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Clinical Governance

A main focus of the revalidation process is clinical governance and effects upon patient safety, and fitness to practise. You will already be monitoring and recording how you proactively engage in clinical governance, patient safety, and CPD  activities.

In order to revalidate you must also record how your react to any clinical governance concerns that you may be involved with in line with the six key domains:An image of a stethoscope.

  1. Continuing Professional Development
  2. Quality Improvement Activity
  3. Significant Events
  4. Feedback from Colleagues
  5. Feedback from Patients (where applicable)
  6. Review of Complaints and Compliments


The revalidation process monitors your "involvement" in various types of clinical governance areas. Whilst this monitoring is robust and required for revalidation it does by no means seek to "blame" any particular doctor involved, any significant event will continue to be dealt with at local level.

Reflection upon the events in which you are involved is an essential part of your learning and training and can be just as "important" as the event itself. Reflection is a learning opportunity which should always be used. For more information please refer to our Reflective Practice web page.


Below are the three main areas which you will be required to declare and reflect upon within your training placement or any work you may undertake outside of your training, including locum shifts and any work for outside agencies:


It is very common for doctors to be named in a complaint, either from a patient or colleague, from time to time. It is not the purpose of the revalidation process to investigate complaints that a doctor may have been involved with, this is the responsibility of the local employing organisation. The revalidation process will examine how you as a professional have dealt with the complaint and any implications it may have, whether you are directly or indirectly involved.

You will also be required to demonstrate that you have engaged in any policies and procedures that your employer may have in place to deal with complaints, this will include any PALs investigations.

Significant Events

Significant events are any unintended or unexpected events, which could have or did lead to harm of one or more patients. This includes incidents which did not cause harm but could have done, or where the event should have been prevented. Each employer will have policies and procedures covering various types of event, often linked to severity, the revalidation process is interested in any that fall under the six domains as above.

You should not only be reflecting on events where you were directly involved or may have been at fault or performed less well than you would have liked, it is best practice to consider all of these events, regardless of your level of involvment. 

Incident reporting systems

The concept of an untoward incident is one which has grown up within the NHS over the years. It is a loosely used term for which there is no standardised definition:

Some characteristics of untoward incidents in the NHS a serious event in which a patient or patients were harmed or could have been harmed;

  • the event was unexpected
  • the event would be likely to give rise to serious public concern or criticism of the service involved

 - Department of Health, January 2012

Conduct and Capability Investigations

Your employer has a duty to ensure that you able to carry out your contractual and legal obligations during the course of your employment with them. Each employing Trust or Practise will have guidance, policies, and prodecures regarding the conduct and capabilities of their employees. You should be made aware of these policies at induction and within your "Statement of Terms of Employment" which you should be provided with upon commencement of employment.

As a rule you can obtain all of the relevant documents from the Human Resources department.

As part of revalidation you are required to document and declare any investigations that you are involved in. These investigations may or may not have a bearing on your ARCP / RITA or Revalidation but they must be declared.

Each case will be assessed upon it's own, individual circumstances, scope, and any subsequent outcomes.


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