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GPs buried under trusts' workload dump

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)

  • In fact I can't add up it has been 70 hours I forgot the audit time!
    It has become an industry. Whilst I am in favour of appraisal it was NEVER envisaged to be like this. Once i get my new license in January I will spill some more beans but as I have a mortgage to pay I have got to get relicensed first!

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  • So now what? Action should be on schedule!! Wake up Doctors and do the Revolution!! Start by refusing confidence to the elected professional body's members responsible of that bureaucratic mess, think of next political elections, presenting candidates able to expose to the public the truth!! Make posters for the patient's waiting room, explain to them what is best for them, also for the General Elections.. and may be things could change..

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  • Una Coales

    In other words Peter, you are being held to ransom to deprive NHS pts of 70 hours of GP appointments for meaningless appraisal/revalidation that is not fit for purpose. What would happen if all GPs acted on their conscience and refused to be appraised/revalidated? What if the BMA took a stand and said this was not what was envisaged or promised!

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  • Una Coales

    If the line is never drawn, the Department of Health may keep piling on more meaningless paperwork, audits, checks, excessive hurdles to remain on the NHS performer's list, 24/7 patient care burden, full and sole criminal culpability for any and every NHS pt mishap on your list whether in hospital or out, cut pay, force practices to sell out or join federations, relinquish their independent GP partner status and work as cheap salaried GPs for federations manned by a handful of GP managing directors. Where do you draw your line?

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  • there are 3 powers: independent intellectuals, money, and politic.
    The Bureaucratic people wants all the powers. That's why they are against us: we have the 3 powers! We are intellectual scientists, we can influence the votes, we are not poor.
    You know now why all this junk..

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  • What revolt ? A 50% cut in pay in 10 years. Discriminatory pension changes that do not apply to the legal profession for example. Imposed contracts. Balls !! what a lot of balls. We are pussycats. we roll over and die.
    If we ever stood up and said we would leave like dentists - now that's balls.

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  • 50% per consultation is the pay cut. Take home pay per consult has exactly halved in 10 years with increased consultation rates and real cut in pay.

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  • Abdul QADRI

    Reading these comments in the last 12 hours is very painful to absorb & I couldn't stop adding more. There is so much discontent among my Colleagues. As I decided to retire recently, I am liberated & not scarred to reveal my identity. Majority of the frustration is evident from those of us who have decided to remain Annonymous obvious reasons. I sympathise with them & feel for my colleagues as it shows , how much scarred we are to face these beauraucrats like GMC and our so called friends BMA.
    What comes to mind is this : If any Doctor has successfully passed his yearly Appraisal & Revaludation. Is he or she immune from patient complaint or will patient complaint be dealt in any different way. Reasonable answer is NO. Then why not to empower patients & let them decide about the choice of their GP. If they are not happy , have free choice to change from that practice or even complain against the Doctor or any other staff member in the practice. I am sure this complain will be dealt in the same way if Appraisal or Revalidation didn't exist. It is an ideology only to please voters and a knee jerk reaction following Shipman sargar. Patients are themselves intelligent enough to choose between good & bad Doctors. Thank Goodness , majority of Doctors are good consciences professionals and care for their patients. As I said this rediculous Appraisal or Revalidation is meaningless and is insult to Doctors especially to those like myself who have spend more than half their age looking after patients. I can openly say that my Appraisal or Revalidation is in the hands of patients. I have worked in an inner city of East London and my working life for 30 years is an open testimony to my ability. By being stubborn and arrogant about the madness of Revalidation , they are loosing vital work force of gross root Gps who could have supported new breed of GPs by providing their services on part time basis. Look at the frustration our locum's or part time salary GPs who have to collect all the rubbish for the Appraisal tool so that they can work. I am not surprised why there is shortage of locum's up and down the country.

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  • Quof and revalidation is why I took VER. The more I read the more I have decided it was the right decision. Where is the proud profession that I knew and loved?

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  • Appraisal and revalidation are parts of the contract. GPs in the main are self employed contractors. It is illegal to suggest or induce people who are self employed to breach a contract. You lot need to through the LMC Confrence/BMA ARM mandate us to renegotiate the DETAILS of what is needed. I don't think you can re argue the principle

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