Revalidation updates

• GMC publishes first guide for patients on what to expect from their doctor (May 2013)
• Revalidation Support Team issues example appraisal portfolios (May 2013)
• Independent Healthcare Advisory Services publishes guidance on whole practice appraisal (May 2013)
• Making revalidation connections conference, 24 May 2013, London (April 2013)
• Guidance for SAS doctors on improving appraisal for revalidation available (February 2013)
• GMC issues further guidance to doctors without a prescribed connection (December 2012)
• GMC issues guidance on how to become a 'suitable person' (December 2012)
• Revalidation now live (December 2012)
• Support for doctors without designated bodies (October 2012)
• Chair of GMC writes to Secretary of State for Health to confirm ready for revalidation (October 2012)
• Revalidation implementation timetable (July 2012)
• RCPCH published final supporting information specialty guidance (June 2012)
• Appraisal processes across the UK (June 2012)
• Appraisals by employers and revalidation (June 2012) 
• Responsible Officer expectations in preparation for revalidation rollout (June 2012) 
• Implementing revalidation - GMC first cycle update (May 2012)
• Clinical academics and revalidation (May 2012)
• GMC updates its revalidation website (April 2012)
• Making your connection campaign (April 2012)
• GMC issues revalidation leaflet to all doctors (December 2011)
• RCPCH signs revalidation online portfolio contract (December 2011)
• HSJ publishes revalidation supplement (November 2011)
• Parent and carer feedback tool (PaedCCF) launched for paediatric outpatient consultations (November 2011)
• RST publishes information management and technology FAQs (July 2011)
• GMC launches new guidance on patient & colleague feedback tools (June 2011)
• Revalidation Support Team (RST) launches monthly Responsible Officer newsletters (May 2011)
• GMC launches new appraisal guidance for revalidation (April 2011)

GMC publishes first guide for patients on what to expect from their doctor

The GMC has published a new guide for patients setting out what they should expect from their doctor.

The new guide is based on the GMC’s core guidance for doctors - Good Medical Practice (2013). It explains the key duties of a doctor and how patients can help to create a good relationship with their doctor and get the most out of their consultations and treatments.

Revalidation Support Team issues example appraisal portfolios  

The Revalidation Support Team in England has published nine example appraisal portfolios to help doctors understand what a good appraisal portfolio looks like.

The portfolios have been prepared by three medical royal colleges and faculties:
• Faculty of Medical Leadership and Management
• Royal College of Physicians (London)
• Royal College of Surgeons (London)

Each fictional portfolio is based on a doctor from a different speciality but will also be relevant to doctors in other specialties. All exceed the minimum standards for revalidation. 

Presented as completed MAG Model Appraisal Forms, the portfolios are designed to be viewed together, as they illustrate different approaches. They are also accompanied by a commentary from the RST on the approaches taken.

The portfolios are expected to develop and evolve in the future, as we learn more about good practice in this area.

Independent Healthcare Advisory Services publishes guidance on whole practice appraisal

The document sets out how whole practice appraisal will be implemented for doctors working in the independent healthcare sector now that revalidation has commenced. It has been prepared by the Independent Healthcare Advisory Services (IHAS) Revalidation Working Group which includes representation from IHAS, NHS Partners Network, NHS Employers, the Independent Doctors Federation, the London Consultants Association and the British Medical Association.

Making revalidation connections conference Friday 24 May 2013

NHS England (London Region) is hosting a conference with the British Medical Association on Friday 24 May 2013 at BMA House for doctors who have been unable to find a prescribed connection for their revalidation. The conference is open to doctors outside of London as well as those in the area. Attendance is free of charge but only those who do not have a prescribed connection should attend.

Speakers will include experts from the GMC and the Revalidation Support Team, as well as those with practical experience of developing connections for doctors. Responsible Officers, doctors from the independent sector and from Local Education Training Boards (LETBs) are also likely to speak, along with one of the first doctors to become a GMC 'suitable person'. Workshops to help doctors secure a prescribed connection will be held in the afternoon.

Doctors who currently have no prescribed connection for their revalidation wanting to register at this conference is tori.awani@nhs.net, tel 020 7932 3119

To check whehter you have a prescribed connection, you may find it helpful to use the GMC tools at http://www.gmc-uk.org/doctors/revalidation/12390.asp 

Guidance for SAS doctors on improving appraisal for revalidation available

Available on the NHS Employers website are workshop presentations from a recent conference held in conjunction with the General Medical Council (GMC), the British Medical Association (BMA) and the NHS Revalidation Support Team (RST). The workshops were an opportunity to share good practice and dispel some of the myths about appraisal within the revalidation process for SAS doctors.

To access the resources go to the NHS Employers website.

GMC issues further guidance to doctors without a prescribed connection 

Around 11,000 doctors responded to the GMC 'make your connection' campaign to say they did not have a connection to a designated body. Of these, the majority confirmed they are not actively practising medicine in the UK. Many advised that they practise entirely overseas. The remaining doctors practise in the UK with or without direct contact with patients.

To help these doctors, GMC has published a supplementary tool which explains their options. Depending on a doctor's individual situation, those options include:

• connecting to one of the organisations that will become designated bodies when the responsible officer regulations covering England are updated in April 2013;
• connecting to a 'suitable person' that will enable them to engage in local systems and revalidate;
• relinquishing their licence to practice, if they do not undertake any form of medical practice or if they practise outside the UK. Doctors can remain registered without a licence and restore their licence if they return to clinical practice in the UK.

Importantly, the GMC are saying to the doctors without a prescribed connection that they will not be scheduled for revalidation until April 2014 onwards. This allows some time for these doctors to reflect on how they wish to proceed.

GMC issues guidance on how to become a 'suitable person'

A ‘suitable person’ can make revalidation recommendations for doctors who do not have a connection to a designated body. Most licensed doctors have a connection with a designated body, but under the current responsible officer regulations some doctors do not have a connection. The GMC revalidation regulations allow the GMC to accept recommendations for doctors made by ‘suitable people’ on behalf of doctors who do not have a responsible officer. This will allow some doctors who do not currently have a connection to engage in local systems and revalidate. Further information about this role is available on the GMC website.

Revalidation now live

 Legislation bringing into effect revalidation went live 3 December 2012.

It is expected that the majority of licensed doctors in the UK will have been revalidated by 2016. Revalidation aims to give patients and the public, as well as employers and other healthcare professionals, extra confidence that doctors are up to date and fit to practice. All licensed doctors will need to revalidate on a regular basis (usually every five years) in order to keep their licence to practise

Dr Alistair Thomson, Vice President (Education) and RCPCH Revalidation Lead said:

'The RCPCH welcomes the introduction of revalidation, which should give assurance to patients that their doctors are proficient and that their training is fully up to date. We’ve worked closely with the Academy of Medical Royal Colleges, the GMC and other professional bodies to develop the standards and processes for revalidation, including a tool which assists parents, carers and children in giving feedback to paediatricians and child health doctors. Our members are prepared for the introduction of revalidation and we look forward to supporting them through the process.'

Revalidation guidance and information is available to support paediatricians through the process on this website.

GMC support for doctors without designated bodies

As part of their ‘make your connection’ campaign, the GMC now know the prescribed connections for nearly 200,000 licensed doctors, while around 10,000 doctors have informed the GMC they don’t believe they have a connection with a designated body. Over 60% of this group do not practise in the UK.
 
Some of the 10,000 doctors will have a prescribed connection when the Department of Health for England updates its responsible officer regulations in the spring of 2013.

In order to help doctors who the GMC believe will be left without a prescribed connection, the relevant regulations will allow the GMC to recognise a ‘suitable person’ to make recommendations about licensed doctors who do not have a statutory connection to a responsible officer.

These regulations will allow GMC to recognise two types of suitable person:

• an existing responsible officer
• a person who holds a post in an organisation which includes responsibilities similar to that of a responsible officer.

The GMC will need to approve anyone acting as a suitable person, whether or not they are an existing responsible officer, via an application process.

The GMC are developing this application process as well as the criteria that will need to be met before the GMC can permit a ‘suitable person’ to make a revalidation recommendation about a doctor and will provide more details about the ‘suitable person’ role later in the year.

Chair of GMC writes to Secretary of State for Health to confirm ready for revalidation

The GMC agreed to recommend to the UK’s Secretary of State for Health, Jeremy Hunt, that revalidation for doctors should begin in December 2012.

GMC Council considered formal reports on readiness from the four health departments of the UK and from the GMC itself which confirmed that the systems are in place and ready enough across all parts of the UK for revalidation to begin. The Chair of the GMC informed the Secretary of State of this and the GMC expects the Secretary of State will make his decision in the next few weeks.

Revalidation implementation timetable

Based on plans developed by the four UK countries, the GMC expects to revalidate:

• Responsible Officers and other medical leaders, including the four Chief Medical Officers of the UK and the Chair of the GMC, first in early 2013
• about a fifth of licensed doctors between April 2013 and the end of March 2014
• the majority of all licensed doctors by the end of March 2016
• and all remaining licensed doctors by the end of March 2018 

RCPCH publishes final supporting information specialty guidance

The RCPCH, along with the other medical royal colleges and faculties, have agreed the simplified core guidance that will form the basis of specialty guidance for doctors on supporting information. This guidance will provide advice on how doctors in particular specialties or general practice can meet the requirements for supporting information that we (the GMC) have set for every licensed doctor. The guidance complements the GMC's own supporting information guidance.  The RCPCH-specific version of the core guidance  (PDF, 171KB, 19 pages)       was published June 2012.

Appraisal processes across the UK

England, Scotland and Wales have published their country specific appraisal guidance.  Northern Ireland guidance is pending. 

While the overall process for revalidation remains the same across the UK and appraisal will be an essential component of revalidation, each of the 4 countries have different forms and guidance for appraisal appropriate to their country.

• England
• Scotland (+ developing the SOAR system for both primary and secondary care appraisal)
• Wales
• Northern Ireland

Appraisals by employers and revalidation
There continue to be concerns, mainly from doctors in primary care, that some organisations are ‘enhancing’ appraisal above and beyond the requirements which GMC have set doctors for revalidation. Revalidation is not the only reason why appraisals take place. Primary care organisations, employers and others have a legitimate interest in ensuring their doctors do a range of things to serve local need.

GMC are not asking employers or commissioners to ‘enhance’ their appraisal schemes, just to make sure their appraisal systems meet GMC requirements for revalidation.  Responsible officers will have to base their recommendations about doctors on whether they have met GMC requirements for revalidation alone. 

Responsible Officer (RO) expectations in preparation for revalidation rollout
As the 'making your connection campaign' has obtained information from doctors, the GMC is asking ROs to:

• confirm their lists of doctors by 20 July 2012, reconciling the data GMC have received from the NHS and doctors with the list ROs hold locally
• allocate the dates ROs will make recommendations about doctors in the first, second and third years of revalidation, by 14 September 2012.

ROs should begin activating their GMC Connect accounts in June 2012. GMC will communicate with ROs to confirm the dates by which they need ROs to confirm their lists of doctors and allocate submission dates.

ROs will have started making recommendation by March 2014 and most will be complete by March 2016, although some will take longer.  Revalidation go live will hopefully be 3 December 2012. 

Implementing revalidation - GMC first cycle update
The GMC has set out the key principles by which the implementation of revalidation will be achieved over the first cycle. The paper, submitted to the UK Revalidation Porgramme Board, has been agreed across the four UK health departments and explains the roles of the national and local bodies and the steps GMC will need to take during 2012. It describes the criteria responsible officers can use in deciding whether a doctor is ready for a revalidation recommendation and whether their portfolio of supporting information is adequate.   

A GMC summary document confirming the agreed requirements of doctors during first phase of revalidation confirms doctors:

• must be participating in an annual appraisal process
• must have completed at least one appraisal with Good Medical Practice as its focus
• must have collected and reflected on all six types of supporting information
• can bring team-based information to their appraisal, as long as they've reflected on what the information means for their individual practice
• can use evidence of patient and colleague feedback obtained up to five years before a revalidation recommendation is made, as long as it's relevant to the doctor's current scope of practice
• can use feedback that doesn't fully meet GMC criteria as long as it's focused on the doctor, their practice and the quality of care delivered to patients. The feedback must also have been gathered in a way that 'promotes objectivity'.

 
Clinical academics and revalidation
GMC confirms that guidance for joint appraisal arrangements for clinical academics governed by the Follett principles remains in place and is unaffected by the revalidation process.

Appraisal arrangements for clinical academics should be covered in trust and organisational appraisal policies. Current agreements between NHS trusts and universities should determine how these principles are applied locally and should continue in the usual way.

GMC updates its revalidation website
New GMC revalidation pages have separate areas for:

• Licensed doctors
• Doctors in training
• Responsible officers and employers
• And patients and the public

There is also a new guidance area for the appraisal framework, supporting information guidance, feedback criteria and questionnaires.

GMC launches making your connection campaign
GMC want every licensed doctor to confirm their designated body before revalidation begins, so GMC knows which organisations will be making recommendations about doctors. In their 'make your connection' campaign they’re asking doctors to confirm their designated bodies before revalidation begins in early December. With the help of the NHS, they’ve already worked out the designated bodies (and identified the responsible officers) for 120,000 doctors across the UK. In October, they’ll start to ask these doctors to confirm or correct this information online. They'll use responses to the national trainees' survey this year to do the same for the 50,000 doctors who are currently in training.

Between now and the end of June, GMC are focusing on those doctors who work outside of the national health services of all four countries. They’ve also written to all licensed doctors about their campaign to let them know when they can expect to hear from them.

 GMC issues revalidation leaflet to all doctors

The GMC has issued a leaflet in December 2011 to all doctors which outlines what doctors should be doing to get ready for the introduction of revalidation in late 2012. It says that doctors should be having regular appraisals, reading the GMC’s revalidation guidance, and thinking about whether they need a licence to practise if they don’t work in the UK or their role doesn’t require them to have one. It also says that the GMC will ask doctors in the spring of 2012 to confirm the organisation they will link to for revalidation (their prescribed connection). This will be the first in a series of direct contacts between GMC and doctors to make sure they are ready for revalidation. Go to the GMC website for more information.

HSJ publishes revalidation supplement

A HSJ supplement on revalidation in association with the GMC, available on the HSJ website to subscribers, provides an update on what revalidation means for doctors and employers.

RCPCH signs revalidation online portfolio contract 

The RCPCH, as part of a cohort of medical royal colleges, has signed a contract with Equiniti 360° Clinical to provide an online portfolio to support UK doctors through their revalidation.  The revalidation portfolio will be easy to use, accessible online, customisable by each medical royal college, and secure, private, and confidential. The next phase of the project includes development, testing and approval processes, involving doctors who will eventually be using the revalidation portfolio. 
 

Parent and carer feedback tool launched for paediatric outpatient consultations

RCPCH has launched its own parent and carer feedback tool for use in outpatient consultations. Following extensive piloting this tool is available for use from 2012 by non training grade doctors who wish to use the RCPCH tool to gain parent and carer feedback as part of revalidation requirements.  Further information on the tool, when it is available, what it costs and how to register is available on the PaedCCF webpage.

The tool will also be available for use by trainees in 2012 following further piloting.

RST publishes information management and technology FAQs

The Revalidation Support Team (RST) in England has published its information management and technology (IMT) FAQs, which explain the support the RST will provide in this area, to enable trusts and Responsible Officers to plan information management work.

The RST will also be publishing guidance in four main areas:

Guidance will be available on the first three areas from October 2011 and on the last one from December 2011.

There will not be a standard national computerised system for appraisal in England. However, the RST is exploring the viability of developing a Responsible Officer (RO) dashboard, which will help ROs track the doctors they are responsible for and keep appraisal and performance information in one place. If approved, this will be available by April 2012.

Find out more at the RST website

GMC launches new guidance on patient and colleague feedback tools

The GMC has recently published a new piece of guidance to support revalidation: a series of helpful checklists for those who will be involved in commissioning, developing, administering (and indeed using) colleague and patient questionnaires.

Feedback from colleagues and feedback from patients (or parents/carers) will be two pieces of supporting information that doctors will need to collect and bring to their annual appraisal. The recent GMC guidance, supporting information for appraisal and revalidation, outlined the full list of supporting information that doctors will need to provide (with the help of their employers). These checklists should be read in conjunction with that document and the RCPCH paediatric version of the Supporting Information guidance (due out Summer 2011). 

Revalidation Support Team (RST) launches monthly Responsible Officer newsletters

Those appointed as Responsible Officers or involved in preparing their organisations for revalidation may be interested in a series of monthly newsletters issued by the Revalidation Support Team (RST) in England.  To access the newsletters, go to the RST website.

The GMC has launched new appraisal guidance for revalidation

The new guidance sets out how doctors can show that they are meeting the professional standards on which good practice is founded. It also outlines the core supporting information that all doctors will need to bring to their annual appraisal, regardless of where they work in the UK or their area of practice.
The guidance is intended to help doctors and employers prepare for the launch of revalidation at the end of 2012.  Employers are being asked to make sure that every doctor can access the supporting information outlined in the guidance.

The guidance is based on the principles set out in Good Medical Practice, the core ethical guidance for the medical profession. The aim is for all doctors to discuss how they have met these core principles at their annual appraisals. However, the new guidance makes clear that doctors will not be expected to mechanistically map supporting information to principles set out in Good Medical Practice.  Specialty-specific guidance on supporting information which will complement the core supporting information outlined by the GMC will be available later this year.