Revalidation is the process by which all licensed doctors have to demonstrate to the General Medical Council (GMC) that they are up to date and fit to practise and complying with the relevant professional standards.
If you are a doctor holding registration with a licence to practise, you must participate in revalidation to continue your licence.
The purpose of revalidation is to assure patients, employers and other healthcare professionals that licensed doctors are up-to-date and are practising to the appropriate professional standards. Revalidation is a way of regulating the medical profession that provides a focus for doctors’ efforts to maintain and improve their practice; facilitate the organisations in which doctors work to support them in keeping their practice up to date; and encourage patients and the public to provide feedback about the medical care they receive from doctors. In these ways, revalidation will contribute to the ongoing improvement in the quality of medical care delivered to patients throughout the UK. Revalidation will also serve as a process for identifying GPs, as far as is practicable, for whom there are significant concerns about their fitness to practise and to detect early signs of deteriorating performance. The RCGP works to ensure that GPs are supported at every stage during the revalidation cycle, particularly if they are experiencing difficulties.
Doctors must revalidate in order to maintain their licence to practise in the UK. The GMC is responsible for revalidating doctors and requires assurance that a doctor is up to date and fit to practise. For doctors who are not in training, revalidation is based on evaluation of your practice through appraisal. You are expected to participate in annual appraisal covering the scope of your work as a doctor over a five-year revalidation cycle, and need to collate a portfolio of required supporting information to bring to your appraisal as a basis for discussion.
The supporting information will demonstrate that you are keeping up to date and have met the requirements for Good Medical Practice. The GMC has set out its generic requirements for medical practice and appraisal in three main documents. These are supported by guidance from the medical royal colleges and faculties, which give the specialty context for the supporting information required for appraisal. • Good Medical Practice • Good Medical Practice Framework for appraisal and revalidation • Supporting information for appraisal and revalidation • Your specialty guidance on the supporting information needed for appraisal and revalidation, available at: http://www.aomrc.org.uk/revalidation/speciality-frameworks-andspeciality… You should also have regard for any guidance that your employing or contracting organisation may provide concerning local policies. Please see the Medical Appraisal Guide available from NHS England and equivalent guidance for doctors in the devolved countries.
A doctor will be recommended for revalidation to the GMC by their Responsible Officer (RO), normally every five years, based on: • information provided from the five annual appraisals • a completed portfolio of supporting information • an absence of concerns about their practice raised through local clinical governance routes.
An RO will be able to make one of three statements to the GMC:
1. That the doctor is up to date, fit to practise and should be revalidated
2. That the recommendation should be deferred while more information is obtained – for example where a doctor has taken a career break
3. That the doctor has failed to engage with any of the local systems of processes (such as appraisal) that support revalidation. In the last case the doctor will be referred to a fitness to practise (FtP) panel of the GMC for consideration of whether the licence to practise should be revoked. It is only the GMC that can give or remove the licence to practise. Please note that if there were concerns arising about the doctor’s fitness to practise at any time preceding the revalidation date, those concerns should be raised with the GMC formally or informally – and this should take place at the time concerns arise, and not at the revalidation date. Revalidation is not about ‘pass or fail’; it is a supportive and developmental process designed to provide assurance about a doctor’s fitness to practise, and will enable doctors to identify areas for improvement at an early stage within a structured approach to personal development. These areas should be addressed at appraisal through the Personal Development Plan each year.
No. Revalidation is required only to maintain a licence to practise in the UK . It is not required to maintain GMC registration. There is an option for doctors in some situations (e.g. working abroad) to relinquish their licence to practise (and therefore not revalidate), but remain registered with the GMC and maintain their entry in the generalist or specialist register. This provides confirmation that their qualifications have been recognised and that they are in good standing with the GMC.
Licences can be reinstated if circumstances change. The generalist and specialist registers are historical documents which record the specialties in which you have trained. If you no longer work in the specialty for which you were originally listed on the register you will not lose your registration if your revalidation is based on supporting information from practice in another field. Revalidation is not about demonstrating that you are up to date in that registered specialty (in which you trained), but that you are up to date and fit to practise in your current fields and across your scope of work. As a specialist or generalist, you will need to continue to meet the existing requirements and this will be evident through the detail of the supporting information that you provide at appraisal.
Key Things to do now:
• Ensure that you have a responsible officer – if not, inform the GMC • Ensure that your annual appraisals are conducted properly with Good Medical Practice as their focus
• Use an electronic portfolio or a Medical Appraisal Guide (MAG) to collect your supporting information for appraisal and revalidation
• Record your continuing professional development (CPD) and Personal Development Plan (PDP) objectives and outcomes
• If you haven’t participated in a Patient and/or or Colleague Feedback survey that is relevant to your current scope of practice within the five year period prior to your first revalidation date, plan to do them
• Ensure that you are participating in annual quality improvement activity, providing significant event analyses or individual case reviews, case discussions, audits etc. each year
You should speak to your responsible officer. They will need to be convinced that the reasons for changing your revalidation date are justifiable. In some circumstances, a responsible officer can recommend that a doctor’s revalidation date is deferred, usually by up to one year.
All doctors should have received their first revalidation date from the GMC. A further GMC notification will be sent to doctors four months prior to the date their recommendation is due.
For practising doctors, the answer is “no”. That is because revalidation is about what doctors do in their actual practice. In most cases, an examination would not tell us about this. Instead, revalidation is based on annual appraisal covering the scope of your work as a doctor. It will require you to show, within the context of your practice, that you are meeting the appropriate professional standards.
It is anticipated that the vast majority of Drs will meet the standards required for revalidation. Some may do so after local support and remediation. For those Drs who do not meet the standards of revalidation, the GMC will assess them through its fitness to practise processes before their licence is put at risk. Support for Drs will be available throughout the revalidation cycle.
You would need to re-activate your licence with the GMC. More information about this process can be found here http://www.gmc-uk.org/doctors/registration_applications/restoration.asp. You would then need to establish a connection with a UK designated body and (if working in the NHS) gain entry onto a performers list.
Doctors working in the UK without a connection to a designated body will need to find a ‘suitable person’ to make their revalidation recommendation to the GMC. A ‘suitable person’ is licensed doctor with GMC approval to make a revalidation recommendation. Information on this route to revalidation is available from the GMC website http://www.gmcuk.org/doctors/revalidation/20386.asp If you do not have a designated body and cannot find a suitable person to make a revalidation recommendation you will have to provide the GMC with evidence that you are up to date and fit to practise. Further information on this route to revalidation is also available from the GMC website http://www.gmc-uk.org/doctors/revalidation/23523.asp
Once you have confirmed your prescribed connection with a designated body, your DB or your Responsible Officer (RO) should advise you on how to access an appraisal, and should ensure that adequate systems are in place in your organisation.
Information about appraisal is confidential and only those with a legitimate right should access it. In addition to your appraiser, this might include your appraisal lead, responsible officer and the GMC – as well primary care organisation (PCO) or Designated Body officers for administrative purposes, who should process that information in accordance with the Data Protection Act 1998.
The NHS England Medical Appraisal Guide states that the “confidential appraisal discussion remains at the heart of every effective appraisal process. The appraiser is in a unique position to support, guide and constructively challenge the doctor, having reviewed the supporting information and commentary provided.” However, the document goes on to say that “confidentiality is not absolute….and in a similar way to the doctor-patient relationship in a consultation, there will be situations in which the appraiser is obliged to share information gained in the appraisal discussion. This would clearly be the case should patient safety issues be identified. The appraiser should always act in a professional manner and should follow published local procedures where they exist. When in doubt the appraiser or the doctor may wish to discuss this with the appraisal lead, responsible officer or nominated deputy.”
You should speak to your RO if you wish to enquire whether you can keep an existing appraiser. It is recommended that Drs do not have the same appraiser for more than three consecutive years.
It is unlikely that you will have free rein to choose your appraiser. ROs are obliged to ensure that there are sufficient numbers of trained appraisers in place in their organisation, and that those appraisers have completed the training prescribed by the NHS Revalidation Support Team (or equivalent organisation). To satisfy themselves that you have an appraisal of the required standard for revalidation, your RO will ensure you are allocated an appraiser who has been through the necessary training. This fits with their obligations and responsibilities to quality-assure appraisal within their organisation.
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