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CAMHS won't see you now

College must heed revalidation concerns

This candidate for the RCGP presidency may not be spot on, but she raises pertinent issues about the flawed plans for revalidation

This candidate for the RCGP presidency may not be spot on, but she raises pertinent issues about the flawed plans for revalidation

Dr Una Coales is not your typical candidate for RCGP president. Her manifesto is short of the usual college buzzphrases about clinical leadership and professional engagement. Instead, it's a rallying call for the grassroots of general practice, demanding more support for GPs on the ground, ‘less ivory tower' and much less of the regulation that seems to be washing towards the profession in waves.

The crux of her argument, as presented in Pulse's letters pages this week, is that the RCGP has been wrong to collude with the Government in its plans to layer general practice with regulatory bureaucracy. It's an enticing line of reasoning, and one that will be instinctively appealing to many GPs. Unfortunately, it's also wrong.

The RCGP had little choice over whether to accept the Government's offer to help develop revalidation and practice accreditation. If it hadn't done so, ministers would have pressed ahead anyway, but without feeling the need to consult with the profession. You would have bet on the Department of Health devising a regulatory system infinitely more grisly than anything to emerge so far.

But that's not to say Dr Coales doesn't talk some sense. When she warns of ‘persistent regulation' threatening GPs with ‘low morale, disillusionment and burnout', she speaks for a sizeable portion of general practice.

In key areas the plans for revalidation are vague, confusing or lacking safeguards. There is still too little detail about how individual pieces of CME will score towards learning credits and questions over whether GPs could fail five-yearly revalidation even if annual appraisals gave them the all-clear.

Nervousness persists over plans for 360-degree colleague assessment, with the RCGP admitting that the existing survey tools aren't really good enough. The lack of guarantees over PCT responsible officers casts a shadow over the whole process, with continued concern over the power yielded over GPs' careers by single individuals, who may not even be doctors. And much more detail is needed about what happens if GPs fail revalidation – whether there is a period of grace during which they can do their extra training, and what support might be on offer for affected practices.

Dr Coales may not succeed in becoming RCGP president, but she has done the profession a valuable service by vocalising its concerns. The college must listen.


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