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![Page 1: Trust, Assurance and Safety – White Paper on regulation –the implications for us all Dr Di Jelley GP Appraisal and Revalidation Advisor Northern Deanery.](https://reader036.fdocuments.us/reader036/viewer/2022062516/56649e6a5503460f94b682be/html5/thumbnails/1.jpg)
Trust , Assurance and Safety –White Paper on regulation–the implications for us all
Dr Di Jelley GP Appraisal and Revalidation Advisor Northern Deanery
Sessional GP Meeting May 17th 2007
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Contact Details
Dr Di Jelley
• Collingwood Surgery North Shields Tel 01912571779
• Email [email protected]
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Summary
• Core areas of the White Paper
• Core statements on appraisal and revalidation
• Questions still to be addressed concerning appraisal and revalidation
• What should we be doing now….
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Core areas of White Paper-seven chapters
• [1] Role and structure of GMC
• [2] Revalidation –ensuring continuous fitness to practise
• [3] and [4] Tackling performance concerns locally and nationally
• [5] Education and Regulatory bodies• [6] Information about health professionals• [7] New roles and emerging professions
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Overview of the White Paper[1]-core principles
• Improving quality standards across all areas
• Concerns all health professionals working within the UK healthcare system
• To support all professionals as well as early identification of any performance concerns
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Overview of the White Paper[2]-the main drivers
• Greater patient involvement in health care
• Better communication between patients and professionals
• Better rehabilitation services for health professionals in difficulty
• High profile media cases and public concern
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[1]Changes in professional regulatory bodies [GMC,GDC etc]
• Equal number of lay and professional members
• All councils to become accountable to Parliament or Devolved Assemblies
• Smaller councils with members independently appointed not elected
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[2] Revalidation –ensuring continuous fitness to practise
• Revalidation is the combined process of re-licensure and re-certification[5 yearly]
• Re-licensure will depend principally on ‘successful’ completion of annual appraisal
• Re-certification will be against specific standards set by Royal colleges
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[3] and [4] Tackling performance concerns locally and nationally
• Review of performers’ lists and keeping these up to date
• Regional network of ‘GMC affiliates’ to work with PCO medical directors
• ‘Recorded concerns’ about individual professionals will be introduced on a pilot basis
• Standard of proof will be civil [ a sliding scale ]• GMC will no longer both investigate and
adjudicate on fitness to practise concerns
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[5] Education and the role of Regulatory bodies
• Three board model for overseeing undergraduate, post-graduate education, and continuing professional development
• Current PMETB will be retained and two more similar boards established
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[6] Information about health professionals
• Improve information exchange between regulatory body and employer when an individual first enters employment
• Development of GMC register as the single authoritative source of information on doctors, with better access for patients, public and employers
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[7] New roles and emerging professions
• Introduction of statutory regulation for health professionals such as psychologists, counsellors psychotherapists etc
• Review of regulation of other emerging professionals
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So what are the core issues from these proposals for us as GPs?
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[1] Changes in GP appraisal
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Changing role of GP Appraisal
– “Appraisal is a positive process to give someone feedback on their performance, to chart their continuing progress and to identify development needs” CMO 1999.
– “The process of NHS appraisal should, in the future, make explicit judgements against generic standards contained within the doctor’s contract” CMO 2006
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Appraisal is here to stay but shift from wholly formative to explicit link with performance review
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Concerns about current appraisal process
• Lack of consistency in delivery of GP appraisal in England-
• Doctors can participate in appraisal yet have significant unresolved concerns [appraisee led agenda]
• Lack of clear guidance on core agenda for the appraisal meeting and required evidence set
• Appraisals do not always refer to previous year’s PDP and Form 4
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Proposed changes in GP appraisal in White Paper
• Appraisal will be both summative [has performance met specific standards] and formative [looking forward to any changes that might be needed]
• QA of the appraisal process will be by GMC –especially appraiser selection, training and performance review
• Standardisation of evidence requirements
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[2] Changes in proposals for revalidation
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Revalidation
• Revalidation –keeping up to date and fit to practise
• For the large majority of doctors, this will provide reassurance and encourage continued improvement
• For a very small minority it will lead to identification of problems and an opportunity to put these right
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So what will these revalidation proposals actually involve?
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Re-licensing- a five yearly ‘generic’ process for all doctors
• Annual appraisal [‘satisfactory completion]
• 360[multi-source] colleague feedback [? At least every 3 years]
• Local Clinical governance sign off [no concerns or resolved concerns]
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All doctors will need to be re-licensed every 5 years – a few may not need to be re-certified eg Some private sector posts ? Ships doctors
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GP Re-certification-5 yearly , in line with Re-licensure if possible
• Comprehensive assessment against standards drawn up by RCGP for GPs
• External QA of process to ensure they are robust yet cost-effective re time taken away from patient care
• GPs will not need to join RCGP to be re-certified ,but there will be a cost attached
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Re-certification standards
• Information from clinical audit, employer appraisal, knowledge tests, patient feedback, CPD and observation of practice
• Establishment of robust local and national clinical audit groups to review performance indicators
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Failure to revalidate
• Those few doctors who do not meet standards of revalidation will be required to spend a period in supervised practice or with a specific rehabilitation plan
• DoH will work with GMC,BMA,NCAS and Colleges to agree appropriate support mechanisms for these processes
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What questions does this raise for you?
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Core questions[1]
• What will be the ‘generic standards’ for GPs
• How in practical terms will GPs be appraised against these?
• What will be the criteria for passing or failing the summative element of appraisal
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Core questions [2]
• Will submission of satisfactory evidence be a part of the summative component?
• What criteria will be used to judge whether evidence submitted is satisfactory?
• Will this judgement be made by your appraiser or via a separate mechanism?
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Core Questions [3]
• What will 360 feedback process involve?
• Who will give GPs their colleague feedback and discuss it with them?
• What will GP re-certification comprise-?knowledge tests and OSCEs for everyone?
• Will the evidence for appraisal overlap with data sources for re-certification?
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What next?
• UK Revalidation Steering Group to be set up to guide carefully phased and managed introduction of revalidation-
• Detailed implementation programme awaited-? First re-validations in 2009-2010
• DoH commissioning and piloting a variety of 360 feedback tools-further guidance awaited