All doctors know that revalidation is coming down the line. Recertification will be necessary for specialists and GPs and every doctor who wishes to remain on the specialist register will need to report to a responsible officer, who will be the link to the GMC and revalidation.
At the moment the first draft on RO functions is out for consultation and will be laid before parliament in early 2010. ROs must be in position by October 2010 with revalidation beginning in 2011.
This raises a large number of issues for all doctors, the first being which RO they must report to. Currently, the documentation suggests that NHS consultants will report via their trusts where it is envisaged that, in the main, the medical director will take on this role. Independent consultants with practising privileges at a private hospital will report to the hospital where they do most work. Thus all independent sector hospitals (or groups) will need to appoint an RO.
The RO will only be able to accept suitable appraisals which are now to be strengthened and will include multi-source feedback. The appraisal system has yet to be formalised and the Academy of Royal Colleges has outlined its view; there is clearly a move towards specialty driven appraisals. All independent sector consultants will need to go through an accredited appraisal system.
The Federation of Independent Practitioner Organisations (FIPO) working in conjunction with other groups such as the London Consultants’ Association will reinforce the appraisal systems that already exist for consultants in the independent sector.
The work for the RO will be massive as there will have to be cross liaison between all hospitals where the consultant has an affiliation. The majority of consultants in the independent sector have an NHS appointment and they will have to take forward to their NHS RO all the details of their work in any private arena; this is “whole practice appraisal” writ large.
So the independent sector will need to produce more precise clinical data and reports on incidents/complaints but as a consultant may work in more than one independent hospital the network could be complex and costly.
There are also questions over data availability, conflicts of interest, fairness, standardisation of appraisals, funding and what constitutes an “incident” plus a general fear that unfounded allegations may end up on a doctor’s file. These are yet to receive satisfactory answers.
Many of these issues will be explored at a forthcoming conference, Consultant Revalidation in the Independent Sector, on 24 November in London. It’s CPD recognised, and full details are available here.
