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Doubts cast on 'affiliates' proposal

The Chief Medical Officer's proposal for a network of 580 local GMC 'affiliates' has been questioned by the NHS organisation charged with protecting patients.

The National Patient Safety Agency said setting up and running the network of affiliates could cost twice as much as estimated by Sir Liam Donaldson in his Good Doctors, Safer Patients report.

Although 'direct costs' had been accounted for, there was 'no obvious provision' for back-filling the clinical work of affiliates, the agency said in its response to the consultation. It also doubted that enough 'willing, able and skilled doctors' were available to fill the posts.

Its views were backed by NHS think-tank the King's Fund, which said in its response that the proposals had not been properly costed, and NHS Employers.

Professor Alastair Scotland, executive director of the NPSA and author of its response, said local NHS organisations would need at least twice the estimated resource.

GMC affiliates working alongside medical directors would cause duplication of work and 'possibly even work in apparent opposition', he added.

The NPSA recommended affiliates be appointed at strategic health authority level instead.

It also cautioned against 'moving too far away from professional leadership of regulation' and called into question the role of revalidation in the CMO's report, proposing that it should focus on continuing professional development rather than identifying poor performance.

The King's Fund criticised the affiliate scheme as 'unclear' and suggested the time and other resources required had been underestimated.

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