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Fewer than 125 GPs could require remediation under revalidation, says GMC

Revalidation could identify fewer than 125 GPs who require remediation in its first five-year cycle – fewer than are currently singled out under existing processes – the chair of the GMC has suggested.

The disclosure from Sir Peter Rubin – the first concrete indication of how many GPs could face remediation – comes amid mounting confusion over the cost of revalidation.

The Department of Health this week said it will not be publishing its impact assessment before a formal decision is made on rollout.

Last week the GMC backed revalidation to begin on 3 December, with health secretary Jeremy Hunt likely to rubber-stamp the process shortly.

Sir Peter told Pulse he had been told ‘fewer than 10’ GPs were likely to require remediation across an area with a population of five million. Extrapolated across the UK, this would mean that only about 125 GPs would need remediation in a five-year revalidation cycle.

Figures from the National Clinical Assessment Service show GPs required remediation in 42 cases in 2011/12 alone, after referral from PCTs based on appraisals or complaints – suggesting revalidation could identify  even fewer doctors requiring remediation than the current system.

Sir Peter said: ‘We are talking about tiny numbers of doctors [who will require remediation]. In an area with a population of five million, we were told, by somebody who would know, the number of GPs needing remediation in that area was under 10.’

But GPs said the figure called into question the huge effort being committed to roll out revalidation, and also criticised the lack of transparency over the cost of the process.

The DH revealed this week its impact assessment setting out all the likely costs of revalidation will only be published after a final decision is made on rollout. The NHS Commissioning Board and the GMC, which has publicly insisted ‘revalidation is affordable and benefits outweigh costs’, have also remained tight lipped on the likely cost (see box).

Costs likely to be factored into the DH impact assessment include expanding appraisal, the revalidation support team and responsible officers, estimated to cost £22m per year. 

GPC negotiator Dr Peter Holden said he was unsurprised  few GPs were expected to require remediation: ‘We have been surveyed to death over the years and consequently things ought to be in good shape.’

Dr Peter Tyerman, a GP in Barnsley, South Yorkshire, said: ‘The costs taken out of patient care are out of all proportion to the benefits. Nobody has shown any evidence it will make any difference.’

And Dr Krishna Korlipara, a retired GP in Bolton who served on GMC Council from 1984 to 2008, said: ‘The effort and cost are greater than the value.’

Professor Mike Pringle, RCGP president-elect, said he expected the number of GPs facing remediation to increase by ‘a handful’ at most. He said: ‘You might say if there is no increase, why are we doing it? Well, since it became obvious revalidation was serious, it has had a catalytic effect on standards.’