WORK-BASED LEADERSHIP PROJECT ASSESSMENT FORM Doctors Name GMC No. Assessors name Position GMC No. Competency Insufficient Needs further development Competent Excellent Evidence Demonstrates (not (some limited awareness (Satisfactory awareness & (Demonstrates and applies solid personal Qualities demonstrated) personal management) demonstrates personal awareness of personal factors manages own time, management fit for independent affecting performance and takes steps health, learning needs, practice) to improve) awareness of own performance and impact on others (12) Working with others (minimal evidence (Only Limited (communicates well with team (encourages team development co-operative working, only) communication with and members to level expected for &performance above level expected communication, utilization of use different newly qualified GP) for in early independent practice) developing team team members) performance and relationships (8) Managing services (minimal evidence (limited understanding of (understands & engages with (identified complex issues concerning Identifies important only) healthcare delivery issues in issues concerning service healthcare delivery and engages in services, engages and the practice/community) management to level expected managing to level of experienced GP) contributes to local for independent practice) delivery (9) (10) Improving Services (minimal evidence (Limited evidence of service (new or improved services (service development area identified, Evaluates and helps only) development activity only) identified and developed to developed AND successfully develop services to be level expected for new GP) implemented & evaluated) delivered more safely or effectively (5) (7) GLOBAL SCORE Insufficient Needs Further Competent Excellent Evidence Development As expected for independent Performing at level of experienced practitioner practitioner
WORK-BASED LEADERSHIP PROJECT ASSESSMENT FORM Doctors Name GMC No. Assessors name Position GMC No. Competency Insufficient Evidence Needs further development Competent Excellent Demonstrates personal Qualities manages own time, health, learning needs, awareness of own performance and impact on others (12) (not demonstrated) (some limited awareness personal management) (Satisfactory awareness & demonstrates personal management fit for independent practice) (Demonstrates and applies solid awareness of personal factors affecting performance and takes steps to improve) Working with others co-operative working, communication, developing team performance and relationships (8) (minimal evidence only) (Only Limited communication with and utilization of use different team members) (communicates well with team members to level expected for newly qualified GP) (encourages team development &performance above level expected for in early independent practice) Managing services Identifies important services, engages and contributes to local delivery (9) (10) (minimal evidence only) (limited understanding of healthcare delivery issues in the practice/community) (understands & engages with issues concerning service management to level expected for independent practice) (identified complex issues concerning healthcare delivery and engages in managing to level of experienced GP) Improving Services Evaluates and helps develop services to be delivered more safely or effectively (5) (7) (minimal evidence only) (Limited evidence of service development activity only) (new or improved services identified and developed to level expected for new GP) (service development area identified, developed AND successfully implemented & evaluated) GLOBAL SCORE Insufficient Evidence Needs Further Development Competent As expected for independent practitioner Excellent Performing at level of experienced practitioner
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