Revalidation was introduced in December 2012. The RCGP has approved a new Guide to Supporting Information for Appraisal and Revalidation (March 2016) that aims to reduce inconsistencies in interpretation and simplify and streamline the recommendations. The full updated guidance can be found on the RCGP website
A brief introduction to the new RCGP Guide to Supporting Information for Appraisal and Revalidation (March 2016)
It is designed to ensure that any areas where there has been a lack of clarity are better understood. The guide confirms that:
- all time spent on learning activities associated with demonstrating the impact of learning on patient care, or other aspects of practice, can be credited as continuing professional development (CPD)
- Quality over quantity - GPs should provide a few high quality examples that demonstrate how they keep up to date, review what they do, and reflect on their feedback, across the whole of their scope of work over the five year cycle
- Only incidents that reach the GMC level of harm need to be recorded as Significant Events in the portfolio. Reflection on all such Significant Events is a GMC requirement and must be included whenever they occur
- GPs only need to do a formal GMC compliant colleague survey once in the revalidation cycle (like all doctors)
- There are many forms of quality improvement activity and they are all acceptable to demonstrate how you review the quality of what you do, and evaluate changes that you make. There is no requirement for GPs to do a formal two cycle clinical audit once in the five year cycle.
The RCGP recognises that GPs need to be supported by their College in resisting inappropriate additional bureaucracy and is working with key stakeholders such as the BMA GP Committee, GMC and Responsible Officer networks to look at reducing the regulatory burden.
Revalidation pre 2016
The GMC has set out the requirements for revalidation for all GPs.
The RCGP set out what it considers best practice and GPs should be working toward this but they must meet the GMC standards.
Revalidation is based on the GMC guidance Good Medical Practice and these documents are published on the GMC website.
Revalidation is designed to reassure patients and the public that all doctors keep up to date and are fit to practice.
GMC’s domains for revalidation.
The GMC has defined the four areas that all doctors need to ensure they can demonstrate through appraisals that they address their needs and provide supporting information to demonstrate this.
The domains are:
- Knowledge, skill and performance
- Safety and quality
- Communication, partnership and teamwork
- Maintaining trust
What do you need to do to be revalidated?
You need to participate in an annual appraisal which meets the requirements as defined by the GMC.
The supporting information that is required for revalidation can be divided into the following areas.
- General information - providing context about what you do in all aspects of your work
- Keeping up to date - how you maintain and enhance the quality of your professional work
- Review of your practice - how you evaluate the quality of your professional work
- Feedback on your practice - how others perceive the quality of your professional work
The six areas for revalidation are:
- Continuing professional development (CPD) - required annually
- Quality improvement activity - required annually
- Significant events - required annually
- Feedback from colleagues - required once every 5 years
- Feedback from patients - required once every 5 years
- Review of complaints and compliments - required annually
Once every 5 years, at a time decided by the GMC the Responsible Officer will need to make a recommendation to the GMC about an individual doctor.
The RO will check that you have completed the annual appraisals to the required standard.
They will ensure a colleague and patient feedback process has been completed.
They will then triangulate this with any outstanding performance issues with the GMC or through the local procedures and ensure there are no other local concerns.
The RO will not decide if you will receive a license to practice just make one of the following 3 recommendations:
- There is no reason know that this individual doctor should not be issued with a license to practice.
- The renewal of the license to practice should be deferred this is a neutral act the only people who will know this has happened will be the GMC the RO and yourself. The deferral could be for 3, 6 or 12 months. This would allow time for completion of one or more elements required for revalidation. It could have resulted from a period of sick leave, maternity leave and in the first year could be due to a patient or colleague feedback had been completed but had not been discuss at an appraisal because the revalidation date fell before your next appraisal. This will not be used for those who simply can’t be bothered to participate in the process.
- Failure to engage - if the RO believes that despite their best efforts you are not engaging in the process they can refer this to the GMC for their investigation or action. The RO therefore cannot fail a doctor and remove their license to practice.
There are many toolkits available to assist GPs in completing appraisal for revalidation there is no obligation to use any particular toolkit.
Somerset LMC have collaborated with Wessex LMCs to use their Multisource feedback toolkit (MSF) developed by FourteenFish to develop a web based revalidation toolkit that is easy to use and compliant with Revalidation. Advice has been taken from Appraisal Leads and a Responsible Officer. You can register and use the toolkit on FourteenFish.
The toolkit has a yearly subscription is required at £42 a year.
The appraisal toolkit is designed to be easy to use and anyone that has started using a MAG form can transfer the data from the MAG form onto the toolkit if they wish.