Supporting doctors through the revalidation process
Medical regulation in the UK was fundamentally changed in 2012 with the introduction of revalidation – a continued process by which “all licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practice in their chosen field and able to provide a good level of care” (General Medical Council, 2013).
Revalidation follows a five-year cycle and relies heavily on annual appraisals. These appraisals are typically organised by the GP’s employing organisation, such as their primary care practice or hospital trust (Tazzyman et al. 2019). The annual appraisal is an integral part of the revalidation process, aiming to give patients greater confidence that doctors are up to date in their area of practice, whilst giving the doctors the opportunity to reflect, improve and develop their practice (Jones, 2024). During these appraisals, doctors undergo a thorough review of their performance, receive feedback, and establish development goals. The cumulative information from these appraisals over the five-year period forms the basis for the revalidation decision, ensuring that GPs continue to meet professional standards and remain fit to practise.
Although the introduction of mandatory appraisals for revalidation provides benefits for both doctors and patients, many doctors feel as though some areas of the process can be time-consuming and an administrative burden (BMJ, 2016). With this in mind, we have identified some of the primary problems that doctors face during the revalidation process, in order to provide some reassurance that we provide ongoing support to overcome these issues.
Access to support
We are aware that doctors who are not part of a particular organisation (including locum doctors, or those who are working within a private practice) do not always have access to the support provided by an organisation or designated body (BMJ Group, 2014). At Doctor 360, we understand how important it is to feel supported when undertaking the feedback process, so our dedicated and friendly support team is always available to answer any queries by email or telephone. The Doctor 360 system also includes a ‘support materials’ area, which includes demo videos and user guides on each area of the Doctor 360 system.
A lower minimum threshold of responses
According to the BMA (British Medical Association), over 80% of locum GPs struggle to find work, which may impact their ability to provide the necessary feedback reports for appraisals. We understand that collecting feedback from our required 12 colleagues and 17 patients (although significantly lower than other providers) may not be attainable, so we have measures in place for a reduced feedback requirement for any doctors who have fewer colleagues or patients but still need to provide feedback reports for their appraisal or revalidation.
A user-friendly system
The BMA’s chair of council, Mark Porter, has highlighted that ‘too often revalidation can feel like an administrative burden’, with another commentator from a 2016 report provided by the GMC on doctors’ feedback on revalidation, stating that the process should be ‘less time consuming’ (Collins, 2016). In addition, research conducted by Julian Archer for The Health Foundation in 2014 highlighted that revalidation should not be seen as an ‘appraisal tick box’ and expressed the importance of ‘systems to help doctors collate the evidence needed’ for revalidation. In 2020, the Doctor 360 system was upgraded to our current version. It was important that the system was intuitive and provided user-friendly navigation that would make the feedback collection process as streamlined as possible.
We aim to make the process of gathering feedback for revalidation as smooth as possible. We offer a simple colleague feedback process; doctors nominate colleagues using their email addresses, and reminders can be sent, if required. The patient feedback process offers a variety of options to suit the needs of doctors and patients, including PDF or online questionnaires, and QR code functionality. Progress can be easily tracked within the system so that doctors known when the minimum requirements have been met and the reports are ready to be released.
Catering for speciality roles
Some doctors, especially those who have speciality roles (Speciality and Associate Specialist/SAS doctors), may find collecting colleague or patient feedback to be a tricky process. According to the 2021 article on SAS doctor development from NHS Employers, the following should be considered when supporting speciality doctors for revalidation: ‘NHS Employers and other partners should work together to improve opportunities for SAS doctors to advance as clinicians and leaders in healthcare’ to enable them to work at their full potential.
We are aware that collecting feedback is not ‘one-size-fits all’, so we have developed a range of alternative 360 colleague and patient feedback questionnaires that are tailored to speciality doctors. These are currently undergoing a trial phase prior to being GMC validated, however many doctors have used our trial questionnaires for appraisal or revalidation as supporting evidence. In addition to our validated Doctor 360, Nurse 360 and Faculty of Pharmaceutical Medicine 360 questionnaires, we also offer:
- Anaesthetist 360.
- Radiologist 360.
- Medico-Legal 360.
- Clinical Leader 360.
- Non-Clinical 360.
- Dentist 360.
- DVLA Medical Advisor 360.
- Physician Associate 360.
- Practice Manager 360.
- Medical Examiner 360.
We also process both Royal College of Physicians and Royal College of Anaesthetist questionnaires, alongside General Medical Council patient questionnaires. If you would like to find out more about any of the questionnaires we offer, please email us at support@edgecumbe.co.uk.
References
GMC (General Medical Council) (2013) An Introduction to Revalidation. General Medical Council, London. URL: http://www.gmc-uk.org/doctors/revalidation/9627.asp.
Working arrangements for locum doctors pose significant patient safety challenges | BMJ
Is revalidation pushing doctors out of the profession? | The BMJ
https://www.health.org.uk/research-projects/revalidation-in-practice
https://www.nhsemployers.org/articles/sas-doctor-development