Andy TomlinsonRevalidation Lead
Royal College of Anaesthetists
Revalidation update and the new CPD matrix
AAGBI Congress Edinburgh 2011
Revalidation: Why?
Revalidation update and the CPD matrix
What is revalidation? Medical appraisal Supporting Information Continuing professional development and
the matrix What should you be doing now?
What 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 Paper
March 2010
Revalidation…..is a continuing cycle
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
Strengthened appraisal
One revalidation cycle
Another revalidatio
n cycle …..for each/every professional lifetime
Revalidation model
Portfolio of Supporting Information
Five x yearly appraisals
Responsible Officer
Cannot recommend revalidation
Query
RCoA adviser and/or GMC ELA review and
support
General Medical Council
Recommend revalidation
Revalidation….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
Revalidation for Doctors: Health Committee
Must ensure: Implemented by 2012 Consistency of appraisal Administrative burden placed on doctors not
excessive Patient and colleague feedback is embedded
HC 5578th February 2011
Appraisal
Discussion/constructive dialogue at the heart of appraisal
Key appraiser skills Support, guide, challenge (constructively)
Based on supporting information Balance
Assessment (Revalidation) Support (Personal development)
Recognise/respond to patient safety concerns
AppraisalCurrent best practice Clinical and non-clinical
aspects mapped to GMP CPD reviewed against
Core topics Job plan
Matching of job plan to Trust needs
Increased use of MSF PDP taking account of the
above
AppraisalCurrent best practice Clinical and non-clinical
aspects mapped to GMP CPD reviewed against
Core topics Job plan
Match job plan to Trust needs
Increased use of MSF PDP taking account of the
above
Appraisal for revalidation ‘Whole practice’
referenced to four domains of GMP
Judgements on: Adequacy of supporting
information including: CPD Quality of practice Learning from complaints MSF
Clinical risks/safety Progress towards
revalidation Match job plan to Trust
needs PDP taking account of the
above
GMC Good Medical Practice Framework
www.gmc-uk.org/GMP_framework_for_appraisal_and_revalidation.pdf_41326960.pdf
Good Medical Practice Framework
Must be used by individual doctors to:
Reflect on practice/approach to medicine Reflect on Supporting Information and what it
demonstrates Identify areas for improvement/further
development Demonstrate they are ‘up to date and fit to
practise’
Supporting information
www.gmc-uk.org/Supporting_information__2_.pdf_39974163.pdf
Core supporting information
Information that all doctors should provide
Core supporting information
Information that all doctors should provide General information
Providing context about your ‘whole’ practice Keeping up to date
Maintaining/enhancing quality of professional work Review of practice
Evaluating the quality of your practice Feedback on professional practice
How quality of professional practice is perceived by others
Core supporting information
Information that all doctors should provide General information
Providing context about your ‘whole’ practice Keeping up to date
Maintaining/enhancing quality of professional work Review of practice
Evaluating the quality of your practice Feedback on professional practice
How quality of professional practice is perceived by othersSpecialty specific advice
added
Specialty specific supporting information
Supporting Information:Feedback on professional practice
www.gmc-uk.org/Colleague_and_patient_questionnaires.pdf_41683779.pdf
Specialty feedback on professional practice
www.rcoa.ac.uk/docs/peer_patFeedback2011.pdf
Supporting Information: CPD
www.rcoa.ac.uk/docs/CPD_2010.pdf
CPD Matrix (Clinical)
Three levels: Level One
Restricted area of essential knowledge Level Two (Knowledge and skills)
Directly related to on-call activity Level Three (Knowledge and skills)
Directly related to special interest clinical activity
www.rcoa.ac.uk/docs/CPD_2010.pdf
(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.
(New) CPD Matrix: level one (L1)
A. Scientific principles
B. Emergency
Mx and resuscitatio
n
C. Airway Mx
D. Pain medicine
E. Patient safety
F. Legal aspects G. IT skills
H. Education &
trainingI. Health
Mx
Physiology and
biochemistry
AnaphylaxisAirway
assessment
Assessment of acute
painInfection control Consent
Use of patient record
systems
Roles and responsibilitie
s of clinical supervisors
Critical incident reporting
Pharmacology and
therapeutics
Can’t intubate
can’t ventilate
Basic airway Mx
Mx of acute pain
Level 2 child protection training
Mental capacity & deprivation of liberty
safeguards
Basic search methodolog
y
Personal education
and learning
Team leadership & resource Mx
Physics and clinical
measurement
BLS (all ages and special situations)
Protection of vulnerable
adultsData
protection
Human factors in
anaesthetic practice
ALS relevant to practice
Blood product
checking [to comply with
local requirements
]
Equality and diversity
Understanding the
process of dealing with complaints
Prophylaxis & management
of VTEEthics
Quality improvemen
t
(New) CPD Matrix: level two (L2)
Level 2 CPD topics should reflect the whole of the individual’s 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.
(New) CPD Matrix: level two (L2)A. General B. ICM C. Neuro D. Obs E. Pain
medicine F. Paeds G. Regional anaes
H. Education & training
Advanced airway Mx
Assess of the critically ill pt
Initial Mx of brain injury [traumatic
or intracranial haemorrha
ge]
Analgesia for labour
Advanced Mx of peri-op pain
Assess & Mx of the critically ill
child
Indications, benefits and risks of RA
Work-place based assess
Assess & initial Mx of major trauma (and
burns)
Initiation and Mx of
ventilatory support
GA for elective/emergency LSCS
Mx of acute non-surgical
pain
Perioperative care of children
Educational supervisor
training
Pre-op assess and preparation
for surgery
Support of threatened and failing
organs
Initial Mx of pts with spinal
injuries
RA for elective/emergency LSCS
Basic assess & Mx of chronic
pain
Vascular access techniques
Principles of performing
local, regional and neuraxial
techniquesPeri-op emergencies
Diagnosis & Mx of shock, inf & sepsis
Mx of pts with neuro trauma for
imaging
Complications of RA in
obs
Fluid Mx for children
Advanced pt monitoring techniques
Sedation in ICU
Mx of obs emergencies
Analgesia for children
Use of nerve/plexus
location techniques Fluid Mx/blood
product usageEnd of life issues &
organ donation
Assessment of critically ill
parturient
Sedation techniques for
children
Sedation for adults
Mx of the ICU Principles of newborn
resus
Team working with retrieval
teams
Recognition & Mx of side
effects and complications
of RA +others
CPD credits and activities
Minimum of 50 credits per year with some flexibility Internal
Minimum 20 credits Minimum of 10 from local clinical governance meetings
External Minimum 20 credits
RCoA encourages wide range of activities
Revalidation: What should I be doing now?
Revalidation: What should I be doing now?
Ask the following of your Trust Is there a robust appraisal process?
Sufficient “Trained” appraisers A hospital-wide appraisal development process?
Revalidation: What should I be doing now?
Ask the following of your Trust Is there a robust appraisal process?
Sufficient “Trained” appraisers A hospital-wide appraisal development process?
Is there robust Clinical Governance?
Revalidation: What should I be doing now?
Ask the following for yourself
Am I: collating/organising relevant supporting
information? developing a CPD portfolio mapped to
professional guidance? How am I involved in Quality Assurance
and Improvement?
Further advice or guidance?
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