By Ian Quinn
Exclusive: The Department of Health is planning to substantially scale back revalidation in light of concerns over cost and anger among GP leaders about the level of bureaucracy to be heaped on practices.
Health secretary Andrew Lansley is demanding that the extended review he announced last month delivers a slimmed-down scheme that will abandon many of its original aims, Whitehall sources have told Pulse.
Ministers believe existing processes such as appraisal already cover many of the key elements of revalidation, negating the need for specific legislation on peer review.
Niall Dickson, chief executive of the GMC, told Pulse the council was already planning to cut revalidation’s requirements, following the review extension and concerns expressed in its recent consultation. Its initial plans would halve the amount of multi-source feedback GPs are asked to collect.
The move comes at a key moment for the controversial programme, with BMA leaders at last week’s Annual Representative Meeting passing a series of motions condemning the bureaucracy involved.
One motion attacked the royal colleges for drawing up ‘unrealistic demands’, with a source involved in the planning process for revalidation claiming the colleges, including the RCGP, had been warned to ‘wind their necks in’.
A Government source told Pulse: ‘Some aspects of revalidation we believe have already happened. For example, peer review already exists in the form of appraisals. Some of it is already being done by the royal colleges. Trusts have known for years that revalidation was on the horizon and have already adapted their processes.’
Mr Dickson said: ‘There is still real political support behind the principle of revalidation but new ministers have decided the NHS must play its part in the economic situation and that revalidation must be practical and workable.’
Mr Dickson said it was ‘not a state secret’ that there was pressure to simplify it and insisted the RCGP had in some cases gone further than the GMC: ‘It proposed 360-degree multi-source feedback twice every five years – we want it once every five years. It doesn’t mean feedback is a bad idea but it may mean once is enough.’
At the ARM, doctors warned revalidation could burden them with a huge amount of work and cost. More than a third said they did not even support it in principle.
GPC member Dr Peter Fellows told the meeting: ‘Senior RCGP members want to introduce more hoops.’
But RCGP chair Professor Steve Field said he had fought to keep down bureaucracy, adding: ‘I’ve always said revalidation is about professional development, not finding another Shipman. If all PCTs were doing proper clinical governance, most GPs wouldn’t notice any difference.’
Professor Field said the RCGP had proposed it could cut costs by taking on management of the outsourced online toolkit.
Dr Una Coales, a GP in Stockwell, south London, said she had calculated revalidation would cost £129m a year for responsible officers and remediation, assuming the need for it was halfway between the estimated figure of 5-14%: ‘Why create a new expense when the Government is £1.4 trillion in debt?’
Dr Una Coales: has calculated revalidation set to cost £129m a year Dr Una Coales: has calculated revalidation set to cost £129m a year Revalidation: what could get the axe?
• Specialist standards set by the royal colleges – likely to be simplified after being criticised by the BMA and could be policed by appraisal
• Multi-source feedback from colleagues – GMC has suggested the RCGP’s frequency of assessments could be cut in half
• Feedback from patients – could be canned as not a key aspect of professional development
• Responsible officers – legislation has been repeatedly delayed amid rumours that the £17m-a-year plans are too expensive