Editorial: Questions remain as revalidation looms

Revalidation is just around the corner. The RCGP continues to call 2010/11 the 'first year of revalidation' (although it has accepted that it will probably only be working with volunteer GPs in this year).

But as the start of revalidation approaches there are still huge questions about how the system will work, not least how it will be funded. The DoH has said it will not pay for revalidation. It says that because revalidation will follow the same form as annual appraisal it will, therefore, cost the same.

This is a dubious claim. Revalidation is to be based on an enhanced appraisal process, which suggests it will cost more. If the DoH will not pay, does this mean GPs will have to?

Then there is the expense of administration at the GMC, will this mean a hike in annual registration fees?

But perhaps the biggest concern is the cost of remediation and dealing with doctors who fail revalidation. Who will pay for this? Will it be the state, the GMC, the primary care organisation (PCO) or the individual doctor? The costs of this are likely to be significant and unless the DoH or PCO foot the bill, doctors will end up covering this themselves.

These are important questions that, as yet, no one seems to have answers to - not least the DoH, which, after all, has been the driving force behind revalidation.

On a more positive note, this week the RCGP released the second version of its guide to revalidation. The document takes account of many of the issues that were of concern to GPs.

It suggests ways to make it easier for locums and sessional doctors to undertake revalidation, has softened the impact of the controversial learning credits and says that GPs recommended to fail revalidation will have the opportunity to appeal.

There are still many issues that need to be resolved around how the process will actually work in practice, but this is progress.

Revalidation is coming whether we like it or not. The RCGP is at least prepared to engage with the profession, listen to its concerns and take them on board. Which is a lot more than can be said for the DoH.

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