A DoH spokeswoman told GP newspaper the annual cost of revalidation would be broadly similar to the current appraisal process, so no extra funding would be required.

Currently, GMS partners receive 26p per patient in their global sum to reimburse them for the time and costs of appraising themselves and their salaried GPs. Locums receive various amounts depending on their primary care organisation (PCO).

But GPC chairman Dr Laurence Buckman told GP he is prepared to fight for a higher fee should revalidation's annual ‘enhanced appraisal' be more burdensome.

GPs at June's LMC conference demanded that revalidation is ‘fully funded and resourced' by the DoH.

Additional work towards enhanced appraisal will include surveys of patients and colleagues and earning learning credits.

Dr Buckman's biggest concern is how the ‘remediation' of doctors identified as struggling during revalidation would be paid for, which the RCGP expects to be the mostly costly aspect of revalidation.

 ‘Who pays for a doctor to be remediated?' said Dr Buckman. ‘The state, the profession, or the individual?

If individual GPs are left to pay, it could cause an exodus from the profession, he said.

Charging the whole profession, through the GMC, would mean ‘GPs dipping in their own pockets to pay for others,' said Dr Buckman.  

PCOs have enough in their allocations to pay for revalidation, but not remediation, he said.

A DoH spokeswoman said there had been no decision on who would pay for remediation but work was ongoing at a ‘local level'. 

A GMC spokeswoman said it was unlikely to be heavily involved in remediation.

‘Revalidation is a by-product of strong appraisal and clinical governance,' she said. ‘If there are concerns about a doctor the GMC isn't necessarily going to be called in.'

An NHS Employers' spokesman said: ‘Revalidation is fundamentally about applying more rigour to existing processes and so should not cost more.' 

tom.ireland@haymarket.com

• Read the full version of this story in this week's GP dated 7 August.
• Who should pay for revalidation?
• RCGP softens impact of revalidation in revised guide Full detail of the RCGP's revised guide to revalidation.