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NHS warned to ‘get to grips’ with preparations for revalidation

The NHS is lagging behind on preparations for revalidation, with a quarter of doctors not receiving appraisals last year and a third of responsible officers saying they do not have sufficient resources, an official report has found.

The lack of readiness for the new system, whereby all doctors have to be assessed to ensure their fitness to practise, has led to the chief regulator to warn that this is a ‘wake up call' for the NHS in England who are risking quality and safety.

The report ‘A review of integrated clinical governance in the context of medical revalidation' - from the NHS Revalidation Support Team - shows 68% of responsible officers were satisfied that their organisation is providing sufficient financial resource to support revalidation and one quarter of doctors had not completed an appraisal in the last year.

In response GMC chief executive Niall Dickson said: ‘This report is a wake up call to health service organisations in England - they must put in place the right systems for monitoring and supporting clinical practice.'

'This is needed for revalidation but more fundamentally it is needed to ensure high quality, safe care. The report shows there is clearly more to do in some areas, although we know from speaking to medical directors and responsible officers that there is momentum and significant progress has been made even since this review was carried out.'

Professor Sir Bruce Keogh, NHS medical director, also called on the healthcare sector ‘to get to grips with its obligations of quality and safety', in response to the review of clinical governance and appraisal in preparation for revalidation of doctors in England.

Sir Bruce said: ‘Good clinical governance and appraisal are the bedrock of high quality care and CQC would expect to see that organisations have appropriate systems in place to support these in order to ensure people receive care that is safe and meets their needs.'

'Indeed, appraisals have been a requirement on all NHS organisations since 2001. While good progress has been made in some areas, all boards in the health sector must grip the issues and make rapid progress.'

'Patients need to know their doctors are up to date and this means doctors need to get the right development and assessment, which they are entitled to as part of their contracts.'

Key findings

The report outlines the progress made by March 2011 and the challenges that still remain, which include:

  • 97.8% of designated bodies had appointed a responsible officer, and most(87.8%) are being supported in the role by the designated body.
  • 73.7% of doctors had completed an appraisal between 1 April 2010 and 31 March 2011
  • 51.7% of designated bodies had a medical appraisal policy that met the requirements of the Responsible Officer Regulations 2010
  • 87.8% of appraisers had received appraiser training
  • 83.2% have a process for investigating concerns about a doctors' practice
  • 30.2% had a policy in place for re-skilling rehabilitation, remediation and targeted support
  • 67.7% of responsible officers were satisfied that their organisation is providing sufficient financial resource to support revalidation