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GPs go forth

Furious GPC negotiator predicts revalidation 'revolt' as GPs spend more than 40 hours preparing for appraisals

The GPC has warned GPs are now routinely spending more than 40 hours preparing for appraisals, with one negotiator launching an outspoken attack on revalidation ‘overkill’ and calling for the wider BMA to ‘get some balls’ in dealing with the controversial process.

Dr Peter Holden, a veteran GPC negotiator and GP in Matlock, Derbyshire, told Pulse he could ‘see a revolt coming’ over the ‘introspective’ process, in the strongest criticism from GP leaders since revalidation got underway a year ago.

The BMA has always supported the process in principle, while expressing concern about elements of the implementation before, such as NHS England’s threat to remove funding for remediation.

Dr Holden told Pulse the BMA’s support for revalidation may need to be reviewed following reports that some doctors are spending more than 40 hours on the annual appraisal process since revalidation was introduced – five times longer than the ‘one working day’ specified in the 2004 GP contract.

He said: ‘In the 2004 contract, where we agreed to annual appraisals, it was supposed to take one day and that’s eight hours. But they keep expanding the remit, and it’s become an industry. And some of us feel that we wouldn’t mind if [the Government was] honest - it doesn’t take eight hours, it takes a week.’

Dr Holden added that his own and his colleagues’ experience of the process was a negative one. He said: ‘A quick straw poll amongst my colleagues this afternoon… we all reckoned it had taken 40 hours.’

He said revalidation now amounted to GPs being guilty until proven innocent, and said GPs were ‘sick and tired of having to prove to the authorities that we’re OK’.

‘Everybody knows you have to collect evidence in all six areas; some people would say you do it as you go along. But actually there’s an awful lot of what we do that counts towards it, and you don’t necessarily collect it as you go along, they also want you to reflect on every one.’

Dr Holden added: ‘A lot of us are getting sick of justifying every breath we take and categorising every motion we pass. This is all introspective crap, at a time when we’re under immense pressure. A lot of us feel this is becoming overkill.’

‘The BMA needs to get some balls over this - we’ve been too willing to fall over,’ he said. ‘We’ve been too willing to be blackened by the spectre of [Harold] Shipman.’

‘A lot of us resent the fact that we pay for the GMC, when in fact it is nothing more than the Government’s poodle. And I can see a revolt coming.’

The GPC itself remains in support of the concept of revalidation. But Dr Dean Marshall, the GPC’s lead on revalidation issues, said that there were mounting concerns over its implementation.

He said: ‘As lead for the UK, we get fed in lots of reports from doctors who are very unhappy with the process. Reports over 40 hours, I’ve certainly heard that. And what was once a day to prepare is now significantly eating into people’s personal time.’

‘I was having a conversation with my partners, a locum and one my sessional GPs this morning, saying exactly the same thing. That the process has taken over completely with no real evidence of any benefit to patients or doctors.’

Dr Marshall also warned against revalidation being used as a tool to performance manage GPs: ‘Unfortunately not being revalidated is frequently used as a threat, that you have to do this, or you have to do that to be revalidated. And either that’s completely wrong or really it’s a misunderstanding – accidental or deliberate – of the process.’

Dr Nigel Sparrow, the medical director for revalidation at the RCGP, and both a practicing GP and appraiser said they aimed to make the process straightforward for all GPs ‘regardless of working circumstances’.

He told Pulse: ‘We have just published version 8 of the RCGP Guide to Revalidation which has many changes to reflect the different roles and working circumstances of GPs. We have given guidance for collecting supporting information which should not be onerous particularly if collected throughout the year.



Readers' comments (78)

  • My wife has been a GP for 26 years. She recently got a letter from her accountant stating that next April her pension pot will exceed George Osbourne's new, lowered, lifetime limit. She has also been informed that her revalidation will take place in Nov 2015. I dont think so....

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  • Revalidation is here to stay in some form or another.Like QoF it has become more onerous with time and may be trimmed down in the future but the concept of periodocally re-evaluating doctors will remain.The only component of any intrinsic value is the CPD/educational learning part.The rest is just trying to prove that you're good at following government dictats.

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  • I have spent 4 days of some desperately needed time off, as well as previous evenings etc, to do this damn thing. I am fed up of being portrayed by all media as a money-grabbing, mass-murdering, lazy, incompetent, wholly-responsible-for-the-terrible-state-of-the-NHS GP. Revalidation will not change this and makes little difference my competence, it simply winds me up more so I wish I was in a position to retire much earlier than I can. I agree with previous comments: grass roots GPs need to be listened to and more vocally supported by the GPC to deliver a much more appropriate revalidation process

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  • Absolutely agree but more worrying is the fact that managers are trying to get hold of revalidation and actually appraise GP's ....this is crazy and must be fought at all costs. To say it takes 40 hours to prepare for revalidation is also takes a MINIMUM of 40 hourse to prepare and its more like 60 to 80 hours in the fact that it will not prevent another shipman......!!!!..........a revolt is needed and long overdue so that we can get back to spending more time with our Patients...!.......the bma was castrated a while back now,....!!

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  • No amount of revalidation would prevent a crook or a murderer like Shipman (this fact GMC admits), particularly when the GMC-processes that allowed him to murder over 20 years & the 'corrupt council of reputable crooks like Rubin' remain largely unchanged. Revalidation has always been 'a lot of anti-patient & anti-environmental paper-pushing', with no tangible benefit for the patients --- or the doctors.

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  • I am sorry to hear that GP's are going through the bureaucratic mill. Nurses have been experiencing similar treatment.

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  • In Wales, we have a central database to which we have to up load our supporting material for appraisal. Its just taken me 8 hours to do this alone.

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  • At last some common sense being spoken - The revalidation process has become and introspective timewasting mess - and will be one of the many reasons I retire early - It is like pulling nails - and does the exact opposite of what I worked hard to achieve all my life - to be a professional - along side the QOF rubbish - I feel that I have almost completely lost that feeling altogether

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  • It's an utter waist of time money and effort!

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  • Sorry waste!

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