Revalidation has failed to improve patient safety, GPs warn

Two in five GPs do not believe revalidation has made general practice safer for patients, a GPonline survey reveals - with some dismissing it as a 'box-ticking' exercise that fails to 'weed out dangerous doctors'.

GP appraisal (Photo: iStock.com/sturti)
GP appraisal (Photo: iStock.com/sturti)

A total of 30% of the 570 GPs who took part in the survey disagreed with the statement that ‘GP revalidation improves patient safety’, while a further 10% ‘strongly’ disagreed. The findings were similar for GP appraisal, which 37% of GPs said does not improve patient safety.

Overall, fewer than one in three GPs felt that GP revalidation (29%) and appraisal (25%) had improved patient safety, while 34% were ‘neutral’ on the subject.

Less than half of GPs (48%) said that appraisal was ‘worthwhile’, and just 37% said revalidation was worthwhile.

'Jumping through hoops'

One GP taking part in the GPonline poll described revalidation and appraisal as ‘jumping through hoops with no real value’, adding ‘It won't pick up dangerous doctors because they just learn how to play the game’.

Another GP said: ‘I'm sure there are better ways of ensuring doctors work safely and remain up to date.’ A third commented: ‘Appraisal takes up a lot of valuable time in an already busy job, it is like a tick-box exercise and an excellent GP may focus more on clinical work and not look great when it gets to the appraisal and a GP that had poor clinical skills may be very good at looking good on paper and ticking the boxes for the appraisal.’

Others argued that appraisal and revalidation was a ‘much needed process’, but that it should be used ‘for the benefit of the doctor to aid their development’.

One respondent wrote: ‘In principle I think it a good idea, we should encourage reflection, lifelong learning and willingness to review and change when things have not gone well. It should help the public to have confidence in their clinicians. In practice I'm not sure how much it helps identify weaker practitioners.’

Appraisal and revalidation

GMC director of registration and revalidation Una Lane said: ‘We believe that appraisal and revalidation can help to foster a culture of reflection and support doctors in developing their skills so that they can provide even better care to their patients.

‘Last year we published new guidance to make our requirements clearer and to make sure that any supporting information submitted for an appraisal is focused on quality rather than quantity. We continue to work closely with stakeholders, including employers and the medical royal colleges, to reduce any unnecessary burden and deliver further improvements.’

A motion listed for debate at this year’s UK LMCs conference, which takes place in Belfast on the 19 and 20 of March, will call on the GPC to work with the GMC and other NHS bodies to ‘overhaul’ revalidation and appraisal.

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