the Responsible Officer to ensure that effective clinical governance is in place for the purposes of revalidation. Please answer all questions. The completed form should be uploaded to your PReP portfolio. Name: Date of appraisal: 1 1a Indemnity Do you have adequate indemnity in place to cover all aspects of your scope of practice? Yes No 2 2 a Clinical Governance Are you aware of your duty to raise concerns relating to gaps in clinical governance in the organisations or service providers with which you work? (You may wish to add supporting information of any action you have taken in this respect, or any information sought about clinical governance compliance from these organisations). Yes No 2 b Are your publications regarding services both factual and accurate? (GMP 2013 Domain 4:Act with Honesty and Integrity; para 70) Yes No N/A 2 c Do you maintain adequate occupational health clinical records? (GMP 2013 Domain 1, Knowledge Skills and performance; para 19 - 20) Yes No N/A 2 d Do you have an effective policy to control access to computerised data and to prevent unauthorised access at all times? (GMP 2013 Domain 1, Knowledge Skills and performance; para 20) Yes No N/A