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At the heart of general practice since 1960

PCTs ordered to take tough line over PGEA

Asking patients, managers and practice staff to take part in GPs' appraisals will be considered by the Chief Medical

Officer in his review of revalidation.

The review will also take a root and branch look at the role of the GMC and whether it should be replaced, a consultation document released by the CMO has revealed.

The document 'After Shipman: A Call for Ideas' asked for responses to a series of questions covering appraisal, revalidation, fitness to practise and the future of medical regulation.

The GMC has so far been confident that its future would not be threatened. GMC president Professor Sir Graeme Catto told Pulse earlier this month that doctors 'should not be reading that' into the review.

But the consultation signals the intent of the CMO, Sir Liam Donaldson, to start from scratch in drawing up a new regulatory regime in the wake of the Shipman Inquiry.

On appraisal, Sir Liam questioned whether there should be a '360-degree' appraisal process, whether the process should become summative, and whether confidential reporting systems should be set up.

On revalidation, he asked whether the process is intended to secure the public trust, detect impairment, promote professional development, or be a combination of these aims.

GPs warned that if both systems were toughened up as part of 'an unrelenting drive for higher standards', there would be fewer GPs left to treat patients.

Derbyshire LMC chair Dr John Grenville said: 'If we keep driving standards up we will always find ourselves getting rid of people at the bottom end when we are underdoctored anyway.'

Sir Liam questioned how information on doctors' fitness to practise should be held and made available and whe-ther a complaints-handling 'portal', as suggested by the Shipman inquiry, will work.

Dr John Cormack, a GP in South Woodham Ferrers,

Essex, and a former member of the GMC, said he was suspicious that key decisions had been taken already.

'Looking into the crystal ball I see the GMC being robbed of any real power,' he said.

By Ian Cameron

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