The GPC has hardened its stance on revalidation by insisting that the profession will not support the process unless the Government and GMC can put forward detailed workable solutions to the unresolved problems around funding for remediation and support for sessional doctors.
Revalidation is finally set to come into force at the end of next year, after years of delays and false starts to the process.
GP leaders had recently appeared to be softening their stance on revalidation, with LMC leaders rejecting calls in June for the process to be put on hold amid fears that such action would hamper the progress they had made in encouraging the GMC to adopt a simpler, more proportionate system.
But following a debate at GPC council yesterday, GPC negotiators said the time had come for the profession to draw a line in the sand, and said they would not support revalidation until the Government and GMC outlined a credible and workable solution to what GP leaders view as the two fundamental obstacles to revalidation.
GPC chair Dr Laurence Buckman said: ‘If remediation and helping sessional doctors get into the revalidation process are not dealt with, it will be very hard for the GPC to support the revalidation process. The GMC and Revalidation Support Team have got to sort out how these things happen.’
‘Doctors who are found through appraisal to have a problem should be assured the NHS will pay for, arrange and deliver their remediation. The process of remediation has to be funded. We’ve been making that clear for years. And yet still, no positive view has been put about remediation to the medical public.’
‘It’s not enough to say there will be remediation. What will there be, who will do it, how will they do it, who’s funded to do it? How will they get time off for their practice, if GP takes time out of their practice, who is going to see their patients and so on. I can’t see how it can work unless the Government finds the money.’
Dr Buckman said the obstacle of how locum doctors would be supported was equally pressing. ‘It’s very difficult for them to produce evidence for certain kinds of things, particularly multi-source feedback or serious events. We’ve been talking about that from the very beginning and yet still it hasn’t been worked out how this group of doctors will be involved.’
‘The process is rolling on despite the fact that there isn’t a conclusion for those doctors.’
‘If those two things are not in the package then the process cannot proceed.’
Dr Beth McCarron Nash, GPC negotiator and a sessional GP in St Columb Major, Cornwall, said there needed to be a specific process designed for non practice-based GPs. ‘Instead of trying to fit this group of doctors into a process, what we should be doing is designing a process around that group of doctors, because we’re not just talking about one or two. This problem isn’t just going to go away, it needs sorting out. Until that is done properly this process can’t go ahead.’
Fellow GPC negotiator Dr Peter Holden, a GP in Matlock, Derbyshire, added: ‘It can’t be on the pending pile any more.’
A DH spokesperson said: ‘We’re committed to a system of remediation that is fair and equitable for all doctors when revalidation is introduced, so they can access the support they need and patient safety can be assured.
‘In January 2010 a group was established to review how the remediation of medical competence and capability issues currently operates in the NHS in England and to explore ways for improving the way remediation is managed and delivered. This review will be published in due course.’
Niall Dickson, chief executive of the GMC, said: ‘Organisations should already have systems in place to remediate and retrain doctors if there are concerns about their practice, just as they should already have appraisal systems in place for their doctors.
‘Our priority is to make sure revalidation is straightforward for all doctors, including sessional GPs. That is why we set out clearly the supporting information all doctors need to provide. We are also introducing a new team of local advisors to support medical directors as they continue to prepare for revalidation.
‘Now is the time to press ahead and deliver revalidation; patients expect nothing less.’