Revalidation of doctors in training D.Sowden COPMeD 10 th National Multi-specialty meeting. 25 th January 2012

Trust, Assurance and Safety stated revalidation Should focus on: Patient safety (ensuring doctors are maintaining and raising professional standards) Effectiveness of care Patient experience And provides assurance to patients, employers and other healthcare professionals.

Revalidation is a cyclical and continuing process. to which doctors have to demonstrate to the GMC, every five years, that they re upto date and fit to practise AND* are complying with the relevant professional standards *my emphasis

All doctors holding a license to practise will need to participate in revalidation and, therefore, this includes all doctors in training once fully registered with the GMC.

Full registration marks the start of revalidation, and the acquisition of a CCT or CESR (CP) [and entry to the specialist or GP register] marks the end of a revalidation cycle and the start of the next, irrespective of the number of years of the revalidation cycle completed at that time.

The Responsible Officer (RO) for trainee doctors is the PG Dean for the deanery in which they are training, and this [Deanery] will normally have issued their NTN.

Four domains: 1.Knowledge, skills and performance 2.Safety and quality 3.Communication, partnership and teamwork 4.Maintaining trust GMC GMP Framework for Appraisal and Assessment (x ref revalidation)

Note: Revalidation is a process not an event. Thus it is about the acquisition and review of all relevant evidence collected during the current revalidation cycle (upto 5 years).

Further note: Thus, all relevant events occurring during a revalidation cycle are and remain current until that revalidation cycle is complete. Hence, for example, disciplinary issues may be “closed” in HR terms but will remain “open” for the purposes of revalidation.

So why aren’t existing ARCP (or RITA) processes sufficient, or at least not sufficient in all cases?

“trainees in specialty training will retain their national training number (NTN) through [confirmed and documented] satisfactorily progress and* performance [in practice]” * My emphasis Gold Guide

An enhanced ARCP process is seen as the appropriate vehicle for a trainee doctor’s revalidation. GMC has accepted that, for trainees, not all the information required of other doctors will be available, initially. For example, PSQs.

Deanery revalidation responsibilities: Provide support to maintain professional standards Oversee a portfolio of information for each trainee to support RO revalidation recommendation Review trainee’s fitness to practise. Through their prescribed connection to the doctor in training

Trainee revalidation responsibilities: “revalidation is an individual doctor’s responsibility” Provision of comprehensive supporting information Make RO aware of all periods of employment AND placement (clinical and non-clinical); scope of practice declaration Time OOP and any relevant activities must also be provided

Employer revalidation responsibilities: Manage, investigate and report on any complaints/concerns generated as a result of the trainee doctor’s employment Organisations hosting the GP performers list and providing placements have the same duties.

An RO can: Recommend revalidation Indicate an inability to recommend revalidation due to: i.Issues that impact directly on the doctor’s license to practise ii.Inadequate and/or incomplete information

Practical steps: 1.) Trainee scope of practice self-declaration: Annual report of past/present employers/placements Self declaration of SUI/SEA Permission for his/her portfolio to be reviewed for purposes of revalidation

2.) Supporting information for employer/host training organisations: Post/placement exit report (SUIs/complaints/investigation) Employer/HTO must have in place reliable systems to allow exit reports to be completed (typically by Medical Director or nominated deputy)

3.) Enhanced ARCP panel

Results of pilot

Revalidation should be as Streamlined Simple Proportionate as possible, [but it is not cost neutral] GMC, Revalidation: A statement of intent