Hospital Dr News

“Revalidation isn’t identifying poor NHS doctors”

Revalidation will fail to identify poor-performing doctors, a poll of more than 5,600 doctors reveals.

More than 80% of hospital doctors and 67% of GPs also pointed to variations in care, saying there are certain doctors they would not want to treat their friends and family.

The survey, by doctors.net.uk, was carried out among more than 4,600 hospital doctors and a further 1,000 GPs.

Doctors were asked whether revalidation – the process of appraising doctors – would help identify and deal with those who are unfit to practise. Some 53% of hospitals disagreed it would (33% disagreed and a further 20% strongly disagreed).

Meanwhile, 22% agreed revalidation would help identify and tackle problem doctors, while the rest neither agreed or disagreed or did not know.

Among GPs, 60% disagreed that the plans for revalidation would help to identify and deal with doctors who are not fit to practise (32% disagreed and a further 28% strongly disagreed) while only 16% agreed (15% agreed and a further 1% strongly agreed).

Some 86% of hospital doctors also agreed there are variations in care and that “there are certain doctors that I would not want to treat friends and family”.

Dr Mark Porter, chair of BMA council, commented: “Revalidation is intended to encourage lifelong learning amongst doctors and lead to a culture of positive professional improvement throughout a medical career. Many doctors have been frustrated by the implementation because heavy workload and financial pressures in the NHS leave little time and space for the reflection and quality improvement that revalidation promised.

“The vast majority of doctors in the UK provide excellent clinical care to the millions of patients who are treated by the NHS each year. It is the duty of all doctors to be vigilant regarding the standards of healthcare delivered by other professionals in the health service, but we do need to ensure the NHS encourages an open, transparent culture where doctors feel supported and empowered to raise concerns, and ramifications are listened too.”

Among GPs, 67% agreed there are variations and certain doctors they would not want to treat friends and family (50% agreed and a further 17% strongly agreed) while 6% disagreed (including 1% who strongly disagreed).

When asked whether “plans for revalidation will help me maintain a good standard of practice”, 33% of hospital doctors agreed they would (30% agreed and a further 3% strongly agreed). Meanwhile, 32% disagreed and a further 23% strongly disagreed. The rest neither disagreed or agreed, or said they did not know.

When quizzed on whether they thought the benefits of revalidation would outweigh the administrative time required for the process, 38% of hospital doctors disagreed they would, while 18% agreed. The rest did not not know or had no opinion either way.

Dr Tim Ringrose, chief executive of doctors.net.uk, said: “GPs and hospital doctors seek to uphold the highest possible standards in care, and their willingness to be totally frank about variations in quality demonstrates how keen they are to see continual monitoring and improvement.

“However, while revalidation should help to address such concerns, there is widespread scepticism about its effectiveness.

“Many hard-pressed doctors view it as yet another administrative burden. They do not see it as a safety net for identifying any doctors who are not fit to practise or as a benchmark for ensuring that all patients receive the highest possible levels of care and treatment.”

Revalidation, introduced by the GMC at the beginning of last year and based on annual appraisal, requires doctors to demonstrate on a five-yearly basis that they are up to date. The majority of licensed doctors are expected to be revalidated by March 2016.

Niall Dickson, the GMC’s chief executive, said: “These are very early days of a new system for making sure every doctor in the UK is subject to an annual check and is able to demonstrate that they are practising safely.

“Of course, it can never spot every instance of poor practice, but over time we are confident it will make a difference.

“So far only 12% of doctors have had their licence revalidated by the GMC, yet we know the process has already had a positive impact.

“Employers are taking their responsibilities for ensuring the quality of medical practice more seriously, and we have seen a significant increase in appraisal rates for both hospital doctors and GPs across the country.

“This is not a panacea, but a contribution to patient safety and we will develop the model over time.”

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2 Responses to ““Revalidation isn’t identifying poor NHS doctors””

  1. Malcolm Morrison says:

    In medicine, as in all walks of life, the will be ‘good’ and ‘bad’ practitioners; and the majority will be ‘average’. It is often difficult to define what is ‘good’ and what is ‘bad’ in medicine – but most of us recognise it when we see it! The purpose of revalidation is to be able to identify DANGEROUS doctors. Will the present method do so? We shall have to wait and see – but I, personally, doubt it.

  2. Suggestion says:

    Any of the poorly performing and criminal doctors in the news over the last few years could have passed revalidation. As long as you collect lots of paper and do your CPD and give the satisfasction questionnaires to people who like you.
    You need to return to the system of three wise men, with just the added caveat that they can also be wise women.

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