This blog is a word to word account from Sir Keith Pearson’s report on the medical revalidation model for UK doctors. It specifically clarifies what an appraisal/revalidation is not.
• Revalidation does not exist solely to identify poor performance.
Revalidation does have a vital role to play in helping to identify concerns about a doctor’s practice at an early stage, before they escalate. It can and should deal with poor behaviour and performance. However, contrary to a commonly repeated myth, it was never intended to ‘catch another Shipman’. Shipman was a serial killer responsible for the deaths of more than 200 people. He was also a family GP. Much has been said about whether he would have been caught earlier if revalidation had been in place. It is impossible to say for certain, but my view is that the array of governance changes put in place since Shipman, including those established as part of revalidation, makes it much more likely that his behaviour would have been detected earlier. Alongside revalidation, these include: changes to the death certification process and coroners system; safer management of controlled drugs; closer monitoring of prescribing data, mortality rates and unexpected deaths; guidance for police officers carrying out investigations into unexpected death or serious harm of patients following medical treatment; improved approaches to investigating complaints and concerns; and inspections of GP practices. Moreover, Good medical practice places an obligation on doctors to report concerns about colleagues who may not be fit to practise and may be putting patients at risk.
• Revalidation is not a complaints process.
Revalidation is not another route for patients to make complaints about a doctor. However, complaints are an important source of information for doctors to use to identify improvements to their practice. When a complaint is made, it goes into the complaints system of the organisation. It is also captured as evidence in the review of the doctor’s performance in their whole practice appraisal every year. Some organisations publish all of the complaints they receive on their website and explain how they dealt with them.
• Revalidation is not the whole system of assurance.
It is one, but only one, important part of a system of assurance in a safety critical industry. There are many processes involved in delivering safe and effective patient care, and numerous organisations responsible for setting standards, monitoring and quality assuring various aspects of healthcare provision in the UK.
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