13th National Multi-specialty Meeting – 20th January 2015 Utilising ARCP related processes which support revalidation to incentivise better learning performance and reward the outstanding ones. GM

Professor Geeta Menon -. Head of School of Ophthalmology (HEKSS) - Professor Geeta Menon - Head of School of Ophthalmology (HEKSS) - Director of Clinical Education (Frimley Health NHS Foundation Trust) Mr Jack Cornish - RO Support Officer (HEE) - Senior Manager for Trainee Development & Resolution (London LETBs) GM/JC

Background “The biggest change in medical regulation in more than 150 years” – Niall Dickinson Two years into revalidation: 55,154 doctors are connected to LETBs & Deaneries 92,059 approved recommendations made to the GMC Of which 22% (20,177) are from LETBs & Deaneries JC

Workshop Objectives By the end of the session participants will be able to: Demonstrate understanding of the principles of revalidation for trainees Role of the Interim Review/ARCP in line with progression and revalidation Appreciate the processes in managing an enhanced ARCP panel effectively Understand and discuss appropriate decisions with regards to the outcomes of an ARCP panel Appreciate the role and responsibilities of the RO in relation to trainee revalidation JC 4

What will we discuss? Information required for ARCP Reality of what is available Determining outcomes based on information provided Disclosures at ARCP What happens after ARCP Transfer of Information JC 5

Principles of Revalidation Confirms that a doctor with a licence to practice continues to be fit to practice Requires all doctors to engage with systems of periodic review (i.e. ARCP) Provides confirmation that a doctor with a licence to practice is working within a governed system (curriculum requirements, SI reporting, portfolio) Requires all doctors to a prescribed connection to a designated body (LETB/Deanery) and a RO (PGD) JC 6

Assessing progression What are the key principles of the ARCP Panel? Making decisions on trainee progression and responding to fitness to practice issues Information reviewed by ARCP panel is confined to that which is presented Information withheld by a trainee is considered a probity issue Referral to GMC can occur at any time, according to circumstances, not just at ARCP GM 7

Which Trainees do you see? The ARCP should be done without the trainee being present, unless: Paper portfolio Trainee is not progressing well Required by the college (PYA) Revalidation concerns raised by Trust, Supervisor or Trainee So most of the trainees you will actually meet are potentially having a difficult time. GM 8

What information needs to be considered by the ARCP Panel? JC 9

ARCP SUPERVISORS REPORTING TRAINEE SUPPORT LEAD FEEDBACK GMC ISSUES OR REFERRALS ARCP TRAINEE PROGRESSION Demonstration of competencies Evidence in logbook/portfolio Exam progression Action plan from previous IR/ARCP EMPLOYER REPORTING Complaints Investigations Serious Incidents TRAINEE DECLARATIONS Form R: Complaints, Investigations, Serious Incidents, Health Discussions at Panel JC

What are serious incidents? Unexpected or avoidable death Serious harm requiring life-saving or major surgical / medical intervention. Permanent harm, reduction in life expectancy, prolonged pain or psychological harm A threat to the organisation’s ability to continue to deliver healthcare services Allegations of abuse Adverse media coverage or media concern A ‘Never Event’ JC 11

1 6 7.1 8 2 3 4 5 7.2 – 7.4 Outcomes Satisfactory Outcomes Unsatisfactory Outcomes Outcomes 3 & 5: Additional Training Time and CCT date change Outcome 4: can only be given after a outcome 3 Outcomes 7.2-7.4: implications as we don’t extend 1 6 7.1 8 Outcome 6 is for Core & Higher 2 3 4 5 7.2 – 7.4 GM 12

Writing up Forms ARCP forms outlining summary for outcome Action Plan (SMART objectives): ES and trainee sent ARCP Action Plan Discussion between ES and TPD before placement starts ARCP action plan to form the Induction meeting with trainee Review during supervision meeting Review at Interim Review and following ARCP GM 13

Transfer of Information – who needs the information? After the Panel Transfer of Information – who needs the information? Educational Supervisor College Tutor Head of School Director of Medical Education Responsible Officer Trainee Support Lead GM 14

Responsible Officer recommendations RO required to ‘make recommendations to the GMC about medical practitioners fitness to practice’ RO’s already make ‘recommendations’ about the fitness to practice of doctors through referral to the GMC – this should continue as now Revalidation adds the positive affirmation of doctors fitness to practice to the current processes ARCP Panels are key to this process JC 15

Responsible Officer recommendations Positive affirmation of suitability to continue to hold a licence to practice Deferral Notification of non engagement N.B. – no “do not revalidate” recommendation JC 16

More issues are being reported By trainees and employers Change to clinical governance within Trusts JC

Incentivise better learning performance? More issues considered at ARCP Leads to more reflective practice? Is just seen as a punitive process? JC

Thank you Questions? 19

Questions for groups Perspective of Trainees and Trainers on introduction of revalidation to ARCP processes? How do we measure better learning performance and how revalidation has contributed? Can ARCP & revalidation “reward” outstanding trainees? Does revalidation make ARCP more of a punitive process? Is this a problem? Does it lead to more reflective practice