Appraisal and revalidation update

October 15th 2012Appraiser Learning set meeting

Crawley and East Surrey

What do all GPs need to knowAbout revalidation and commissioning

Autumn 2012

Revalidation Responsible officers will be revalidated in first four months

April 2013 roll out to all doctors- expected all revalidated by march 2016

If you are on the performers list the RO is responsible for recommending you to the GMC for revalidation

From December 2012 you will know the year you will be revalidated

Revalidation The RO needs to be satisfied that you have participated in an

annual appraisal that covers all of your medical practice, and that your appraiser has signed off at least one appraisal that has good medical practice as its focus

You have brought to your appraisals appropriate supporting information

There are no unresolved concerns about your performance as a doctor

here are six types of supporting information that you will be expected to provide and discuss at your appraisal at least once in each five year cycle

They are:

Continuing professional development

Quality improvement activity

Significant events

Feedback from colleagues

Feedback from patients

Review of complaints and compliments

Revalidation “Minimum supporting information” applies to the 12 month period

prior to your last appraisal before your revalidation dateIe for some of us that means information gathered this year: 2012-

13Revalidation is a continuous process , not a high stakes exam at a

fixed point in time- the RO should give you time to put things right Part timers , retainers ,and locums all expected to submit a full

standard portfolio

Minimum supporting information Personal details, scope of your work, record of annual appraisals, PDPs,

probity and health declarations

At least 50 CPD credits in the 12 months prior to your last appraisal before your revalidation date

At least 2 significant event reviews in 12 months – must include any serious incident

Minimum supporting information Audit –evidence of regular participation in in quality improvement activity

relevant to your scope of work, and discussed at appraisal

Colleague feedback and patient feedback- one of each in 5 years before your revalidation recommendation

Description of any formal complaints

MSF and PSQ Various tools approved by GMC – their own tools are simple; require 40

patients and 15 colleagues

Can use GP-SPRAT, CFET, 2Q MSF, Edgecumbe 360

Initially other non validated tools will be acceptable if they focus on what you do, but suggest data externally collated

MSF and PSQ Feedback and reflection essential

Can be challenging

RCGP faculties will be providing support

Means if you haven’t done a personal PSQ or MSF in the past 3 years , do one soon

Extended rolesAny activity beyond the scope of GP training and the

MRCGP, or with a separate contract eg GPwSI or receiving fees outside of care to registered practice population eg teaching , medico-legal work , occ health

Must demonstrate fit for these roles- eg trainer approval from deanery, review of appraisers practice, statement from OOH provider

PDPs Must be SMART, no max or min number of items

Must contain statement of development need, how this will be addressed, date by which it will be achieved, intended outcome , and review by appraiser

If not achieved , explanation as to why not

Need to consider more than just clinical learning, eg leadership and management

CPD credits250 in 5 year cycle required

In essence 1 credit = 1 hour if accompanied by reflective record; a certificate alone is no credit

Claim 2 credits per hour if can demonstrate impact eg leading to a change in practice

Self allocated and approved by appraiser

Should reflect broad range of activity over 5 yrs- ie not just diabetes courses for diabetes GPwSI

Significant events Need to include description of event, who was involved and who it was

discussed with

What went well?

What could have been done differently?

Reflections in terms of knowledge, skills , safety, partnership and communication

Agreed changes ,and their effect

Significant events Ideally discuss in team , but may be difficult for locums

Encourage practitioner groups, locum chambers

Can do serial case review -10 consecutive cases , or 10 cases with a specific condition

Audit At least one full cycle audit that you have taken part in ie not just the

medical student audit!

Audit is a systematic analysis of the quality of care

Needs to be relevant to your practice, amenable to change, and appropriately actioned

Audit Criterion – statement of best practice , preferably evidence based

Standards set- how you think you will measure up to best practice , bearing in mind reality of GP

Data collection 1

Compare to standards , discuss changes needed

Audit Changes put into action

Compare to standards and discuss whether quality improvement resulted , and if not why not – and repeat as required

Topics could include antibiotic prescribing, use of investigations, prescribing, hypertension management etc

Audit Can submit a quality improvement project eg reviewing use of care

pathways in a particular group of patients

Action audit – reviewing care of cases of a defined nature with a colleague , matching performance to preset criteria- my be suitable for locums / OOH doctors

Commissioning New responsibility for GPs to be cost aware and make efficient use of

resources

We are all involved in commissioning through referral and prescription

Links to QIPP agenda and QOF ongoing

Suggestion that PDPs take local and national priorities into account ,as well as personal needs

Update from RCGP tool fully integrated with the RCGP’s

Online Learning Environment (OLE), which includes

the RCGP Essential Knowledge Updates,

Essential Knowledge Challenges and the

Personal Education Planning (PEP) learning needs assessment tool

free for College members

September 2012 RCGP Revalidation ePortfolio Lead Appraiser. -help organisations quality assure their appraisal process.

RCGP Trainee ePortfolio to Revalidation ePortfolio integration Upon log in we will introduce an Appraisal Year Warning. to ensure appraisees do not complete an

appraisal in the wrong year.

RCGP Single Sign On. Log on only once to access all of the RCGP products that you are eligible to access.

Introduction of the Medical Appraisal Guidance (MAG) appraisee and appraiser declaration statements

October 2012 The GMC patient and colleague questionnaires will be integrated in the RCGP’s

Revalidation ePortfolio, enabling GPs to self-assess and benchmark against their peers.

The new revalidation ready ‘Form 3’ equivalent. Any existing data will be mapped

over.

November 2012 Responsible Officer functionality. The RCGP Revalidation ePortfolio will offer ROs everything they need to

make a revalidation recommendation, including (subject to GMC readiness) a link to the GMC database.

Dashboard. This will be reorganised to reflect the new GMC supporting information headings.

Form 4 will be replaced with its revalidation ready equivalent and any existing data will be mapped over.

The new ‘Form 4’ will include an option for appraisers to add PDP items resulting from the appraisal discussion.

Appraisal summary document. This will be reformatted for ease of use, by GPs and organisations. The PDP

section will be significantly enhanced.