Surgeon’s view: Why I value appraisal and patient feedback – by Dr Zaf Naqui

Consultant hand and wrist surgeon, Zaf Naqui, writes for CP blog about his experience of collecting patient feedback and how it has influenced his medical practice.

In my opinion, continued professional development (CPD) is a vital strand in enabling patient safety and high quality care in a constantly changing healthcare environment. I see it as a privilege afforded to me to be able to continuously refresh my career and broaden my clinical interests.

I lead patient safety and governance in the trauma and orthopaedic department at Salford Royal NHS Foundation Trust. I am a consultant hand and wrist surgeon, I am a trainer, I am an examiner – and I enjoy trekking with my children.




Annual appraisals provide an excellent opportunity for us to focus on our career development and assist in helping to create and maintain an environment that not only allows CPD to be undertaken, but actively pushes it. It is a useful time to reflect on last year’s achievements and plan for the future.

I have set various goals in terms of my career progression and use the time I have to develop within these fields. Having an interest in training, education and examination gives me many opportunities to continually review my field of expertise and keep up to date. This includes representing my faculty at conferences, lectures and practical courses, as well as the examinations themselves.

I found revalidation slightly cumbersome in terms of the administrative processes; I imagine it will become easier as it is repeated. I am pleased that the recent report on revalidation highlighted the need to make this easier for us. I was disappointed to read that some doctors did not see the benefit, though I suspect this is down to their personal experience.

I personally found it was really useful to be able reflect upon my achievements, receive feedback from my team and my patients and focus on my career goals. In the end, it was personally very rewarding and affirming. Being able to discuss feedback with my appraiser was helpful as I gained an additional and more objective perspective on my practice.

Patient feedback can offer real insight into our practices. Openly asking for feedback, especially when things don’t go to plan, can be a good step to maintain positive relationships with your patients. You may receive patient feedback as part of a complaint. It is natural to react defensively when you receive criticism and to focus on system failures that are frequently implicated within complaints.

However, if the criticism is used as an opportunity to evaluate how we could have done things differently, despite possible system issues, we can find better ways of working within our teams. The formal collection of patient feedback, although cumbersome, gives us further opportunity to reflect and can be an early warning sign that there is an issue that needs to be addressed.

I gather feedback from a variety of sources including paper forms in outpatient areas, which the clinic nurses will kindly distribute and collect for me independently. Feedback has helped me focus on spending as much time as possible with patients to enable clear communication, particularly around consent and the expectations of surgery.

It is reassuring that the GMC has recognised that more efficient IT systems could help make the process much easier for us. I have just recently started using the GMC’s My CPD app on my phone to help collect my CPD activity and found it straightforward. Better systems will also make it far easier for patients to give their feedback going forward.


Considering specialising in hand surgery? Here’s some advice from Zaf:

Hand surgery is an exciting emerging field in its own right. The pathway is currently through either Orthopaedic or Plastic Surgery with further higher interface training allowing specialisation as a hand surgeon. Pathology can be highly variable and so a critical mind is required to consider aetiology of the loss of hand function. An eye for precision is paramount as is a high level of dexterity in terms of surgical skill. Hand surgery requires close working relationships with allied professionals, such as hand therapists, so teamwork is imperative. The results are very rewarding as restoration of hand function enables people to work, play and express themselves in their lives. You can find out more about hand surgery training on the British Society for Surgery of the Hand

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