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The Changing Regulatory Environment for Industry
SupportThe accreditation bodies’ point of view.
Ian Starke (UK)
Competing Interests
• Vice-chair Academy of Medical Royal Colleges Directors of CPD committee
• No commercial affiliations
Learning objectives
• To know about the proposals for medical revalidation in the UK
• To understand the effect that these proposals may have on the accreditation of CME/CPD activities
• To appreciate the importance of industry’s commitment to quality CME/CPD
Overview
• Medical revalidation in the UK• The medical regulator’s review of CPD• The industry regulator’s guidelines for
commercial support• The view of the accrediting bodies• An example for discussion.
Regulatory Structures in the UK
Department of Health
UK Government
General Medical Council (GMC)
Revalidation Support Team (RST)
Responsible Officer
Appraiser
Doctor
Royal Colleges (the N.A.A.)
Medical Revalidation in the UK
• Revalidation is the means by which, every five years, licensed doctors will demonstrate that they remain up to date and fit to practice (GMC 2011).
• “The more that [CPD] credits can encompass the value of the learning and not simply the time spent engaged in CPD, the more it will be valued by doctors and the better a measure it will be of their CPD activities” (CMO 2008).
The Revalidation Process
Annual appraisalSupporting
information
ResponsibleOfficer
X 5
PersonalDevelopment
PlanCPD
Recommendationto GMC
ClinicalGovernanceinformation
Professional excellence.
Lord Patel and the GMC (2010)
• The regulator should, therefore, be extremely cautious before seeking to intervene directly in CPD through application of prescriptive requirements which may add little or no value and put effective practice at risk.
• The GMC should re-examine how the regulatory role in CPD should be exercised so as to support doctors in meeting the requirements of revalidation and providing high quality care for their patients.
http://www.gmc-uk.org/Patel_review.pdf_39254211.pdf
Review of the GMC’s Role in Doctors’ CPD: final report (2011)
• A continuing learning process, outside formal undergraduate and postgraduate training, which enables doctors to maintain and improve their performance across all areas of their medical practice through the development of knowledge, skills, attitudes and behaviours.
http://www.gmc-uk.org/Final_Report_on_review_of_CPD_14_Oct_2011_web_version.pdf_448
Review of the GMC’s Role in Doctors’ CPD: final report (2011)
• GMC: – Will not dictate content of individual CPD– Will not dictate a minimum number of hours– Quality assurance of activities may be carried out
by Colleges / Faculties
• The individual is responsible for ensuring quality and value for money
• The effectiveness of the CPD activity should be discussed at appraisal.
ACADEMY STANDARDS AND CRITERIA
Draft Standards and Criteria
• Clearly defined target audience• Clearly defined learning aims / objectives• Programme has scientific or educational
content only• Delivery methods appropriate to the learning
aims• Supporting information clear and relevant
Draft Standards and Criteria
• Expertise of Faculty appropriate for the programme
• No influence or bias by commercial interests• The feedback process must include:– Whether the learning objectives were met– Presence or absence of bias
• Compliance with legislative and ethical requirements
OTHER REGULATORY ISSUES
Association of the British Pharmaceutical Industry
CODE OF PRACTICEfor the
PHARMACEUTICAL INDUSTRY2011
in association with THE PRESCRIPTION MEDICINESCODE OF PRACTICE AUTHORITY
Meetings, Hospitality and Sponsorship
• Clear educational content• Appropriate venue• Subsistence secondary to the meeting• Sponsorship clear and open• Costs similar to those the attendee would pay• Complaints may be made to the Prescription
Medicines Code of Practice Authority.• http://www.pmcpa.org.uk/files/sitecontent/
ABPI_Code_2011.pdf
Not that far apart?
• “The fact that a meeting or course has CPD approval does not mean that the arrangements are automatically acceptable under the Code” (ABPI).
• “You must not ask for or accept any inducement, gift or hospitality which may affect, or be seen to affect, the way you prescribe for, treat or refer patients” (GMC).
Summary
• Medical regulation must not mean that the regulator determines the content of CME/CPD
• The primary responsibility for keeping up to date through CME/CPD rests with the learner
• The effectiveness of CME/CPD activity should be evaluated regularly
• Industry regulators are increasingly aware of the need to avoid competing interests and bias
Thank you!