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A letter from Sussex Place, August 2012

Ian Currie, Honorary Secretary, writes...

Revalidation will be the new way of regulating licensed doctors and will give extra confidence to patients that their doctors are up to date and fit to practice.

We will all have to undergo revalidation, usually every five years, by having regular appraisals that are based on the core guidance for doctors, Good Medical Practice. Revalidation starts across the UK in early December 2012 and the GMC wants to revalidate the majority of licensed doctors for the first time by the end of March 2016. It is envisaged that in 2013 lead appraisers and responsible officers will undergo this process. In the first year 20% of a Trust’s consultant body will be revalidated with 40% in the second year and 40% in the third year. We will need to be ready. Those doctors in the first year will need to have all their documentation in place and it is my understanding that they will be revalidated on the basis of that first appraisal. Doctors being revalidated in the final tranche might think that they do not need to be concerned about the process yet . How wrong they are! Those doctors will need to show their documentation and appraisal structure for the full three years prior to their sign off.

So what is different about revalidation and isn’t it just appraisal?

Revalidation goes much further. It is not just about collecting CPD points. The framework put in place will designate a person called a 'responsible officer' who will make a recommendation to the GMC that the doctor is up to date and fit to practice, and therefore should be revalidated. The responsible officer will usually be your medical director. They will make their recommendation based on your appraisals over the last five years and other information drawn from their organisation’s clinical governance systems. It is this latter point that in my opinion will be the most challenging.

How many clinicians are collecting patient outcome data or even registering all their surgical cases and how do we extract our personal outcome data if we are an obstetrician for example? It is well recognised that the IT provision within Trusts is patchy throughout the UK but it will be our own responsibility to revalidate and there will certainly need to be a partnership with the Trusts to achieve what is required. As a urogynaecologist I put my surgical cases into the BSUG online database but it is much more challenging to follow-up with patients and get good outcome data. Only a handful of units are using this national database, a fact which I am sure will change once urogynaecologists realise they have a portal that will help them to revalidate. Going further than merely logging surgical cases will be challenging. Some areas such as oncology and colposcopy are ahead of the game as they have been driven by quality assurance visits and the need to ensure patient safety. I am sure there are other areas of our specialty that have done the same.

In order to be ready to have a revalidation recommendation you will have to fulfill the following criteria:

  • The doctor must have demonstrated, through appraisal, that they have collected and reflected on the following information as outlined in the GMC’s guidance supporting information for appraisal and revalidation
  • Continuing professional development, quality improvement activity
  • Feedback from colleagues and patients
  • Review of complaints and compliments

It will not just be about presenting data. The clinician will need to show reflection and what has been learnt. Not a new concept for trainees but I fear it is for the vast majority of consultants.

I would urge you to start thinking about revalidation and get your documentation in order. I have been told I am in the first group so the words ‘headless’ and ‘chicken’ spring to mind.

Ian Currie
RCOG Honorary Secretary

If you have any comments, please write to letterfromsussexplace@rcog.org.uk