Ready for revalidation

REVALIDATION was launched by the General Medical Council in December 2012 and is a process that all doctors who are fully registered with a licence to practise will have to engage with. This includes doctors in specialty training (and those in foundation year 2).

More than 7,500 doctors were revalidated in the first six months, with that tally expected to reach 30,000 by the end of 2013. The majority of the UK’s 235,000 licensed doctors should have completed the process by 2016.

Under the system, doctors undergo a continual evaluation of their fitness to practise and will have to provide evidence demonstrating they are up to date. This usually involves one appraisal per year over a five year cycle.

The good news is that for trainee GPs revalidation should be relatively straightforward as their practice is already subject to periodic review.

Designated body

The organisation that will provide you with your regular appraisal and help you with revalidation is known as your designated body. For (fully qualified) GPs who are on a performers list, this is the primary care organisation that manages that list, i.e. NHS England or NHS Health Scotland.

The situation is a little different for doctors in training. In Scotland, your designated body is NHS Education for Scotland while in Wales or Northern Ireland, it is your postgraduate deanery. If you are training in England, your designated body is one of the 13 new Local Education and Training Boards (LETBs) known as, for example, Health Education North West.

It is the responsible officer of this designated body (for trainee GPs, usually the postgraduate dean or NES medical director) who will make a recommendation about you, usually every five years, that you are up to date, fit to practise and should be revalidated.

When?

At the start of 2013, the GMC informed all licensed doctors of their revalidation date. Formal revalidation notices are also sent out four months before a recommendation is due from your responsible officer.

For GP trainees, those with an expected Certificate of Completion of Training (CCT) between April 1, 2013 and March 31, 2018 will revalidate at the point of CCT. Those with a CCT expected after March 31, 2018 (and those trainees who do not currently have an expected CCT date) will revalidate between April 1, 2016 and March 31, 2018. Where necessary, your responsible officer can bring forward your revalidation to align with your expected CCT.

Gathering evidence

Appraisals are based on the General Medical Council’s core guidance, Good Medical Practice, with more specific requirements detailed in the GMC’s appraisal framework.

Fully qualified doctors are expected to maintain a portfolio of supporting information that is drawn from their practice, feedback from patients and colleagues, and participation in continuous professional development (CPD). It should demonstrate how they meet the principles and values of Good Medical Practice. Doctors will have to collect some of that information themselves and the rest will come from their designated body.

For trainees, your responsible officers will make a revalidation recommendation to the GMC periodically. They will base this on your participation in the Annual Review of Competence Progression (ARCP) process, or its equivalent the Record of In-Training Assessment (RITA).

You should already be engaged in regular discussions with supervisors about your progress and outstanding learning needs, reflecting on your strengths/weaknesses and achievements/difficulties. This will usually also include information on significant events and complaints/compliments.

The GMC has reassured trainees: “As long as you are doing this, there is nothing extra you need to do to be ready for revalidation.”

The RCGP Guide to the Revalidation of General Practitioners advises trainees that in order to comply with revalidation: “Full engagement in Workplace-Based Assessment is likely to suffice.” It adds that “in most cases GPs will revalidate five years after CCT. If, however, a doctor takes longer than five years to complete training from the point that they are licensed, the Postgraduate Dean would (in most cases) make a recommendation to the GMC prior to the completion of CCT.”

The recommendation

A doctor’s responsible officer will make a recommendation to the GMC usually every five years (this may vary for trainee GPs), that the doctor is up to date, is fit to practise and should be revalidated. This will be based on appraisals from the previous five years. The GMC will then carry out a series of checks to make sure there are no other concerns relating to the doctor and, if no concerns exist, the doctor will be revalidated. This means they can continue to hold their licence to practise.

Sources:

• General Medical Council – How revalidation will work

• GMC: Ready for Revalidation – Information for doctors in training

• The RCGP Guide to the Revalidation of General Practitioners