Revalidation Update

Teresa DormanAPA Linkman Meeting18th November 2013

APA education and training committee

The roll out of revalidation• Year Zero – 2012/13 (December 3rd 2012,Secretary of State sign off, Legislation, Responsible

Officers revalidate by 31st March 2013.

• Year 1 – 2013/14• Year 2 – 2014/15• Year 3 – 2015/16

• The starting gun has sounded…

Who does what in revalidation

• Appraisers appraise

• Responsible officers make recommendations• Revalidate• Defer• Failing to engage

• The GMC revalidates

Who’s who

• GMC• Revalidation Support Team(RST)

revalidation support team (RST)

the purpose of the RST is to work in partnership with the DH, GMC and designated bodies to deliver an effective system of revalidation for doctors in England

What’s what?

•ORSAorganisational readiness (OR)

the purpose of the OR project is to prepare healthcare systems and designated bodies in England for their role in delivering revalidation for doctors through appropriate training, guidance and tool.

What’s what?

•MAG

What’s what?

•MAG Form v3

Docs to read

Docs to read

Revalidation

“It is not a point in time assessment of knowledge and skills .It is a five year process not a fifth year event.”

A Tomlinson VP RCoA 2010

Revalidation Portfolio of Supporting Information

Five x annual appraisals

Responsible Officer

Cannot recommend revalidation

Query

RCoA advisor and/or GMC affiliate review

and support

General Medical Council

Recommend revalidation

Recommendations

RO can make one of 3 recommendations:• Recommendation to revalidate• Deferral• Notification of failure to engage

RecommendationsDeferral• Insufficient supporting information• Information gaps• Participation in a local or national process

– HR investigation– Performance or remediation

• New date must be within 12 months

*this does not affect the license to practice

(Responsible Officer Protocol GMC)

RecommendationsNotification of failure to engage• Confirms responsible officer cannot make informed

recommendation as the doctor hasn’t engaged• Related to insufficient information in support of

revalidationBut notification of failure to engage:• Is not a mechanism for addressing concerns about fitness

to practice• It concerns doctors who have had sufficient opportunity

and support to engage in revalidation but have failed to do so

• Is where there are no reasonable grounds for failure to engage.

GMP

• Updated March 2013• Effective 22nd April 2013• 4 Domains• Matches the framework

for appraisal and revalidation

GMP – what’s new?

• Mentoring: Structured support activities (10)Mentoring role for more junior colleagues (42)• Clinical Records (19-21)• Respond to risks to safety (24-27)• Continuity and coordination of care (44-45)• Communicating information (68-71)

GMC framework

Based on four domains

•Knowledge, skills and performance, •Safety and quality, •Communication, partnership and teamwork •Maintaining trust.

Framework

Last updated 16 March 2011 | 1

What’s new about appraisal• Doctors are appraised on the whole of their scope of work

• Clinical governance information and information arising from appraisal will be combined to enable the responsible officer to make a recommendation about revalidation to the GMC

• The doctor will have to sign off statements about significant events, complaints, probity, health, the appraisal portfolio, and GMC requirements

• The appraiser will have to sign off statements about engagement with appraisal, progress with the previous PDP and the appropriateness of the new PDP and GMC requirements

Appraisal statements• An appraisal has taken place that reflects the whole of the doctor’s

scope of work and addresses the principles and values set out in Good Medical Practice

• Appropriate supporting information has been presented in accordance with the Good Medical Practice Framework for appraisal and revalidation and this reflects the nature and scope of the doctor’s work

• A review that demonstrates progress against last year’s personal development plan has taken place

• An agreement has been reached with the doctor about a new personal development plan and any associated actions for the coming year.

• no information has been presented or discussed in the appraisal that raises a concern about the doctor’s fitness to practise.

Appraisal processI N P U T S

Personal information

Scope and nature of work

Supporting information

Review of last year’s personal

development plan

Achievements, challenges and

aspirations

Confidential appraisal discussion

O U T P U T S

Summary of appraisal

Appraiser’s statements

Doctor’s personal development plan

Post-appraisal sign-off by doctor and

appraiser

Medical Appraisal Guide, RST

Developmental

MAG form v3

•Developed by RST•Meets GMC requirements for information•Electronic•Series of PDFs – write and save•Stores appraisal history

Supporting InformationThere are six types of supporting information:

1. Continuing professional development2. Quality improvement activity3. Significant events4. Feedback from colleagues5. Feedback from patients (where applicable)6. Review of complaints and compliments

Supporting information

•General information about you and your professional work•Keeping up to date•Review of practice: quality improvement activity, significant events•Feedback on professional practice: colleague feedback, patient and carer feedback, complaints and compliments

http://www.rcoa.ac.uk/node/1951

CPDMinimum of 50 credits p.a.(250 credits in 5 years)

• internal - min 20At least 10 from clinical governance meetings

•External - min 20Mix of regional, national meetings

http://www.rcoa.ac.uk/node/1922

CPD matrix

• Guide• Not mandatory

• Not all inclusive / exclusive

• Broad range of topics

RCoA On line CPD• Personal online space to record CPD activity

and associated credits and to reflect on CPD activity

• Keeps a running total of CPD credits annually and 5 yearly for revalidation

• Reporting – summaries of CPD activity for appraisal

• Link to all CPD activities against the RCoA matrix, helps identify any gaps

Online CPD

• Can record absences e.g. maternity leave in a 5 year cycle

• The yearly CPD cycle will be set when the user logs in to the system for the 1st time. The day and month can then be selected to start the cycle from.

• All data backed up automatically• Consultants can register online on the RCoA

website.

AAGBI

learn@AAGBIPersonal CPDRecord ReflectionCertificate

30. It is your responsibility to do enough appropriate CPD to remain up to date and fit to practice in your work. This applies whether you are full time or part time

Most medical royal colleges and faculties have developed CPD systems or guidance to support doctors ....... participating in these schemes to obtain a specific number of CPD credits over 5 years.

We don’t require you to be a member of a college or faculty CPD scheme to undertake a specific number of hours of CPD each year or acquire a particular number of CPD credits. However you may find that participating in such a scheme is helpful........

GMC - Reflection

16 Reflection drives change in performance and is key to effective CPD. GMP requires you to reflect regularly on your standards of medical practice

18 You must also reflect on what you have learnt from your CPD activity......record whether your CPD has had any impact....on your performance and practice

Reflection

CPD Reflective Note Guidance and Template

www.aomrc.org.uk/component/docman/doc_download/9335-reflective-practice-template.html?Itemid=33

AoMRC

Quality improvement activityAudit cycle• Audit recipe book RCoA

Review of clinical outcomes• National standards• Individual and team practice

Case review or discussion• 2 per year• Reflect against national standards or guidelines• Evidence of discussion with peers/presentation at audit

Quality Improvement Activity

Can be done!

Significant events

• Clinical incidents• SUI

Details based on data logged on local systems or national reporting systems

Up to 2 incidents per yearAll SUIs or root cause analyses involved in

Feedback

• Colleague• Patient / carer• On practice e.g. teaching

Feedback on practice

Clinical supervision, teaching and training• Evidence of performance as clinical supervisor at

least once in cycle• Evidence that you meet the minimum training

requirements of the GMC ( accreditation of trainers)• Feedback on any formal teaching done• Deanery QA process

Feedback on practice

Formal complaints• All complaints• All areas of work not just patient complaints• Summary of issues raised AND reflection• Reflection will be the focus• Self declaration if none

Compliments and thanks!

FeedbackPatient and /or carers feedback

• comply with GMC requirements• can take a while• can use departmental information e.g. satisfaction survey

Colleague feedback•Min 1 in 5 year cycle•Year 2

Can take a while

RCoA feedback

• Piloting in 4 sites• Adults and children• User guide• Logistics guide• Facility for departments

to collate feedback

Revalidation

• 6 months: check designated body information is correct

• 4 months: formal notice that GMC requires a recommendation by your revalidation date

• 10 days: if the GMC haven’t got a recommendation they tell you

• Let you know the decision• Next date 5yrs minus one day from date the

decision is made

The First Cycle

The first cycle

• Revalidation dateIf you haven’t:• Register for GMC online account• Find you designated body RO• Contact the GMC

The first cycle

You should be:• be participating in an annual appraisal process• have completed at least one appraisal with

Good medical practice as its focus• have collected and reflected on all

six types of supporting information.

***minimum***

Read relevant documentsGMC Good Medical Practice Framework for Revalidation and AppraisalGMC Supporting Information

RST Medical Appraisal Guide v3MAG form v3

RCoA Supporting InformationRCoA Continuing Professional Development

The First Cycle

READ!!

Don’t Leave it to the last minute!

“It is not a point in time assessment of knowledge and skills .It is a five year process not a fifth year event.”

Any questions?