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Responsible officers to rule on appraisals and revalidation

By Gareth Iacobucci

Ministers have set out the full extent of the huge powers to be handed to responsible officers to police GPs at a local level.

The new brand of official – who will mainly be existing PCT medical directors – will oversee the entire appraisal process and get a key say in whether GPs pass or fail revalidation.

But critics expressed fears about the capability of medical directors to take on the ‘awesome power' of the new role, and warned of the potential for personal vendettas.

A DH consultation document released this week reveals the officers will make recommendations to the GMC both on revalidation and on referrals for fitness to practice investigations.

The GMC is to rely ‘to a large extent' on these recommendations, particularly in reference to revalidation, which every doctor will need to pass to continue practising.

An accompanying impact assessment predicts the cost of unleashing the officers is set run to £25m a year, with average salaries set to be £200,000. They will need to be medically qualified.

The plans, given the go-ahead last week with the passing of the Health and Social Care Act 2008, are underpinned by the Government's wish for robust implementation of revalidation and better liaison between local organisations and the GMC.

But Dr Richard Vautrey, deputy chair of the GPC, said: ‘It's all very well if you have confidence in the person, but if there are perceived personality issues, people will start to question the system. Getting the right people for a potentially quite a thankless job is going to be very challenging.'

There are also fears that the officers will face conflicts of interest over other PCT objectives such as hitting targets for access.

Dr Stephanie Bown, director of communications at the Medical Protection Society and a member of a working party which scrutinised the consultation document, said: ‘The role of responsible officer is very demanding, with awesome powers.

‘It would be wrong to assume that everybody who's currently holding the role of medical director is going to have the skills.'

But Professor Mike Pringle, professor of general practice at the University of Nottingham and a member of the GMC, said is was ‘essential for revalidation that there are good local processes'.

‘Responsible officers are a necessary part of the process,' he said.

The consultation will close in October 2008, with the national rollout following soon after.

The GMC will rely heavily on responsible officers' recommendations The GMC will rely heavily on responsible officers' recommendations Role of the responsible officers

- Seen as the ‘eyes and ears of the GMC' at local level
- Expected to be rolled out nationally following the end of the consultation period in October 2008
- Will be a senior doctor within a healthcare organisation - for GPs, this will usually be a PCT medical director
- Appointed by PCTs, with salaries set to average £200,000
- In most cases, will take 'personal responsibility' for recommendations to GMC on revalidation
- Will advise GMC in referring GPs to fitness to practise cases
- Will liaise closely with local GMC affiliates, which are being piloted this year
- Estimated total cost of implementation of up to £25m

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