Revalidation and Appraisal Update October 2008  What’s happening  Appraisee stuff  Appraiser stuff  Handouts and

The Three “R”s  Relicensing GMC  RecertificationRCGP  Remediation(only tiny minority expected to require GMC referral)

The Real News  Revalidation WILL happen  Licensing starts in 2009 (autumn) (no assessment for this but…)  Once you are licensed the clock is ticking  Relicensing 5 years from then  You must start methodically collecting your evidence (portfolio) straight away if you are not already doing so….

Good news  Incremental piloted approach  Being rolled out first in areas that are better developed, NOT randomly by GMC number  ? DOH still scarred by MTAS debacle  The Three to watch: DOH proceeding cautiously GMC RCGP

Appraisal and assessment  Appraisal remains formative and developmental  New framework against which to objectively assess Drs evidence  Appraiser is not asked to make a judgement  Judgement made via clinical governance pathway, appraisal evidence feeds in as a part of this

Local and National  Relicensing –GMC for most Drs a local process: WILL BE PILOTED Appraiser and Responsible Officer (local) GMC affiliate-> GMC rubber stamp-Regional/National  Recertification - RCGP Avoid duplication – same portfolio, MSF, Appraisal In Addition: Probably a Knowledge test (AKT) Possibly Simulated Surgery (?) ALSO PILOTING

Evidence and Processes  The CONTINUOUS Process-portfolio  The Episodic processes: Annual appraisal Multi-Source Feedback (MSF) Patient feedback Knowledge testing (AKT) Possibly simulated surgeries Report of Responsible Officer- Performance and Clinical Governance sent to GMC Affiliate

Judgment Day- Recertification  Responsible officer collates all evidence From Appraisal From Clinical Governance channels eg (lack of) complaints, performance markers  RO’s main concern is to assure safety and “good enough” quality The challenge to GMC Nationally is to produce tools to measure these objectively

What happens if there are concerns about a Drs performance?  Numbers to GMC (low) currrently ~350pa  Numbers with concerns to be addressed not via current GMC mechanisms (much more but still max 5% of Drs) 33,000 GPs  How to decide thresholds for formal GMC referral  New procedures for remediation/ support for those not requiring GMC referral

Preparation for appraisal

Each Dr will need  A Responsible Officer  A Professional body  To produce the necessary evidence regularly .. And to engage constructively with the process

E-portfolio websites NHS Appraisals toolkit RCGP in development, running for registrars NHS e-portfolio site BMJ learning GP notebook Drs net Etc etc Avoid duplication and if use more than one make sure can upload data from one site to your chosen core site

Web tools -outline  NHS Appraisal toolkit:  LMC: Leicester SRTS; MSF/ 360 degree samples  GMC: realistically awkward interactive Scenarios  RCGP EGP update distance learning dummy e-portfolio site: Curriculum headings Clinical skills list  RCGP Scotland nPEP – Knowledge learning needs assessment: online MCQs for a fee  

Doing the detail Documentation Written reflections Amount?

Not too much

Not too little

…but just right The Goldilocks principle

Useful handouts and articles  RST BMJ Careers article (Maurice Conlon, GP and Director of RST)  GMC Today  Good Medical Practice in action-flyer  nPEP flyer  RCGP EGP Update flyer  360/MSF flyer  Examples of Structured Reflective Templates (RSTs)  GMC Framework for Appraisal and assessment

Take home message  Make sure you have an annual Appraisal  Learn how to use an e-Portfolio  Stay up to date with what’s happening in revalidation: local events, the GMC newsletter, and websites: GMC website (

Check out  Multisource feedback (MSF) will be compulsory examples at  Applied Knowledge testing (AKT) eg Scottish RCGP nPEP RCGP Essential GP Update Programme pilot at ning/egp_update.aspx ning/egp_update.aspx ning/egp_update.aspx

KISS Keep It Simple Stupid  The Goldilocks Principle (Amount of evidence) Not too much, not too little, but just right  SMART (PDP goals) Specific Measurable Achievable Realistic Timely  The Good, the Less Good and The Ugly Compliments and successes Significant Incidents Complaints

QUESTIONS