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What is Revalidation?

Definitions

  • The aim of appraisal: to facilitate and support personal and professional development, within the context in which an appraisee works. This will include supporting individuals in ensuring that their portfolio of supporting information is such that it will meet the requirements of revalidation and challenging them to produce personal development plans (PDPs) that are going to meet their learning needs going forward.
  • The aim of revalidation: to demonstrate that doctors are up to date and fit to practise.

 

The Responsible Officer (RO), who will be responsible for making a recommendation to the General Medical Council (GMC) about whether a doctor should be allowed to revalidate or not. The ultimate decision will still lie with the GMC, as it does now, if a doctor is thought to have serious fitness to practise issues.

It is thought that around two percent of doctors will come under increased scrutiny from the Responsible Officer, as a result of significant concerns about their health, professional practice or professional conduct. Most of these will be flagged up through clinical governance processes but it is possible that a doctor might reveal something during their annual appraisal that led to a need for further scrutiny by the RO. The RO will also be responsible for ensuring that the clinical governance and appraisal processes are robust and quality assured so that s/he can have confidence in the information that s/he receives in order to make the recommendation to the GMC.

For this reason, it is thought possible that a further proportion of those appraisees, who apparently have no difficulties, will be spot checked at random to ensure that the systems are robust, and to identify those with genuine difficulties appropriately.

There are still likely to be 98% of doctors, who have no difficulty in demonstrating that they are up to date and fit to practise, for whom the appraisal and revalidation process needs to deliver a useful structure. It needs to help them with their personal and professional development, and to improve the quality of their clinical care, in order to justify the time and cost involved to the individual and to the NHS. It is known that the RST pathfinder pilots have resulted in very clear recommendations that the process of strengthened medical appraisal used in the pilots should be “streamlined and simplified” to ensure that the process of appraisal and revalidation is proportionate and appropriate.

Appraisal

Annual appraisal will be core to the appraisal and revalidation processes. Highly trained appraisers can help individuals to benchmark themselves and their performance by encouraging them to reflect on supporting information brought to the appraisal and added to their portfolio. The appraisal discussion will remain a confidential, formative and developmental process.

The baseline supporting information for revalidation should be supplemented by any other supporting information the appraisee wants to bring to discussion, regardless of it being on any official checklist, within the appraisal portfolio. During appraisal, doctors will benefit from the chance for reflection, and personal and professional development planning in a confidential and supportive environment.

Facilitating self-reflection will remain a core role of appraisers. However an increased emphasis on helping the individual review their own progress towards revalidation, both in terms of supporting information about performance already gathered, and in planning what else may be needed, is likely to be introduced. There has been new training requirement for appraisers to learn about the standards expected of a “good enough” doctor, to enable them to support the doctor during this process, without frightening individuals with “gold star” standards.

Revalidation

Revalidation is a continuous five year process.

At any point in time a doctor, who is found not to be up to date and fit to practise, can have their license to practise revoked. All other doctors will be reviewed on a predictable five yearly timetable, with annual “checkpoints” at the time of the annual appraisal, during which the appraisee will be able to review whether they are “on track” to revalidate.

In March 2011, the GMC produced a Framework which set out the principles under which a doctor should be collecting supporting information to demonstrate that they are up to date and fit to practise. This will be supplemented by more specific speciality related guidance from the Royal Colleges and Faculties, moderated, so that the requirements are similar no matter what speciality a doctor has trained in, and refined with experience.

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