Letters

The coverline to your feature on consultant appraisal screams:

'Consultants on the rack' (29 June), but does it reflect the supportive, affirmative, motivating, developmental, morale enhancing process I learnt about on my appraisal course - or a punitive instrument of management control?

Fortunately, the accompanying articles were rather more sensible. Appraisal is more likely to throw up problems with the structure, staffing, systems and management of an NHS organisation than issues over clinical performance.

There are a number of issues for management to address. How about providing the IT and information systems to support the process? They will need to be considerably more sophisticated than just counting procedures as successes or failures.

Expecting consultants to collect their own performance data is neither reasonable or realistic. What about providing support staff to help? Or what more valuable tasks would you like us to stop doing as we struggle with 50-hour weeks? Who will meet the shortfalls in nursing, therapist and junior doctor numbers that we identify? I support appraisal - done properly. Puerile headlines only serve to make doctors even more distrustful.

Dr Rowan Harwood Consultant geriatrician Nottingham