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A faulty production line

Revalidation is not a waste of time

Niall Dickson argues that GPs shouldn’t dismiss the process just yet

From Niall Dickson, chief executive and registrar of the GMC

Pulse’s article on GPs needing remediation misses the point. Revalidation is a process not a point in time, pass or fail test. There is a moment in every cycle when the doctor’s responsible officer signs off that he/she has been part of that process. Unsurprisingly at that point, the vast majority of doctors have successfully provided the evidence and had their appraisals.

A closer look at the figures suggests that it is having an effect. A large number of doctors are being subjected to an appraisal for the first time. Between seven and 12 per cent of doctors are having their revalidation deferred, in most cases because they have not yet been able to produce all the evidence they need to be revalidated. Most will be able to do so, but in some cases it is because they are subject to some form of local disciplinary or remediation process.

There is a further group whose revalidation has been put on hold because they are being investigated by the GMC. Around 1.6 million patients have evaluated their doctor, as have huge numbers of staff who have given feedback on colleagues.

These are early days but initial signs are encouraging. Senior doctors charged with operating the system are overwhelmingly positive and groups such as peripatetic locum doctors who have previously been neglected - and in some cases been viewed as a cause for concern - now collect information about their practice and are subject to annual appraisal.

It remains our ambition to work with the profession, employers and patient groups to refine the system once every doctor has been through it.

We have commissioned an independent evaluation and after interim results in January 2016, we should all be in a better position to assess the impact of the first wave of revalidation and how it can be improved and developed.

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Readers' comments (46)

  • This comment has been removed by the moderator.

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  • Of course revalidation is absolutely vital. You have to look at the bigger picture. Without revalidation GMC employees would not be able to justify their grossly inflated salaries, and they would not be able to justify having private health care. After all everyone knows what the problems are in the NHS !!

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  • Take a straw poll of the whole profession. Most GPs do not want this hassle. Most do not think it benefits them. Most do not think it benefits the patients. Most are sick of bureaucracy and forms. Most are deeply resentful of bureaucrats like those in the GMC.

    Don't condescend to us Dr Dickson.

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  • But there needs to be some sort of process, right? Its a matter of how its done.

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  • Well said Niall so many people have just had to shut up about lously treatment from health workers who had not kept up since they qualified decades ago .People do move/live in different parts of the country and register in different practices ,

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  • He would say that wouldn't he!

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  • Revalidation was one of the reasons I retired early. Now, Mr Dickson might think that is unimportant, but I'll bet there were plenty of others like me.

    It is pretty typical that he is not listening to the views of the profession.

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  • 'We have commissioned an independent evaluation and after interim results in January 2016, we should all be in a better position to assess the impact of the first wave of revalidation and how it can be improved and developed' -> translation -> if we find we have not failed enough GPs we will tighten up the process and add in more hurdles and barriers so we can at least fail 5% of GPs every 5 years so that you come to fear us and do exactly what we tell you to do. Oh btw we will increase our fees and make you pay it x

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  • Is there any evidence, actual evidence, that revalidation has done anything to improve patient care?
    It has certainly done harm as some GPs are being driven out from an under-doctored service.

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  • Why are you proud that doctors have revalidation put on hold when they have a complaint being investigated by the GMC? Do they not have the same "innocent until proven Guilty" rights as the rest of the population? Nothing should make them feel like they are guilty until proven innocent and these needs to be addressed IMMEDIATELY by the GMC. otherwise you are treating the people who pay your salaries with complete disrespect and I'm sure breaking some human rights laws at the same time.

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  • @ 9.42

    GMC doesn't care. It has massive political cover and is effectively part of the establishment. The GMC appears to be applying its code of ethics to doctors but doesn't think it needs to bother when it comes to itself. And why should it? You HAVE to pay their wages.If you're in any doubt please read this corker from the BMJ very recently:

    http://www.bmj.com/content/350/bmj.h2400.full?ijkey=hEthgPnnuA3tB0F&keytype=ref

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  • The above:

    "GMC’s supposedly independent training review included secret meetings with politicians"

    Owe, and the GMC also spent thousands of pounds of our money in legal fees trying to resist a feedom of information request.

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  • Yes it is.

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  • Annual appraisal is a definite waste of my precious time

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  • The GMC do not have the support of the profession. I am stopping as early as I can - giving up medicine- because of revalidation.

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  • It's actually worse than a waste of time. Revalidation is resulting in large scale failure of primary care with total collapse of some services in large areas of the country. This is seriously harming large numbers of patients and needs to be halted immediately.

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  • Revalidation the final straw for me. Retired mid-fifties.

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  • just because a group of professionals (eg locums) might benefit from the process (debatable), then surely this does not automatically mean this process has to be forced onto the whole profession.

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  • Revalidation is not the issue - the change of appraisal to become a summative assessment rather than a formative process has robbed it of it's value as a tool to encourage doctors, and made it into a number-crunching exercise feeding the revalidation process. It is for this reason that I resigned as an appraiser earlier this year, as have many colleagues in my area. Grass roots GPs have lost faith in a system that seeks to quantify GP processes, and by inference open up the possibility of punishment.
    there is more than enough information held at CCG level, such as referral data, prescribing habits, practice performance indicators etc. etc that gives an accurate view of GP performance, but none of this is used for appraisal or revalidation - instead it is all self-declared, which opens up a for greater door to dishonesty and manipulation, should a failing doctor wish to step through it. The vast majority of GPs are conscientious, hard-working honourable, and self-aware. The easiest revalidation would simply be to ask each GP for the names of the best and worst doctors in their area, and to investigate those names that crop up more than 3 times. Sorted. Revalidation and appraisal are politically-motivated, poorly considered, and have neither the specificity nor sensitivity to be effective screening tools.

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  • It won't be long before all of us are simultaneously being investigated by the GMC given their witchfinder style enthusiasm. More seriously the point about revalidation being on hold if under GMC investigation does indicate a guilty until proved innocent mindset. WHY???

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