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NHS England ‘reviewing and rebooting’ appraisal and revalidation process



Exclusive NHS England is currently reviewing the appraisals and revalidation process, to ensure GPs want to remain in the profession and are not put off by the ‘complex’ system. 

The head of primary care for NHS England told Pulse a key challenge faced by GPs – particularly later in their careers – is the difficult process of staying appraised and revalidated.

Therefore to help GP retention, the system is being reviewed – although there is currently very little detail on what the review is looking at and when it will report.

Pulse previously revealed GPs spend on average 55 hours a year filling out revalidation paperwork – equivalent to 1,300 full-time GPs working eight sessions a week.

An investigation also showed that only 0.4% of all the revalidation recommendations made for GPs are serious enough for the regulator to threaten to withdraw a licence to practise, and there is little evidence that revalidation improves patient care.

But speaking to Pulse, NHS England primary care acting director Dr Nikita Kanani said a ‘reboot’ of revalidation is currently ongoing.

She said: ‘We’ve got a reboot of appraisal and revalidation under way, which I’m doing on behalf of [NHS England medical director] Steve Powis because actually, we know that one of the challenges that GPs find, particularly later in their career, is how complex it is to stay appraised and revalidated under the current guidelines. 

‘What we want to do is create a space for people to be reappraised preferably around their passion.’

‘GPs are really valued, we want to make the work better for them so they want to stay and people want to be GPs for as long as possible,’ she added.

Last month, the Government-commissioned GP partnership review – chaired by Dr Nigel Watson – called on NHS England to look at revalidation processes and tackle ‘inconsistency in the appraisal requirements’.

Welcoming the news, Dr Watson told Pulse the review should tackle the lack of consistency across the country and between primary and secondary care, and help retain GPs who are ‘fed up’ with the bureaucracy.

He said: ‘There are older GPs who were telling us they’re going to stop practising because they’re fed up with appraisals and bureaucracy.’

‘Doing an annual appraisal can be a positive thing – and in some areas it still remains that way – but I think increasingly there have been a number of extra requirements brought in, [with GPs] having to record more things.

‘If you look at some secondary care appraisals, compared to what is required for primary care, there is a mismatch between the two. There needs to be some consistency across the country,’ he continued.

Dr Watson added at the moment the process can be seen as ‘onerous’ and a ‘tick box’ exercise, without being actually valued by the patient or the person,’ .

GPs have also been concerned about appraisals and the use of their reflections since the Dr Hadiza Bawa-Garba case, when it was suggested that the junior doctor’s reflections had been used against her in court

Meanwhile, a Pulse survey revealed over half of GPs have stopped or changed appraisal reflections in the wake of the case.