After many years of debate and planning, the General Medical Council (GMC) is on the verge of introducing revalidation.
For the vast majority of doctors we believe it will be straightforward and it is certainly what patients expect.
We understand that doctors are under a lot of pressure, but we know many see the introduction of revalidation as strengthening clinical governance, and providing better information to help them reflect on and improve their practice.
After many years of debate and planning, the General Medical Council (GMC) is on the verge of introducing revalidation.
For the vast majority of doctors we believe it will be straightforward and it is certainly what patients expect.
We understand that doctors are under a lot of pressure, but we know many see the introduction of revalidation as strengthening clinical governance, and providing better information to help them reflect on and improve their practice.
Maintaining momentum now is crucial. There’s a strong appetite for revalidation amongst patients – they really want this to happen and, quite frankly, won’t accept any further delays.
There is growing evidence that the Council is making good progress across all healthcare organisations in the UK in getting ready to support the introduction of revalidation.
We recently wrote to over 232,000 licensed doctors to update them on our plans to introduce revalidation from the end of 2012 and we are contacting all doctors as part of our Make your connection campaign, which runs until the end of the year. It asks doctors to confirm the organisation providing them with an appraisal and helping them with revalidation, also known as their ‘designated body’.
We are working closely with the four UK health departments, the NHS and other healthcare organisations to help them prepare. Considerable progress has already been made and some organisations are now more or less ready, while others are well on their way.
We will soon be working with responsible officers to plan the dates doctors will have recommendations made about them during the first revalidation cycle. That said, we are not expecting every doctor to revalidate immediately – we plan to revalidate around 20% of doctors in 2013/14 and build from there.
Here are some further facts about where we are:
• The delivery boards in England, Scotland, Northern Ireland and Wales – with representatives of the BMA, the NHS, the private sector and the governments of each part of the UK – are leading change locally and reporting good progress.
• There are over 600 responsible officers now in place.
• More than 105,000 doctors have an account with GMC Online, and the number is growing daily.
• We have linked 120,000 doctors with the organisation that will provide their regular appraisal.
Revalidation is built on a regular appraisal based on our core guidance, Good Medical Practice, so doctors need to ensure they are having an annual appraisal that covers all of their practice. To have their revalidation recommendation made, doctors must have completed at least one appraisal, signed off by them and their appraiser.
Their appraisal must demonstrate that they have collected and reflected on information outlined in our guidance, Supporting information for appraisal and revalidation including:
• Continuing professional development
• Quality improvement activity
• Significant events
• Feedback from colleagues
• Feedback from patients
• Review of complaints and compliments.
Doctors should take reasonable steps to collect this information. Their employer or organisation supporting them should provide access to relevant information, such as complaints, compliments, and feedback from patients and colleagues.
We know many doctors are already collecting supporting information, and NHS Revalidation Support Team research shows almost 80% of GPs had appraisals in 2010-11 so we believe the vast majority of primary care doctors are in a good place for revalidation.
However, we know some organisations, and therefore some doctors, are more ready than others. Doctors won’t be put forward for revalidation until they’re ready, provided they’re doing all they can to prepare.
Gathering feedback will provide doctors with information about their work through the eyes of those they work with and treat, to help them develop and improve their practice.
Medical practice relies on trust between doctors and their patients, and between healthcare professionals – the views of patients and colleagues matter and for the vast majority of doctors, feedback will be overwhelmingly positive, but there will be things they can learn about their practice.
We have produced questionnaires to help employers and doctors collect feedback, which have been subject to in depth research over several years and tested with 1,450 doctors, 44,000 patients and 21,000 colleagues in a project led by Professor John Campbell at Peninsula College of Medicine and Dentistry.
Doctors and employers are free to choose another feedback tool for revalidation, but must ensure that it meets our criteria.Responsible officers must ensure their organisation’s appraisal system reflects Good Medical Practice and their clinical governance system can provide doctors with supporting information. They should agree locally how to engage with doctors and ensure that every doctor is having a regular appraisal.
Responsible officers can make a positive recommendation that a doctor is fit to practise and should be revalidated, request a deferral if they need more information about the doctor, or notify us that the doctor has failed to engage with appraisal or revalidation.
We expect to finalise guidance over the summer to help responsible officers make their recommendations in a fair, consistent and objective way, giving doctors and patients confidence in the process. This guidance will include the statements supporting each of the recommendations they can make and the criteria they will use as the basis for any recommendation.
As revalidation is around six months away, work is ongoing to ensure everyone is getting ready. One of our main priorities is to continue to help doctors prepare for revalidation and explain what it means for them. However, it is important to note that not everything needs to be in place for revalidation to start.
From a patient safety perspective, it is important that there are systems in place to help doctors who need remediation, as it is part of good clinical governance and workforce development. The Department of Health is in discussions with the BMA to develop a clear statement of the principles underpinning the remediation of doctors, focusing particularly on responsibilities and resources and work is underway in all four countries of the UK to improve the quality and consistency of support being provided to doctors.
Final word
The revalidation process has been designed to be as simple and straightforward as possible and is not a pass or fail – it is about demonstrating that you are a professional who can reflect on their practice and improve year on year.
We are encouraged by the progress being made across the UK to get ready and are confident that we will establish a system of assurance that supports doctors in their practice and is not burdensome. We will try not to bombard doctors with information, but we want them to feel comfortable about the process. We will therefore keep doctors updated and tell them exactly what they need to do and by when, in order that they will be ready to revalidate.
Professor Sir Peter Rubin, Chair, General Medical Council
Resources
Information and guidance on getting ready:
www.gmc-uk.org/revalidation
Colleague and patent questionnaires:
www.gmc-uk.org/colleague_questionnaire.pdf_48212261.pdf
