Revalidation: Towards implementationJon BillingsAssistant Director, Continued Practice and Revalidation

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Revalidation is…• Part of a wider system of measures to promote improvements in

safety and quality

• Intended to ensure all medical practice takes place within a governed environment

• A positive affirmation of a doctor’s professionalism based on GMC core guidance Good Medical Practice

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Revalidation isn’t…• A test or exam with a pass or fail outcome

• A new way to raise concerns about a doctor

• The only purpose or output of appraisal or training assessment

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Revalidation requirements…

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The process…

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Requirements for doctors…

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Minimum requirements for readiness

The doctor must be participating in an annual appraisal process which has Good Medical Practice as its focus and which covers all of their medical practice

The doctor must have completed at least one of these appraisals, which has been signed off by the doctor and their appraiser

The doctor must have demonstrated, through appraisal, that they have collected and reflected on the information as outlined in the GMC’s guidance Supporting information for appraisal and revalidation

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Implementation principles

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Recommendation options…

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Concerns about Fitness to Practise must be raised when they arise

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Positive recommendation• a doctor’s participation in appraisal or assessment

• a doctor’s collection of supporting information

• any other information used to inform your recommendation

• a doctor’s compliance with any GMC conditions or undertakings

• a doctor’s compliance with locally agreed conditions on their practice

• any unaddressed concerns about a doctor’s fitness to practise.

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Deferral requests…

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Deferral

• engaged in the systems and processes that support revalidation, but there is incomplete information on which to base a positive recommendation

• participating in an ongoing local HR or disciplinary process, the outcome of which you will need to consider prior to making your recommendation

A deferral request is not:• an RO’s request for the GMC to delay making a decision about a doctor’s

revalidation after receiving a recommendation• a route to address concerns about a doctor’s fitness to practise with the

GMC • an RO’s request to delay making a recommendation while a doctor is

subject to an on-going GMC fitness to practise investigation

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Non-engagement

A doctor is not engaging in revalidation where, in the absence of reasonable circumstances, they:

• do not participate in the local processes and systems that support revalidation on an ongoing basis

• do not participate in the formal revalidation process.

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Suitable person…

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Upstream

System design

Training

Guidance

Midstream

Professionaljudgement

Decisionsupport

Downstream

Monitoring

Evaluation

Review

Quality for RO recommendations is like quality for clinical judgements

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· system design, including training and guidance

· professional judgement· decision support

· monitoring· evaluation· review

In place are:

· statutory requirements· professional duties on doctors· GMC Guidance· training· business rules and processes· information systems

· designated body governance systems· RO networks· GMC – contact centre, revalidation decision team· GMC ELAs – local support and overview· national quality standards across UK countries· systems regulators and quality improvement bodies· royal colleges advice and guidance

Will develop processes to:

· monitor trends in revalidation and demographic data

· learn from revalidated doctors later in FtP· feed back to ROs on recommendations and

potential inconsistencies

Elements of the quality system

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Implementation…

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GMC support

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Contacts

GMC websitehttp://www.gmc-uk.org/doctors/revalidation/12385.asp

GMC Revalidation inquiries team0161 923 6277revalidation@gmc-uk.org

GMC Employment Liaison Advisorshttp://www.gmc-uk.org/doctors/revalidation/12402.asp

NHS Revalidation Support Team0207 972 5818http://www.revalidationsupport.nhs.uk/index.php

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The state of medical education and practice in the UK: 2012 Exploring the barriers and enablers to good medical practice

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Thank you