Revalidation: Towards implementation Jon Billings Assistant Director, Continued Practice and Revalidation

2 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 2 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

3 Revalidation requirements… 3 Employers Appointed an RO Provided support to the RO Robust local systems Responsible Officers Robust local systems & processes Aware of all the doctors they are responsible for Provide doctors access to supporting information Doctors Collecting all their supporting information Reflecting on their practice Engaging in whole practice appraisal

4 The process… 4 Doctor Appraiser Cycle of appraisal & review Responsible Officer Revalidation recommendation General Medical Council Revalidation decision

5 Requirements for doctors… 5 Whole practice annual appraisal based on GMP CPD Quality Improvement Activity Significant Events Colleague Feedback Patient Feedback Reviewed Complaints & Compliments

6 Minimum requirements for readiness The doctor must be participating in an annual appraisal process which has Good Medical Practice as its focus and which covers all of their medical practice The doctor must have completed at least one of these appraisals, which has been signed off by the doctor and their appraiser The doctor must have demonstrated, through appraisal, that they have collected and reflected on the information as outlined in the GMC’s guidance Supporting information for appraisal and revalidation

7 Implementation principles Consistent, fair & transparent implementation principles Patient safety paramount Driven & owned locally Representative of connected doctors Representative of total population of doctors Vast majority revalidated by March 2016 May take up to 5 years to revalidate all doctors Manageable for the service & GMC

8 Recommendation options… 8 Responsible Officer recommendation Revalidation Request for more time (defer) Failure to engage Concerns about Fitness to Practise must be raised when they arise

9 Positive recommendation a doctor’s participation in appraisal or assessment a doctor’s collection of supporting information any other information used to inform your recommendation a doctor’s compliance with any GMC conditions or undertakings a doctor’s compliance with locally agreed conditions on their practice any unaddressed concerns about a doctor’s fitness to practise.

10 Deferral requests… 10 Providing supporting information Insufficient information Information gaps Participating in a local or national process HR or investigation Performance or remediation Participating in a GMC process [revalidation placed on hold] Fitness to Practise

11 Deferral engaged in the systems and processes that support revalidation, but there is incomplete information on which to base a positive recommendation participating in an ongoing local HR or disciplinary process, the outcome of which you will need to consider prior to making your recommendation A deferral request is not: an RO’s request for the GMC to delay making a decision about a doctor’s revalidation after receiving a recommendation a route to address concerns about a doctor’s fitness to practise with the GMC an RO’s request to delay making a recommendation while a doctor is subject to an on-going GMC fitness to practise investigation

12 Non-engagement A doctor is not engaging in revalidation where, in the absence of reasonable circumstances, they: do not participate in the local processes and systems that support revalidation on an ongoing basis do not participate in the formal revalidation process.

13 Suitable person… Suitable Person (Criteria to be finalised) Existing DB & RO e.g. DB employer contracting doctors for services e.g. PCT taking on doctors in their area e.g. DB taking responsibility for doctors with similar practice Not a DB but the GMC will recognise to appoint an RO GMC would want to limit extension to existing DBs and ROs Recognise there are healthcare organisations that maybe suitable

14 Upstream System design Training Guidance Midstream Professional judgement Decision support Downstream Monitoring Evaluation Review Quality for RO recommendations is like quality for clinical judgements

15 Elements of the quality system

16 Implementation… Jun to Oct 12 – DBs and ROs sign up to GMC Connect and Schedule 1 st revalidation dates Oct to Nov 12 – GMC assigns submission dates for doctors Dec 12 – Regulations come into effect subject to SoS decision Dec 12 to Mar 13 – Majority of medical leadership revalidation submissions Apr 13 onwards – Recommenda tions made for doctors

17 GMC support

18 Contacts GMC website GMC Revalidation inquiries team GMC Employment Liaison Advisors NHS Revalidation Support Team

19 The state of medical education and practice in the UK: 2012 Exploring the barriers and enablers to good medical practice

20 Thank you