The guidance also signals a shift away from formal audits being perceived as the expected way to provide evidence of quality improvement activities (QIAs) to support revalidation.
Sessional GP leaders have welcomed the move, which they said will give locums ‘room to be creative with meaningful QIAs’.
The previous recommendations advised GPs to reflect on two significant event analyses or case reviews a year and one quality improvement project – such as a clinical audit or service redesign – once every five years.
Although the suggestion to do annual audits was only intended to be an example, these were widely interpreted as a requirement in the old guidance.
Taking into account feedback from GPs, the RCGP has now stripped these ‘suggested’ QIAs out of the new guidance.
Locum GP revalidation
GPs are instead advised they can satisfy QIA requirements through a range of methods – many of which are better suited to the way locums work, such as plan/do/study/act cycles and reflective case reviews.
‘Experience has shown that, although this is still appropriate for some, for many GPs it is too restrictive, and a far wider range of ways to review and improve the quality of your practice may be appropriate,’ the updated guidance says.
‘This is in recognition that some forms of QIA may be difficult to achieve in certain circumstances, such as truly peripatetic locum work, and that there is a growing understanding of the variety and breadth of excellent quality improvement activities presented by GPs.'
RCGP revalidation lead Dr Susi Caeser told GPonline: ‘People have spent a lot of time trying to do formal audits, when other QIAs would be more appropriate for their circumstances.
‘Particularly for locums, who aren’t necessarily in the same practice to repeat something in the same environment – it’s much, much better to follow a patient through the system or review their personal outcome data.
‘There are lots of quality improvement activities, I think a very narrow emphasis on audits wasn’t actually what the previous RCGP guidance said, but it was how people interpreted it.’
Dr Richard Fieldhouse, chairman of the National Association of Sessional GPs (NASGP), welcomed the guidance. ‘We really like this new guide – it is good news for all GPs, not just locums,’ he said.
The previous guide ‘confused the issue’, he added. ‘There was an over-interpretation, it added too much value to the GMC guidance and locums were getting quite confused by this – there was all sorts of hearsay about having to do the annual audits.
‘What’s really good about the latest guidance from RCGP’s Dr Susi Caeser is you can tell it’s written by just the one person, rather than a whole committee. It’s a lot leaner, it’s a lot more muscular. And it takes a less is more approach.
‘When it comes to QIA, what’s really good about it is it actually doesn’t make any suggestions, because people were taking these suggestions as read whereas now there is scope for GPs to be more creative with their QIA.’