You are quite right to point to the importance of the approved working environment to our proposed revalidation model (GP, 20 January). We proposed that doctors working within approved environments demonstrate their suitability for revalidation by means of participation in appraisal and certification that there are no significant unresolved concerns about their fitness to practise.
This certification would come from an appropriate named person within the doctor's employing or contracting authority. We are considering a risk-based approach to revalidation, which would mean a lighter touch for doctors. But our proposed revalidation model is just that, and the final shape of the revalidation process will of course depend on the outcome of Sir Liam Donaldson's review.
We do have a set of working criteria for our approved environment, but those you print do not fully reflect the position. Our criteria are likely to include:
- An effective system of clinical governance;
- An effective annual appraisal system based on Good Medical Practice;
- Independent regulation or quality assurance;
- Complaints handling procedures which meet relevant external standards.
We envisage that approved working environments will include organisations within and outside the health service.
It is encouraging that organisations such as National Association of Sessional GPs are starting to benchmark their existing arrangements for assuring quality against our proposed criteria. This can raise standards and give the public confidence that the doctors who treat them are fit to practise.
Amanda Watson, director of registration and education, GMC.