1. Registered charity no 212808 Revalidation in Surgery [name] [Council Member] Royal College of Surgeons of England

2. Registered charity no 212808 Background Bristol and other events Proposals on revalidation Stalled by Shipman Inquiry criticism 2006 Chief Medical Officer’s report Good Doctors Safer Patients 2007 White Paper Trust Assurance and Safety

3. Registered charity no 212808 But this time… Revalidation would have two parts: Relicensure And Recertification All doctors Every 5 years Mainly through appraisal Must include a multi-source feedback exercise (360˚ feedback) Only doctors on the specialist register (finished training, got their CCT – ALL consultants) Every 5 years Variety of evidence/ assessment methods College Responsibility GMC

4. Registered charity no 212808 Recertification “Recertification, like relicensure, will be a positive affirmation of the doctor’s entitlement to practise, not simply an absence of concerns.” The purpose of recertification is therefore to: –further ensure patient safety; –encourage continuous professional improvement; and –allow early warning of potential difficulties.

5. Registered charity no 212808 What we know Enhanced appraisal is the main mechanism for revalidation There will be a new “revalidation module” for appraisal Responsible Officers will make the recommendation of revalidation to the GMC

6. Registered charity no 212808 Key Players GMC (responsible for the whole thing) Colleges and Associations (setting standards and supporting surgeons) NHS (including the NHS Revalidation Support Team) Employers (SHAs, Trusts and other employers) Department of Health

7. Registered charity no 212808 Timetable Early 2009: Pan-Specialty Project Board need to come up with the standards and evidence requirements 2008-2009: College need to set up implementation and support systems 2009-2010: Piloting 2011 onwards: Implementation

8. Registered charity no 212808 What’s happened so far Standards – finalising with specialties E-portfolio – tested, developing for release CPD –requirements set Advice, support and remediation –options being considered Regional Structures –piloting in South West and West Midlands – four new pilots from August 2009

9. Registered charity no 212808 Standards framework Only standards dealing with: –Surgical practice; and/or –Consultant level generic practice. Addition to relicensure standards Follows GMC model of standards Surgical specialty specific standards being added

10. Registered charity no 212808 CPD requirements 250 points evenly spread across five years 1 point/hour (but some points/activity when difficult to measure) Balanced across categories (clinical, professional, managerial) and context (internal, external, personal) Dependent on practice and career aims

11. Registered charity no 212808 Outcomes Different evidence for different surgeons: –National Audit –Hospital Episode Statistics (HES) or similar –Local Audits –PROMs Specialty associations determine: –Best evidence –Best indicators (not always mortality!)

12. Registered charity no 212808 Outcomes Outcomes will be one source of evidence for recertification – a tile in a mosaic Concerns about data especially HES BUT Impetus for change Profession’s opportunity to tell the NHS how to do it

13. Registered charity no 212808 Outcomes – when concerns are raised

14. Registered charity no 212808 What next? Specialty Associations adding specialty informed standards and evidence Waiting for Academy guidance on MSF Colleges developing implementation plans Colleges and associations to think about support for surgeons Knowledge testing – something for the future

15. Registered charity no 212808 Implementation GMC consulting on models for the revalidation process All Colleges are discussing them with their Councils Discussions ongoing at Academy level Trusts and SHA’s also feeding into debate

16. Registered charity no 212808 GMC model for revalidation

17. Registered charity no 212808 College proposal Local process to take into account local circumstances College to play key roles in: –Setting and maintaining standards –Quality assurance of process –Support for surgeons

18. Registered charity no 212808 Our model for revalidation

19. Registered charity no 212808 Specify what is required Guidance E-Portfolio to collect Advice from Professional Affairs Board Standards for appraisal and appraisers Education and training provision for appraisers Representative from Regional Professional Affairs Board to quality assure the work of this Panel National level involvement External QA – ?periodic visit C&A

20. Registered charity no 212808 Support Three big areas for Colleges and Associations to consider: –CPD (in the broadest sense) Providing courses and events Sign posting Guidelines and guidance and advice Event and course accreditation –Advice, support and remediation –E-portfolio

21. Registered charity no 212808 Key Contact Claire Steel Recertification Project Manager csteel@rcseng.ac.uk 020 7869 6224 csteel@rcseng.ac.uk