1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

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

10. 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

11. 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

12. 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 : 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

13. 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

14. 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

15. 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

16. 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

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

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

19. Thank you Questions? 19

20. 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