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'Bulk of doctors' back revalidation processes, says GMC chief

The 'bulk of doctors' support having annual appraisals as part of the revalidation process as it leads to better patient care, the chief executive of the GMC has said.

Charlie Massey told delegates at Pulse Live that the annual appraisal and revalidation processes are leading to 'beneficial reflections', which 'one has to assume' are improving patient safety.

His comments came after he was was asked what evidence the GMC has that revalidation is improving patient care.

Mr Massey said that findings from the UMbRELLA group, a research group that has been evaluating the revalidation process since 2016, 'tells us that doctors have been reflecting as part of that process and that most of the time when they've been reflecting it has led to changes in practice and one has to assume that those changes in practice are the ones that lead to benefits in patient safety'.

He added: 'I do think that the fact that the bulk of doctors are saying that having gone through the annual appraisal process, that that is leading to a beneficial reflection is something that one should - and keep being beneficial to patients.'

According to GMC guidance, doctors are required to have regular appraisals in order to revalidate every five years. 

But Mr Massey said that the regulator is taking a ‘range of different actions’ based on the Sir Keith Pearson review of revalidation including to ‘reduce burdens’ placed on doctors by their local employer.

He said: ‘A lot of the things that people described as burdens being borne out of the revalidation process are actually borne out of what local employers are deciding in terms of their in house process.

‘So I think there is a really important piece of work, which we have the intention of doing, in terms of really stripping it back and defining what revalidation is about.’

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

However, Medical Protection Society (MPS), which represented Dr Bawa-Garba in court, issued a statement to say that her e-portfolio reflections were never submitted to court.

Mr Massey said that 'being reflective is a really important part of medical professionalism' and despite 'lots of misunderstandings' over the use the reflections, the GMC maintains that it 'will never ask a doctor or a third party for their reflective notes'.

As part of evidence submitted to the Department of Health and Social Care's Williams Review into gross negligence manslaughter in medicine, the GMC called for doctors' reflections to be legally protected against use in court.

Readers' comments (29)

  • Vinci Ho

    You see
    Sometimes I wonder what does the job description of the GMC CEO require exactly ?We essentially pay the salary for a Dr Jekyll and Mr Hyde. The former is the one who kept reminding us how beneficial we should be closely regulated and the latter has , ironically, the first duty of protecting the public , finding ‘guilty’ doctors to send them to the Gulag(some of them died during this journey).
    Must be an ‘awful’ job to do and requires an extraordinary ‘integrity’........

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  • When a government representatives are prepared to lie to this extent, it's surely time to call for resignations? A recent Facebook survey was overwhelmingly against revalidation. It's caused and still causing massive harm to our profession, being responsible for a number of early retirements, a recruitment crisis and tying up doctors in an exhausting treadmill of box filling instead of patient care. All this can easily be quantified but the BMA have taken their eye off the ball. We should be calling for a public investigation into how this nonsense came about and examining the probity of its defenders who are no doubt making plenty of money from the wretched thing.

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  • Mr Massey 'assumes' a lot. He 'assumed' about the Dr Bawa Gabra case and 'assumes' about 'benefits' to patients and assumes about the 'bulk of doctors and 'assumes' that doctors never reflected before the GMC came up with this toxic nonsense and 'assumes' that unpaid doctors efforts are cost free to the service. How can a CEO justify his position on his personal ignorant evidence free 'assumptions'?

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  • Cobblers

    So the GMC relies almost entirely on an 'independent review' chaired by Sir Keith Pearson who himself has been involved in revalidation process since its inception.

    So not an independent review then. One of the boys saying it as the GMC would like it to be.

    Reflection, that half arsed scribble we are required to complete after each and every educative session. Don't get me wrong, as a professional, I would often read an article or attend a conference and come away with something new that I would put into practice. That's what being a doctor is all about, learn and change. It then becomes a requirement to write it down and it becomes a stupidity not to say a medicolegal minefield.

    Charlie fall on your sword please. You are not worth your salary if you ever were. Fortunately I no longer pay it.

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  • He hasn't got a clue. Overpromoted apparatchik is being found out by his own stupidity.

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  • Delusional in extreme, you have lost the trust and good will of the medical profession.I would say you relationship with those you regulate is unworkable.Non of this BS will stop the vanilla or non reflective practice you have instigated by the lynching of individuals for systemic failures.Go we do not trust you or anyone at the top echelons of the GMC.There will be a continued exodus from these shore and from the profession until the collapse which your addition actions have made inevitable.More about a gravy train than patient safety Mr Massey.Pathetic.

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  • Charlie 'Pinocchio' Massey

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  • Did hs Mummy not tell him that lying is naughty?

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  • if you refuse to participate in revalidation you get investigated and threatened to be thrown off the GMC register which nearly happened to me when NHS England lost my revalidation files. its blackmail all the way. of course doctors are going to say its ok, the alternative is to be struck off. I got told to put up with it till I can retire. so that's what I will do.

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  • AlanAlmond

    At the end of appraisal you are asked to complete a questionnaire asking how useful the process was. I ‘asume’ this is what Mr Massey is basing his assumptions on.

    Given that half the CCG and any number of other future as yet undisclosed snoopers will likely have access to your appraisal, does anyone seriously believe these surveys represent what people really think...or just what the appraisal system wants to hear.

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  • 'Ad hominem' attacks are distasteful. But Charlie your in a powerful position which licenses you to enforce your opinions. Unfortunately are a person who simply 'doesn't know what he doesn't know'. Tell us Charlie, what are your intellectual, academic, political and philosophical credentials. Not like we don't actually know (Oh Yeh, 'II'
    I'll have quarter of million a year being a political flunky' - and ' fxxk the damage I do'.

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  • An organisation charged with looking after the integrity of the medical profession prepared to lie so brazenly?
    There are boxes at the end of the so called 'useful' revalidation process that Charlie Boy would clearly not be able to tick.
    This organisation no longer has anything to do with representing me until those responsible resign and it is completely reformed. I note Dr Bawa Garba is not back at work yet...

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  • Bulk of doctors? All I have spoken to does not share your findings Mr Pinnochio Massey. We do not back you and we certainly do not back the broken GMC.

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  • Mr Massey should provide the data upon which he relies.

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  • Cobblers

    Giles 10:36am no point in that data. Not only has the research been run by someone who 'organised' revalidation from the start (hence has a conflict of interest) but the data they espouse is garnered from those whom the GMC has by the balls (ie GMC registerd Doctors)? So they are likely to say precisely what the GMC wants to hear.

    Crap data, crap research, crap conclusions. GIGO.

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  • I foolishly contributed to the Umbrella feedback about appraisal and received an offer to have my appraisal videoed, so that the GMC could better understand the problems I was having with the process that so many other doctors enjoyed. I got the message, and now I have a 'great time' and 'look forward to my appraisal more than my birthday'

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  • Bulk because only those sitting on fat asses and not dealing with patients can support them:)

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  • David Banner

    OK Pulse, time for a survey. Simply ask.....”Do you support the current process of revalidation?” We can send the results to the GMC to help back its claim that the “bulk” of GPs are in favour.. (they may have a nasty surprise)

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  • I absolutely agree with you David Banner.
    Easy for another more independent organisation to survey. It’s worth the BMA paying for Mori or similar.
    I just don’t believe Massey and anyway, as already pointed out it was not independent research.
    Very poor. GMC really know how to keep digging. GMC are a maleavolent organisation.

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  • I think he is probably using the feedback that we complete on our appraiser. I believe I may have contributed when I ticked the 'useful' box. I was trying to be kind to my appraiser, as he is making the best of a bad deal.

    In no way is this a true reflection of how I feel about the appraisal process itself.

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  • I contributed to that UMbRELLA survey but wasn't one of the bulk approvers. As far as I recall it was a self selecting sample of volunteers. I bailed out at the 'can you do a video?' stage as it was clearly aimed at supporting the process rather than properly reviewing it. Appraisal is still a good idea, just not the way its done by the GMC, revalidation is different, 'beneficial reflections' happen without either process Charlie.

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  • Umbrella Interim Report January 2016, p7 para2 from GMC website:

    executive summary
    'less than half of respondents agreed that appraisal is an effective way to help improve clinical practice (9,833/23,514 = 41.8%). Responding doctors were divided in their opinions about the impact of revalidation on appraisal with less than a third believing that revalidation has had a somewhat or very positive impact on appraisal (8,412/25,983 = 32.3%).'

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  • Copernicus, you are a genius.

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  • What’s the difference between revalidation and a colonoscopy?
    The preparation is a pain in the **se, the procedure is a pain in the **se - but there is a proven benefit to a colonoscopy.

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  • This comment has been removed by the moderator

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  • David Banner

    How I look forward to that magic month before appraisal - rooting around for certificates, weekends lost filling in BS “reflections”, dreaming up PDP items that require no work, finding excuses for last year’s neglected PDP, uploading reams of certificates, digging out complaints, begging colleagues & patients for meaningless feedback, nicking someone’s audit to claim as my own,,,,,,,,,oh, and paying an annual subscription to the online provider for the privilege.

    Look, I don’t want to return to the Wild West days of the 90s when you could go decades without any education, but the current Kafkaesque nightmare of meaningless, petty, pointless beaureaucratic annual appraisal is a grotesque over reaction. In the early 2000s a friendly appraiser leafed through your certificates to ensure you were keeping up, then had a cosy fireside supportive chat. And what was wrong with that???

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  • Methinks he assumes too much!
    Management speak gobbledegook borne of misinformation and wishful thinking.

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  • CENSORSHIP?

    Why would anyone actually want to be an Appraisor let alone be Appraised..
    by the process as it is...
    It seems anyone can become an appraisor
    You just have to be anal enough to want to be one

    Better to whip than to be whipped?
    Better than actually seeing patients???
    Pseudo intellectual appearance.?

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  • Does the GMC chief get his anti-psychotics prescribed by an online service? Can we get him to repeat this whilst attached to a polygraph? Hang on, his nose is getting longer.....

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