Upload
kateb
View
38
Download
1
Tags:
Embed Size (px)
DESCRIPTION
The Changing Face of Revalidation. Ian Starke, Medical Director, Revalidation, Royal College of Physicians, London. February 28 th 2012. Overview. Revalidation – definition and process Supporting Information How medical appraisal will work The Medical Appraisal Guide Current issues - PowerPoint PPT Presentation
Citation preview
February 28th 2012
The Changing Face of Revalidation
Ian Starke,Medical Director, Revalidation,Royal College of Physicians, London
Overview
• Revalidation – definition and process• Supporting Information• How medical appraisal will work• The Medical Appraisal Guide• Current issues• Timetable for revalidation.
What is Revalidation?
• Revalidation is the means by which, every five years, licensed doctors will demonstrate that they remain up to date and fit to practice.
• The purpose of revalidation is to assure patients and the public, employers and other healthcare professionals that this is so.
The Revalidation Process
The Revalidation Process
Annual appraisal
Supporting information
ResponsibleOfficer
X 5
PersonalDevelopment
PlanCPD
Recommendationto GMC
The Revalidation Process
Annual appraisal
Supporting information
ResponsibleOfficer
X 5
PersonalDevelopment
PlanCPD
Recommendationto GMC
ClinicalGovernanceinformation
The Revalidation Process
Annual appraisal
Supporting information
ResponsibleOfficer
X 5
PersonalDevelopment
PlanCPD
Recommendationto GMC
ClinicalGovernanceinformation
Professional excellence.
Supporting Information.
General Information• A description of your whole practice
since your last appraisal • Record of previous appraisals• Previous PDPs and their review• Current job plan (for reference)• Probity and Health
– Self-declaration that you comply with the obligations of Good Medical Practice
Keeping up to date
• Continuing Professional Development– Minimum average of 50 hours per year– Systems and credit categories vary – Cover all areas of your professional work. – Address the agreed PDP objectives
Review of your practice – 1
Quality Improvement Activity• Clinical Audit
– One full cycle per five years• Clinical Outcomes
– Robust, attributable and validated• Case review or discussion
– Two per year if used instead of audit
Review of your practice – 2
Significant Events• Your involvement in SUIs • Summary of clinical incidents in which you
have been involved• Emphasis on learning and practice change• Self-declaration if no such involvement
Feedback on your practice• Colleague Feedback
– Validated multi-source feedback tool• Patient Feedback
– Validated patient questionnaire• Feedback on Teaching and Training• Complaints and Compliments
– Summary of all formal complaints since last appraisal,
– How managed, what was learned– Self-declaration if no complaints.
Supporting Information.
http://www.aomrc.org.uk/revalidation/revalidation-publications-and-documents/item/speciality-frameworks-and-speciality-guidance.html
How appraisal will work
The Medical Appraisal Guide (under development)
Appraisal for Revalidation• Effective appraisal and revalidation will:
– satisfy the requirements of GMP– support the doctor’s professional
development• The Responsible Officer will inform the
GMC of any concerns• Concerns should be addressed as they
arise.
Appraisal for Revalidation
Predominantly formative– Striving for professional excellence
Summative element for revalidation– Up to date and fit to practice
Different systems in UK nations– Medical Appraisal Guide – England– Scottish Online Appraisal Resource– On-line system in Wales
Purposes of Medical Appraisal
To enable doctors: • to demonstrate that they meet the principles
and values of GMP• to enhance their quality of care by planning
their professional development• to consider their own professional development
needs• to ensure that they are working productively
and in line with organisational requirements
The stages of medical appraisal
Confidentialappraisal
discussion
Review by appraiser
ofappraisalPortfolio
Other information from doctor
including; achievements, challenges and
aspirations
Review of last year’s PDP and
summary ofappraisal
Supporting Information (SI) with additional comments from
doctor
Inputs Outputs
Doctor’s PDP
Summary of appraisal discussion
Appraiser’s statements
Post appraisal
sign off bydoctor andappraiser
Description of the doctor’s
scope of work
The stages of medical appraisal
Appraiser’s Statements - 1These should confirm that:• Appraisal has taken place, reflects the scope of work,
and addresses the principles and values of GMP• Appropriate SI has been presented according to the
GMP Framework, and this reflects the nature and scope of the doctor’s work
• Appropriate progress against last year’s PDP has taken place
• Agreement has been reached about a new PDP and any associated actions for the coming year.
Appraiser’s Statements - 2• “I understand that I must protect patients from risk of
harm posed by another colleague’s conduct, performance or health. If I have concerns that a colleague may not be fit to practice, I am aware that I must take appropriate steps without delay, so that concerns are investigated and patients protected where necessary”.
• No information has been presented or discussed in the appraisal that raises a concern about the doctor’s fitness to practice.
Tools for Revalidation
Tools for revalidation• MSF colleague and patient questionnaires
– http://www.rcplondon.ac.uk/resources/clinical-resources/revalidation-practice/multi-source-feedback-msf-colleague-and-patient-q
• Personal Clinical Audit Tool (pCAT)– www.p-cat.org.uk
• Supporting Information, guidance and FAQs on AoMRC and College websites
– http://aomrc.org.uk/revalidation.html
• Revalidation e-system – June 2012
Outstanding issues• Training, advice and support• Quality assurance• Remediation
Training• Responsible Officers
– Training provided by RST• Appraisers
– “Top-up” training by RST• Specialty advisers
– Training by Academy and Colleges– Consistency essential
• between individuals • between specialties
Advice and support
• Legal responsibility on the RO to make a recommendation
• Local advice based on written guidance and FAQs
• Otherwise routed through Colleges• NCAS and ELAs
Quality Assurance• GMC guidance [CQC, SHAs, RO networks]
http://www.gmc-uk.org/doctors/revalidation/9613.asp
• QA of RO recommendations?• RST on QA of medical appraisal
http://www.rcpsg.ac.uk/Education/Revalidation_CPD/Documents/Revalidation%20Papers%2009/NHS%20AQMAR.pdf
• RO responsible for QA of appraisal process in the organisation
Remediation and re-skilling
Academy report – Dec 2009 http://www.gmc-uk.org/Item_6e___Annex_E_AoMRC_Remediation_Report.pdf_28987523.pdf
DH (England) report – 2011 http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131814.pdf
Academy working party now set up.
Remediation: DH report• Performance problems should be managed locally
wherever possible• Local processes need to be strengthened• The capacity of staff to be increased with access
to necessary external expertise• A single organisation is required to co-ordinate• The medical Royal Colleges to provide guidance,
assessment and specialist input• Deaneries to develop their assessment processes
to address any problems arising during training.
Proposed DefinitionsRemediation: The overall process agreed with
the practitionerRe-skilling: Provision of support, training and
education to address identified needsSupervised remediation programme: A formal
programme, usually including both re-skilling and supervised clinical placement,
Rehabilitation: The process for restoring a practitioner to independent practice by managing physical or mental health problems
Remediation and re-skilling
Need for support / remediation
Personal Development Plan
RO / GMC
Directed remediation activity
Specialty expert advice
Enhanced PDP
Targeted learning
Specialty support available
Developmental PDP
Employer ‘in-house’ support
Specialty advice available
Fitness to Practice
Specialty expert advice
RO / NCASRO / Appraiser Appraiser
Summary
• Supporting information as simple as possible • SI will cover domains / attributes of GMP• CPD increasingly focussed on learning• Appraisal is the key to revalidation• Mechanisms for advice and support• Quality assurance• Remediation and re-skilling
AoMRC, RST and GMC websites
http://aomrc.org.uk/revalidation/revalidation-publications-and-documents/item/academy-reports-and-resources.html
http://www.revalidationsupport.nhs.uk/medical_appraisal_guide/draft_core.asp
http://www.gmc-uk.org/Supporting_information.pdf_42293176.pdf
http://www.gmc-uk.org/doctors/revalidation.asp