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03.05.18

Value of revalidation remains unknown, according to GMC review

A General Medical Council-backed review evaluating the value of doctors entering the process of revalidation has argued that the impact of which the system has achieved its objectives remains inconclusive.

The three-year long review found that doctors and patient organisations “remain confused about the purpose of revalidation and what it is therefore intending to achieve,” adding that many doctors see appraisal as simply completing tasks to achieve documentary evidence of their adequate performance to maintain their licence.

The report argued that this ‘tick-box’ method of revalidation through appraisals “is much more significant” if it only needs to demonstrate a doctors’ achievement of the bare minimum standard as the desired outcome.

In addition, the review claims that the appraisal system of revalidation has a minimal impact upon the practice of doctors in the future, claiming “a significant minority of doctors reported changing an aspect of their clinical practice, professional behavior or learning activities as a result of their most recent appraisal.”

Doctors operating outside existing governance structures such as locums were also highlighted in the report, where the ability to achieve an annual appraisal for revalidation was labelled “inconsistent.”

To lessen ambiguity caused by the revalidation process, the GMC also published advice on information to achieve validation and made its requirements clear of information needed for discussion at appraisals: significant events, feedback from colleagues, complaints and compliments, professional development and quality improvement activity.

The medical council explicitly outlined the ‘overarching principles’ to meet revalidation requirements:

 

  • Annual appraisal: this should be supportive and developmental, not a pass or fail exercise. An appraisal can be used for a variety of other reasons, not just for revalidations.
  • Whole scope of practice: all previous roles and places carried out as a doctor since your last appraisal must be declared. You must collect supporting information that cover the whole of this practice.
  • Quality, not quantity: Supporting information covering the whole scope of practice must be “of sufficient quality” and helps to reflect and identify strengths and areas of improvement in your practice. No minimum or maximum quantity of supporting information.
  • Proportionality: consider what evidence demonstrates your strengths as well as areas of practice that may benefit from further development. Choose clear examples within each supporting information category in line with requirements in this guidance.
  • Reflection: reflecting on supporting information and what it says about your practice will help improve the quality of care given to patients and the services provided as a doctor.
  • Focus on learning: discuss with your appraiser the changes you have made or plan to make, and areas of good practice you intend to maintain or build on as a result of your reflections on supporting information and appraisal discussion.
  • Link to improvement and development planning: consider the learning needs and opportunities identified through the appraisal process in discussion with your appraiser, and agree how this feeds into personal development plans and continuing professional development activities for the following year.

 

Responding to yesterday's updated guidance from the GMC to help doctors with appraisals and revalidation, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare system, said:

“This guidance is good news for doctors and patients. It should make appraisals and revalidation quicker and more streamlined for doctors, freeing them up to do what they signed up to do – providing good patient care.


“Patients will have renewed confidence in the capability and professionalism of the people looking after them.”

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