Terence Stephenson: The GMC is listening to what doctors are telling us on revalidation

The GMC is often the misguided target for the ire of those frustrated by the burden of regulation

The General Medical Council (GMC) is often at the sharp end of questions from doctors about the value of annual appraisals and revalidation, especially from doctors who’ve practised for many years and who are thinking of winding down or retiring.

As an experienced consultant paediatrician myself—and preparing to revalidate for the second time as I’m still practising—I’m more than familiar with the challenges of collating patient and colleague feedback, reflecting on my practice and ensuring I meet the various requirements for my annual appraisal.

At University College London Hospitals—my main employer—that includes regular updates on everything from resuscitation training, infection control and blood transfusion, to correct use of firefighting kit, how to lift heavy items, and equality and diversity.

Added to that are the requirements of my royal college, and it doesn’t take long before it looks a formidable burden.

Yet the requirements of an employer, who quite rightly expect staff to know one end of a fire extinguisher hose from another, and of a royal college, keen to ensure its members keep abreast of new developments, shouldn’t be confused with the GMC’s requirements for revalidation.

The GMC simply requires, over a five year period, one collection of colleague feedback; one collection of patient feedback; annual whole practice appraisal; evidence of quality improvement or audit activity; a discussion of any complaints and compliments, and a self-declaration of health.

The GMC does NOT require mandatory training in fire extinguishers or a minimum number of annual CPD credits, but it is possible your employer or college does.

Patients have an expectation that the doctors who treat them are up-to-date and fit to practise, and have largely assumed that some sort of system to that effect has been in place for many years. In fact, as we know, it’s relatively new.

To a patient it makes little difference whether the doctor is a fresh-faced youngster in the early stages of his or her career, or a semi-retired GP working just a couple of days a week … they want assurance that they’re in safe hands.

Annual appraisals have been a fact of working life for professionals in most fields for many years already. They’ve been in the NHS for more than 10 years, and the Royal College of GPs championed appraisals before revalidation ever existed, with completion rates high from the outset.

But at a time when the pressures on UK healthcare and on GPs in particular, are undeniable, I understand that the bureaucracy, however necessary, can be unwelcome.

Keith Pearson’s review of revalidation, published in January, acknowledged this, and among his recommendations were that more is done to make the process as straightforward as possible for doctors.

He also recommended the GMC works alongside employers and royal colleges so the differences between our guidance and theirs are clearer for everyone.

This work is ongoing—and we have recently published a plan to implement his recommendations—but in the meantime if a doctor is unsure, or if they suspect they’re being asked to go beyond what the GMC requires, I would urge them to raise the issue with their appraiser, employer or Responsible Officer.

The fact the GMC is often the misguided target—because we introduced revalidation—for the ire of those frustrated by the burden of regulation, shows that how important it is to progress this and to get it right.

We are listening to what doctors are telling us, but we remain committed to the value of a system that meets the expectations of patients and upholds the importance of professional development for doctors.

Terence Stephenson, Chair of the General Medical Council.

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