Professor William Roche: Medical Revalidation

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  • Commitment increasing in various parts of the NHS system, Coalition Government’s vision for the reform of the health service reinforces the importance of medical leadership and the engagement of doctors in leading commissioning and service improvement at all levels. High Quality Care for All Final Report, Doctors in Society: medical professionalism in a changing world (2005) by the Royal College of Physicians (London) has provided an important contribution to the debate on the changing nature of the medical profession. EEML Project – joint AoMRC and NHS Institute, aim to promote medical leadership and help create organisational cultures where doctors seek to be more engaged in management and leadership of health services and non-medical leaders genuinely seek their involvement to improve services for patients across the UK. MLCF key product.This is now incorporated into training and educational curricula at both undergraduate and postgraduate levels with supporting e-learning materials particularly for the latter. In this context Colleges and other relevant interest groups have been engaging for some time on how standards in the area can be defined and maintained and particularly how the medical profession can take greater ownership of this agenda.Interested parties included AoMRC, NHS Institute, nominated SHA medical directors, NHS Employers and others with BAMM related experience.Working group established as result and a paper submitted to Academy Council which was endorsedSupport for establishment:Work has now been progressing to make the concept of a Faculty into reality. The NHS Institute is supporting the establishment of the Faculty with some funding for 2011-12. It is intended that the Faculty be the future home for the work of the EEML project. The Royal College of Physicians (London) is providing accommodation for the Faculty at Regent’s Park, London.
  • Professor William Roche: Medical Revalidation

    1. 1. July 2013 Prof William R Roche Faculty of Medical Leadership and Management Medical Revalidation, From Reactive Responses to Regular Reviews
    2. 2. Impact of the Responsible Officer Legislation • Changes in Professional Governance • Implementation • Costs • Benefits to Patients, Public and Profession
    3. 3. Why Revalidation? OUR PILOTS WERE ALL TRAINED (years ago)
    4. 4. Why Revalidation? OUR PILOTS ALL UNDERTAKE REGULAR TRAINING AND ASSESSMENT
    5. 5. Why Revalidation? DO YOU KNOW IF THE SURGEONS ABOUT TO OPERATE ON YOU PARTICIPATE IN REGULAR UPDATES AND ASSESSMENT OF THEIR RESULTS?
    6. 6. Situation prior to 2012 Doctor qualifies - Provisional Registration One Foundation Year – Full Registration Subject to payment of annual fee and no GMC action - registered for life
    7. 7. From 3 December 2012, by statute GMC requires Doctors to revalidate their Licences to Practise Licensed doctors will have to revalidate, usually every five years. Based on by having regular appraisals that are based on the core guidance for doctors, Good Medical Practice. Supported by a hierarchy of Responsible Officers
    8. 8. Hierarchy NHS Commissioning Board MD (Level 3 RO) Regional MD (4) (Level 2 RO) Area Team MD (27) (Level 1 RO) GPs etc. Providers’ RO (Level 1 RO) Deaneries RO (Level 1 RO) Trainees Connected Doctors
    9. 9. 9 Scheduling doctors for revalidation
    10. 10. Enhanced Appraisal is the Cornerstone of Revalidation • The GMC requires that doctors must demonstrate their fitness to practise in all the areas in which they work • Appraisal covers all aspects of practice inside and outwith the employing organisation • Records of Annual Appraisal must be maintained • Responsible Officers use Appraisals and other sources of information to make recommendations to the GMC
    11. 11. Six Types of Supporting Information Required for Appraisal 1.Continuing professional development 2.Quality improvement activity 3.Significant events 4.Feedback from colleagues 5.Feedback from patients 6.Review of complaints & compliments
    12. 12. Responsible Officers make Recommendations to GMC Options: 1. No Concerns, GMC revalidates 2. Doctor failing to engage with process (GMC acts) 3. Deferral, revalidation date reset, e.g. Doctor on Maternity Leave Concerns about Fitness for Practise should be referred to the GMC in the usual way and should not await the revalidation date.
    13. 13. Scale of the Task (UK) Register* No. of doctors % No. of doctors licensed % Specialist Register 74,449 29.47% 70,368 29.70% GP Register 62,453 24.72% 60,068 25.36% Total no. of doctors on LRMP 252,653 100.00% 236,898 100.00%
    14. 14. COSTS • £93 M per annum, mainly medical time • Financial Benefits – Less harm and litigation – Fewer doctors excluded – Fewer doctors not working because of health issues
    15. 15. The Challenge HOW TO USE REVALIDATION TO SECURE THE BEST OUTCOMES FOR PATIENTS AND DOCTORS
    16. 16. OUTCOMES PATIENTS & PUBLIC: – HIGH QUALITY EXPERIENCE AND OUTCOMES – REASSURED AND CONFIDENT DOCTORS: – BETTER TEAM WORKING – CONFIDENCE THAT ISSUES ARE ADDRESSED – INDIVIDUAL SUPPORT AND WELL-BEING MEDICAL LEADERS – SUPPORT – ADVICE AND CONSISTENCY
    17. 17. Revalidation is Just One Component of Clinical Quality and Safety Measures in the Responsible Officer Regulations • Enhanced Recruitment Checks, including language • Assurance that Doctors are Appropriately Qualified for Proposed Duties • Better Appraisals • Monitoring Governance Data • Records of Outcomes, Adverse Events etc. • Information Sharing across Sectors about Doctors • Earlier Remediation
    18. 18. Thank you for your attention QUESTIONS

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