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GPs buried under trusts' workload dump

NHS England 'reviewing and rebooting' appraisal and revalidation process

Exclusive NHS England is currently reviewing the appraisals and revalidation process, to ensure GPs want to remain in the profession and are not put off by the 'complex' system. 

The head of primary care for NHS England told Pulse a key challenge faced by GPs - particularly later in their careers - is the difficult process of staying appraised and revalidated.

Therefore to help GP retention, the system is being reviewed - although there is currently very little detail on what the review is looking at and when it will report.

Pulse previously revealed GPs spend on average 55 hours a year filling out revalidation paperwork – equivalent to 1,300 full-time GPs working eight sessions a week.

An investigation also showed that only 0.4% of all the revalidation recommendations made for GPs are serious enough for the regulator to threaten to withdraw a licence to practise, and there is little evidence that revalidation improves patient care.

But speaking to Pulse, NHS England primary care acting director Dr Nikita Kanani said a 'reboot' of revalidation is currently ongoing.

She said: 'We've got a reboot of appraisal and revalidation under way, which I'm doing on behalf of [NHS England medical director] Steve Powis because actually, we know that one of the challenges that GPs find, particularly later in their career, is how complex it is to stay appraised and revalidated under the current guidelines. 

'What we want to do is create a space for people to be reappraised preferably around their passion.'

‘GPs are really valued, we want to make the work better for them so they want to stay and people want to be GPs for as long as possible,' she added.

Last month, the Government-commissioned GP partnership review - chaired by Dr Nigel Watson - called on NHS England to look at revalidation processes and tackle ‘inconsistency in the appraisal requirements’.

Welcoming the news, Dr Watson told Pulse the review should tackle the lack of consistency across the country and between primary and secondary care, and help retain GPs who are 'fed up' with the bureaucracy.

He said: 'There are older GPs who were telling us they’re going to stop practising because they’re fed up with appraisals and bureaucracy.’

'Doing an annual appraisal can be a positive thing - and in some areas it still remains that way - but I think increasingly there have been a number of extra requirements brought in, [with GPs] having to record more things.

'If you look at some secondary care appraisals, compared to what is required for primary care, there is a mismatch between the two. There needs to be some consistency across the country,' he continued.

Dr Watson added at the moment the process can be seen as 'onerous' and a 'tick box' exercise, without being actually valued by the patient or the person,' .

GPs have also been concerned about appraisals and the use of their reflections since the Dr Hadiza Bawa-Garba case, when it was suggested that the junior doctor's reflections had been used against her in court

Meanwhile, a Pulse survey revealed over half of GPs have stopped or changed appraisal reflections in the wake of the case.

Readers' comments (34)

  • This process has been changed every year, a different approach without us being told, no change here.Apart from a dog of a contract,no seniority pay in the near future and ever increasing work load.Good luck trying to stop the floodgates opening wider NHSE.Now when are you going to get the extra 5000 GPs.Up to now an epic fail on your part.

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  • Appraisal and revalidation consume an enormous amount of time and tax payers money for little or no benefit. Why is the process itself not being appraised and revalidated?
    If a GP were as poor performing as 'revalidation' is as a process at weeding out poorly performing GPs, they would have been referred to the GMC long ago.

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  • I find the "mandatory training", which is nothing to do with appraisal and revalidation, to be more annoying. (I think the push for mandatory training comes from the CQC.)

    (http://www.pulsetoday.co.uk/news/gp-topics/education/bma-launches-crackdown-on-gps-being-forced-into-unnecessary-training/20035077.article)

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  • Great. Shouldn't take long as the answer is easy. Get rid of appraisal and re-validation entirely for the majority of doctors as generally a completely pointless exercise. Make it optional for those that want it and call it 'mentorship' and make it mandatory for a period of time for those whom concerns exist.

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  • A simple change is make appraisal every three years and revalidation every 10 years. As well as cut what needs recording. There is nothing special about the period it takes for the Earth to go around the Sun when it comes to appraisals.

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  • I also agree the proliferation of mandatory courses/tests is getting out of hand. It goes up every year and most are pointless or a joke. I can see BLS and safeguarding but diversity and data security etc seem pointless. I am sure we all skip through the reading and do the inane test at the end and get 80% first time. Perhaps make them all so you can just go straight to the test and tick the box.

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  • It is high time to drastically reduce appraisal and revalidation burden specially for semiretired and part time GPs like me. I know most of my colleagues gave up general practice purely because of the heavy and totally unnessasary burden of Appraisals . Appraisals should be once every 3 years followed by revalidation in 6 years with reduced requirements for part time and retired GP's.
    I am retired and do only two or three sessions a week and quitting completely soon purely because of burden of appraisals

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  • Knowledge is Porridge

    Would be very interesting to try stopping appraisal / revalidation in an area and carefully reviewing the cost, workforce and performance implications for perhaps 5 years.
    I would propose the South West for this...
    I expect would be cheaper, support recruitment and retention, have no harmful affects on patient safety or trust in the profession.

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  • Too little too late. Appraisal and revalidation are just two of the mosquito bites that irritate GPs. There are so many other bites that sorting these two out will make little difference to the exodus

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  • ‘Appraisal and revalidation’ reminds me of the ‘promise of seventy two virgins in heaven’. Both concepts based on wilful misinterpretation and promoted by the unscrupulous to manipulate the innocent.
    It’s time history called out this travesty.

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