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Andy TomlinsonMember Revalidation Delivery Committee
Royal College of Anaesthetists
Update on revalidation and remediation
CDs meetingApril 2012
Revalidation and remediation Anticipated timetable RST, GMC and Academy updates
RCoA update: Supporting Information Remediation
Revalidation: anticipated timetable
May/June 2012 Final organisational state of readiness assessment (ORSA)
Summer 2012 Assessment of readiness and business case prepared for Ministers
Sept/Oct 2012 Ministerial decision
By end of 2012 Enablement of necessary legislation
By 31 March 2013 All ROs to have been revalidated
By 31 March 2014 At least 20% 0f doctors revalidated with all designated bodies
By 31 March 2016 All remaining doctors revalidated – i.e. approximately 40% each year
Revalidation: anticipated timetable
“In the light of the importance of this process to the quality of services delivered to patients, and of the status of the GMC as an independent regulator, the Committee looks to the GMC to give early and public notice if it concludes that delivery of this timetable is at risk.”
Health Select Committee , March 2012
Updates
Updates: RST
www.revalidationsupport.nhs.uk
www.revalidationsupport.nhs.uk/CubeCore/.uploads/RSTMAGforReval0312.pdf
Updates: GMC All doctors: confirmation of designated
body Make your connection campaign 4,000 – 40,000; estimate of possible problems! All locum agencies should be designated bodies
Colleague and patient feedback Instructions for administering GMC colleague
and patient questionnaires www.gmc-uk.org/
Instructions_for_questionnairesfinal.pdf_48334410.pdf
Updates: Academy Specialty Guidance
Helpful in pilots Greater awareness needed To be finalised end of May 2012
www.aomrc.org.uk/revalidation/item/speciality-frameworks-and-speciality-guidance.html
Specialty advice for ROs, doctors and appraisers by Royal Colleges and Faculties Formal generic training agreed
Updates: Academy RCoA, FPM and FICM Specialty Advice
Demand uncertain Uncomplicated queries dealt with by College staff Commence with a small (15-20) team of advisors
Membership to include representation from: FPM & FICM All home nations All major sub-specialties SAS grade Retired/ independent practice
Training packages currently being developed
RCoA Update: Specialty specific supporting information
www.rcoa.ac.uk/docs/Revalidation_doh_pilots.pdf
RCoA update: Specialty specific supporting information
More guidance required for:
RCoA update: Specialty specific supporting information
More guidance required for:
Outcomes Target departments
Appoint LARCs Survey all departments re outcome measurements RCoA audit recipe book may be key Join laparotomy and ♯NOF networks
Patient and Colleague feedback
Specialty feedback on professional practice
www.rcoa.ac.uk/docs/peer_patFeedback2011.pdf
Update: Specialty feedback on professional practice
www.rcoa.ac.uk/docs/REV-Statement-03.02.12.pdf
Specialty feedback on professional practice
GMC commissioned survey for feedback showed Colleague feedback straightforward
75% >14 questionnaires Patient feedback much more difficult
51% >21 questionnaires
Further work by RCoA with PLG to consider Communication skills Quality of care
Remediation
Remediation
Revalidation likely to identify increased numbers of doctors with fitness to practice issues
~ 1000 remediation cases in progress in England
2,800 (~2%) of all doctors in England subjected to investigation annually
Remediation provision will need to be enhanced & increased
DH report on remediation published Dec 2011
Remediation: what is meant?
The overall process agreed with the practitioner to redress identified aspects of underperformance. Remediation is a broad concept varying from informal agreements to carrying out some reskilling, to more formal programmes including supervised remediation and/or rehabilitation.
Remediation: DH report
Highlights lack of: consistency in how organisations tackle doctors with
performance issues clarity about where a PDP stops and remediation starts clarity as to who has responsibility for the remediation
process clarity on what constitutes acceptable clinical
competence and capability clarity about when the remediation process is complete
and successful clarity about when the doctor’s clinical capability is not
remediable capacity to deal with the remediation process
Remediation: DH report
Key recommendations: Wherever possible, performance problems including clinical
competence and capability issues, should be managed locally
Local processes need to be strengthened to try and avoid performance problems occurring and reduce their severity at the point of identification
The capacity of staff within organisations to deal with performance concerns needs to be increased with access to external expertise as required
A single organisation is required to advise and, when necessary, to co-ordinate the remediation process and case management so as to improve consistency across the service
Remediation: DH report
Key recommendations (cont’d): The medical royal colleges should produce guidance and also
provide assessment and specialist input into remediation programmes
Postgraduate deaneries and all those involved in training and assessment need to assure their assessment processes so that any problems arising during training are fully addressed
Remediation: CDs view
Survey Monkey survey: 240 individuals emailed (all four nations) 54 responses (22.5%)
General consensus that: Much should be managed locally College should be involved
‘A supportive rather than driving role’ Setting standards - consistency Providing advice on assessment and processes Help make it happen
Concerns about funding
Remediation: RAs view
From breakout session March 2012: General consensus that:
College should be involved in Setting standards and establishing framework Assessment: both advice and doing Helping make it happen – organise external
placements Training for specialty needs
Remediation: NCAS view
Response to Remediation report With 10 yrs of experience the organisation best
placed to manage process locally Has an “industry standard” in supporting the
management of performance concerns and can provide external expertise to local organisations
Expertise in working in conjunction with many other bodies during case management, including trainees
Understands funding problems
Remediation: General consensus
Preferable to identify early Ensure robust local appraisal and clinical
governance processes are in place Act on information obtained Majority should be manageable locally
Recommended