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One in seven GPs may be told to retrain under revalidation plans

By Gareth Iacobucci

Exclusive: As many as one GP in seven will face having to retrain under the RCGP's plans for revalidation, Pulse can reveal.

LMCs have been told to expect between 5% and 14% of all GPs will fail at least one element of the programme, with some having to do up to 18 months of ‘corrective training'.

The figures, which the college said were in line with its own predictions, could mean up to a third of three-partner practices, and almost half of four-partner practices, having at least one GP who does not pass first time.

Dr Maurice Conlon, national director of the NHS Revalidation Support Team and a GP in Birmingham, told Pulse practices might need to consider rewriting partnership agreements to outline who was financially liable if a partner had to take time out of work to retrain. He said he expected a ‘surge' of GPs to need some sort of intervention in the first year or two of revalidation, but insisted this would then ‘settle down and tail off'.

He added: ‘A very small number of doctors might find they're in the wrong job, some will have a significant need for remediation and some will need some form of retraining.'

The RCGP expects GPs to begin compiling portfolios from this month for the first five-year revalidation cycle, with the first GPs scheduled to move through the system in 2010/11.

Professor Steve Field, chair of the college, said the 5-14% estimate was ‘about right', but that most struggling GPs should be identified via PCT appraisals long before the end of the five-year cycle: ‘Learning needs should be identified each year and additional support given.

‘But nothing will work unless we have effective appraisal.'

Dr Conlon said many GPs requiring retraining would still be fit to practise, depending on how much work was needed, with revalidation targeting areas such as communication problems, absence of an established practice team and lack of engagement with CPD.

But he warned that GPs might have to fund some retraining themselves if it extended beyond study leave written into their contracts. ‘Partners could choose to write into agreements that if you run into difficulty, you limit their ability to share profits. I'd be very disappointed to see that,' he said.

Kent LMC has begun warning its members of the ‘significant' effort and cost likely to be involved, after being presented with the failure-rate figures at a meeting between GP educationalists and local PCT managers.

Dr Gary Calver, secretary of Kent LMC, said: ‘There are big question marks over how it's going to work and be funded.'

Gloucestershire LMC warned: ‘Partnerships should consider very carefully and put into partnership agreements what is to occur should a partner fail. For instance, would the partnership continue to pay the GP a share of profits while retraining?'

The GPC has stressed the need to ensure all aspects of revalidation, appraisal and remediation are adequately supported, but the Department of Health has given no guarantees.

The revalidation process

Areas where GPs could fail
GPs may demonstrate deficiencies in areas such as communication, poor premises or CPD.

What type of retraining?
GPs could receive educational support from the RCGP, deaneries or other specialised academics for those that need ‘more intensive support'. With significant concerns, and if remediation is required, National Clinical Assessment Services procedures could be used, which can last up to 18 months.

The process
GPs to collect information for revalidation portfolios over five-year period. PCT responsible officers will give a recommendation to the GMC over whether or not to revalidate

One in seven GPs may have to retrain under the RCGP's revalidation plans

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