Revalidation for SAS doctors

1. Revalidation for SAS doctors John Bache FRCS RST Associate NHS Revalidation Support Team SASG Annual Conference Manchester 13th January 2010

2. How did we get here? … 1999 Supporting Doctors, Protecting Patients - CMO 2004 Shipman Inquiry Report (plus Bristol, Alder Hey etc..) 2006 Good Doctors, Safer Patients – CMO 2007 Trust, Assurance and Safety – White Paper on ‘Regulation of Health Professionals in 21st century’ 2008 Medical Revalidation - Principles and Next Steps - CMO

3. 2008Medical Revalidation – Principles and Next Steps “In the NHS, appraisal is patchy geographically and is not fit for the purpose of re-licensing. …To address this will require a standardised module of appraisal, agreed by the GMC, to be included in all appraisal systems. This module will be derived from Good Medical Practice… and will inform a judgment on whether the evidence presented supports revalidation or not over a five year cycle…”

4. Purpose of medical revalidation • To confirm that licensed doctors practise in accordance with the GMC’s generic standards • (re-licensure) • For doctors on specialist or GP register, to confirm that they meet the standards appropriate for their speciality (re-certification) • To identify for further investigation, and remediation, poor practice where local systems are not robust enough or do not exist 4

5. What is needed for revalidation? The key elements required for implementation are: • a revised system of appraisal • a regional network of GMC Affiliates • a network of Responsible Officers • the issuing of licences to practise - done! • standards for assessment and evaluation methods for specialist recertification (+ generic standards for all doctors) 5

6. Changes needed … Piloted introduction of revalidation through careful introduction of ‘new’ appraisal: - new appraisal forms - electronic support Standards for assessment (Royal Colleges) Improvements in Trust/PCT/etc infrastructure to support ‘new’ appraisal

7. GMC, RST, NCAS, Royal Colleges • GMC • Ultimate decision on whether doctor revalidated • Concerns about fitness to practise • RST • Design, support and piloting for strengthened appraisal • NCAS • Advice to RO in support of local remediation • Royal Colleges • Specialty standard setting + formal assessment

8. The legislation - ensures that there is investment in systems of clinical governance, audit, and multi-source feedback - ensures that RO decision making is rigorous, high quality, and consistent - ensures that appraisal systems are mandatory, high quality, and consistent

9. GMC: Good Medical Practice • 4 Domains – insufficiently sensitive for comprehensive assessment • 12 Attributes – pragmatic level on which to base reasonable assessment • 75 Standards – too complex to expect all doctors to present evidence on each one

10. Good Medical Practice Attributes

11. ‘Generic’ Portfolio

12. Multi-source (“360”) feedback • From colleagues • From patients (where appropriate) • Appraiser must know how MSF works, including statistical validity • Feedback of results must be done well

13. Timetable • Licenses issued to all doctors who requested them and on the GMC register in November 2009 • Re-licensing will be based on future participation in appraisal • Re-certification proposals to be piloted in all specialities in 2010/11, to start probably in 2011 • Guidance on approved MSF tools shortly

14. What do I need to do now? 1. Gather detailed evidence • CPD • Workload - hospital episode statistics • Audits • Teaching and other roles • Reviews of significant events or interesting cases • Complaints or concerns • MSF - colleagues (and patients) • Health - and reflect!

15. What do I need to do now? 2. Establish contact with relevant Royal College • Website • Colleagues • Direct They are defining standards and methods of evaluation

16. What do I need to do now? 3. Keep up to date with developments • GMC • Royal Colleges • Revalidation Support • Websites • Literature • Colleagues • Direct

17. Any questions? ?