Revalidation

Revalidation

Revalidation is a formal system for ensuring that doctors remain fit for practise. It is a positive affirmation that doctors are safe and keeping up to date, rather than just an absence of concerns. This will take the form of a recommendation to the General Medical Council (GMC) every 5 years through a satisfactory sign-off of 5 annual appraisals. All licensed doctors in the UK, in all sectors (NHS and private) and all branches of practice will need to be revalidated.


Relicensing and recertification

Relicensing is the process that will confirm that licensed doctors practice in accordance with the GMC’s generic standards. Recertification will confirm that doctors on the GP and specialist register meet the standards of their specialty. The term ‘revalidation’ encompasses both relicensing and recertification processes.

You will need a licence to practise to undertake any form of medical practice for which UK law currently requires you to hold GMC registration – whether you practise full time, part time, as a locum, privately or in the NHS, employed or self employed.


The introduction of revalidation

The first stages of implementation of revalidation began in May 2009 with a General Medical Council (GMC) exercise to establish which doctors on the medical register require a licence to practise. You will need to apply to the GMC for a licence by 14 August 2009 and these will come into effect on 16 November 2009. Taking a licence will also mean that it is your responsibility to follow the guidance in Good Medical Practice.

The GMC, in conjunction with the four departments of health, will decide when and where revalidation will be rolled out. It will take place gradually, starting with localities and branches of practice where systems of appraisal and clinical governance are developed enough to support a system that can reliably produce the right output i.e. a recommendation to the GMC to revalidate.

Pilot studies commenced in spring 2009 and are likely to run until late 2010. It now seems likely that revalidation will be implemented from 2011 at the earliest as the introduction of responsible officers has been delayed and further work is required to develop the appraisal systems: GMC Press Release


Revalidation Survey

In June 2011, the FFLM Revalidation committee conducted a survey to assess the needs of the membership in terms of revalidation and specifically the requirement for a Responsible Officer. In addition the committee was keen to gain information on appraisals and the usefulness of FFLM appraisal documentation. The results of the survey are available here


Appraisal

Revalidation will work through the satisfactory sign-off of 5 annual appraisals based on the headings of the GMC’s Good Medical Practice. The Department of Health (DH) and GMC are currently designing an enhanced appraisal system for this purpose.

The doctor’s input into this process will be a portfolio of evidence to be considered at the appraisal. An electronic system to manage this process at employer level is being tested, using the headings from the GMC’s Good Medical Practice.

The Faculty has now established appraiser training courses. To register for a course click here. In due course a database of trained appraisers will be established.

In addition, a series of core competencies for appraisal for each of the three disciplines have been developed - click here. Documentation for your appraisal can be found in the members only area of the website – please log in and click here. Whether you use a paper based system or e-portfolio, your appraisal folder will consist of 5 forms:

  1. Your personal and registration details.
  2. Description of your current practice (what you do).
  3. Material for appraisal.
  4. The formal summary of the appraisal which should be completed during and immediately after the discussion. This is the responsibility of your appraiser.
  5. This may be used to make a more detailed and confidential record of the appraisal discussion, but it is optional.

Appraisers

A list of people who have notified the FFLM that they have received appraiser training can be downloaded from the link in the right hand menu on this page. You must be logged in to access the document. NB The faculty does not recommend or endorse these individuals for appraisal, but is able to provide contact details and information about training completed. If you wish to make contact with any of the individuals listed below please do so directly rather than through the FFLM.


Continuous Professional Development (CPD)

The Faculty uses a learning credit system with a minimum of 50 credits per year and 250 credits in a 5 year cycle to support a positive revalidation decision - 1 credit represents 1 hour of study – these can be collected in different ways:

  • Personal development credits
  • Internal credits
  • External credits
  • Distance learning credits

You should aim to achieve an even balance of CPD activity spread across many types of CPD activity as relevant to your practice. Further details can be found on the CPD page.


Multi-source feedback tools

Multi-source feedback (MSF), or 360-degree assessment, is a questionnaire-based method of assessing an individual in which multiple individuals (assessors), representing discrete informant groups, provide confidential feedback on key performance behaviours. The information is fed back to the individual to help promote personal development and continuing performance improvement.

MSF was developed 20 years ago in industry and is now embedded as a routine and recognised assessment of individual performance. Throughout UK healthcare, interest in performance assessment methods, including the MSF, has increased in recent years. This has arisen in response to increasing public and political pressure on doctors to show that they are ‘up to date and fit to practise’ and also to provide more transparency and accountability in healthcare provision.

Following publication of the Department of Health’s white paper, Trust, assurance and safety – the regulation of health professionals in the 21st century, the move towards the use of the MSF in the assessment of doctors is now inevitable. This document recommends that doctors should have ‘participated in an independent 360-degree feedback exercise in the workplace’ at least once every five years in order to be relicensed by the GMC.

The purpose of a formative MSF is to guide self-development by identifying behaviours that can be addressed and improved. However, MSF can also be used as a screening tool for the identification of doctors whose practice should be the subject of further scrutiny, as advocated for revalidation purposes. Studies show that MSF can be reliable, valid and demonstrate good psychometric properties, and that from a learning and change perspective, doctors do make changes in their practices in response to MSF feedback.

The Faculty will undertake further work over the coming months to develop validated, well researched multi-source feedback tools.


Responsible Officers

A ‘responsible officer’ will be the person who considers the output of appraisal with a view to making a recommendation to the GMC on a doctor’s fitness to practise. All licensed doctors will relate to one responsible officer. GMC affiliates at SHA level will act as the link between national and local processes and will be responsible for ensuring regional systems are strong enough to support revalidation.

The 2008 DH consultation on the role of responsible officers and the outcome can be found here. Further details about responsible officers will be published by the GMC in due course.