Revalidation is a reality GPs must accept
Revalidation will benefit both patients and the profession, writes Professor Mike Pringle, president-elect of the RCGP.
Last month I was elected to succeed Dr Iona Heath as president of the RCGP from November. As president, I will be representing the views of members within the college and ensuring they are heard.
Many members – and non-members – will be fearful of the arrival of revalidation and will need support through its early years. Some may be confused at its imposition, seeing it as unnecessary and de-professionalising.
I am currently the college's clinical lead for revalidation, and I've spent the past few years planning the implementation of revalidation. How can I square these two circles?
We could continue to question whether revalidation is necessary, but the debate is becoming increasingly redundant. Revalidation is about to happen.
I believe it will restore public trust in doctors and that it is a necessary step to ensure all doctors remain up to date and fit to practise.
Without revalidation, we will be mired in the spiral of mistrust that has already tainted our relationship with politicians, colleagues, NHS managers and, to an extent, our patients.
My role in revalidation has been two-fold. First, I have been working to make the process practical and non-threatening for all good GPs. And second, I have been ensuring a level playing field for all doctors so that GPs are treated no better or worse than our consultant colleagues.
The supporting information we must provide in our appraisals is, with one important exception, information that we should have readily to hand.
We should be recording our CPD. We should be doing an occasional audit and considering significant events. Almost all of us survey our patients from time to time. For some GPs, a colleague survey may be a new idea, but now a majority of GPs I speak to have done one.
Appraisal should continue to be a supportive opportunity to review your year and plan the next. Most GPs already share information with their appraiser that they can build into a revalidation portfolio, and your appraiser will only need to make sure all areas are covered.
Ensuring patient safety
But the new dimension is the one that sits behind the appraisal: the appraiser needs to reassure your responsible officer that you are on track for revalidation. If concerns are raised, your responsible officer must address them. This is a key part of ensuring patient safety in all settings, including general practice.
All doctors will be expected to provide similar supporting information. The portfolios of a dermatologist, cardiac surgeon, psychiatrist or GP will be populated by the same types of information.
Each of the royal colleges has published a similar core document, with only minor modifications that can be justified by the circumstances of that specialty.
Surgeons, for example, will be expected to provide hard outcomes data personal to them – GPs cannot provide data on outcomes specific to themselves, so are not expected to do so.
The RCGP's Guide to revalidation takes into account pilot studies involving locums, out-of-hours GPs, prison doctors, GPs with a special interest, non-clinical GPs, rural GPs and so on. We are a diverse group, and the flexibility over the supporting information required for GPs reflects that complexity.
I have seen part of my role as representing the views of all GPs in my revalidation work. I have also been aware of the need to listen to patients and respect their opinions and needs.
I think revalidation will achieve a good balance between professional and patient priorities, and will be fit for purpose. It will raise standards, protect patients, enhance the quality of appraisals and minimise disruption for doctors. Revalidation should be seen as a positive process for doctors.
If a case is made for refining revalidation, I'll ensure that whoever leads revalidation is made aware of it and, if anomalies arise, the advice given to responsible officers must be adapted.
I hope that over the next few years, you will see my aspirations put into practice. My evolution from revalidation lead to president feels a natural one. In my view, placing patients and GPs at the heart of the college, and representing their interests, are complementary activities.
Professor Mike Pringle is president-elect of the RCGP and its clinical lead on revalidation