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Revalidation, Relicensing, Recertification

Revalidation, Relicensing, Recertification. New words for old concepts. Introduction. Discuss continuing professional development (CPD) Changes to CPD over past few years Revalidation, Relicensure, Recertification RCGP proposals What you need to do now you’re on your own!. The 3 R’s.

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Revalidation, Relicensing, Recertification

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  1. Revalidation, Relicensing, Recertification New words for old concepts

  2. Introduction • Discuss continuing professional development (CPD) • Changes to CPD over past few years • Revalidation, Relicensure, Recertification • RCGP proposals • What you need to do now you’re on your own!

  3. The 3 R’s • Relicensure via GMC for all practicing doctors • Recertification by relevant royal college • Both processes done simultaneously every 5 years. If successful = Revalidation!

  4. How do I get there? Reflect and improve and record!

  5. CPD GMC: “A continuous learning process that complements formal undergraduate and postgraduate education and training. CPD requires doctors to maintain and improve their standards across all areas of practice.”

  6. Why is it important? • Individual: job satisfaction, decreased burnout, develop PDP, revalidation • Patient: trust, increased Dr knowledge, ?better Rx • Profession: trust • Society: Changes to medical regulation, rapid increase in medical knowledge, Janet Smith inquiry

  7. How do I do it? You probably are! • Choosing what to learn (Educational needs assessment) • Choosing how we learn (Learning Styles) • Time to think about what you learned (Reflection) • Making the learning work (Application) • Studying the effects of what we have learned (Evaluation) (Write it down!)

  8. Educational Needs Assessment • We tend to focus on comfortable, familiar, fun topics • BUT, knowledge gaps lay hidden • Johari’s window • Identify using various techniques: PUNS, questionnaires, talking, feedback, MCQs, Audit, guidelines etc.

  9. Doing the Learning • What skill / knowledge do I want to have after the activity? • SMARTER objectives • Learning Styles (Honey and Mumford) • Activist • Reflector • Theorist • Pragmatist

  10. Prioritising Learning • Most Impact – personal/patients • Urgency – clinical, time, resource • Team needs • National / local importance • Own desires (care!) • Easiest – time, travel • Least resources • Which fits best with PDP?

  11. Evaluation Kirkpatrick’s Hierarchy of evaluation: • Own sense of achievement • You actually learned something! • Your behaviour changed and you use the learning • Your patients have benefitted from your learning

  12. The Cycle of Learning

  13. Appraisal Now • Started April 2003, all GPs appraised yearly • Formative process • Mixed responses from GPs, depends on area • Aim to discuss previous year and plan learning objectives for the next • Produce PDP at end of the process • Review each PDP at next appraisal • You can choose appraiser from a list • Documents in 2 weeks prior to appraisal • Meet and discuss for 2-3 hours • Post appraisal documents to be signed off • Paid full day if a locum by PCT

  14. The Near Future…

  15. Revalidation • = The process by which a regulated professional periodically has to demonstrate their fitness to practice • Professional regulation is all about patient safety • Three purposes of revalidation?

  16. Purposes of Revalidation • Minimally acceptable care • Reassure patients and the public • Improve quality of care

  17. Revalidation • MORI survey 2005: half thought regular assessments already! • Much delayed; 2005 proposed – due launch 2011! • 20% Drs revalidated each year, five year cycle per Dr • Some revalidated on 3 years work initially

  18. Why now? • Good Doctors, Safer Patients, CMO 2006 • Dame Janet Smith report - Shipman • Public pressure • International examples USA,NZ,Oz • Revalidation for every health professional proposed

  19. Relicensure • License issued every 5 years by GMC • You should be registered now! Starts officially 16/11/09 • Standards for relicensing based strongly on Good Medical Practice • New GP version of GMP out (July 2008) – new focus on CPD • Relicensure will only be problematic if fitness to practice concerns • Local GMC affiliates and “responsible officers” can raise concerns

  20. Recertification • Every 5 years • Only for those on specialist register • Run by relevant College • Based on standards in GMP • Each college has different CPD plans and requirements • Annual appraisal forms bulk of evidence

  21. Revalidation • Satisfactory recertification and relicensure = Revalidation - simple! • Unsatisfactory • Appraisal feedback • PCO Responsible officer • Local group (RO, College member, layperson) • National Adjudication Panel • GMC affiliates • National Clinical Assessment Service • GMC fitness to practice procedures • Council for Healthcare and Regulatory Excellence

  22. RCGP Proposals for GPs • From Revalidation for GPs v2 • Pilots 2009/10 Merseyside • Enhanced Appraisal will form basis • Collect evidence across 12 GMC Standards • Greater role for appraisers • Additional compulsory elements

  23. Which portfolio? • Appraisal portfolio links into (and is part of) Revalidation portfolio • Appraisal portfolio currently the online NHS toolkit or paper • Revalidation portfolio online only • Will all be merged into ePortfolio

  24. Revalidation Portfolio • Basic details • Exceptional Circumstances • Evidence of appraisals • PDP’s from each appraisal • Review of PDP and reflection • Learning credits • MSF • Feedback from patients

  25. Revalidation Portfolio • Causes for concern / complaints • SEA • Audits • Statement on probity and health • Evidence from extended practice

  26. RCGP Learning credits • RCGP managed CPD scheme • Members free, non members charged • Credit system for CPD • Scored by impact and challenge • Higher score (potentially double credits) if followed learning cycle • Includes reflections/reading etc • 250 credits needed over 5 years for recertification

  27. Impact

  28. CPD Credits • Example 1: Remembering to use generic lansoprazole • Example 2: Quick search splenectomies on correct Rx, 4 patients • Example 3: Presentation changed practice of attendees and yourself • Example 4: RCGP update on CFS, impact on patients directly, evidence of reduced prescriptions • Example 5: Approval as trainer and training practice status

  29. Essential Knowledge Updates • Knowledge updates for credits released every 6 months by RCGP • Linked essential knowledge challenge, voluntary, 70% pass rate • Pilot online now • Based on curriculum for GP and latest developments

  30. Role of Appraiser • Effective delivery of appraisal • Maintenance of standards • Develop and analyse PDPs • Validation of credits • Feedback on MSF • Feedback concerns to GP and RO if needed

  31. What do you need to do now? • Protected by VTS/MRCGP until now • Plenty of material to date, all in ePortfolio • Read GMP for GPs • Record your learning and prepare well for appraisals • Ideally, write reflective comments after each learning activity • Consider doing an audit, SEA etc. • Take care if locuming – CPD trickier but revalidation still applies!

  32. Summary • CPD to be much more scrutinised • Get used to learning cycles, reflecting/evaluating your learning • Record everything! • Annual appraisal the cornerstone • Recertification/Relicensure and hence Revalidation should follow easily for most good GPs

  33. Questions?

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