Revalidation March 2010


Published on

Published in: Health & Medicine, Business
1 Like
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Revalidation March 2010

  1. 1. REVALIDATION PowerPoint Presentation Just click the arrow to start the show <ul><li>Dr Juno Jesuthasan 1 March 2010 </li></ul>
  2. 2. Revalidation <ul><li>The videos and downloadable resources below are probably more useful than this PowerPoint presentation </li></ul><ul><li>However it does contain some useful background information </li></ul><ul><li>Clicking on the BLUE LINKS should take you to the websites or resources </li></ul><ul><li>Can be viewed in FULL SCREEN if preferred </li></ul>
  3. 3. Revalidation <ul><li>Revalidation is neither EASY or HARD </li></ul><ul><li>It’s somewhere in the middle </li></ul><ul><li>But your must get ORGANISED </li></ul><ul><li>And UNDERSTAND THE PROCESS </li></ul>
  4. 4. Revalidation <ul><li>The GMC introduced licensing in November 2009. </li></ul><ul><li>It is the licence rather than registration that signifies to patients that a doctor has the legal authority to </li></ul><ul><ul><li>write prescriptions </li></ul></ul><ul><ul><li>sign death certificates </li></ul></ul>
  5. 5. Revalidation
  6. 6. Revalidation <ul><li>These proposals are intended to be fit for the purpose of demonstrating that GPs are </li></ul><ul><ul><li>Up to date </li></ul></ul><ul><ul><li>Fit to practice </li></ul></ul>
  7. 7. Revalidation <ul><li>Revalidation starts 1 st April 2011 </li></ul><ul><li>Timetable would see the early adopter GPs revalidating in the summer of 2011 </li></ul><ul><li>It is important that GPs begin putting together a portfolio of evidence from April 2009 [if they have not been doing so already] </li></ul>
  8. 8. Regulation <ul><li>Good Medical Practice [GMP] </li></ul><ul><ul><ul><li>inform education, training and practice </li></ul></ul></ul><ul><li>Trust Assurance and Safety – The Regulation of Health Professionals in the 21st Century </li></ul><ul><ul><ul><li>invited the GMC to translate Good Medical Practice into an effective framework against which individual doctors’ practice can be appraised and objectively assessed. </li></ul></ul></ul>
  9. 9. In other words <ul><li>The Government asked the GMC to develop a Framework for Appraisal and Assessment which would form a core element of Revalidation </li></ul><ul><li>The key principles of professionalism set out in GMP are relevant to the whole profession and would therefore form the basis of this framework </li></ul>
  10. 10. 4 Domains : 12 ATTRUBUTES <ul><li>The definition and the scope and purpose of each domain </li></ul><ul><li>are derived principally from </li></ul><ul><ul><li>Good Medical Practice </li></ul></ul><ul><li>With contributions from other GMC publications: </li></ul><ul><ul><li>Management for Doctors </li></ul></ul><ul><ul><li>Research: The role & responsibilities of doctors </li></ul></ul>
  11. 11. Domains <ul><li>four domains </li></ul><ul><ul><ul><li>Knowledge, Skills and Performance </li></ul></ul></ul><ul><ul><ul><li>Safety and Quality </li></ul></ul></ul><ul><ul><ul><li>Communication, Partnership and Teamwork </li></ul></ul></ul><ul><ul><ul><li>Maintaining Trust </li></ul></ul></ul><ul><li>GMP with its wider purpose – seven headings </li></ul><ul><ul><ul><ul><li>Good clinical care </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Maintaining good medical practice </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Teaching and training, appraising and assessing </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Relationships with patients </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Working with colleagues </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Probity </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Health </li></ul></ul></ul></ul>
  12. 12. Attributes <ul><li>Domain 1 – Knowledge, Skills and Performance </li></ul><ul><li>Attribute 1 -Maintain your professional performance </li></ul><ul><li>Attribute 2 - Apply knowledge and experience to practice </li></ul><ul><li>Attribute 3 - Keep clear, accurate and legible records  </li></ul><ul><li>Domain 2 – Safety and Quality </li></ul><ul><li>Attribute 1 - Put into effect systems to protect patients and improve care </li></ul><ul><li>Attribute 2 - Respond to risks to safety </li></ul><ul><li>Attribute 3 - Protect patients from any risk posed by your health  </li></ul><ul><li>Domain 3 – Communication, Partnership and Teamwork </li></ul><ul><li>Attribute 1 - Communicate effectively </li></ul><ul><li>Attribute 2 - Work constructively with colleagues and delegate effectively </li></ul><ul><li>Attribute 3 - Establish and maintain partnerships with patients  </li></ul><ul><li>Domain 4 – Maintaining Trust </li></ul><ul><li>Attribute 1 - Show respect for patients </li></ul><ul><li>Attribute 2 - Treat patients and colleagues fairly and without discrimination </li></ul><ul><li>Attribute 3 - Act with honesty and integrity </li></ul>
  13. 13. Revalidation <ul><li>The domains and standards in this framework are drawn from Good Medical Practice [GMP] but do not replace it. </li></ul><ul><ul><ul><li>GMP will continue to fulfil its existing functions: </li></ul></ul></ul><ul><ul><ul><li>inform education, training and practice </li></ul></ul></ul>
  14. 14. GMC FRAMEWORK <ul><li>As not all the guidance in GMP has been included in the framework. Not drawn on those sections that: </li></ul><ul><li>State very high level values </li></ul><ul><li>Relate to matters where it would not be reasonably practicable to produce evidence of compliance, or where effort of obtaining such evidence would be disproportionate to its benefit in assessing doctors’ practice. </li></ul><ul><li>Describe unacceptable conduct , for example in relation to financial probity, or improper relationships with patients. Doctors cannot be asked to demonstrate that they are not defrauding the NHS. </li></ul>
  15. 15. Appraisal <ul><li>The framework can however be used by doctors to: </li></ul><ul><ul><li>reflect on practice and their approach to medicine </li></ul></ul><ul><ul><li>identify where they could make improvements </li></ul></ul>
  16. 16. Revalidation <ul><li>When placing evidence in the Revalidation Portfolio </li></ul><ul><li>the GP and his or her appraiser </li></ul><ul><li>will agree which of the 12 standards are covered by that evidence </li></ul><ul><ul><li>building an overall picture against all GMC Standards </li></ul></ul>
  17. 17. Appraisal <ul><li>‘ strengthened appraisal’ or “enhanced appraisal” = Appraisal fit for Revalidation </li></ul>
  18. 18. Appraisal <ul><li>Appraiser will be asked to check </li></ul><ul><li>quantity of evidence is appropriate for that point in the revalidation cycle </li></ul><ul><li>gathered evidence, as far as the appraiser can assess </li></ul><ul><li>appropriate quality </li></ul>
  19. 19. PDP <ul><li>A valid PDP must contain the following key elements for each goal: </li></ul><ul><li>a statement of the development need </li></ul><ul><li>an explanation of how the development need will be addressed </li></ul><ul><ul><li>the action to be taken </li></ul></ul><ul><ul><li>resources required </li></ul></ul><ul><li>the date by which the goal will be achieved </li></ul><ul><li>the intended outcome of the goal. </li></ul>
  20. 20. PDP <ul><li>Most GPs will set themselves between three and five goals that reflect the breadth of their practice, responsiveness to the health needs of their local population, and their own development needs </li></ul>
  21. 21. PDP <ul><li>It is very important that the GP reflects on </li></ul><ul><li>the goal </li></ul><ul><li>the development achieved </li></ul><ul><li>any reasons for not achieving the goal </li></ul><ul><li>This reflection is an important attribute of a GP’s fitness to practise </li></ul>
  22. 22. PDP <ul><li>Over a 5-year period the GP should not only consider clinical learning and development but also </li></ul><ul><li>the competencies around </li></ul><ul><li>leadership and management </li></ul><ul><li>recognising the importance of all doctors’ </li></ul><ul><li>role in a safe system of health care </li></ul>
  23. 23. CPD Credits <ul><li>The current proposal is that a GP will claim credits for the time involved in the activity, </li></ul><ul><ul><li>which can include planning and reflection </li></ul></ul>
  24. 24. RCGP CPD Credits Scheme <ul><li>The scheme works on the basis that: </li></ul><ul><li>A minimum of 50 credits is required per year </li></ul><ul><li>A broad range of general practice should be covered in 250 credits over 5 years </li></ul><ul><li>Credits will be self-assessed and verified at appraisal </li></ul>
  25. 25. QUALITY ASSURANCE OF GP APPRAISAL <ul><li>Role of the RCGP will be to quality assure the process of appraisal and the training and support of appraisers. </li></ul><ul><li>When doctors consider events from actual practice the word ‘review’ will be preferred to ‘reflection’ as this emphasises challenge and learning. </li></ul><ul><li>Early indicators of underperformance highlighted by appraisal will lead to prompt support for doctors in difficulty . Early direction to sources of support will help to reduce potential under performance. </li></ul><ul><li>Support for Appraisers </li></ul><ul><li>  All Appraisers must be selected, trained and supported to a common standard the mechanism for this will be development of an RCGP Accredited Appraiser Training course, together with quality assurance, calibration and support systems. </li></ul>
  26. 26. Personal Development Plan (PDP) Guidance for Appraisers <ul><li>Most of a doctor's learning occurs continually in the workplace and the PDP should not be thought of as a learning log, but as a tool that encourages reflection and provides evidence of this. </li></ul><ul><li>It should not be assumed that learning derived from the PDP is in some way superior to that which occurs on an ad hoc basis , as the two approaches to learning are often complementary. </li></ul><ul><li>Many appraisers use the term ‘general professional update’ to cover learning driven by events i.e. recognised during practice and usually directly concerning patient care. </li></ul>
  27. 27. Ad Hoc learning <ul><li>Opportunistic Ad Hoc learning can be just as important as the pre-planned developmental aims from you PDP </li></ul><ul><li>Recording and commenting on this type of learning will also add to your learning credits </li></ul>
  28. 28. Personal Development Plan (PDP) Guidance for Appraisers <ul><li>Typically at least three needs will be recorded in the PDP following the appraisal interview. </li></ul><ul><li>Needs may be personal, practice-based, local, or national </li></ul><ul><li>[ DIMENSION personal, local, external] </li></ul><ul><li>SMART objectives :Specific, Measurable, Achievable, Relevant & Time-bound </li></ul><ul><li>There is appropriate evidence to demonstrate learning. </li></ul>
  29. 29. Personal Development Plan (PDP) Guidance for Appraisers <ul><li>You will have collected evidence under GMP headings for your appraisal, including last year’s completed PDP. What does this evidence say about your performance? </li></ul><ul><li>Determine outcomes or evidence </li></ul><ul><li>What evidence of learning will you keep </li></ul><ul><li>(notes/memos etc)? </li></ul><ul><li>Will you be able to show changes in your practice (guidelines/protocols etc)? </li></ul><ul><li>Will you be able to show any impact of your learning on patient care (audits, case reports etc)? </li></ul>
  30. 30. Impact <ul><li>By demonstrating the impact of the learning on practice </li></ul><ul><li>the credits claimed can be multiplied by a factor of 2 . </li></ul><ul><li>IMPACT in this context refers to the impact on: </li></ul><ul><li>Patients e.g. a change in practice, implementing a new clinical guideline, initiating a new drug for the first time </li></ul><ul><li>The Individual personal development, e.g. development of a new skill or further development of existing skills </li></ul><ul><li>Service e.g. developing and implementing a new service, becoming a training practice, teaching others </li></ul><ul><li>Others teaching, training, NHS locally or nationally </li></ul>
  31. 31. DEMONSTRATING IMPACT <ul><li>In addition, to claim the impact factor </li></ul><ul><li>[credit × 2] the GP would be expected to include a demonstration of application of new learning: </li></ul><ul><li>case study </li></ul><ul><li>simple data collection </li></ul><ul><li>audit </li></ul><ul><li>reflective piece demonstrating change in a practice. </li></ul>
  32. 32. What can be claimed? What should not be claimed? <ul><li>“ Time spent on developmental activities may include preparation, activity and reflection. Credits should only be awarded when a demonstration of the learning achieved is relevant to the practice of the GP. </li></ul><ul><li>What should not be claimed? </li></ul><ul><li>The credit-based system is designed to move beyond a simple ‘hours = credits’ scenario. By requiring the individual to record learning relevant to the GP’s practice, simple certification of time spent is not adequate to claim credit. Examples of inadequate credit claim would be: </li></ul><ul><li>reading the BMJ every week for 1 hour – claim 52 credits </li></ul><ul><li>audit data collection, 6 hours – claim 6 credits. </li></ul><ul><li>The above example of reading the BMJ may be eligible for credit claims. However, in the format presented it gives little indication of relevance to the GP’s practices, and such untargeted reading should not normally exceed 10 credits. Performing data collection for the purposes of audit should not be claimed. ” </li></ul>
  34. 34. CREDITS FAQ
  35. 35. CREDITS FAQ
  36. 36. Responsible Officer <ul><li>RO will usually be the medical director or equivalent who, at local level, will: </li></ul><ul><li>ensure that appraisal is carried out to a good standard </li></ul><ul><li>support doctors in addressing any shortfalls </li></ul><ul><li>ensure any concerns/complaints are addressed </li></ul><ul><li>collate information to support a recommendation on the Revalidation to doctors to the GMC </li></ul><ul><li>  </li></ul>
  37. 37. REVALIDATION <ul><li>The evidence as a whole will be initially assessed into three broad categories: </li></ul><ul><li>appears satisfactory </li></ul><ul><li>needs discussion </li></ul><ul><li>substantial issues are raised </li></ul><ul><li>  </li></ul><ul><li>In every PCO there will be a trio consisting of </li></ul><ul><li>Responsible Officer </li></ul><ul><li>RCGP external assessor </li></ul><ul><li>Lay assessor </li></ul>
  38. 38. REVALIDATION <ul><li>The trio will allocate their time appropriately, sampling satisfactory portfolios and assessing fully other portfolios. </li></ul>
  39. 39. REVALIDATION <ul><li>In addition to the evidence provided by GPs in their </li></ul><ul><li>Revalidation Portfolio the RO in the Primary Care </li></ul><ul><li>Organisation (PCO) will have access to </li></ul><ul><li>clinical governance evidence </li></ul><ul><li>performance evidence </li></ul><ul><li>relevant to that GP </li></ul><ul><li>Such data will be shared with the GP, who will </li></ul><ul><li>have an opportunity to reflect on it. </li></ul><ul><li>The Responsible Officer will take all the evidence </li></ul><ul><li>available into account when making a revalidation </li></ul><ul><li>recommendation. </li></ul>
  40. 40. REVALIDATION <ul><li>The Responsible Officer will notify the GMC </li></ul><ul><li>Names of those GPs that the local group is able to Recommend for Revalidation . </li></ul><ul><li>Notification will be copied to the RCGP so that a sample of anonymised approved portfolios can be quality assured </li></ul>
  41. 41. REVALIDATION <ul><li>Where the local trio are unable to recommend Revalidation to the GMC </li></ul><ul><li>Portfolio will be shared centrally </li></ul><ul><li>RCGP’s National Adjudication Panel </li></ul>
  42. 42. GMC Affiliates <ul><li>The GMC is currently conducting pilots to develop the role of the regional GMC affiliate </li></ul><ul><li>Offer guidance on standards and quality assurance for ROs </li></ul><ul><li>Independent assurance of the quality and consistency of </li></ul><ul><li>local appraisal </li></ul><ul><li>clinical governance systems </li></ul><ul><li>that underpin revalidation decisions </li></ul>
  43. 43. Sessional Doctors <ul><li>Salaried Doctors </li></ul><ul><li>But especially Locums and other Sessional Doctors </li></ul><ul><li>Face special challenges in meeting the requirements for revalidation </li></ul><ul><li>The RCGP is Piloting this area </li></ul>
  44. 44. Sessional Doctors: Click here to watch an interesting Healthcare Republic interview with Richard Fieldhouse the chair of the National Association of Session GPs
  45. 45. RCGP Revalidation Portfolio <ul><li>An at a glance Traffic Lights system will help you easily keep tabs on your progress </li></ul>
  46. 46. RCGP Revalidation Portfolio <ul><li>The GMC Framework is important </li></ul>
  47. 47. RCGP Revalidation Portfolio <ul><li>So is Curriculum Coverage over the course of the 5 year revalidation cycle </li></ul>
  48. 48. RCGP Revalidation Portfolio <ul><li>Familiarity with the concepts of Area and Dimension is important </li></ul>
  49. 49. RESOURCES <ul><li>RCGP REVALIDATION HOME PAGE </li></ul><ul><li>Revalidation – FAQ </li></ul><ul><li>REVALIDATION GUIDE </li></ul><ul><ul><ul><li>Changes to the Guide </li></ul></ul></ul><ul><ul><ul><li>Revalidation Guide - Section by Section </li></ul></ul></ul>
  50. 50. RESOURCES <ul><li>RCGP Guide to the Credit-Based System for CPD . </li></ul><ul><li>GMC </li></ul><ul><ul><ul><li>GMC FRAMEWORK </li></ul></ul></ul>
  51. 51. The End <ul><li>Well not quite! </li></ul><ul><li>If you are viewing this slideshow on my website slideshare will mention some “related slideshows” at the end of this presentation </li></ul><ul><li>IGNORE THEM THEY ARE UNRELATED! </li></ul>