1. Get ready for revalidation
AGM 2012, London Olympia
22 November 2012
2. Get ready for revalidation
• Revalidation: towards implementation
Jon Billings, General Medical Council
• Doctors’ experiences of revalidation
Dr Anita Donley, NHS Revalidation Support
Team
• Preparing for revalidation: information
and support
Dr Ian Starke, Royal College of Physicians
• Your questions
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4. Revalidation is:
• Part of a wider system of measures to promote
improvements in safety and quality
• Intended to ensure all medical practice takes place
within a governed environment
• A positive affirmation of a doctor’s professionalism
based on GMC core guidance Good Medical
Practice
Revalidation isn’t:
• A test or exam with a pass or fail outcome
• A new way to raise concerns about a doctor
• The only purpose or output of appraisal or training
assessment
4
5. Statutory framework
RO regs – since Jan 2011 Revalidation regs – from Dec 2012
5
6. How revalidation works: the process
For doctors in
training
• Trainee
• Panel
Regular
ARCP/RITA
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7. Requirements for doctors
(not trainees)
Pursuit of excellence Recognising human factors
• Knowledge, skills and performance
• Safety and quality
Openness Seeking comparators
• Communication, partnership and
teamwork
Disclosure Reflection
• Maintaining trust
Learning
Valuing peers
Commitment to improving
Showing insight
10. Revalidation
• ‘…supporting, quality
assuring and
improving the practice
of the vast majority of
doctors who already
perform to an
acceptable standard ’
(2006)
12. Developing, piloting and testing
Objectives of RST Testing and Piloting project (2011-12) were to:
• inform implementation of revalidation
• inform development of guidance for doctors and designated
bodies
• provide information to inform Department of Health (England)
business case for revalidation.
13. Developing, piloting and testing: what RST found
• Medical Appraisal Guide (MAG) pilot : Appraisal for revalidation set out in
MAG takes nine hours. This is no longer than previous systems.
• Public and patient involvement : Patients felt proposed model would meet
their needs, expectations and concerns. Many assumed system similar to
revalidation already existed.
• Doctors in training pilot : Trainees found modified ARCP process piloted was
fair, efficient and took very little extra time. However, employers found completion of
exit reports for each trainee time-consuming and resource intensive.
• Colleague and patient feedback study : Doctors most positive when
appraiser discusses colleague and patient feedback with them. They strongly prefer
a known and trusted colleague to deliver feedback.
14. Medical appraisal
Inputs Outputs
Scope of PDP
work
Supporting Appraisal
Portfolio Confidential Summary of
information sign off
review discussion discussion
Last PDP
& appraisal
summary
Appraiser statement
Other
16. Organisational readiness: ORSA 2011-12
• High level of engagement in ORSA exercise (95% response rate from
designated bodies).
• Substantial progress made between 2010-11 and 2011-12.
• Improvements in all measured key indicators.
Key findings:
• 82% of doctors linked to organisations ready to support them with
revalidation.
• Almost 100% doctors had a responsible officer.
• Overall appraisal rate rose to 73%, with significant increases reported
for every grade of doctor.
17. Action plans
• Designated bodies in England produced action plans by the end of
July 2012 to ensure systems ready by December.
• Progress against plans monitored by SHA clusters, working closely
with designated bodies.
• NHS RST supporting SHA clusters with this process.
19. Revalidation: a personal view
• Revalidation for me:
– A realistic challenge
– How good is “good enough”?
– The importance of effective appraisal
– The retention of the “excellence” agenda
• Revalidation for my service :
– How can revalidation drive quality of care?
– How will we know that revalidation is “working”?
20. Preparing for revalidation
• GMC requirements and specialty guidance
• NHS Revalidation Support Team on appraisal
• Your RO, appraiser and date
• Supporting information for the first cycle
– Continuing professional development
– Quality improvement activity – types of audit
– Significant events
– Feedback from colleagues and patients
– Review of complaints and compliments
• Trainees and SAS doctors
21. Support available from Colleges
• Establishment of helpdesks – e-mail / FAQs
• Specialty training of advisers for doctors, appraisers
and ROs
• Tools for the job:
– E-portfolio to record supporting information
– Colleague and patient feedback tools
– Personal clinical audit tool
– Clinical guidelines and CPD opportunities
• Monitor experience of doctors and appraisers.
