Revalidation

What is Revalidation?
When will Revalidation begin?
What can I do to prepare for Revalidation?
What is the role of Medical Royal Colleges and Faculties in Revalidation?
What is the Academy doing to support the development of Specialist Recertification?
Collaboration with other key stakeholder organisations

1. What is Revalidation?

Revalidation is a process where doctors will be required to “periodically demonstrate their continued fitness to practise … and for specialist doctors, to demonstrate that they meet the standards that apply to their particular medical specialty” (DH 2007: 6). Revalidation has two elements:

Relicensing will be required for all doctors who hold a licence. This process will be largely undertaken through local clinical governance processes with the responsibility for final relicensing resting with the General Medical Council
Recertification will be required for doctors who are on the GMC’s specialist register and GP register. Recertification will be led by the Medical Royal Colleges who will need to provide a ‘positive statement of assurance’ to the General Medical Council.

The vast majority of doctors are practicing medicine to a high standard. Revalidation should be a process that will support continuous quality improvement in standards and practice for both doctors and patients alike.

Trust, Assurance and Safety - website link

Good Doctors, Safer Patients - website link

2. When will Revalidation begin?

Relicensing -	Before this process can begin, doctors need to be issued licenses to practice. Legislation is currently being consulted on by the Department of Health to enable licences to be issued. The GMC anticipate that the first licenses will be issued in summer/autumn 2009 subject to the legislation being in place.
*Recertification* -	The Medical Royal Colleges are piloting and implementing elements of recertification as they are developed. Legislation is also currently being consulted on to enable recertification to take place. We do not envisage a ‘big bang’ approach to recertification, but a phased roll-out that is likely to begin during 2010.

3. What can I do to prepare for Revalidation?¹

Review your appraisal documentation from the last few years
Check the evidence you have claimed are in your files (e.g. courses attended; CPD certificates)
Check what aspects of your PDP have been achieved and what has not. If there are uncompleted elements, identify reasons for this and record them.
Review any changes to you job plans or specialist practice and confirm that you have active CPD in those areas
Collect or make a list of any accolades or letters of appreciation you have received
Collect evidence of any other clinical activity you may have undertaken (e.g. clinical audits)
Collect evidence of any non-clinical activity you may have undertaken (e.g. multi-source feedback; patient surveys; teaching; research; work for the greater NHS)
Make sure that all of the documentation is in place for any complaints or incidents that you may have had
Ensure that the ‘local responsible officer’ (clinical or medical director) within your trust has copies of your appraisals and a record that they have taken place

4. What is the role of Medical Royal Colleges and Faculties in Revalidation?

The Chief Medical Officer’s report Good doctors, safer patients and the subsequent White Paper Trust, Assurance and Safety, represent an opportunity for Colleges and Faculties to offer their expertise in setting standards for the development of specialist recertification as a component of revalidation. The development of standards, methods and evidence for recertification should be co-ordinated and supported by the Academy of Medical Royal Colleges (AoMRC) to ensure consistent development and implementation across the different medical specialties.

For specific information about individual Medical Royal Colleges and Faculties and their work on Revalidation:

Faculty of Occupational Medicine
Faculty of Pharmaceutical Medicine - website link
Faculty of Public Health
Royal College of Anaesthetists
Royal College of Emergency Medicine
Royal College of General Practitioners - website link
Royal College of Obstetrics and Gynaecology - website link
Royal College of Ophthalmologists
Royal College of Paediatrics and Child Health
Royal College of Pathologists - website link
Royal College of Physicians Edinburgh - website link
Royal College of Physicians London - website link
Royal College of Physicians and Surgeons Glasgow - website link
Royal College of Psychiatrists - website link
Royal College of Radiologists
Royal College of Surgeons Edinburgh - website link
Royal Colleges of Surgeons England

5. What is the Academy doing to support the development of Specialist Recertification?

In the White Paper, Trust, Assurance and Safety, the Academy of Medical Royal Colleges was charged with two primary tasks:

To “… support the development of recertification processes and working closely with the GMC, to establish a UK working group to support co-ordination and piloting of these processes, including ensuring equivalence of standards between Medical Royal Colleges” (DH 2007: 35).
To lead the work of the Medical Royal Colleges and Faculties in drawing up standards for each area of specialist recertification. “These standards will be tested against the needs of patients and healthcare providers and based on wide consultation with all relevant stakeholders. The standards will be agreed with the GMC to ensure that they are sufficient to meet the requirements for remaining on the appropriate part of the medical register” (DH 2007: 35).

As a starting point to address these tasks, we have drafted a Project Plan which contains three workstreams:

Standards – building on an adapted framework for appraisal and revalidation developed by the GMC, we have asked all of the colleges to define specialty specific standards for recertification and to identify the methods and evidence that could be used by doctors to demonstrate that they have achieved the standard.
Work Groups – we have established work groups covering areas of common interest for development across the specialties. These groups include: E-portfolio; MSF; Non-Clinical Work of Doctors; CPD; and Remediation.
Methods and Tools – we have asked the Colleges and Faculties to establish and run a number of projects looking at the development and piloting of specific methods for recertification.

Academy Revalidation Project Plan – download

6. Collaboration with Other Key Stakeholder Organisations

We have established the Academy Revalidation Development Group (ARDG) with representation from the Medical Royal Colleges and Faculties as well as Patients; General Medical Council; British Association of Medical Managers; National Clinical Assessment Service; NHS Employers and the British Medical Association. This group is concerned with all aspects of the development of processes and procedures related to the specialist recertification of doctors.

Terms of Reference of the ARDG – download
British Medical Association (BMA) - website link
NHS Employers - website link
National Clinical Assessment Service (NCAS) - website link
British Association of Medical Managers (BAMM) - website link

General Medical Council

An Academy/GMC Steering Group has been established to facilitate collaborative working on revalidation. This overarching group is jointly chaired by Professor Sir Graeme Catto and Professor Dame Carol Black and contains five GMC Council members and six College Presidents.

Terms of Reference of the Academy/GMC Steering Group – download
General Medical Council - website link

Departments of Health

We feel that is it very important to open a collaborative dialogue on revalidation with all of the Departments of Health in the four countries of the United Kingdom. We have communicated with the four CMOs and will send the four UK Health Departments regular progress updates on our work.

Department of Health, England - website link
Welsh Assembly, Health and Social Care - website link
Scottish Government, Health and Community Care - website link
Department of Health, Social Services and Public Safety, Northern Ireland - website link

Patient and Lay Representation

Patients are represented through the Academy Patient/Lay Group on the Academy Revalidation Development Group and Working Groups. Most of the individual Medical Royal Colleges also have patient/lay representation on those committees and project groups formed to support the development of revalidation.

Communication with Doctors

Doctors will have representation through their membership bodies, Colleges and Faculties, on the Academy Revalidation Development Group and Working Groups. This website will be used to communicate general information about revalidation and the Academy’s specific work in support of specialist recertification.

Anaesthetists
	1. Dodds, C. (2008). Revalidation: where are we now? Bulletin of the Royal College of Anaesthetists, Vol 48: 2433-2437
Physicians (London)
	2. Shaw, K., Armitage, M. and Starke, I. (2008). Specialist Recertification: a survey of members and fellows. Clinical Medicine, Vol 8 (2): 155-156
Psychiatry
	3.Mynors-Wallis L (2008). What will revalidation means for psychiatrists? Advances in Psychiatric Treatment, 14;86-88.
Surgery (Edinburgh)
	4.Youngson, G and Lamb, A. (2008). Rising Standards. Surgeons News, Vol 7 (2): 62-65