The strengthened appraisal process that will underpin revalidation has the potential to improve the quality of care but it takes longer to complete, an independent evaluation finds.
Doctors took 18 hours to complete the new appraisal process in the revalidation pilot studies as compared with 12 hours previously.
The evaluation report also highlighted the need for a simpler system, and a better approach to remediation with struggling doctors.
Doctors struggled to provide supporting information on all 12 of the appraisal attributes, such as showing respect for patients and acting with honesty and integrity. The evaluation recommends that more work needs to be done to on establish which attributes are necessary for appraisal and to rationalise the information requirements for those attributes.
However, 96% of organisations involved in the pilots expect revalidation to lead to improved quality of care.
The pilots - which ran from April 2010 in 10 sites and involved 3,000 doctors - tested the proposed systems of appraisal for revalidation for practicality, efficiency and supporting quality care.
Health secretary Andrew Lansley said: “Patients and the public have a right to expect that their doctors’ skills are up-to-date and that they are fit to practise. Maintaining rigorous standards is critical to offering good care.
“It is encouraging to see that 96% of the pilots recognise that revalidation will improve the quality of care. It is important to ensure that the extent of the benefits of revalidation are justified in relation to the costs. These findings will allow us to identify the areas on which we need to focus in the additional year of piloting.”
While the organisations and responsible officers were very positive about the potential benefits of revalidation, appraisees and appraisers were less impressed. These differences in perception need to be understood if revalidation is to be successfully rolled out, the report says.
Dean Royles, director of the NHS Employers organisation, said: “It is important that the next phase of pilots continue to reflect employers’ requirements for a workable system that can both reassure the public of the continued quality of doctors and also ensure that doctors keep their practice up to date, safe and effective.”
Revalidation is due to be introduced in late 2012.
Niall Dickson, chief executive of the GMC, commented: “We want better safer care for patients - to achieve that we must give doctors the space to reflect on their practice, to gather information about their performance and to benchmark their results.
“We have already streamlined the system following earlier feedback from the pilots, and this report will give us further insight as we prepare for roll out. Doctors need to find the process both rewarding and effective. The next year of preparation will help to make sure the system works well for all doctors, wherever they practise.”
Read more on the evaluation.
Tags: appraisal, Revalidation
Everyone should remember that ‘Reappraisal’ and ‘Revalidation’ are different and have different ‘objectives’ or functions.
Reappraisal is between the doctor and employer (or other colleagues if in private practice). The purpose is to identify how well the doctor is doing his/her job and what ‘assistance’ they need to enable them to do it better. (It may form a part of revalidation)
Revalidation is between the doctor and the GMC and is to determine if the doctor is still ‘fit to practise’. Thus it should be to ensure that the doctor is SAFE to practise - i.e. they are not a danger to patients. Hence, the GMC can only demand a MINIMUM standard - even though it might be nice if ALL doctors could be polite to patients and colleagues all the time regardless of how provoked they may have been! They can only demand competence - not sainthood!