Shortage of GP medical directors poses new revalidation questions

By Gareth Iacobucci

More than a quarter of primary care organisations do not currently have a GP medical director in place, leaving them wholly unprepared for the introduction of responsible officers, Pulse can reveal.

The network of local officers, who will be in charge of recommending GPs to the GMC for revalidation, were expected to be in place by September this year, with PCT medical directors earmarked to take on the role in most cases.

But Pulse's investigation shows that 27% of PCOs do not currently have a GP medical director in place, casting huge doubt on trusts' preparedness for revalidation.

The findings appear to justify health secretary Andrew Lansley's decision last week to delay the rollout of revalidation by extending pilots until 2012, due to his lack of confidence about the ‘costs, benefits and practicalities' of the current proposals.

In a letter to GMC chair Professor Peter Rubin, the health secretary made clear that ‘organisational readiness, and in particular having responsible officers in place, are essential elements to ensuring the NHS is ready for revalidation'.

Although Pulse's investigation lays bare the lack of GP medical directors in some PCOs, it does show significant overall improvement in GP representation at board level in the past three years.

Freedom of Information responses from 55 UK trusts and health boards show that 73% now have a medical director in post – compared to just 59% in 2007.

However, this masks huge variation between PCOs, with the GP ratio on Professional Executive Committees (PEC), or equivalent boards, ranging from as low as 13% in one case to as much as 77% in another.

Just four PCOs had more than two-thirds GP representation on their PEC, while GPs took up third or less of PEC positions in 16 trusts or health boards.

Dr John Grenville, a GP in Derby, and secretary of Derbyshire LMC, which is proposing a motion at this week's LMCs conference stating that responsible officers ‘must be on the GP register' and ‘have a current license to practice', said it was essential that GPs held medical director posts.

He said: ‘People who are acting as responsible officers for GPs should know about general practice, have been practising for a significant amount of time, and have already gained the respect and confidence of their colleagues in their career.'