Revalidation is a five-year process in the UK that aims to bring all doctors into a clinical governance system, help identify problems earlier, encourage self-reflection, and contribute to safer, higher quality patient care. So far, over 118,000 doctors have been revalidated. Early evidence suggests revalidation is increasing appraisal rates and identification of concerns, while 24,795 doctors have given up their licenses. Responsible Officers report revalidation is central to quality improvement and allows better understanding of doctors' practices. The future of revalidation may see it more integrated with team performance and use more objective data linked to specialist expectations.

1. Outcomes/Effectiveness of
revalidation in the UK
IAMRA Revalidation Symposium
29 October 2015
Una Lane
Director
Registration and Revalidation

2. The register tells you:
 Name
 Date of Qualification
 Date of entry to
specialist register
Holding registration with a licence to practise will move from being an
historical record of educational achievement to a contemporary
affirmation of competence
What are we trying to achieve?

3. What are we trying to achieve?
 Bring all doctors into a clinical governed system
 Help to identify problems earlier
 Encourage self reflection
 Contribute to safer and higher quality care for patients

4. Revalidation – the process
This is a five year process – NOT a fifth year process

5. Revalidation: requirements for doctors
4 domains of GMP

6. Where are we now? The numbers
 Doctors subject to revalidation in
the UK: 228,609
GMC figures, as at 31 August 2015
 recommendations received by
the GMC: 144,777
 number of doctors revalidated:
118,448
 number of deferrals: 26,061
 number of notifications of non-
engagement: 268
Revalidate
Deferral
Non-engagement
Not yet received
recommendation

7. Early evidence of impact?
 94% of licensed doctor in the UK now connected to a designated
organisation/Responsible Officer
 Appraisal rates for all doctors have increased significantly
 e.g. from 64% (2011) to 87% (2015) for NHS consultants
 Anecdotal claims of earlier identification of concerns – strong
support among Responsible Officers
 24,795 doctors have chosen to give up their licence to practise
 Suspended approval of recommendations in three organisations
 Removed 1,890 licences due to failure to engage with the process
as a whole (e.g. providing no information to GMC)

8. What Responsible Officers say
 “Revalidation for me is central to the quality agenda
that I am pushing in this hospital”
 “….allowed me to develop a far better understanding
of what my doctors are actually doing in the hospital
and elsewhere - I feel more assured”
 “….there is clearly a move towards better sharing of
information around doctors’ whole scope of practice
…. this is a direct result of revalidation”
 “In short, fewer bolt holes for doctors with
unaddressed concerns to disappear into.”

9. What Responsible Officers say

10. What others say
 86% of doctors who had been revalidated believed they
were treated fairly throughout the revalidation process
 34% of doctors who had been revalidated indicated that
they were reflecting more on their work than a year ago
 73% of employers said they felt that doctors were reflecting
more on their practice compared to 12 months ago and
 59% of employers said they felt that doctors were more
aware of how to apply the principles in Good medical
practice compared to a year ago.
 Over 2 million patients have provided feedback to their
doctors

11. How will we know it’s working?
 Bring all doctors into a clinical governed system
 Help to identify problems earlier
 Encourage self reflection
 Contribute to safer and higher quality care for patients
Evaluation
 UK Medical Revalidation Evaluation Collaboration (UMbRELLA)

12. The future of revalidation
Revalidation the next phase?
 More integrated with team performance
 More objective data
 More linked to specialist expectations
 Easier to complete
 Safety and quality increasingly recognised as critical everywhere
 Data drives patients, professionals and providers to different
behaviours
 Various systems for re-certification, re-licensure around the
world.

13. Thank you
ulane@gmc-uk.org
www.gmc-uk.org/revalidation