Revalidation

What do you know about Revalidation?

On 16 November 2009 the GMC introduced the licence to practise. To practise medicine in the UK all doctors are required by law to hold both registration and a licence to practise. Licensing is the first step towards the introduction of revalidation.  Licences will require periodic renewal by revalidation.

Revalidation is the process by which doctors will have to demonstrate to the GMC, normally every five years, that they are up to date and fit to practise and complying with the relevant professional standards.

Revalidation is expected to begin in late 2012.

How will revalidation work?

Revalidation a step to step guide:

  • Licensed doctors will be required to link to a Responsible Officer (new statutory post). The responsible Officer will usually be a senior, licensed doctor like the medical director in the healthcare organisation where the doctor works.
  • Licensed doctors will need to maintain a portfolio of supporting information drawn from their practice which demonstrates how they are continuing to meet the principles and values set out in Good Medical Practice Framework for appraisal and revalidation.
The supporting information needed for appraisal will fall under four broad headings:

  • General information – providing context about what you do in all aspects of your work
  • Keeping up to date – maintaining and enhancing the quality of your professional work
  • Review of your practice – evaluating the quality of your professional work
  • Feedback on your practice – how others perceive the quality of your professional work
  • Licensed doctors will be expected to participate in a process of annual appraisal based on their portfolio of supporting information.
  • The Responsible Officer will make a recommendation to the GMC about a doctor’s fitness to practise, normally every five years.  The recommendation will be based on the outcome of a licensed doctor’s annual appraisals over the course of five years, combined with information drawn from the clinical governance system of the organisation in which the licensed doctor works.
  • The GMC’s decision to revalidate a licensed doctor will be informed by the Responsible Officer’s recommendation.

What are the key pieces of evidence a doctor will need to supply for revalidation?

Key pieces of evidence a doctor will need to supply for revalidation include:

  • Evidence of continuous professional development
  • Evidence of quality improvement activity
  • Significant Events
  • Colleague Feedback (multisource feedback)
  • Patient feedback (where relevant)
  • Review of complaints and compliments

Do you feel Revalidation will resolve the issues they are meant to address?

The purpose of revalidation is to provide greater assurance to patients and the public, employers and other healthcare professionals that licensed doctors are up to date and fit to practise.

Revalidation aims to:

  • Provide a focus for doctors’ efforts to maintain and improve their practice
  • Encourage the organisations in which doctors work to support their doctors to improve their practice and, where necessary, to identify and respond appropriately to emerging concerns about doctors at an early stage
  • Encourage patients to provide feedback about the medical care they have received from a doctor, to be considered in their annual appraisals

In these ways, revalidation will contribute to the ongoing improvement in the quality of medical care delivered to patients throughout the UK. The principles of revalidation are sound. The process is likely to be effective as long as the trusts and doctors engage in the process.

Some people think that revalidation/appraisals are a waste of time and just a paperwork/box-ticking exercise. Do you feel it is a useful process?

The revalidation process requires the hospital and the consultant to reflect on their practice and the organisation and to identify possible improvements. As such it is a desirable process. However, it requires commitment from both the trust and the consultant. The trust need to provide training to its appraisers and appraisees and provide adequate time for it in the job plan. It also needs to support the consultant in achieving the objectives set in the PDP. Obviously, the consultant needs to be committed to the process for it to be effective.

What can you tell me about appraisals?

Appraisal is a formal process aimed to give doctors regular feedback on past performance, to chart their continuing progress and to identify education and development needs. It is part of a doctor’s career development.

The key principles of professionalism set out in Good Medical Practice will be used to create a framework for annual appraisals. The evidence for appraisal will be collected under 4 domains:

  • General information – providing context about what you do in all aspects of your work
  • Keeping up to date – maintaining and enhancing the quality of your professional work
  • Review of your practice – evaluating the quality of your professional work
  • Feedback on your practice – how others perceive the quality of your professional work

The doctor and appraiser will agree a written overview of the appraisal, which should include a summary of achievement in the previous year, objectives for the next year, key elements of a personal development plan, actions expected of the organisation, a standard summary of the appraisal and a joint declaration that the appraisal has been carried out properly.

Personal development plan (PDP) – This is an outcome of the appraisal process listing the key development objectives of the appraisee for the following year as agreed with the appraiser.

What is the difference between Assessment and Appraisal?

Appraisal is a formal process to provide feedback on doctors’ performance, chart their continuing professional development, and identify their developmental needs.

Assessment is a formal process which examines performance.  In other words, assessment is ticking boxes set by others, whereas appraisal is ticking boxes that you have helped to set yourself. Revalidation will include both appraisal and assessment.

Who is the main beneficiary in an Appraisal or revalidation?

  • It increases public confidence in doctors by reassuring the public that doctors are up to date and fit to practice.
  • It leads to the personal and professional development of the individual and the NHS benefit as a whole.

What about appraisal of doctors in training?

Specialist training and progress through the grade are noted in the Record of In Training Assessment (RITA) or ARCP, and are subject to assessment and development review.

Ref: http://www.gmc-uk.org/doctors/revalidation/9546.asp

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