Impact of revalidation remains unclear, finds GMC-backed review

More than five years after it was launched, the impact of revalidation and the extent to which it has achieved intended outcomes remains unclear, a review backed by the GMC has found.

Most doctors have now been brought into the system of medical revalidation, the report found, but groups such as young, female, black and minority ethnic (BAME) doctors and sessionals have found it harder to engage with - and overall, the report found, revalidation 'may not necessarily improve professional practice'.

Appraisal is inconsistent across the UK, with 'local and appraiser interpretations central in shaping individual doctors' experience of the system', the report Evaluating the regulatory impact of medical revalidation warned.

Supporting information required from doctors in different areas varied, the report found, with some local organisations or individual appraisers asking for information that went 'beyond the requirements set by the GMC for revalidation'.

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Doctors in different roles - such as locums - had found it harder to collect some types of supporting information, although overall doctors found 'patient and colleague feedback and significant event analysis most helpful in informing practice'.

The review highlighted findings from a GMC survey that found 42% of doctors reported changing an aspect of their practice following their most recent appraisal - largely around the 'focus or quantity of their CPD activities'.

But it warned that 'some doctors identified potentially negative impacts on practice or for professional autonomy'.

'Doctors and patient organisations we spoke to remain confused about the purpose of revalidation and what it is therefore intending to achieve,' the report warned.

Licence to practise

Although many doctors see the system as a means of achieving 'documentary evidence of their adequate performance to maintain their licence', but the drift towards a 'tick-box' approach to completing revalidation risks reducing it to a bureaucratic process that is 'not translated into active reflective practice'.

GMC director of registration and revalidation Una Lane said: ‘We made a commitment at the outset to review and learn from the initial experiences of revalidation. This report gives us an insight into the first few years and will help us as we continue to improve the process.

‘We knew that something on the scale of revalidating tens of thousands of doctors would take time to bed in, and would need to be reviewed and refined. But these are still early days and there are positives.

‘Most doctors now have regular appraisals, which help to address local concerns raised by doctors, particularly in relation to workplace and health issues. Most doctors now collect the supporting information that revalidation requires, although we accept that some do not find the process as simple and straightforward as it could be.'

The GMC has also published advice on supporting information for revalidation to clarify its requirements around the six types of information needed - CPD, quality improvement activity, significant events, feedback from colleagues, feedback from patients and complaints and compliments.

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