Revalidation support for locums

For GP locums, revalidation is like DIY car maintenance.

Unlike GPs working in conventional practices with ready access to close-at-hand resources, GP locums could be forced to take a DIY approach to revalidation. The majority work in isolation and do not have an infrastructure to help them with the revalidation process.

This will comprise regular, compulsory assessment based on several annual appraisals and include multi-source feedback and gaining CPD credits.

MOT tests
Revalidation is akin to a MOT test. As with cars, there are different GP 'types': practice-based (partners, salaried doctors and retainers); academics; those who work in NHS management; and of course, GP locums.

My main car is a youngish second-hand VW Golf. It is safe, efficient and performs consistently. If a bulb fails, a warning light on the dash tells me. I know exactly how much fuel it has in its tank. It has gone wrong a few times, but it is still under warranty. I take it to the local dealership whose mechanics are usually able to fix it while I drink a cup of tea.

DIY revalidation
My other car is a VW Type 2 Bay campervan. It is noisy, does a maximum 50 mph and the fuel gauge is temperamental. But it is great for cheap weekend breaks. When it needs repairing, I do it myself or friends from the local VW club help me. It is significantly more trouble than the Golf but I love it.

Both cars have their annual MOT at the same garage and must meet the same minimum standard - as GPs, whether locums or not, must do with revalidation.

Choice of car is not actually that important but depends on individual preferences and circumstances. The same cannot be said of doctors.

As professionals publicly funded by the NHS, it is almost inconceivable that a significant proportion of GPs will have to take the DIY campervan route to revalidation.

Yet that is what is likely happen given that one in four GPs work as peripatetic locums who are almost invariably professionally isolated and whose membership of informal, self-funding locum groups is patchy.

While practices - my GP version of German car dealerships - offer the potential for peer-support, colleague feedback and professional development networks, being a locum is subject to the same vagaries and frustrations of maintaining a quirky campervan.

How best to support GP locums in preparing for revalidation is a crucial issue that must be addressed now.

Road traffic would grind to a standstill in the next few years if everyone personally serviced and maintained their vehicles. So too might general practice if too many locums have problems getting through the revalidation process successfully.

It is not revalidation that makes us good GPs but ongoing support and professional development.

The NHS has a moral duty to ensure that the same high level of support is given to every GP, no matter what make, model, speed, engine size or colour.

  • Dr Fieldhouse is a GP locum, chief executive of the National Association of Sessional GPs and a member of the RCGP's Revalidation Stakeholder Group.

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