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Why revalidation must be delayed

Revalidation has been on the cards so long the GMC has published a ‘historical timeline’ of its introduction – even before it has gone live.

Revalidation has been on the cards so long the GMC has published a ‘historical timeline' of its introduction – even before it has gone live.

It was first discussed in 1999 in the wake of the Bristol Heart Inquiry, a few years later co-opted as a convenient response to the Shipman Inquiry, and has now been bounced around and argued over for 13 years. This year is supposed to be the one revalidation finally goes live – yet in many ways, it looks as far from the launch pad as ever.

BMA chair Dr Hamish Meldrum is now publicly questioning whether the late 2012 deadline for revalidation to begin can possibly be met.

His letter last week highlighted a range of concerns over how revalidation would work – questioning the time and resources being made available for it, the state of employers' clinical governance systems and the readiness of responsible officers.

BMA Scotland chair Dr Brian Keighley raised similar concerns. The list of questions they ask is important, but by no means exhaustive. There are a number of more fundamental reasons why this has to be the wrong time for a race to the revalidation starting line. The GMC is being rashly premature in trying to rush the system into being before GPs' concerns over it have been assuaged.

Revalidation has always suffered from a lack of clarity over its purpose – a consequence of a system first proposed to tackle lack of competence that soon became so closely tied with the understandable desire to prevent episodes of mass murder.

That confusion is more than a theoretical concern – it colours all of the discussions over what revalidation should include, and how much should be expected of doctors who undergo it.

As recently as last September, the RCGP was forced to remove from its revalidation guidance all references to the supporting materials GPs would need to supply in the introductory phase – because of ‘uncertainty' over how the system would be implemented. It is alarming that so close to the starting line, GPs still don't know the route they will be running.

Neither has the GMC provided firm evidence that GPs are capable of lasting the course.

Last June, Pulse revealed GPs participating in the Government's pilots of revalidation had found the IT system used to collate information ‘unworkable'.

New pilots were launched, collecting evidence for revalidation by paper, but the results from those won't be ready until later this year.

Will the few remaining months before the start date really leave enough time to learn from the results, and to assure GPs their concerns have been addressed?

But there is a stronger argument still for why revalidation must not begin later this year. Back in 1999, William Hague was still strutting around in his baseball cap, and there was simply no prospect that a Conservative-led revolution in healthcare would hand GPs responsibility for swathes of the NHS.

GPs are unprecedentedly busy getting to grips with their new responsibilities. They have, quite frankly, enough on their plates.

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