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Could revalidation be the next casualty of NHS cuts?



By Richard Hoey

Making revalidation work will require serious money, and some senior GPs are starting to question whether it will ever actually happen

Revalidation of GPs is being spearheaded by the GMC, with many of the key details worked up by the RCGP.

It has the support of the BMA and, in the wider political world, not only of the Government but also of the Conservative opposition.

Frameworks are in place for the collection of CPD credits and the scrutiny of appraisals by responsible officers, and the GMC has just announced the first GP pilots.

Revalidation is, in other words, a done deal. It is happening, whether GPs like it or not – an inevitable, increasingly concrete feature on the future skyline of general practice.

And yet… some of the key elements required for revalidation to work are not in place, and GP leaders are beginning to question whether they ever will be.

Some senior GPs are privately beginning to question whether the Government – whether Labour or Tory – will be able to find either the money or political will to make it happen.

Take the following two developments over the last couple of weeks.

Firstly, the BMA and RCGP submitted a letter demanding full funding of remediation for all GPs who are referred to the National Clinical Assessment Service as a result of revalidation.

GP leaders have been very careful not to spell out what would happen if that request was turned down flat. They know any threat to block scrutiny of the quality and safety of general practice might not play well with the public.

On the other hand, the GPC also realises it would be very difficult to maintain support for revalidation without substantial funding for remediation.

As one GP leader put it to me recently, without remediation, revalidation just becomes a mechanism to make it easier to strike off GPs, and where would the professional interest lie in supporting that?

The second development is also significant. A trial of revalidation in hospital doctors has, according to BMA chair Dr Hamish Meldrum, identified ‘clear concerns’ with the system.

All the fears about revalidation being a bureaucratic nightmare could just be coming true.

Now imagine a scenario where two things happen.

The Government decides it simply cannot find the cash to fund any of remediation – leaving some GPs facing five-figure bills just to get their license back.

And then, while the BMA is wobbling over whether it can maintain its support, the full pilot results of revalidation are published, and make grim reading.

In such a scenario, doctors’ leaders might surely decide that supporting revalidation was more than their jobs were worth.

And even the RCGP – which has a lot riding on making revalidation a success – realises that without the BMA, the whole system might never get off the ground.

Much depends on the wrangling over the next few months on remediation funding.

As so often is the case, it all comes down to money.

By Richard Hoey, Pulse editor