Andy Tomlinson Revalidation Lead Royal College of Anaesthetists Revalidation update and the new CPD matrix AAGBI Congress Edinburgh 2011

Revalidation: Why?

Revalidation update and the CPD matrix  What is revalidation?  Medical appraisal  Supporting Information  Continuing professional development and the matrix  What should you be doing now?

What is Revalidation? “A new process to assure patients, the public, employers and other healthcare practitioners that licensed doctors are up to date and fit to practise.” Revalidation: The Way Ahead GMC Consultation Paper March 2010

Revalidation…..is a continuing cycle Strengthened appraisal One revalidation cycle Another revalidation cycle …..for each/every professional lifetime

Revalidation model Portfolio of Supporting Information Five x yearly appraisals Responsible Officer Cannot recommend revalidation Query RCoA adviser and/or GMC ELA review and support General Medical Council Recommend revalidation

Revalidation….is coming to us all In 2012 provided:  Responsible Officers appointed  Effective clinical governance systems in place  Effective annual medical appraisal  Agreed core supporting information  Agreed strategy for remediation

Revalidation for Doctors: Health Committee  Must ensure:  Implemented by 2012  Consistency of appraisal  Administrative burden placed on doctors not excessive  Patient and colleague feedback is embedded HC th February 2011

Appraisal  Discussion/constructive dialogue at the heart of appraisal  Key appraiser skills  Support, guide, challenge (constructively)  Based on supporting information  Balance  Assessment (Revalidation)  Support (Personal development)  Recognise/respond to patient safety concerns

Appraisal Current best practice  Clinical and non-clinical aspects mapped to GMP  CPD reviewed against  Core topics  Job plan  Matching of job plan to Trust needs  Increased use of MSF  PDP taking account of the above

Appraisal Current best practice  Clinical and non-clinical aspects mapped to GMP  CPD reviewed against  Core topics  Job plan  Match job plan to Trust needs  Increased use of MSF  PDP taking account of the above Appraisal for revalidation  ‘Whole practice’ referenced to four domains of GMP  Judgements on:  Adequacy of supporting information including:  CPD  Quality of practice  Learning from complaints  MSF  Clinical risks/safety  Progress towards revalidation  Match job plan to Trust needs  PDP taking account of the above

GMC Good Medical Practice Framework uk.org/GMP_framework_for_appraisa l_and_revalidation.pdf_ pdf

Good Medical Practice Framework  Must be used by individual doctors to:  Reflect on practice/approach to medicine  Reflect on Supporting Information and what it demonstrates  Identify areas for improvement/further development  Demonstrate they are ‘up to date and fit to practise’

Supporting information uk.org/Supporting_information__2_.pdf_ pdf

Core supporting information  Information that all doctors should provide

Core supporting information  Information that all doctors should provide  General information  Providing context about your ‘whole’ practice  Keeping up to date  Maintaining/enhancing quality of professional work  Review of practice  Evaluating the quality of your practice  Feedback on professional practice  How quality of professional practice is perceived by others

Core supporting information  Information that all doctors should provide  General information  Providing context about your ‘whole’ practice  Keeping up to date  Maintaining/enhancing quality of professional work  Review of practice  Evaluating the quality of your practice  Feedback on professional practice  How quality of professional practice is perceived by others Specialty specific advice added

Specialty specific supporting information

Supporting Information: Feedback on professional practice uk.org/Colleague_and_patient_question naires.pdf_ pdf

Specialty feedback on professional practice patFeedback2011.pdf

Supporting Information: CPD CPD_2010.pdf

CPD Matrix (Clinical)  Three levels:  Level One  Restricted area of essential knowledge  Level Two (Knowledge and skills)  Directly related to on-call activity  Level Three (Knowledge and skills)  Directly related to special interest clinical activity

(New) CPD Matrix: level one (L1) Level 1 covers the core knowledge areas expected of all those who have trained as anaesthetists. The CPD evidence for this level will be largely ‘internal’ and may be obtained from reviews/reflection of personal clinical practice utilising records of clinical activity, e-learning material, reading and local hospital departmental meetings.

(New) CPD Matrix: level one (L1) A. Scientific principles B. Emergency Mx and resuscitation C. Airway Mx D. Pain medicine E. Patient safety F. Legal aspects G. IT skills H. Education & training I. Health Mx Physiology and biochemistry Anaphylaxis Airway assessment Assessment of acute pain Infection controlConsent Use of patient record systems Roles and responsibilities of clinical supervisors Critical incident reporting Pharmacology and therapeutics Can’t intubate can’t ventilate Basic airway Mx Mx of acute pain Level 2 child protection training Mental capacity & deprivation of liberty safeguards Basic search methodology Personal education and learning Team leadership & resource Mx Physics and clinical measurement BLS (all ages and special situations) Protection of vulnerable adults Data protection Human factors in anaesthetic practice ALS relevant to practice Blood product checking [to comply with local requirements] Equality and diversity Understanding the process of dealing with complaints Prophylaxis & management of VTE Ethics Quality improvement

(New) CPD Matrix: level two (L2) Level 2 CPD topics should reflect the whole of the individual’s clinical practice including on-call responsibilities in non-specialist centres. The CPD evidence for this level may be provided, in part, by updates from local experts but it will also include the need for more ‘external’ CPD activity through attendance at courses and meetings.

(New) CPD Matrix: level two (L2) A. General B. ICM C. Neuro D. Obs E. Pain medicine F. Paeds G. Regional anaes H. Education & training Advanced airway MxAssess of the critically ill pt Initial Mx of brain injury [traumatic or intracranial haemorrhage] Analgesia for labour Advanced Mx of peri-op pain Assess & Mx of the critically ill child Indications, benefits and risks of RA Work-place based assess Assess & initial Mx of major trauma (and burns) Initiation and Mx of ventilatory support GA for elective/emerge ncy LSCS Mx of acute non- surgical pain Perioperative care of children Educational supervisor training Pre-op assess and preparation for surgery Support of threatened and failing organs Initial Mx of pts with spinal injuries RA for elective/emerge ncy LSCS Basic assess & Mx of chronic pain Vascular access techniques Principles of performing local, regional and neuraxial techniques Peri-op emergenciesDiagnosis & Mx of shock, inf & sepsis Mx of pts with neuro trauma for imaging Complications of RA in obs Fluid Mx for children Advanced pt monitoring techniques Sedation in ICUMx of obs emergencies Analgesia for children Use of nerve/plexus location techniques Fluid Mx/blood product usage End of life issues & organ donation Assessment of critically ill parturient Sedation techniques for children Sedation for adultsMx of the ICUPrinciples of newborn resus Team working with retrieval teams Recognition & Mx of side effects and complications of RA +others

CPD credits and activities  Minimum of 50 credits per year with some flexibility  Internal  Minimum 20 credits  Minimum of 10 from local clinical governance meetings  External  Minimum 20 credits  RCoA encourages wide range of activities

Revalidation: What should I be doing now?

Ask the following of your Trust  Is there a robust appraisal process?  Sufficient “Trained” appraisers  A hospital-wide appraisal development process?

Revalidation: What should I be doing now? Ask the following of your Trust  Is there a robust appraisal process?  Sufficient “Trained” appraisers  A hospital-wide appraisal development process?  Is there robust Clinical Governance?

Revalidation: What should I be doing now? Ask the following for yourself  Am I:  collating/organising relevant supporting information?  developing a CPD portfolio mapped to professional guidance?  How am I involved in Quality Assurance and Improvement?

Further advice or guidance? OOr