Andy Tomlinson Revalidation Lead Royal College of Anaesthetists

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Revalidation update and the new CPD matrix . Andy Tomlinson Revalidation Lead Royal College of Anaesthetists. AAGBI Congress Edinburgh 2011. Revalidation: Why ?. Revalidation update and the CPD matrix . What is revalidation? Medical appraisal Supporting Information - PowerPoint PPT Presentation

Text of Andy Tomlinson Revalidation Lead Royal College of Anaesthetists

Revalidation and anaesthesia

Andy TomlinsonRevalidation LeadRoyal College of Anaesthetists

Revalidation update and the new CPD matrix AAGBI Congress Edinburgh 20111Revalidation: Why?

Before starting, it is worth recalling why revalidation was demanded AND how long it has taken us to get to where we are today.

Indeed the GMC were a long way towards producing guidance on the requirements for revalidation when Dame Janet Smiths was asked to review the Shipman case and this torpedoed their efforts and it had to start again. Her 5th Report Safeguarding Patients: Lessons from the Past Proposals for the Future wasnt published until Dec 2004 - this when the impetus for Reval recommenced once again and the CMOs report was published following this.

We are still some way off the implementation of a revalidation process. Personally I believe that, whilst recognizing that it is essential that we have a workable system in place, it is essential that we do not delay further2Revalidation update and the CPD matrix What is revalidation?Medical appraisalSupporting InformationContinuing professional development and the matrixWhat should you be doing now?So what am I going to cover3What is Revalidation?A new process to assure patients, the public, employers and other healthcare practitioners that licensed doctors are up to date and fit to practise.

Revalidation: The Way AheadGMC Consultation PaperMarch 2010

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Revalidation..is a continuing cycle Strengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalStrengthened appraisalOne revalidation cycle Another revalidation cycle..for each/every professional lifetimeTo emphasise the on-going commitment5Revalidation modelPortfolio of Supporting InformationFive x yearly appraisals Responsible OfficerCannot recommend revalidationQueryRCoA adviser and/or GMC ELA review and supportGeneral Medical Council Recommend revalidationThis outlines the process of collecting supporting information which feeds into the annual appraisal. Annual appraisal summary/Form 4 will then be available for the RO to review.6Revalidation.is coming to us all In 2012 provided: Responsible Officers appointedEffective clinical governance systems in placeEffective annual medical appraisalAgreed core supporting informationAgreed strategy for remediation

Andrew Lansley [SoS for Health]7Revalidation for Doctors: Health Committee Must ensure:Implemented by 2012Consistency of appraisalAdministrative burden placed on doctors not excessivePatient and colleague feedback is embedded

HC 5578th February 2011

More work needed.but HAS to be implemented in 20128AppraisalDiscussion/constructive dialogue at the heart of appraisalKey appraiser skillsSupport, guide, challenge (constructively)Based on supporting informationBalanceAssessment (Revalidation)Support (Personal development)Recognise/respond to patient safety concerns

AppraisalCurrent best practiceClinical and non-clinical aspects mapped to GMPCPD reviewed againstCore topics Job planMatching of job plan to Trust needsIncreased use of MSFPDP taking account of the above

Chris Dodds slide to try and demonstrate the differences, which I think works well.MSF, and separately patient feedback where appropriate [at present not considered appropriate for anaesthetists]That in red is trying to differentiate between now and the future10AppraisalCurrent best practiceClinical and non-clinical aspects mapped to GMPCPD reviewed againstCore topics Job planMatch job plan to Trust needsIncreased use of MSFPDP taking account of the above

Appraisal for revalidation Whole practice referenced to four domains of GMPJudgements on:Adequacy of supporting information including:CPDQuality of practiceLearning from complaintsMSFClinical risks/safetyProgress towards revalidationMatch job plan to Trust needsPDP taking account of the aboveThe areas in Bold/Italics identify the major additions.Important points to stress are the Judgements, especially around adequacy of supporting information, clinical risk/safety issues and ability to assess overall progress towards revalidation 11GMC Good Medical Practice Framework

www.gmc-uk.org/GMP_framework_for_appraisal_and_revalidation.pdf_41326960.pdfGood Medical Practice FrameworkMust be used by individual doctors to:

Reflect on practice/approach to medicineReflect on Supporting Information and what it demonstratesIdentify areas for improvement/further developmentDemonstrate they are up to date and fit to practise

You should use the Framework to:reflect on your practice and your approach to medicinereflect on the supporting information you have gathered and what that information demonstrates about your practiceidentify areas of practice where you could make improvements or could undertake further developmentdemonstrate that you are up to date and fit to practise

13 Supporting information www.gmc-uk.org/Supporting_information__2_.pdf_39974163.pdf

Core supporting informationInformation that all doctors should provide

Core supporting information Information that all doctors should provideGeneral informationProviding context about your whole practiceKeeping up to dateMaintaining/enhancing quality of professional workReview of practiceEvaluating the quality of your practiceFeedback on professional practiceHow quality of professional practice is perceived by others

Note removed the word clinical from Review of Practice, as this holds equally for the few doctors who may have no clinical practice [e.g. full time medical managers/academics].16 Core supporting information Information that all doctors should provideGeneral informationProviding context about your whole practiceKeeping up to dateMaintaining/enhancing quality of professional workReview of practiceEvaluating the quality of your practiceFeedback on professional practiceHow quality of professional practice is perceived by others

Specialty specific advice addedNote removed the word clinical from Review of Practice, as this holds equally for the few doctors who may have no clinical practice [e.g. full time medical managers/academics].17Specialty specific supporting information

Supporting Information:Feedback on professional practicewww.gmc-uk.org/Colleague_and_patient_questionnaires.pdf_41683779.pdf

Specialty feedback on professional practice

www.rcoa.ac.uk/docs/peer_patFeedback2011.pdfWorking Party report20Supporting Information: CPD

www.rcoa.ac.uk/docs/CPD_2010.pdfCPD Matrix (Clinical)Three levels:

Level OneRestricted area of essential knowledgeLevel Two (Knowledge and skills)Directly related to on-call activityLevel Three (Knowledge and skills)Directly related to special interest clinical activitywww.rcoa.ac.uk/docs/CPD_2010.pdf

THE CONCEPT OF THREE LEVELS is retained, though it looks very different from the original plan Note this is different from other specialties they only have Two Levels. Because of what we cover on call.Level Two:Unit specificDirectly related to on-call commitments not in job-planned service deliveryAble to rescue a colleague in difficultyAble to provide anaesthesia for patients too complex for more inexperienced colleaguesTherefore knowledge and skills

Level Three:ExpertiseState-of-the-art skills and knowledgeAble to support consultant colleagues with their most complex casesUsually accessible from specialist society meetings

22(New) CPD Matrix: level one (L1)Level 1 covers the core knowledge areas expected of all those who have trained as anaesthetists. The CPD evidence for this level will be largely internal and may be obtained from reviews/reflection of personal clinical practice utilising records of clinical activity, e-learning material, reading and local hospital departmental meetings. Final sentence in the preamble states: Every item included in this level of the matrix must be completed in each Revalidation cycle (there are 30 in total, which equates to 6 per year, although some may be included in local mandatory requirements more frequently).23(New) CPD Matrix: level one (L1)A. Scientific principlesB. Emergency Mx and resuscitationC. Airway MxD. Pain medicineE. Patient safetyF. Legal aspectsG. IT skillsH. Education & trainingI. Health MxPhysiology and biochemistryAnaphylaxisAirway assessmentAssessment of acute painInfection controlConsentUse of patient record systemsRoles and responsibilities of clinical supervisorsCritical incident reportingPharmacology and therapeuticsCant intubate cant ventilateBasic airway MxMx of acute painLevel 2 child protection trainingMental capacity & deprivation of liberty safeguardsBasic search methodologyPersonal education and learningTeam leadership & resource MxPhysics and clinical measurementBLS (all ages and special situations)Protection of vulnerable adultsData protectionHuman factors in anaesthetic practiceALS relevant to practice

Blood product checking [to comply with local requirements]Equality and diversityUnderstanding the process of dealing with complaintsProphylaxis & management of VTEEthicsQuality improvement(New) CPD Matrix: level two (L2)Level 2 CPD topics should reflect the whole of the individuals clinical practice including on-call responsibilities in non-specialist centres. The CPD evidence for this level may be provided, in part, by updates from local experts but it will also include the need for more external CPD activity through attendance at courses and meetings.Final sentence in the preamble states: Every item included in this level of the matrix must be completed in each Revalidation cycle (there are 30 in total, which equates to 6 per year, although some may be included in local mandatory requirements more frequently)