Editorial: Are PCOs ready for revalidation?

The introduction of revalidation was always going to be fraught with difficulties, but on the verge of its introduction there are major obstacles to overcome.

Last week, GP reported that the RCGP had set an ambitious target to revalidate 12,000 GPs in the first year. But issues around funding and doubts about primary care organisations' (PCOs) ability to support the system raise huge questions about how achievable this will be.

Nick Clarke, head of health and social care regulation at the DoH, stressed last week that pilots were still gathering evidence about whether revalidation was 'affordable for the Treasury and doctors'.

The GMC has also said that, in these tighter financial times, it wants to ensure the system will not be a 'burden on the NHS'.

One cannot imagine that revalidation would be abandoned if it was deemed too expensive, but would some aspects have to be scaled back to make it more affordable? Or, could it mean that the profession has to foot the bill? The pilots could raise some very difficult issues that will have to be addressed.

Meanwhile, there are concerns that some PCOs may simply not be up to the task. At last week's RCGP conference, college chairman Professor Steve Field revealed that some PCOs had stopped appraising GPs in a bid to save money and some were failing to support appraisers adequately.

In this week's GP, Professor Field says that revalidation is solely about professional development, not about weeding out bad doctors (page 21). This is an admirable vision and one that doctors would support, providing all other stakeholders, including PCO managers and the public, recognised this was revalidation's main objective.

Unfortunately, not everyone views revalidation in this way. This is why many GPs see the system as yet more hoops through which they have to jump and a potential stick with which they can be beaten. Until PCOs become more supportive and start taking GPs' professional development and appraisals seriously this will remain the case.


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