REVALIDATION: THE BASICS

June 2012

Basic requirement

• 5 annual appraisals • Required content of appraisal • Appraiser must be ‘approved’ – (More on this later)

GMC or UKPHR?

• Revalidation is not an FPH process • It is a process of the GMC and UKPHR for people who want to retain their license to practise

GMC process

• Set out in law (regulations) • ...for people who want to retain their license to practise • Based on 5 annual appraisals • Framework is Good Medical Practice

UKPHR process

• Mandatory • …for people who wish to remain registered with UKPHR • Based on 5 annual appraisals • Framework is likely to be Good Medical

Practice

(to ensure equivalence)

• • • •

Evidence Based Appraisal Information about ENTIRE SCOPE of your work

•

Keep up to date

CPD and reflection • •

Review your practise

Quality improvement Significant events • • •

Get feedback

Colleagues Patients and carers Compliments and complaints

Appraisal evidence

(Information about ENTIRE SCOPE of your work) • Probity • Health • Sign off of previous appraisal • PDP plus review

Appraisal evidence

(Keeping up to date) • CPD certificate • Summary including reflection on learning

Appraisal evidence

(Review of practice) • Clinical audit* (once every 5 years) • Audit, review, re-audit • Case review or discussion (every year - two per annum) • Significant events • Or nil declaration

Appraisal evidence

(Feedback) • Colleague • Supervision / training feedback • Formal Complaints • Compliments • Multi source feedback* – At least once in the revalidation cycle – ‘normally by the end of year two’

The ‘RO’ system - GMC

• Applies to GMC revalidation • ‘Prescribed connection’ in law to ‘designated body’ • RO of your designated body recommends (or not) your revalidation to GMC

Who is my appraiser?

• Appointed by your RO (if GMC) • May or may not be a doctor • May or may not be public health

Who is my RO? - GMC

• Laid down in law – no choice • “Prescribed connection” • GMC will write to you but…

Designated bodies

1. Primary Care Trusts 2. Local Health Boards 3. National Health Service Trusts 4. NHS Foundation Trusts 5. Strategic Health Authorities 6. Health Boards 7. The Department of Health 8. The Scottish Ministers 9. The Welsh Ministers 10.Postgraduate medical deaneries in England and Wales 11.Any Scottish training governance body 12.The Royal Navy 13.The regular army within the meaning of section 374 of the Armed Forces Act 2006 14. The Royal Air Force

Designated bodies

15. Special Health Boards 16. Special Health Authorities 17. The Common Services Agency for the Scottish Health Service 18. Bodies which provide independent health care services within the meaning of section 2(5) of the Regulation of Care (Scotland) Act 2001(2) A Government department or any executive agency of a Government department 19. The following locum agencies: (a) limited companies with shares owned wholly by the Secretary of State for Health, which are concerned with the contracting of locum doctors(3); and (b) locum agencies in England and Wales which are participants in the NHS Purchasing and Supply Agency’s national framework agreement for the supply of medical locums(4) 20. A non-departmental public body 21. Any body whose principal office is located in the United Kingdom and whose President or Dean is a member of the Academy of Medical Royal Colleges

Employed by a Local Authority?

• Many PH consultants in England will be employed by local authorities • DH has indicated that upper tier local authorities in England will be ‘designated bodies’ (this is currently the subject of an open consultation)

GMC readiness criteria

RO recommendations

There are three types of recommendations an RO can make to the GMC. These are: 1. Positive recommendation 2. Deferral request 3. Notification of non-engagement

UKPHR RO?

• UKPHR may or may not use an RO system • In Wales, PHW will be the RO • UKPHR will announce its process in 2012 • Please continue to access the UKPHR website for updated information

Dual specialties

• You only have one RO, who must make a recommendation to the GMC about the totality of your work • One session per week of GP (on a 'performers list') trumps a further nine sessions in public health

Academic appraisal

• The current guidance remains unchanged: Follett principles to be followed • If you hold an honorary contract with an NHS Trust or health Board, you will revalidate through them

Working overseas

• If you continue to hold your licence to practise while practising abroad, you will need to revalidate via connection to a UK organisation.

• However, you may not need a licence to practise if you practise entirely outside of the UK. You may decide it is better to give it up. And apply to have your licence restored if you need it at some point in the future. More information about giving up and restoring your licence is available on the GMC website.

FPH role

• ‘Specialty specific guidance’ – Document – Advisers • Offer advice to ROs and appraisers in other designated bodies • Vice president as RO for ‘waifs and strays’

Other issues 1

• FPH Appraisers – Training day 14 Sep – Your RO appoints your appraiser • MSF instrument – Needs GMC approval (if GMC) – Your RO decides on instrument to use

Other issues 2

• Electronic portfolio – Your responsibility to keep records – Portfolio used in FPH pilot unsatisfactory – RST free ‘portfolio’

Not yet live

• Secretary of State to activate the legislation • Expected go-live date is end 2012 • ‘Go live’ means GMC ready to receive recommendations from ROs

Summary

• GMC or UKPHR process not FPH • Five ‘enhanced’ appraisals by an approved appraiser • FPH provides ‘specialty specific guidance’ • Not live yet

GMC Revalidation Timeline

• Summer 2012: SoS assessment of organisational readiness in UK • Dec 2012: Legislation enabled • Dec 2012: Revalidation begins • March 2013: ROs revalidated • March 2014: Recommendations to regulators begin • March 2016: All doctors revalidated

Preparation

• Continue CPD • Annual appraisals with PDP as output • Gather evidence: – General information – providing context about what you do in all aspects of your work – Keeping up to date – maintaining and enhancing the quality of your professional work – Review of your practice – evaluating the quality of your professional work – Feedback on your practice – how others perceive the quality of your professional work

What if I can’t be bothered?

Failure to engage Fitness to practise

Fitness to practise

Issues that will impact on fitness to practise include: • Patient safety concerns • Failure to engage in revalidation • Undermine confidence in the profession • Conduct (which includes fraud and dishonesty among many other factors) • Performance • Health

Remediation

• Remediation will commence if someone fails to provide sufficient satisfactory evidence • A locally driven process with full compliance as the most likely outcome • Indications of impaired Fitness to Practise in the view of the RO will be referred to the regulator • FPH will not fund remediation

Further information

• http://www.gmc-uk.org/doctors/revalidation.asp

• http://www.publichealthregister.org.uk/revalidation • http://www.revalidationsupport.nhs.uk/ • http://www.fph.org.uk/revalidation • [email protected]