Revalidation for public health doctors

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Revalidation for public health doctors

• Jean Chapple
• Westminster PCT
• Faculty of Public Health Medicine

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What is revalidation?

• Revalidation is the regular demonstration by
  doctors that they remain fit to practise.

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Why revalidate?

• For patients and the public-
• Will protect public from poorly performing
  doctors - who will be identified as early as
  possible.
• Will promote good medical practice.
• Will increase public confidence in doctors.

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Why revalidate?

• For doctors-
• Will help conscientious doctors to show that they
  are giving good medical care, and support them to
  become even better.
• Will enable doctors to correct weaknesses in
  their practice safely and promptly in a
  supportive environment.
• Will protect doctors from unfounded criticisms of
  their fitness to practise.

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Why revalidate ?

• For employers
• Will provide the assurance and protection that
  will flow from knowing that the doctors they
  employ are fit to practise.

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The principles of revalidation

• Effective
• Reflective of a doctor's actual practice against
  national standards.
• Transparent and comprehensive
• Thorough
• Proportionate
• Fair, non-discriminatory, and consistent.
• Verifiable

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Who will need to revalidate?

• Revalidation will be a requirement for all
  doctors wherever they work
• NHS, academic departments, public companies,
  self-employed
• and whichever type of post they hold
  consultant, principal in general practice,
  training post, locum etc.

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What does revalidation mean for practice?

• Revalidated doctor will retain the FULL rights of
  a doctor, even if they seldom prescribe or sign
  certificates.
• BUT must be in context of the GMC good practice
  guidelines (for example, doctors should avoid
  treating themselves or close family members.)
• AND will also be bound by the duties of a doctor
  (for example, a doctor must offer anyone at risk
  the assistance the doctor could reasonably be
  expected to provide in emergency, wherever it may
  arise)

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What practice needs revalidation?

• Doctors will be required to revalidate for all
  areas of their practice, not just the part in
  which they spend the majority of their time.
• Revalidation is not an attempt to make doctors go
  back to basic training and take examinations
  again.

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How can a doctor prepare for revalidation?

• Two key tools for revalidation
• Continuing professional development (CPD)
• Appraisal

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How can a doctor prepare for revalidation?

• Appraisal is concerned with the doctors
  professional development within his or her
  working environment and the needs of the
  organisation for which the doctor works.
• Revalidation involves an assessment against
  standards of fitness to practise.

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Good portfolios include

• Summaries which reflect a robust appraisal
  discussion
• Detailed job plans with specified outcomes
• Details of activities, work load and feedback
  from colleagues and patients
• 360 degree feedback

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360 degree appraisalKing J. BMJ 2002324S195
( 22 June )
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GMC pilot concluded-

• When appraisal documentation is complete and
  contains a summary which reflects a robust
  appraisal discussion, it is adequate for
  revalidation without reference to the
  underpinning evidence
• Robust underpinning evidence within the appraisal
  documentation across the headings of Good Medical
  Practice gives a clear insight into the doctors
  performance and can be adequate for revalidation

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How will the GMC run revalidation?

• Doctors will be asked to send the GMC a copy of
  their revalidation portfolio every five years

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When will revalidation start?

• Doctors will be asked to collect information for
  revalidation as soon as the primary legislation
  is amended (end 2003).
• First revalidation groups scheduled to start by
  the end of 2005.
• Aim for one fifth of doctors to be revalidated by
  the end of 2005, with all doctors having
  undergone the process by 2009.

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Useful web sites

• Departments of Health and GMC collaborative
  websites
• www.appraisaluk.info and www.revalidationuk.info
• For information on appraisal
• http//www.doh.gov.uk/nhsexec/consultantappraisal/
  
• For standards in medical management
• http//bamm.co.uk/awf/index.php?id335

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GMC Portfolio

• Section 1 Your personal and registration details
• Section 2 What you do.
• Section 3 Information about your practice
• Good professional practice
• Maintaining good medical practice
• Relations with patients
• Working with colleagues
• Teaching and training
• Honesty
• Health
• Section 4 Appraisal
• General declaration (health and probity)

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GMC Portfolio SECTION 2 WHAT YOU DO

• For all work you do (including any clinical
  sessions outside your public health post) you
  should include-
• Your job plan including-
• Obligatory professional requirements
• Teaching commitments
• Non fixed session commitments, including
  emergency, administrative, research and on-call
• Management roles and functions
• Details of any private practice undertaken

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GMC Portfolio SECTION 3 INFORMATION ABOUT YOUR
PRACTICE

• A public health doctor must
• practise good standards of public health in the
  ten key areas of public health practice
• make sure that individuals and communities are
  not put at risk
• work within the limits of their professional
  competence.

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GMC Portfolio SECTION 3 INFORMATION ABOUT YOUR
PRACTICE

• In your work you must
• keep clear, accurate and contemporaneous records
  which report the relevant findings, the decisions
  made, the information given to colleagues/the
  public
• keep colleagues well informed when working in
  partnership
• pay due regard to efficacy and the use of
  resources
• advise only the course of action which best
  serves the populations needs.

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You might want to include-

• Reports and papers you have written
• Minutes of meetings with professional and lay
  groups
• Evidence or your participation in consultation
  exercises
• Examples of your record keeping, memos etc
• Details of any particularly relevant work such
  involvement in the production of papers,
  articles, guidelines, protocols, instigation of
  new services etc.
• Evidence of any resource shortfalls which may
  have compromised the health of individuals or
  communities

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You might want to include-

• Reflective practice
• Records of how results of audit have resulted in
  changes to practice
• Record of attendance and contributions to local
  departmental meetings
• Record of attendance at conferences etc.
• A list of membership of professional societies

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Relations with individuals, communities and
colleagues

• You may wish to include-
• Examples of correspondence about complaints or
  difficulties from members of the public or lay
  groups
• Brief details of look back exercises
• Brief examples of arrangements you have made for
  clinical governance
• Examples of patient and community information
  literature you have written

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Teaching and training

• You may wish to include-
• Brief description of teaching and training
  activity
• Courses attended such as Training the Trainers
• Brief description of supervision or mentoring
  duties
• Methods employed for teaching public health
  examples of lecture notes etc
• Recorded feedback and evaluations from those
  taught or trained

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Health and probity

• Self certification