Transcript Revalidation and anaesthesia - Royal College of Anaesthetists

Update on revalidation and
remediation
Andy Tomlinson
Member Revalidation Delivery Committee
Royal College of Anaesthetists
CDs meeting
April 2012
Revalidation and remediation
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Anticipated timetable
RST, GMC and Academy updates
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RCoA update: Supporting Information
Remediation
Revalidation: anticipated timetable
May/June 2012
Final organisational state of readiness
assessment (ORSA)
Summer 2012
Assessment of readiness and business case
prepared for Ministers
Sept/Oct 2012
Ministerial decision
By end of 2012
Enablement of necessary legislation
By 31 March 2013
All ROs to have been revalidated
By 31 March 2014
At least 20% 0f doctors revalidated with all
designated bodies
By 31 March 2016
All remaining doctors revalidated – i.e.
approximately 40% each year
Revalidation: anticipated timetable
“In the light of the importance of this process to the
quality of services delivered to patients, and of the
status of the GMC as an independent regulator, the
Committee looks to the GMC to give early and public
notice if it concludes that delivery of this timetable is at
risk.”
Health Select Committee , March 2012
Updates
Updates: RST
www.revalidationsupport.nhs.uk/CubeCore/.uploads/RSTMAGforReval0312.pdf
www.revalidationsupport.nhs.uk
Updates: RST
www.revalidationsupport.nhs.uk
Updates: GMC
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All doctors: confirmation of designated body
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Colleague and patient feedback
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Make your connection campaign
4,000 – 40,000; estimate of possible problems!
All locum agencies should be designated bodies
Instructions for administering GMC colleague and patient
questionnaires
www.gmc-uk.org/Instructions_for_questionnairesfinal.pdf_48334410.pdf
Updates: Academy
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Specialty Guidance
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Helpful in pilots
Greater awareness needed
To be finalised end of May 2012
www.aomrc.org.uk/revalidation/item/speciality-frameworks-and-speciality-guidance.html
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Specialty advice for ROs, doctors and appraisers by
Royal Colleges and Faculties
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Formal generic training agreed
Updates: Academy
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RCoA, FPM and FICM Specialty Advice
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Demand uncertain
Uncomplicated queries dealt with by College staff
Commence with a small (15-20) team of advisors
 Membership to include representation from:
FPM & FICM
 All home nations
 All major sub-specialties
 SAS grade
 Retired/ independent practice
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Training packages currently being developed
RCoA Update: Specialty specific supporting information
www.rcoa.ac.uk/docs/Revali
dation_doh_pilots.pdf
RCoA update: Specialty specific supporting
information
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More guidance required for:
RCoA update: Specialty specific supporting
information
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More guidance required for:
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Outcomes
 Target departments
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Appoint LARCs
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Survey all departments re outcome measurements
RCoA audit recipe book may be key
Join laparotomy and ♯NOF networks
Patient and Colleague feedback
Specialty feedback on professional practice
www.rcoa.ac.uk/docs/peer_
patFeedback2011.pdf
Update: Specialty feedback on professional practice
www.rcoa.ac.uk/docs/REV-Statement-03.02.12.pdf
Specialty feedback on professional practice
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GMC commissioned survey for feedback showed
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Colleague feedback straightforward
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Patient feedback much more difficult
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75% >14 questionnaires
51% >21 questionnaires
Further work by RCoA with PLG to consider
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Communication skills
Quality of care
Remediation
Remediation
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Revalidation likely to identify increased numbers of doctors
with fitness to practice issues
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~ 1000 remediation cases in progress in England
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2,800 (~2%) of all doctors in England subjected to investigation
annually
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Remediation provision will need to be enhanced & increased
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DH report on remediation published Dec 2011
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Remediation: what is meant?
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The overall process agreed with the practitioner to
redress identified aspects of underperformance.
Remediation is a broad concept varying from informal
agreements to carrying out some reskilling, to more
formal programmes including supervised remediation
and/or rehabilitation.
Remediation: DH report
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Highlights lack of:
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consistency in how organisations tackle doctors with performance
issues
clarity about where a PDP stops and remediation starts
clarity as to who has responsibility for the remediation process
clarity on what constitutes acceptable clinical competence and capability
clarity about when the remediation process is complete and successful
clarity about when the doctor’s clinical capability is not remediable
capacity to deal with the remediation process
Remediation: DH report
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Key recommendations:
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Wherever possible, performance problems including clinical competence
and capability issues, should be managed locally
Local processes need to be strengthened to try and avoid performance
problems occurring and reduce their severity at the point of identification
The capacity of staff within organisations to deal with performance
concerns needs to be increased with access to external expertise as
required
A single organisation is required to advise and, when necessary, to coordinate the remediation process and case management so as to improve
consistency across the service
Remediation: DH report
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Key recommendations (cont’d):
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The medical royal colleges should produce guidance and also provide
assessment and specialist input into remediation programmes
Postgraduate deaneries and all those involved in training and assessment
need to assure their assessment processes so that any problems arising
during training are fully addressed
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Remediation: CDs view
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Survey Monkey survey:
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240 individuals emailed (all four nations)
54 responses (22.5%)
General consensus that:
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Much should be managed locally
College should be involved
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‘A supportive rather than driving role’
Setting standards - consistency
Providing advice on assessment and processes
Help make it happen
Concerns about funding
Remediation: RAs view
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From breakout session March 2012:
General consensus that:
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College should be involved in
Setting standards and establishing framework
 Assessment: both advice and doing
 Helping make it happen – organise external placements
 Training for specialty needs
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Remediation: NCAS view
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Response to Remediation report
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With 10 yrs of experience the organisation best placed to
manage process locally
Has an “industry standard” in supporting the management of
performance concerns and can provide external expertise to
local organisations
Expertise in working in conjunction with many other bodies
during case management, including trainees
Understands funding problems
Remediation: General consensus
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Preferable to identify early
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Ensure robust local appraisal and clinical governance
processes are in place
Act on information obtained
Majority should be manageable locally
Comments or questions to:
[email protected]