This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

GMC review finds revalidation 'may not improve practice'

The GMC has issued new guidance to doctors undertaking revalidation, after a three-year review found the process ‘may not necessarily improve professional practice’.

The new advice comes as official research commissioned by the GMC found that only a ‘significant minority’ of doctors had changed their practice as a result, while some doctors ‘identified potentially negative impacts’.

The GMC suggested its new guidance would help some doctors for whom the requirements of revalidation 'remain unclear'.

The GMC said its newly-updated guidance, available online, now:

  • Provides information on the balance between quality and quantity of supporting information that a doctor must collect, but explains that the GMC does not set a minimum or maximum amount.
  • Reinforces the importance for doctors who have multiple roles of gathering information that covers the whole of their practice;
  • Emphasises that appraisals and revalidation are not ‘pass or fail’ exercises, but should be developmental;
  • Provides more information on collecting feedback from colleagues.

The report concluded: 'Revalidation, through appraisal, provides a means to document practice but may not necessarily improve professional practice.'

The GMC first introduced revalidation in 2012, with doctors required to go through the process every five years and alongside an annual appraisal.

All licensed doctors are expected to collect six types of supporting information, to reflect on and discuss at their appraisals, in order to demonstrate that they are up-to-date and fit to practise.

Una Lane, the GMC’s director of registration and revalidation, said the report from the UK Medical Revalidation Collaboration (UMbRELLA) had given GMC 'an insight into the first few years and will help us as we continue to improve the process'.

She added: ‘We knew that something on the scale of revalidating tens of thousands of doctors would take time to bed in, and would need to be reviewed and refined. But these are still early days and there are positives.’

Ms Lane said: ‘Most doctors are now collecting the supporting information that revalidation requires, but for many the processes for doing so are not as simple and straightforward as they could be.

‘Employers have a major role to play to address this, and too often there remains confusion between the GMC’s requirements and those of employers or royal colleges. Our updated guidance will help doctors by making our requirements clearer, with a focus on quality rather than quantity.’

The updated guidance also includes advice aimed at responsible officers.

The GMC said last year that it intended to simplify revalidation in line with recommendations from the Pearson review, which had made a range of recommendations including on how to reduce the related workload.

This comes as GMC chief executive Charlie Massey recently claimed that the ‘bulk of doctors’ support having annual appraisals as part of the revalidation process as it leads to better patient care.

But at the same time, a Pulse survey revealed over half of GPs have stopped or changed appraisal reflections following the case of struck-off junior doctor Hadiza Bawa-Garba.

RCGP chair Professor Helen Stokes-Lampard said: 'This new GMC guidance is welcome and includes some important developments around appraisal and revalidation, particularly the increased emphasis on quality not quantity of supporting information.

'There is still work to influence the implementation of the regulatory agenda, so that it is truly proportionate and reasonable for all GPs. The college has been updating our own supporting information guidance accordingly and this will be published shortly.'

Key findings from the UK Medical Revalidation Collaboration (UMbRELLA) review

  • Revalidation, through appraisal, provides a means to document practice but may not necessarily improve professional practice.
  • A significant minority of doctors reported changing an aspect of their clinical practice, professional behaviour or learning activities as a result of their most recent appraisal.
  • However, some doctors identified potentially negative impacts on practice or for professional autonomy as a result of their appraisal.
  • Some Responsible Officers do not feel that the three options available for revalidation recommendations (revalidate; deferral; and non-engagement) adequately cover all circumstances.
  • Expectations set by employing organisations or individual appraisers can go beyond the requirements set by the GMC for revalidation.
  • Outside existing governance structures, there are peripheral groups, including but not exclusively locums, where the ability to obtain an annual appraisal has been inconsistent.

Source: Evaluating the regulatory impact of medical revalidation

Readers' comments (52)

  • So, let me get this right. We are still in an experimental stage and the tsunami of retirements, ill feeling among hard working GPs , unpaid extra work, involved, sheer uselessness of the work and the fact that it fails to pick up the 'dangerous' doctors it was set out to find, are all 'teething' factors. That with indemnity was the reason why I gave up my licence when I retired. Sheer waste of time trying to prove to a young GP why I , after all these years, should be entitled to see patients. Insulting, patronising, poorly thought out and wrong

    Unsuitable or offensive? Report this comment

  • "The report concluded: 'Revalidation, through appraisal, provides a means to document practice but may not necessarily improve professional practice.'"
    As Cilla would have said Surprise Surprise!

    Unsuitable or offensive? Report this comment

  • With Dr Bawa Garba still sidelined, another good reason to get rid of this organisation.
    In all its pious perversity it is probably more of a threat to the nation's health than a hundred Dr Shipmans. The irony.

    Unsuitable or offensive? Report this comment

  • Oh, interestingly, the GMC found revalidation does not work but they continue this non-sense programme for What?

    Unsuitable or offensive? Report this comment

  • So no research feedback can make them step back and reflect that the negatives outweigh the positives and the whole thing should be binned?
    And since when was Revalidation not pass/ fail?

    Unsuitable or offensive? Report this comment

  • The DoH should take over from GMC as a regulation body and health professionals to run this body not others.

    Unsuitable or offensive? Report this comment

  • The only persons who benefit from this are those who collect the money for overseeing it.

    Unsuitable or offensive? Report this comment

  • How much money and my time has been wasted on this exercise

    Unsuitable or offensive? Report this comment

  • Entirely predictable: Bloody appraisals carried out by doctors still wet behind the ears ( better than seeing patients!!) were what caused me to give up.

    Unsuitable or offensive? Report this comment

  • A little advice for Ms Upa Lane (GMCs director for this disastrous activity). Most medics saw where this was going, years ago, so many bailed out. It speaks volumes when a regulatory agency misunderstands (possibly purposely) the concept of 'public accountability' and replaces it with 'self serving / own interests'.
    Where too now, seeing the current has served?

    Unsuitable or offensive? Report this comment

  • What a surprise the amount of time and stress we have all spent. No one needs a study to tell us. Basically if we mess up, the patient will sue us, and that plus our professionalism keeps us on our toes. There is no need for this useless exercise so they can up our fees again. Scrap the GMC and the CQC. The ambulance lawyers are more than sufficient.

    Unsuitable or offensive? Report this comment

  • Totally predictable.
    If this was a new treatment or a new care pathway, this would constitute the worst sort of negligence and carelessness. And yet, we’re watching powerless, as the CQC, GMC, NHSE triad destroys our profession with impunity.

    Unsuitable or offensive? Report this comment

  • This is what happens when politics and power are allowed to govern medicine. It's pretty obvious revalidation has done significant harm to UK patients in terms of doctors lost, working hours lost, the collapse in confidence around regulation and the problems with recruitment. Usually in medicine when something does harm we stop doing it but when this much money is at stake the thing will be kept going whatever cost. What really needs to happen is an investigation into the probity of the architects of it and possibly even a criminal investigation into how much resource has been squandered and who profited from it.

    Unsuitable or offensive? Report this comment

  • If it makes no difference then why persist.It detracts from valuable clinical/family time

    Unsuitable or offensive? Report this comment

  • This is quite a shame given the whole industry that has been created around appraisal and revalidation. however if you create a façade just to placate the vocal over Shipman what can you expect?

    Unsuitable or offensive? Report this comment

  • The only comparison I can find to GMC Revalidation is where Negan in the 'The Walking Dead' beats people to death with his baseball bat for the sole purpose of ensuring Rick and his group realise who is really in charge. It is an exercise in ensuring subservience, flushing out those who can't endure kneeling to their overlords and masters!

    Unsuitable or offensive? Report this comment

  • And yet GPs I know like being appraisers. Perhaps they believe in the value of the process? And I have been told you don't even have to be doctor to be an appraiser of GPs. You can apparently be a retired GP no longer licenced to practice or you can be an educationalist or something.
    Please someone tell me I wrong wrong about this...

    Unsuitable or offensive? Report this comment

  • Is it possible the GMC may be engineering a retreat from this position to try and stop an angry membership from baying for their blood and head to roll or am I being an old cynic.The Dr BG case being the catalyst,the straw that breaks the camels back.

    Unsuitable or offensive? Report this comment

  • Time to get rid of the GMC. We should we still pay for all of this.

    Unsuitable or offensive? Report this comment

  • When appraisal first came out, I was invited to be an appraiser. Might as well, I thought. Me or someone else, and I'm pretty easy going. It was the easiest work I have ever done, the fees paid for may car (only a Corsa, but, hey...). Don't get me wrong, I did it sincerely, but as time went by I came to see what a waste of time and money it all was. I went public on the waste-loads of GPs agreed with me, but my manager didn't and I had to resign. That was years ago, and now it has got much worse with revalidation.

    I always said, if revalidation was a drug, we ought to have asked

    1) what condition are we treating?
    2) is this the best way to treat it?
    3) does the drug work?
    4) is it safe?
    5) is it cost effective?

    But none of these questions were ever asked. We had mass medication on a hunch. It was a case of 'something must be done-this is something-therefore this must be done.'

    But as a filthy rugby song I sadly remember says,'now we come to the tragic bit, there was no way of stopping it.'

    The main side effects of this drug has been disillusionment leading to early retirement of good doctors who had another few years work in them. How many good GPs have quit early because of this, we shall never know.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say