impact of cpd/appraisal/revalidationthe outcomes/effectiveness of revalidation in the united...
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DATE:
Impact of
CPD/Appraisal/Revalidation
on healthcare
Dr Andrew Long
Vice President, Education, RCPCH
Consultant Paediatrician, Great Ormond Street Hospital
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Cost benefit
The Department of Health has published a long awaited
impact assessment for revalidation, revealing that the
scheme will cost doctors over £450 in ‘opportunity costs’ per
revalidation cycle and will only prevent 0.75% of cases of
death, severe harm and moderate harm per year.
The impact assessment reveals the scheme will cost a total
of £97m a year, the majority of which accounts for the added
pressures on doctors’ time.
The impact assessment said that there will be two main
costs for revalidation: those associated with undertaking
appraisals and making revalidation decisions.
Evidence that revalidation is delivering value include:
• a continued increase in appraisal rates (which increased from 63% to 91%
between March 2011 and March 2016)
• an increased focus on the quality of appraisers and the appraisal process
• indicative signs that concerns about a doctor’s practice are being identified at an
earlier stage
• strong support for the system among responsible officers and appraisers
• strong support from doctors, appraisers and responsible officers for medical
appraisal, a key element of revalidation.
However, the report also highlights a few areas where further work is needed:
• While doctors continue to value appraisals and continuing professional
development, some feel that revalidation is not yet relevant to their needs..
• Patients and the public need clearer and more powerful roles in revalidation in the
future.
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The outcomes/effectiveness of revalidation in the United Kingdom:evaluating the regulatory impact of medical revalidation
Julian Archer, Niall Cameron, Katie Laugharne, Martin Marshall, Sam Regan de Bere, Kieran Walshe, Richard Wright
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Purpose of the evaluation
• 30 research questions, addressing 6 core regulatory aims for medical revalidation:
– Is the GMC’s objective of bringing all doctors into a governed systemthat evaluates their fitness to practise on a regular basis being consistently achieved?
– How is the requirement for all doctors to collect and reflect upon supporting information (SI) about their whole practice through appraisal being experienced by revalidation stakeholders?
– Is engagement in revalidation promoting medical professionalism by increasing doctors’ awareness and adoption of the principles and values set out in Good Medical Practice?
– Are revalidation mechanisms facilitating the identification and remedy of potential concerns before they become safety issues or FTP referrals?
– How do ROs fulfil their statutory function of advising the GMC about doctors’ fitness to practise and what support do they have in this role?
– Are patients being effectively and meaningfully engaged in revalidation processes?
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Patient involvementInstruments
Patient feedback questionnaires
Patient survey
Patient information from GMC and
patient groups
Patients, Public
Lay
representatives
Rules
Revalidation
processes/regulations
Fitness to Practice
Organisational Protocols
Organisational structures
Rules
Revalidation
processes/regulations
Fitness to Practice
Organisational Protocols
Organisational structures
Community
Medical Community
Patients/carers
Patient groups
Medical Institutions
DoH
NHS
Healthwatch
CCG’s
Non-medical communities
Division of Labour
Patients
Lay representatives
Doctors
Revalidation Representation
Outcome
“Up to date and fit to
practice”
Increased patient
safety and public
confidence
Current system inadequate
- further work in progress
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Benefits to profession
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Summary
• Revalidation has been implemented in the UK with numerical success
• CPD is an essential component of revalidation
– demonstrate knowledge and skills necessary
– show relationship to Good Medical Practice
• Revalidation portfolio should demonstrate professional attitude to working life
• Best outcome for patients is likely to relate to how seriously clinicians engage with the process
• Highlights the need for reflective practice
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Questions….?