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What is the GMC?13. The GMC is the independent regulator for doctors in the UK. Our
purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine
a. By controlling entry to and maintaining the list of registered and licensed medical Practitioners
b. By setting the educational standards for medical school
c. By determining the principles and values that underpin Good Medical Practice
d. By taking firm but fair action against doctors’ registration where the standards of Good Medical Practice have not been met
What is revalidation?
14. The purpose of revalidation is to assure patients and the public, employers and other healthcare professionals that licensed doctors are up to date and are practising to the appropriate professional standards.
Although it is widely understood that the delivery of medical care to patients will always involve an element of risk, revalidation will help doctors, employers and the GMC to provide further assurance to patients and the public that doctors working in the UK are fit to practise.
What will happen?
5-year cycle Based on annual appraisal Performance against
professional standards from GMC and Royal College
Clinical governance information Paper based exercise for majority Decision by Trust’s Responsible Officer
Producing the evidence
Too many standards for individual evidence! Reduced to 4 domains:
Knowledge, skills and performance Safety and quality Communication, partnership and teamwork Maintaining trust
Each domain has attributes
Collating the evidence
Portfolio for appraisal
Electronic appraisal/revalidation pilots
MUST START NOW!!
To what standard?
Independent evidence where possible
Triangulation important, avoid multiple use
Enough evidence to make a judgement
Much more reflective practice
Standard of evidence
Mapped to domains and attributes
Self assessment of evidence and practice
Appraiser assessment of evidence and practice
All domains/attributes covered over 5 years
What tools do I have…? (Very similar to trainee requirements) Patient feedback) 1 per 5 yrs + Colleague feedback (MSF/360)) before
Y3
Personal Development Plan every yr CPD record incl reflective notes* every yr Significant events) 2 per yr Case reviews) Audit data 1 per yr* Now includes electronic recording and GMP domains
And……
Complaints (all) every yr Teamwork e.g. peer review meetings, audit
meetings Performance data every yr Job plan every yr Probity (self declaration) every yr Health (self declaration) every yr Teaching
What do I need to do?
Continue with usual appraisal, but make sure evidence is more robust
Are you registered somewhere for CPD? If not, are you collecting evidence?
Worked example:case review Learning point from clinical practice
Identified learning need (DEN)
How I will meet that learning need
Microsoft Word Document
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice √ Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice √ Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively √
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Colleague and patient feedback Trusts will have to set up systems GMC will define standards but not stipulate
providers RCPCH piloted tool with peer comparison WUTH using commercial company Patients
Usually recommend minimum of 20 or so for analysis
Will child feedback be addressed?
Worked example:patient feedback Participated in RCPCH pilot 1st patient feedback since 2003
Different attributes Peer comparison
Reflection on results
Adobe Acrobat DocumentAdobe Acrobat
Document
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients √
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients √
Maintaining trust Show respect for patients √ Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Aide memoire
Knowledge, skills and performance Maintain your professional
performance √ Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients √
Maintaining trust Show respect for patients √ Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Colleague multisource feedback (MSF/360)
Provides the opportunity for non-medical co-workers medical colleagues (including trainees and
juniors) to reflect on the professional skills and
behaviour of a doctor
Colleague multisource feedback (MSF/360)Suggestions for community paediatricians Require 1 per 5 year cycle, 1st before Y3
If working in isolated situation might wish to consider doing more
Usually recommend minimum of 11 or so replies for analysis
Questionnaires need to comply with guidance issued by GMC
Adobe Acrobat Document
Who should I ask?Suggestions for community paediatricians
Clinical colleagues Medical
Consultant colleagues SAS/trainees CD/lead clinician
Nursing Therapists
Non-clinical A&C staff Secretary Head teachers/SENCOs Ed Psych Social care
If statutory role Senior managers in
CYPD, HPA, PCT
Worked example:teaching/training Devised a ‘return to work’ programme for UK-
trained comm paed returning to UK practice after 10-yr break
Evidence Anonymised copy of programme Comments from NCAS on programme
Aide memoire
Knowledge, skills and performance Maintain your professional
performance Apply knowledge and
experience to practice Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care √
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively √
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity
Other possibilities for teaching/training GMC/PMETB annual trainee survey
Dept results Deanery quality assurance Feedback forms from teaching/training
activity Example of a presentation, e-learning
material prepared
Worked example:performance Very little official performance data Clinic numbers compared with hospital peers
so hard to interpret MDTs, CP etc not counted electronically Evidence
Use diary to collect information on MDTs
Microsoft Excel Worksheet
Microsoft Word Document
Aide memoire
Knowledge, skills and performance Maintain your professional
performance √ Apply knowledge and
experience to practice √ Keep clear, accurate and
legible records Safety and quality
Put into effect systems to protect patients and improve care √
Respond to risks to safety Protect patients and colleagues
from any risk posed by your health
Communication, partnership and teamwork Communicate effectively Work constructively with
colleagues and delegate effectively
Establish and maintain partnerships with patients
Maintaining trust Show respect for patients Treat patients and colleagues
fairly and without discrimination Act with honesty and integrity √
Worked example: record keeping GMC standard
3(f) Keep clear, accurate and legible records, reporting the relevant clinical findings, the decisions made, the information given to patients, and any drugs prescribed or other investigation or treatment
3(g) Make records at the same time as the events you are recording or as soon as possible afterwards
51 When you refer a patient, you should provide all relevant information about the patient, including their medical history and current condition
What evidence might be available?
Medical record audits CP peer review SEN(M) reports compliance with code of practice Anonymised letters to patients/colleagues Colleague MSF Any comments received from colleagues on
quality of records/letters SAIL instrument Copying letters to patients (NHS standard)