Revalidation Update
Teresa Dorman
APA Linkman Meeting
18th 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?
•ORSA
organisational 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
Recommend
revalidation
Query
Cannot recommend
revalidation
RCoA advisor and/or
GMC affiliate review
and support
General Medical Council
Recommendations
RO can make one of 3 recommendations:
• Recommendation to revalidate
• Deferral
• Notification of failure to engage
Recommendations
Deferral
• 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)
Recommendations
Notification of failure to engage
• Confirms responsible officer cannot make informed
recommendation as the doctor hasn’t engaged
• Related to insufficient information in support of
revalidation
But 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 process
INPUTS
Personal
information
OUTPUTS
Scope and nature of
work
Supporting
information
Review of last year’s
personal
development plan
Achievements,
challenges and
aspirations
Doctor’s personal
development plan
Confidential
appraisal discussion
Summary of
appraisal
Post-appraisal signoff by doctor and
appraiser
Appraiser’s
statements
Medical Appraisal
Guide, RST
MAG form v3
•Developed by RST
•Meets GMC requirements for
information
•Electronic
•Series of PDFs – write and
save
•Stores appraisal history
Supporting Information
There are six types of supporting
information:
1. Continuing professional
development
2. Quality improvement activity
3. Significant events
4. Feedback from colleagues
5. 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
CPD
Minimum of 50 credits p.a.
(250 credits in 5 years)
• internal - min 20
At least 10 from clinical
governance meetings
•External - min 20
Mix 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@AAGBI
Personal CPD
Record
Reflection
Certificate
30. It is your responsibility to do
Most medical royal colleges and faculties
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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/9335reflective-practice-template.html?Itemid=33
AoMRC
Quality improvement activity
Audit 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 year
All 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!
Feedback
Patient and /or carers feedback
• comply with GMC
requirements
•Can
can take
a while
take
a while
• can use departmental
information e.g. satisfaction
survey
Colleague feedback
•Min 1 in 5 year cycle
•Year 2
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 date
If 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 documents
GMC Good Medical Practice Framework for
Revalidation and Appraisal
GMC Supporting Information
RST Medical Appraisal Guide v3
MAG form v3
RCoA Supporting Information
RCoA 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?