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GPs buried under trusts' workload dump

Government approves ‘historic’ rollout of revalidation from December

The Government has given the final green light to the start of revalidation for all doctors from the end of this year, and revealed they expect concerns to be flagged up in 5% of all doctors.

Under the new legislation, due to be enacted on 5 November, GPs and other doctors will begin to be revalidated in December and vast majority of doctors are expected to be revalidated by April 2016.

The announcement from the Department of Health comes after the BMA backed the rollout following the agreement of a deal over funding remediation.

GMC chairman Sir Peter Rubin said this month that ‘fewer than 10 GPs’ GPs were likely to require remediation across an area with a population of five million. If extrapolated across the UK, this would mean that only about 125 GPs would need remediation in a five-year revalidation cycle but the Department of Health estimates suggest this figure could be much higher.

Alan Coffey, chief executive of the Department of Health’s Revalidation Support Team, revealed their survey of more than 300 healthcare organisations in England found 4.1% of doctors – translating to 6,800 doctors across the country – were deemed to have concerns, although more than half of these were ‘low-level concerns’.

Mr Coffey added that the number of doctors with concerns might rise to 5% when revalidation begins: ‘But we are hoping these 5% will require low-level interventions and the environment would be much more consistent and supportive.’

He also said the survey found ‘high-level concerns’ in over 0.7% of all doctors, around 1,200 doctors across England, which would mean they would require ‘significant remediation’.

Health secretary Jeremy Hunt said revalidation would help the UK to gain the best survival rates in Europe for the major killer diseases.

He said: ‘Doctors save lives every day and making sure they are up to speed with the latest treatments and technologies will help them save even more. This is why a proper system of revalidation is so important.’

The health secretary also announced that there will be one national list of GPs, dentists and ophthalmologists approved to provide primary care services. The DH said this will replace the individual lists held by PCTs, which means ‘if a poorly performing doctor is removed from one list, they can move to a different area and keep practicing’.

Niall Dickson, chief executive of the GMC, said this was a ‘historic moment’ and represented the UK’s ‘biggest change in medical regulation’.

Professor Sir Peter Rubin, GMC chair, said:  ‘This is an historic day for patients and for the medical profession. We are confident that the introduction of revalidation will make a major contribution to the quality of care that patients receive and will give them valuable assurance that the doctors who treat them are regularly assessed against our professional standards.’

But Dr Peter Swinyard, Family Doctors Association chair, said: ‘I don’t think it will weed out a significant number of bad doctors. I think it will cause a lot of grief for a number of good doctors. It is yet another added burden which is causing demoralisation in general practice. It is to some extent calling into question our professionalism. But it is one of the inevitabilities of modern life that nobody trusts anyone else and no-one trusts their doctor unless they have a rubber stamp every five years saying they are up to date.’

A readiness assessment published earlier this year found almost all GPs were connected with a responsible officer, but that 10% of GPs still not have an appraisal in 2011/12.

BMA chair Dr Mark Porter, said they supported the rollout as it would give patients confidence their doctors have up-to-date skills and knowledge.

But he added: ‘We still need to ensure consistency across the UK so that all doctors are working to the same standards. And it is vital that sufficient support exists across the UK for those doctors who need it.

‘It is essential that revalidation is reviewed every step of way so that we can be sure that the system works for patients and for doctors.’


Readers' comments (6)

  • This is a very positive direction and a milestone in healthcare provision. I think other countries are cgoing to follow suit soon. It is going to reduce cases of negligence as well.

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  • Let common sense prevail

    Is it?

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  • Revalidation of practice will ensure that all doctors and more importantly, other hcp such as paramedic/nurse practitioners who are now out there providing primary care, within the local communitys, to maintain a level of skills and knowledge that is acceptable, safe and up to date with current practice and changes in practice.

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  • I didn't follow this very closely since I'm fully retired. My work was NHS, hospital-based psychiatry and I rather had the impression that 'revalidation' could almost go through on the nod, since colleagues could revalidate one another. For sure, a dossier of evidence has to be provided that one has kept up to date but how well does that correlate with being a good doctor? Is it yet another paper exercise, like some sort of kite-mark? Who guards the guards? Who validates the validators?

    And anyway, experience shows that so often yesterday's 'certain' knowledge of best practice is today's rubbish. I remain on the skeptical side. Can't help feeling that the whole thing was a panicky measure in response to a few bad episodes. Cf the dangerous dogs act?


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  • The UK’s 220,000 registered doctors will scarcely be finished with one round of “checks” before the next annual round starts. It is creating a compliance treadmill that may turn out to be loathed for the time it diverts from patient care. It is meant to start before the end of this year with medical leaders. This means the very GP leaders we need to be putting all their energies into the new CCG commissioning system which kicks off in April 2013 will now have to divert time and attention to jumping through Mr Hunt’s new hoop. David Nicholson warned only a few days ago that if we get the CCG implementation wrong, the whole thing will end in “misery and failure”. I do not want him to be proved right and this could increase the risks.
    Mr Hunt’s announcement about revalidation for doctors comes only days after he announced at the Tory Conference that he wants the CQC to license individual managers and hold them to account for safe and effective care in the institutions they run. This helps turn the NHS into a regulatory monster. It won’t make things better and could make them worse. Piling everything on to individuals will still allow organisations to behave badly and dangerously. Perhaps we should license health ministers next?

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  • anyone who thinks this is going to stop another Shipman is delusional and needs help. Shipman would have gone through revalidation with flying colours and would have been the example used to set the standard for others!

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