Medical Revalidation
Sir Liam Donaldson, in his recent report, Medical Revalidation: Principles and Next Steps, has described a new system through which family doctors, hospital consultants and private practitioners will have to apply to renew their licences. According to this report, this new system will be “focused on raising standards, not a disciplinary mechanism to deal with the small proportion of doctors who may cause concern”.
The new regime is designed to identify doctors who repeatedly make poor clinical decisions. Inspectors will use evidence from patients’ questionnaires and feedback from colleagues and annual reviews will be made mandatory. These yearly checks will examine doctors' prescribing habits, the quality of their interactions with patients, the adequacy of the pathological assessments as well as personal troubles that might adversely affect their work, such as drug or alcohol abuse.
Under the new system, senior doctors - usually medical directors - will assess others who are practising in their area to ensure they are not putting patients at risk. Patients will be asked for details on how their doctor communicates, including how well he or she explains and listens. The degree to which patients are involved in decisions about their treatment and whether they are treated with dignity and respect will be taken into account.
Appraisals will be considered a “continuing process” leading up to licences being reissued every five years. Medical students and those who work in short-term appointments or as locums will also face annual checks.
At the moment doctors face no formal reassessments of their competence, clinical skills or performance between entering independent practice as a GP or consultant and retiring.
The medical colleges, which represent different clinical specialties, will have to develop tests to check that doctors are keeping abreast of advances.
The new regulatory system will be introduced in stages from the spring of 2009, after a series of pilot schemes.
The proposals were produced with the General Medical Council (GMC) and the Academy of Medical Royal Colleges. Many doctors may be concerned about bureaucracy diverting them from patient care. Critics said that it would mean doctors spending less time with patients and practising “defensive medicine”.
The Patients Association has been calling for genuine assurance for patients that their doctors are up to date and safe to practice. We have had a ‘roll call’ of horror stories over the past few years while revalidation has been discussed.
Katherine Murphy said ‘If patients are to trust their doctors, doctors in turn must ensure that true professionalism is subject to regular and genuine reappraisals which must involve the patient’. She added ‘medicine is constantly changing and professionals must ensure that they change and update themselves with it’.
The Patients Association hopes that this initiative will make for better clinical and safer care and positive outcomes so that there are no unnecessary postcode lottery between clinicians and that the revalidation will be genuine and as efficient as possible.
To download the report from the Department of Health, please click here
