Revalidation

GMC Revalidation Case Study

We were one of two locum agencies selected for the GMC’s Revalidation pilot project. To view the case study on the GMC website please follow the link: http://www.gmc-uk.org/doctors/revalidation/13400.asp

Background

In August 2011, we were successful in our application to take part in an NHS Revalidation Support Team pilot to test its new Medical Appraisal Guide (MAG). We were keen to assess how well the appraisal guide would work for some of their doctors who, because of their location, were likely to find it more difficult to engage in appraisal and revalidation. RST needed around 30 locum doctors for the pilot who qualified outside of the UK and work in England.

It was decided to run the pilot with locums who live abroad and come to the UK infrequently. The group was made up of doctors with fifteen different nationalities who had qualified in some seventeen different countries - including India, Romania, South Africa and the Sudan.

The pilot began in September 2011, and prior to the pilot commencing we created a code of conduct, appointed and trained a team of appraisers, and identify a number of doctors willing to travel to the UK. We trained 7 appraisers from our senior locums as we were keen to have appraisers who understand the nature of locum work.

Challenges

One of the main challenges in the preparations for the revalidation pilot was the small number of locum doctors who had previously taken part in appraisals. At the time locum doctors were required to provide the date of their last appraisal, which was expected to have taken place in the last 12 months. However, it was estimated that more than half of new recruits that had not recently worked in the NHS had not had a recent appraisal and in many cases had never been appraised at all.

For the pilot this challenge was exacerbated as the team had no experience of medical appraisal, not being clinical staff themselves, and therefore knew they would have to seek external support to help them develop a system of appraisal for those doctors who will revalidate with the organisation.

At the time we were responsible for the revalidation of approximately 200 of the doctors in our candidate pool. However, because of the nature of their work, keeping track of the number of locum doctors who will revalidate with the organisation was a major challenge to overcome.

Results

The feedback from doctors who took part in the pilot was very positive and many found the template RST materials particularly useful in guiding them through the process of appraisal and the information they need to collect.

One of the key issues identified was that many of the locum doctors feel excluded from CPD events and as a result unable to collect the supporting information required for medical appraisal and revalidation. In response, we have adapted the list of information doctors can provide to be more flexible.

Colleague and patient feedback is one area that can be more challenging. Some doctors will not come into contact with patients very often, while others may only see them for a short space of time, such as pathologists or anaesthetists. It was discovered that provided there are procedures in place peer feedback can be collected reasonably easily.

In response, we host a variety of events with locum doctors and clients across the country. These events are open to all and aim to provide candidates with an overview of what is involved in revalidation and the support available to help them prepare. Client specific events focus on working together to find joint solutions to challenges such as patient and colleague feedback, for best practice in sharing information or concerns.

Key Findings

  • We understand the challenges that locum doctors may face in collecting supporting information and keep our arrangements as flexible as possible, such as accepting supporting information in different formats to make it simpler for doctors to demonstrate they are keeping up to date with their practice.
  • We believe the systems which are in place for revalidation and for dealing with concerns about doctors are giving our clients greater confidence in the services we provide.
  • Some doctors may find it more challenging than others to collect supporting information for appraisal. Having appraisers who have experience of these challenges or understand them is hugely important.