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Practice governance procedures to be included in GP revalidation

Exclusive: GPs will only be revalidated if they can demonstrate their practice has adequate governance procedures, in a move the GPC has warned confuses assessment of individual doctors with the organisation they work for, Pulse can reveal.

The RCGP told Pulse responsible officers would have to ensure adequate practice governance systems were in place as part of every GP’s revalidation, and that an assessment of governance would be expected to ‘feed in’ to every GP’s appraisal.

The surprise revelation, which the GPC said went ‘beyond the purpose and remit of revalidation’, came after it emerged a responsible officer in Cheshire had begun contacting practices to warn them their governance procedures would be taken into account in revalidation of GPs.

Professor Mike Pringle, RCGP medical director for revalidation, said: ‘The way it will work is the responsible officer will need to know a practice has adequate clinical governance and will expect that to feed into GPs’ appraisals. I think we’ll see this issue coming more to the fore as responsible officers begin to really bed in to their responsibilities.’

Professor Pringle insisted individual GPs shouldn’t find their revalidation dependent on practice governance, because practices would be expected to have sorted out their governance systems in advance of the revalidation coming in.

But a letter to practice clinical governance leads from Dr Maureen Swanson, responsible officer for NHS Western Cheshire and NHS Warrington, suggests governance could become a key strand of revalidation.

She wrote: ‘The responsible officer’s recommendation for revalidation of GPs will take account the clinical governance systems within each practice as well as the GP’s participation in appraisal.’

But GP leaders expressed concern. Dr Andrew Mimnagh, chair of Sefton LMC, said: ‘It is news to me that governance arrangements within a practice may affect an individual’s revalidation status. This would appear to draw an unfair distinction between principles and non principals in fulfilling revalidation.’

Professor Pringle denied salaried GPs would be adversely affected.

But GPC negotiator Dr Chaand Nagpaul said: ‘It appears the emphasis in this letter is making the practice’s clinical governance a formal part of revalidation. That is not correct. By necessity an individual’s performance might be contextualised in their working environment, but the way this is presented goes beyond the purpose and remit of revalidation which is about assessment of an individual doctor.’

Dr Rob Barnett, chair of Liverpool, said: ‘It’s like saying everyone at Mid Staffs should have failed revalidation because of problems in the hospital.’