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Revalidation pilots find process 'unworkable'

Exclusive: Doctors leading on revalidation for the Government are to scrap the IT system used in the pilots so far and adopt a paper-based version for future test sites after GPs found the process ‘unworkable' and were overwhelmed by workload.

GPs in pilots said they faced more than 40 hours' work uploading information for revalidation and that appraisers had become so frustrated with the ‘terribly poorly thought-out' software that many boycotted the pilots ‘en masse'.

The NHS Revalidation Support Team, including representatives of the GMC and medical colleges, is due to publish an evaluation of the one-year pilots next month.

But Pulse has learned it has already decided to abandon the IT system and switch to a new approach based on PDF printouts for future pilots as part of plans to streamline the process.

Pulse revealed in November that GPs who were being appraised under the pilots had quit because of IT failures. A BMA report in March detailed some of the difficulties with the software, prompting the GMC to pledge to address its ‘clunkiness'.

But GPs said the IT system had remained deeply frustrating and time-consuming to use even after several revisions, and many appraisers had ‘boycotted' the pilots for a time, with only some agreeing to resume their roles.

The Revalidation Support Team insisted the software had been commissioned specifically for the pilots and was ‘never intended to be a final solution' for revalidation when it begins at the end of 2012.

Dr Jonathan Evans, chair of Dorset LMC and a GP in Blandford Forum in Dorset – one of the pilot sites – said he had felt duty-bound by his leadership role to complete the process, which had been ‘very stressful'.

‘I spent over 40 hours on the process. I spent weekend after weekend trying to fathom it. My wife and I joke it almost cost our marriage,' he said. ‘Some of my colleagues just stopped because they felt it was unworkable. The appraiser group boycotted it en masse initially – and they were some of the main stalwarts.'

Dr Duncan Walling, a GP in Southampton who sat on the Dorset pilot steering committee, said: ‘The level of frustration was very high, but I was impressed GPs tried to make it work. We're going to need more a culture of recording evidence than we've ever had before.'

Dr Shelagh McCormick, chair of Cornwall and Isles of Scilly LMC and a GP in Gunnislake, Cornwall, said the scheme was ‘incredibly work-intensive': ‘Appraisal documentation can already be time-consuming, and mapping against the various attributes took extra time.'

She added that some GPs remained concerned over the potential risks to confidentiality of an IT-based system.

Dr Nick Lyons, clinical lead for the pathfinder pilots and a GP in Wareham, Dorset, insisted moving to paper appraisals in the second wave of pilots would bring a ‘huge improvement': ‘We fully recognise the toolkit caused many problems. We won't be providing a single system for all doctors to use – it will be up to doctors to choose. Pilots this year will use forms. If really complicated software was needed, there would be concerns implementation could be delayed if it didn't work.'

London Deanery said some GPs had become ‘disengaged' even though it offered payments to participate in its pilot.

But Dr Lyons said: ‘We had 3,022 doctors complete appraisals and I'm aware of less than 100 who withdrew. We know some appraisers withdrew – a minority were quite discontented.'

Niall Dickson, GMC chief executive, said: ‘We're committed to making sure revalidation is straightforward and useful for all doctors, and the pilots are invaluable in helping us do that. The feedback from doctors in the pilots is helping us get the right systems in place.'

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