CEM - Revalidation

Introduction

What is Revalidation?

Revalidation is a process where doctors will be required to “periodically demonstrate their continued fitness to practise … and for specialist doctors, to demonstrate that they meet the standards that apply to their particular medical specialty” (DH 2007: 6). Revalidation has two elements:

• Relicensing will be required for all doctors who hold a licence. This process will be largely undertaken through local clinical governance processes with the responsibility for final relicensing resting with the General Medical Council

• Recertification will be required for doctors who are on the GMC’s specialist register and GP register. Recertification will be led by the Medical Royal Colleges who will need to provide a ‘positive statement of assurance’ to the General Medical Council.

Although revalidation has two elements, doctors will not need to clear two separate hurdles in order to be revalidated. The two strands will form a single, integrated process. Doctors will be required to maintain an ongoing portfolio of supporting information to demonstrate at annual appraisals that they are meeting the attributes and generic and specialist standards set for revalidation. Relicensing and recertification will draw upon largely the same supporting information.

The vast majority of doctors are practicing medicine to a high standard. Revalidation should be a process that will support continuous quality improvement in standards and practice for both doctors and patients alike.

When will Revalidation begin?

On 16 November 2009 the GMC introduced the license to practice. To practice medicine in the UK all doctors are required by law to hold both registration and a license to practice.

This applies whether they practise full time, part time, as a locum, privately or in the NHS, or whether they are employed or self-employed. Licensing is the first practical step towards the introduction of revalidation.

The DH Revalidation Support Team in England will be piloting whole system pathfinder pilots in early 2010 until March 2011. The College aims to pilot the specialty standards alongside these pilots.

It is anticipated that early adopter sites will begin revalidation in 2011.

How will Revalidation work in practice for Emergency Medicine?

It is difficult to provide a detailed and precise answer at this stage of the development of revalidation. There may also be differences between the four national areas.

In broad terms:

• All doctors holding a license to practice and working in Emergency Medicine will need to collect supporting information to demonstrate that they meet their continued fitness to practice against the standards set by the GMC and the College.

• Each doctor will have an annual appraisal, and every 5 years their Responsible Officer will review the appraisals for the past 5 years and make a recommendation to the GMC as to whether that doctor should be revalidated.

• The GMC will make the final decision to revalidate each doctor.

It is important to note that revalidation will be an ongoing, 5 year process; not a fifth year process.

What can I do to prepare for Revalidation?

Most doctors will already be collecting evidence of performance for medical appraisal and CPD. The College recommends you take the following steps in preparation for revalidation:

• Review your appraisal documentation from the last few years

• Check the evidence you have claimed are in your files (e.g. courses attended; CPD certificates)

• Check what aspects of your PDP have been achieved and what has not. If there are uncompleted elements, identify reasons for this and record them

• Review any changes to you job plans or specialist practice and confirm that you have active CPD in those areas

• Collect or make a list of any accolades or letters of appreciation you have received

• Collect evidence of any other clinical activity you may have undertaken (e.g. clinical audits)

• Collect evidence of any non-clinical activity you may have undertaken (e.g. multi-source feedback; patient surveys; teaching; research; work for the greater NHS)

• Make sure that all of the documentation is in place for any complaints or incidents that you may have had

• Ensure that the ‘local responsible officer’ (when appointed) within your trust has copies of your appraisals and a record that they have taken place.