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Revalidation delayed by year amid concern over managers' role

By Gareth Iacobucci

Exclusive: Revalidation is set to be delayed by at least a year amid huge concerns over the role of local NHS managers in judging GPs, Pulse can reveal.

The GMC has been forced to ask the Government for more time following warnings from the RCGP over the responsible officer role and the poor quality of GP appraisal.

A battle is also raging behind the scenes over how high to set the bar, with ministers placing the RCGP under strong pressure to agree to tougher procedures.

The Government has caved in to demands by the college to formally pilot the planned network of responsible officers rather than rolling it out in one, after warnings primary care organisations were ill-prepared to adjudicate on doctors.

But it is putting the college under pressure to accept tougher requirements of GPs to gain their revalidation, with demands for a doubling in the number of significant events needing to be reviewed to 10 over the five-year revalidation cycle.

The move to pilot responsible officers' role as the arbiters of GPs' revalidation and allow more time to sort out GP appraisal – which suffers from stark variations in quality – comes as a Pulse investigation reveals PCOs are floundering in their revalidation preparations.

Our survey of 83 PCOs found only 59% have a medical director who is a GP, and a quarter have no medical director at all.

The RCGP insists all responsible officers should be GPs and hold the post of PCO medical director, and therefore be accountable at board level.

Of PCOs that do have a medical director, 78% are GPs and 3% former GPs, but the remaining 17% are consultants and public health clinicians, whom the college says would not be appropriate for the job.

Professor Steve Field, chair of the RCGP, told Pulse: ‘Until you've got appraisal sorted and responsible officers in place, I don't think revalidation can go ahead. I think the process will be delayed, probably until 2011.

‘We welcome the fact that the [GMC's] programme board has decided to delay the implementation of responsible officers so they can be piloted.'

Dr Alan Keith, a GP in Rotherham – one of the pilot areas for revalidation but which has no medical director – said it was essential responsible officers were GPs: ‘I would rather have somebody who has been in practice recently and understands what can and can't be achieved.'

While the planned rollout of responsible officers is faltering, the Government is demanding the final revalidation programme be much tougher than had been envisaged.

Dr Maurice Conlon, national director of the NHS Revalidation Support Team, said of the doubling of significant events: ‘It's reasonable for any doctor to review two cases a year.'

How PCOs are unprepared for revalidation

of trusts do not have a medical director

of trusts have a medical director who is a GP

of medical directors are not GPs

Source: Pulse survey of 83 PCOs

Dr Alan Keith: essential responsible officers are GPs who have recently been in practice Dr Alan Keith: essential responsible officers are GPs who have recently been in practice

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