Recommendation BRIS-85: Mandate periodic appraisal for all healthcare professionals in employment contracts
From Bristol Heart Inquiry — Final Report, published 18 July 2001.
Recommendation
Periodic appraisal should be compulsory for all healthcare professionals. The requirement to participate in appraisal should be included in the contract of employment.
Government response
No government response to this recommendation is on the record yet.
Delivery
DHSC and NHS England say in progress (27 February 2026)
The Thirlwall Inquiry has noted action taken in response to this recommendation.
Please see response to Recommendation 83 (CPD).
The NHS Terms and Conditions of Service (as updated February 2024) require that the annual system of performance appraisal review be provided to all staff.
This is in addition to appraisal and revalidation requirements as may be set by the relevant professional regulators. The Academy of Medical Royal Colleges published an updated guide to medical appraisal in 2022.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 6.2 No. 85, PDF page 109-110.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
The Government agreed with this recommendation.
In its January 2002 response, the Department of Health said it had made it clear that appraisal would be introduced for all health professionals.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 6.2 No. 85, PDF page 99.
Themes and tags
Who has spoken
- DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding