Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme...
Transcript of Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme...
![Page 1: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/1.jpg)
Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West &
Programme Manager, South Central Revalidation Pilot, NHS South Central
Medical Revalidation
![Page 2: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/2.jpg)
Revalidation: what is it?• A system to assure patients and the public that
doctors are fit to practise, up to date and providing clinically effective, personal and safe care.
• Appraisal is part of revalidation and affirms professional practise and defines future learning plans
• Revalidation occurs within governance frameworks (GMC, DH & Royal Colleges) that aim to build trust, assure standards and improve patient safety
![Page 3: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/3.jpg)
RevalidationRevalidationRevalidationRevalidation
Re-Re-CertificationCertification
Re-Re-CertificationCertificationRe-LicensingRe-LicensingRe-LicensingRe-Licensing
Is this doctor fit to Is this doctor fit to practice as a medical practice as a medical practitioner in the UK?practitioner in the UK?
Is this doctor fit to Is this doctor fit to practice as a medical practice as a medical practitioner in the UK?practitioner in the UK?
Is this doctor fit to Is this doctor fit to practice as a specialist practice as a specialist
or generalist?or generalist?
Is this doctor fit to Is this doctor fit to practice as a specialist practice as a specialist
or generalist?or generalist?
General Medical Council Royal Colleges & Faculties
General Medical Council
Local Responsible Officer
The initial proposed model
![Page 4: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/4.jpg)
Revalidation – current thinking
• Licence to Practice issued to every doctor who requested one, October 2009
• The GP and Specialist Registers are a record of historical achievement; once on it the doctor will stay on it
• The Licence will reflect what a doctor is revalidated for and relicensing will be the main output from revalidation
![Page 5: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/5.jpg)
Qualification
Registration
Renewal of Licence
Licence to Practice
Revalidation
Train
ing
Strengthened Appraisal
Every
5 Years
Life-long
Registration(Specialist or GP)
Changes in role and interests
The current proposed model
![Page 6: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/6.jpg)
General Medical General Medical CouncilCouncil
General Medical General Medical CouncilCouncil
Local Local Responsible Responsible
OfficerOfficer
Local Local Responsible Responsible
OfficerOfficer
Royal Colleges Royal Colleges & Faculties& Faculties
Royal Colleges Royal Colleges & Faculties& Faculties
GMC GMC AffiliateAffiliateGMC GMC
AffiliateAffiliate
ProfessionaProfessionall
ProfessionaProfessionall LayLayLayLay
Local ProcessesLocal ProcessesLocal ProcessesLocal Processes
StrengtheneStrengthened Appraisald Appraisal
StrengtheneStrengthened Appraisald Appraisal Job PlanningJob PlanningJob PlanningJob Planning
PerformancPerformance e
ManagemenManagementt
PerformancPerformance e
ManagemenManagementt
Clinical Clinical AuditAudit
Clinical Clinical AuditAudit
Clinical Clinical GovernanceGovernance
Clinical Clinical GovernanceGovernance
Specialty Specialty Specific Specific
AssessmentsAssessments
Specialty Specialty Specific Specific
AssessmentsAssessments
BoardBoardBoardBoard
![Page 7: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/7.jpg)
RegulatorRegulator‘‘R’ - high level R’ - high level remedial supportremedial support
‘‘r’ - low level r’ - low level remedial remedial supportsupport
Informal SupportInformal Support
College/Faculty Quality College/Faculty Quality Assurance (audit of sample)Assurance (audit of sample)
Port
folio
of
Port
folio
of
Evid
en
ceEvid
en
ce
Appra
isal x 5
Appra
isal x 5
Loca
l R
esp
onsi
ble
Lo
cal R
esp
onsi
ble
O
ffice
rO
ffice
r
Self-HelpSelf-Help
Colle
ge/F
acu
lty
Colle
ge/F
acu
lty
(fu
ll evid
en
ce
(fu
ll evid
en
ce
revie
wre
vie
w))
Colle
ge/F
acu
lty P
lus
Colle
ge/F
acu
lty P
lus
Loca
l R
esp
on
sib
le
Loca
l R
esp
on
sib
le
Offi
cer
Offi
cer
Gen
era
l M
ed
ical
Gen
era
l M
ed
ical
Cou
nci
lC
ou
nci
l
QueryQuery
Positive Statement of AssurancePositive Statement of Assurance
Satisfactory
Satisfactory
![Page 8: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/8.jpg)
Appraisal is a tool which:• … helps individuals consider their performance
and their development needs in the context of:The requirements of their current role
The evolving needs of their organisation
Developments in their specialty/profession
Personal needs, wants, aspirations
Political imperatives
![Page 9: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/9.jpg)
Appraisal is an opportunity to:• Review performance (and address issues)
• Consider the doctor’s contribution to the service
• Identify and address working environment issues
• Discuss opportunities and aspirations
• Discuss and plan personal development needs
• Balance skills and resources
![Page 10: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/10.jpg)
Challenge
Personal Development
Support
The Appraisal Balance
![Page 11: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/11.jpg)
Strengthened Medical Appraisal1. Common framework for appraisal, and
assessment of supporting information
2. Availability of supporting information to support the appraisal process
3. A common quality framework for appraisal
4. Effective local clinical governance systems
![Page 12: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/12.jpg)
The appraiser’s role in strengthened medical appraisal (SMA)
• Ability to assess a portfolio of supporting information
• Ability to make judgements about the progress of an appraisee towards revalidation
• Ability to benchmark own personal standards against those of peers, and moderate individual judgements and assessments to achieve consistency with other appraisers
![Page 13: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/13.jpg)
• What do appraisers do in SMA?• Manage the process of the appraisal interview
• Manage the content of the appraisal interview
• Review/Assess supporting information
• Make a judgement about whether there are any immediate concerns about patient safety
• Make a judgement about whether doctor is on track to revalidate (at this point in the cycle)
• Record the agreed outcomes of the appraisal interview
• Assist in the planning of development needs
![Page 14: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/14.jpg)
Supporting information• Current GMC License and Registration• Complaints and Litigation• Adverse Incidents (incl. learning from)• Multi-source Feedback• Patient Satisfaction Questionnaires• Other pertinent documents
(e.g. audit; outcome measures)• Significant Event Audits• Specific items recommended by College• Anything else the appraisee thinks appropriate
![Page 15: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/15.jpg)
RST Proposed Generic Essential Information
Type of InformationType of Information Min. Required Min. Required in 5 Yearsin 5 Years CommentsComments
1Significant Event Review/Case
Review10 Minimum 2 per year
2 Review of Complaints All
3Audit (of which some may be less
formal data review)5 Minimum 1 per year
4Patient Feedback Survey and
Review1 To be presented no later than yr 5
5Colleague Feedback Survey and
Review1 To be presented no later than yr 5
6New PDP and Review of Previous
Year’s PDP5 Annually
7 CPD Completion 5 Annually
8 Health Self Declaration and Review 5 Annually
9 Probity Self-Declaration and Review 5 Annually
![Page 16: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/16.jpg)
RCGP Proposals for Continuing Education• Continuing education recorded in the form of
learning credits• At least 50 learning credits a year• More than 250 over 5-year revalidation cycle• Minimum of 1 credit for each hour of education• Each hour of education leading to improvements
in care or practice will qualify for 2 credits.
![Page 17: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/17.jpg)
Good Medical Practice Domains, Attributes & StandardsGMC, 2005
4 Domains:Knowledge skills & performanceSafety & qualityCommunication, partnership & team workMaintaining trust
12 Attributes70+ ‘standards’
![Page 18: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/18.jpg)
Assessing supporting information
• Does it suggest cause for immediate concern?
• Which attribute(s) of GMP does it inform?
(NB Many items will inform more than one attribute.)
• Does it show evidence of personal reflection?
![Page 19: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/19.jpg)
• Does it contribute to revalidation:• Yes, on it’s own (e.g. colleague and patient feedback)
• Yes, if produced regularly (e.g. outcome data)
• Not as it stands, because … (e.g. incomplete)
• No, it doesn’t reflect what the doctor does
• Has the doctor met the CPD recommendations of their College/Association?
• What learning needs (if any) does it identify
![Page 20: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/20.jpg)
Conclusion by Appraiser …A) Potential risk:• Are there genuine immediate concerns about this doctors practice?• If yes, are measures in place to protect patients, colleagues, the doctor and
the public? (with detail)
B) Areas for development:• Are there areas where the doctor’s performance has not been clearly
demonstrated to be of a satisfactory standard with regard to the guidance expressed in GMP?
• Does the PDP cover all areas that the doctor needs to address, with timeframes?
C) Revalidation:• Are there areas where the doctor’s progress towards satisfactory
Revalidation may be in doubt? • Have these been identified and understood, with an appropriate plan in
place?
![Page 21: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/21.jpg)
The appraiser’s judgement and evidence from the organisation’s clinical governance systems will inform the Responsible Officer’s recommendation to the GMC.
![Page 22: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/22.jpg)
![Page 23: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/23.jpg)
Revalidation Support Team Pathfinder pilots• 3000 appraisals across England• Whole system testing• Testing Information flows• Nominated “Responsible officer” role• Preparation for “live” testing• Evaluation to inform Treasury impact
assessment• Single & Multi organisational• Advanced and early stage sites• Range of doctor specialties and roles
![Page 24: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/24.jpg)
High level aims• To identify the impact on individuals and
organisations in terms of cost, time andresources
• To identify problems arising atorganisation and individual level inimplementing the proposed arrangements
• To identify any benefits related to theappraisal and revalidation process egpatient care and clinical outcomes
![Page 25: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/25.jpg)
Whole system sites:Isle of WightMilton KeynesRoyal Berkshire Foundation TrustVoluntary sites:Other South Central organisations
![Page 26: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/26.jpg)
Participation in the pilot:• Consent• Agree to complete evaluation forms• Strengthened Training of Appraisers for
Revalidation (STAR)• Register on electronic toolkit• Collect supporting information for appraisal on
toolkit & map to GMC attributes• Appraisal discussion• Evaluation• Responsible officer review
![Page 27: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/27.jpg)
![Page 28: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/28.jpg)
![Page 29: Ros Crowder, Primary Care Continuing Professional Development Tutor, NHS Berkshire West & Programme Manager, South Central Revalidation Pilot, NHS South.](https://reader035.fdocuments.in/reader035/viewer/2022070409/56649e715503460f94b6eeb6/html5/thumbnails/29.jpg)
Further information:• GMC consultationhttp://www.gmc-uk.org/doctors/licensing/5786.asp• NHS South Centralhttp://www.southcentral.nhs.uk/page.php?id=433• Revalidation Support Teamwww.revalidationsupport.nhs.uk• RCGPhttp://www.rcgp.org.uk/_revalidation.aspx• South Central Revalidation Pilothttp://www.southcentral.nhs.uk/page.php?id=433• Ros Crowder / Maggie Woods, CPD [email protected]@southcentral.nhs.uk