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GPs buried under trusts' workload dump

Revalidation paperwork equivalent to 390,000 days' worth of GP appointments

Exclusive GPs spend on average 55 hours a year on the revalidation process – equivalent to 1,300 full-time GPs working eight sessions a week – a Pulse survey has revealed.

The survey of 870 GPs found that more than a quarter spend more than 70 hours on revalidation, while only 15% spend less than 20 hours – which is how long it is supposed to take.

This is equivalent to 390,000 days’ worth of appointments lost to patients at a time when many are waiting at least two weeks for an appointment.

A Pulse investigation has also revealed that only 231 – or 0.4% - of all the revalidation recommendations made for GPs were serious enough for the regulator to threaten to withdraw a licence to practise. And that there is little evidence that revalidation improves patient care.

The survey, carried out last November, asked GPs how long they spend on the overall process of revalidation. A midpoint analysis revealed that they spend on average 55 hours a year. However, this is far greater that the two sessions a year cited by the RCGP for preparation and appraisal.

Dr Alan Woodall, a GP in Powys, Wales and the founder of the pressure group GP Survival, said: ‘For every hour of learning you can add another hour of recording and collating information. I spent three hours the other night going through information governance and child protection, none of which required any real learning.’

Meanwhile, the deputy chair of the BMA’s GP Committee, Dr Mark Sanford Wood, said although the union is supportive of the principle of revalidation, ‘considerable improvements’ need to be made.

He said that the 55 hours identified in Pulse’s survey was higher than the BMA’s findings, but added: ‘The time originally set aside was two sessions a year, one for preparation and one for the appraisal. But we know anecdotally that GPs are spending considerably more than that in putting together appraisal and evidence, probably in the region of four or five sessions a year which is a significant chunk of time taken away from patient contact.’

He added: ‘We need a national discussion about the evidence that’s required versus the delivery of patient care, particularly at the moment where we just don’t have enough GPs to do that job.’

But the GMC said this is bringing about positive change. A spokesperson said: ‘Revalidation has helped to strengthen the way we regulate doctors and embed a consistent approach to appraisal. Indeed, appraisal rates have risen steeply in all four countries of the UK since its introduction.

‘Doctors have said that the feedback they get from patients is particularly valuable for identifying areas for improvement. Revalidation in turn plays a vital role in assuring patients that their doctors are keeping up to date and have regular checks, maintaining confidence in the profession.’

But neither the GMC or the Department of Health were able to point to any evidence that revalidation has reduced avoidable deaths, harm caused by doctor or litigation costs, as claimed before revalidation was rolled out.

A DH spokesperson said: ‘As highlighted in the Taking Revalidation Forward review in January, the process has delivered significant benefits through its appraisal system and strengthened clinical governance procedures.’

Please note: the orginal version of this article mistakenly said it included the ’ten hours a year spent on CPD’. This was incorrect. The survey question referred to time spent on the ‘revalidation process’. We’re sorry for any confusion caused 

revalidation benefits vs costs 580x1668px

revalidation benefits vs costs 580x1668px

Readers' comments (32)

  • Another GP for whom the Appraisal and Revalidation process can take sole credit for the fact that I'm leaving medicine completely in my mid-fifties instead of reducing my workload to a level that would be sustainable for another decade.

    Given the amount of box-ticking we have to do to avoid having income withheld, maybe the point of Appraisal and Revalidation is to screen out those GPs who would rather see patients than do mindless box-ticking. Within my own practice, the most "valuable" GP is now a very mediocre clinician who is in their element doing QOF reviews with check lists and codes. The clinical and consulting skills that we acquired in medical school and the old VTS appear to be obsolete.

    For me, the expectation that I log and "reflect on" (UGH!) everything I learn is an active deterrent to engaging with medical education. There's a whole world of fascinating and unrelated information out there, and I'd rather get my brain wrapped around stuff that nobody has assumed the right to police.

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  • When appraisal first started my senior partner retired, and then my remaining partner became seriously ill, and very sadly died. This left me, previously part-time and with four children including a young baby, single-handedly looking after 4000 patients.

    It seemed the only way to escape this insane situation was either to get struck off, go to prison, or fail my appraisal. Deciding that the last option was the best one, I did no preparation for my appraisal, and had the worst attitude you can imagine. However, I still passed the bloody thing!

    After an extremely difficult six months, a new partner joined. However, since then, I refuse to worry too much about appraisals. They don’t want you to fail!

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  • I think it’s more than that. Look at how much u get in the salaried BMA GMS model contract.

    1 credit of CPD is always more than 1 hour spent. More like two. And we are no longer allowed to double up our CPD credits. And no evidence to suggest it makes us better,. A huge waste of time and money. Scrap CQC or revalidation no need to have both

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  • I am horrified that the GMC spokesperson, who takes money from me every year, didn't bother to find out, or know to start with, that revalidation and appraisal are mandatory requirements of the GMC!

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  • What use is a system which accepts a person's claim to be honest at face value and is unable to tell if they are lying? Who wants to pass and does not tick the probity box to say they are honest?
    This question would pick up more doctors with tremor who can't control their mouse, than it would pick up dishonest doctors. And we know it fails to detect at least some....

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  • Appraise and earn cash ...that's the game..nonsense that it saves lives or even doctors..show the evidence.

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  • Feed back from colleagues is a joke. you will name those who you know will give good report. be sensible with consultation with patients 40 times every 5 years and all feedback is good.
    50 hours is nonsense it is more than 150 hours. 1 hours cpd then you write refection individually then over all. audits ,sea ,case discussion puns and dens and then reflect , reflect on feed back from every one. reflect on every thing you reflected. prepare for next years cpd.

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  • The middlemen once again has generated lots of time consuming work.

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  • Re-validation has encouraged many Doctors to take early retirement and get away from unnecessary bureaucracy and time wasting Revalidation and appraisals do not make one a good Doctor. A good Doctor is always a good Doctor. I agree about CPD this is important to keep up with knowledge knowledge
    F.M. Hirji
    Grovehill Medical Centre
    Hemel Hemspstead
    HP2 6AD

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  • GMC says ‘Doctors have said patient feedback is particularly valuable for identifying areas for improvement.
    But really Who the **** thinks this ?.
    The process of getting and reflecting on this absoulute garbage is sould destroying .

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