Crossing the T’s

Revalidation is the process by which doctors will demonstrate to the GMC that they remain up to date and fit to practise, and in future, all licensed doctors will need to revalidate on a regular basis if they wish to keep their licence to practise, reports Richard Mackillican

Since November 2009, all doctors who wish to practise medicine in the UK have been required to have a General Medical Council Licence to Practise, “the first practical step in introducing a system for regularly checking and assuring every doctor’s continued fitness to practise.” 1

Revalidation is seen as a way of identifying and affirming that all doctors are keeping their knowledge up-to-date and providing safe patient care, along with strengthening professional regulation and enhancing service quality. 2

“Revalidation is really about professional development, and it’s something we’ve been looking at for over 10 years,” says Professor Steve Field, chairman of the Royal College of General Practitioners.

“The purpose of revalidation, as defined by the GMC, is to assure patients, employers and other healthcare professionals that licensed doctors are up-to-date and are practising to the appropriate professional standards.

“There had been a lot of work done in this area quite a while ago and it gathered pace after the inquiry into the case of Harold Shipman. But what this did was refocus revalidation on identifying poor practice, whereas at the College we want it to demonstrate that GPs are working at the appropriate level.

“It is not about finding another Shipman. It’s about improving the quality of care delivered by all GPs. Finding poor practice should be the role of clinical governance, but unfortunately this has not been rolled out consistently across all of the primary care trusts. Indeed, in some PCTs appraisal had been stopped a few years ago whereas in Wales and other areas of the UK, there are good systems of appraisal and clinical governance which are working well.

“Revalidation for us is about professional development, about encouraging GPs to reflect on their practice and to reflect on what they are doing. This includes receiving feedback from patients and then working towards improving the quality of care whilst also keeping up to date through continuous professional development. If a GP can demonstrate all of that, accompanied by clinical governance evidence, then a GP will be able to revalidate.”

Revalidation will also see the creation of the new role of responsible officer which will require every PCT to appoint a key individual who will be responsible for ensuring that the doctors within that organisation are fit to practise and have been revalidated.

The responsible officer will have a number of responsibilities, such as ensuring that an annual appraisal is carried out to a sufficiently high standard and that the appraisal system links adequately with other primary care trust systems whilst also making clinical governance data available to support a review of a practitioner’s work and inform service development.

The responsible officer will also have deal with any issues around the quality of doctors’ work and address those concerns accordingly with the GMC.

“This will be an employee of the primary care organisation or the hospital trust, who has a particular set of responsibilities and who is involved in the clinical governance of the organisation. At the College we very much hope that this will be a GP from within that organisation.”

Overall these efforts are a way of increasing the quality of care to patients and to maintain the high standards on which the British medical community prides itself.

“It is really important that GPs are keeping up-to-date and practising in an appropriate way and revalidation will be a way of assuring and reassuring patients and the public that this is happening.”

1 NHS Employers

2 http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/Medical-regulation/MedicalRevalidation/Pages/Medical-revalidation.aspx