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Revalidation Update. Teresa Dorman APA Linkman Meeting 18 th November 2013. APA education and training committee. The roll out of revalidation. Year Zero – 2012/13 (December 3 rd 2012,Secretary of State sign off, Legislation, Responsible Officers revalidate by 31 st March 2013.
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Revalidation Update Teresa Dorman APA Linkman Meeting 18th November 2013 APA education and training committee
The roll out of revalidation • Year Zero – 2012/13 (December 3rd 2012,Secretary of State sign off, Legislation, Responsible Officers revalidate by 31st March 2013. • Year 1 – 2013/14 • Year 2 – 2014/15 • Year 3 – 2015/16 • The starting gun has sounded…
Who does what in revalidation • Appraisers appraise • Responsible officers make recommendations • Revalidate • Defer • Failing to engage • The GMC revalidates
Who’s who GMC Revalidation Support Team (RST) revalidation support team (RST) the purpose of the RST is to work in partnership with the DH, GMC and designated bodies to deliver an effective system of revalidation for doctors in England
What’s what? ORSA organisational readiness (OR) the purpose of the OR project is to prepare healthcare systems and designated bodies in England for their role in delivering revalidation for doctors through appropriate training, guidance and tool.
What’s what? MAG
What’s what? MAG Form v3
Revalidation “It is not a point in time assessment of knowledge and skills .It is a five year process not a fifth year event.” A Tomlinson VP RCoA 2010
Revalidation Portfolio of Supporting Information Five x annual appraisals Responsible Officer Query Cannot recommend revalidation Recommend revalidation RCoA advisor and/or GMC affiliate review and support General Medical Council
Recommendations RO can make one of 3 recommendations: • Recommendation to revalidate • Deferral • Notification of failure to engage
Recommendations Deferral • Insufficient supporting information • Information gaps • Participation in a local or national process • HR investigation • Performance or remediation • New date must be within 12 months *this does not affect the license to practice (Responsible Officer Protocol GMC)
Recommendations Notification of failure to engage • Confirms responsible officer cannot make informed recommendation as the doctor hasn’t engaged • Related to insufficient information in support of revalidation But notification of failure to engage: • Is not a mechanism for addressing concerns about fitness to practice • It concerns doctors who have had sufficient opportunity and support to engage in revalidation but have failed to do so • Is where there are no reasonable grounds for failure to engage.
GMP • Updated March 2013 • Effective 22nd April 2013 • 4 Domains • Matches the framework for appraisal and revalidation
GMP – what’s new? • Mentoring: Structured support activities (10) Mentoring role for more junior colleagues (42) • Clinical Records (19-21) • Respond to risks to safety (24-27) • Continuity and coordination of care (44-45) • Communicating information (68-71)
GMC framework Based on four domains Knowledge, skills and performance, Safety and quality, Communication, partnership and teamwork Maintaining trust.
Framework Last updated 16 March 2011 | 1
What’s new about appraisal • Doctors are appraised on the whole of their scope of work • Clinical governance information and information arising from appraisal will be combined to enable the responsible officer to make a recommendation about revalidation to the GMC • The doctor will have to sign off statements about significant events, complaints, probity, health, the appraisal portfolio, and GMC requirements • The appraiser will have to sign off statements about engagement with appraisal, progress with the previous PDP and the appropriateness of the new PDP and GMC requirements
Appraisal statements • An appraisal has taken place that reflects the whole of the doctor’s scope of work and addresses the principles and values set out in Good Medical Practice • Appropriate supporting information has been presented in accordance with the Good Medical Practice Framework for appraisal and revalidation and this reflects the nature and scope of the doctor’s work • A review that demonstrates progress against last year’s personal development plan has taken place • An agreement has been reached with the doctor about a new personal development plan and any associated actions for the coming year. • no information has been presented or discussed in the appraisal that raises a concern about the doctor’s fitness to practise.
O U T P U T S Doctor’s personal development plan Summary of appraisal Appraiser’s statements Appraisal process I N P U T S Personal information Scope and nature of work Supporting information Confidential appraisal discussion Post-appraisal sign-off by doctor and appraiser Developmental Review of last year’s personal development plan Achievements, challenges and aspirations Medical Appraisal Guide, RST
MAG form v3 Developed by RST Meets GMC requirements for information Electronic Series of PDFs – write and save Stores appraisal history
Supporting Information There are six types of supporting information: 1. Continuing professional development 2. Quality improvement activity 3. Significant events 4. Feedback from colleagues 5. Feedback from patients (where applicable) 6. Review of complaints and compliments
Supporting information General information about you and your professional work Keeping up to date Review of practice: quality improvement activity, significant events Feedback on professional practice: colleague feedback, patient and carer feedback, complaints and compliments http://www.rcoa.ac.uk/node/1951
CPD Minimum of 50 credits p.a. (250 credits in 5 years) internal - min 20 At least 10 from clinical governance meetings External - min 20 Mix of regional, national meetings http://www.rcoa.ac.uk/node/1922
CPD matrix • Guide • Not mandatory • Not all inclusive / exclusive • Broad range of topics
RCoA On line CPD • Personal online space to record CPD activity and associated credits and to reflect on CPD activity • Keeps a running total of CPD credits annually and 5 yearly for revalidation • Reporting – summaries of CPD activity for appraisal • Link to all CPD activities against the RCoA matrix, helps identify any gaps
Online CPD • Can record absences e.g. maternity leave in a 5 year cycle • The yearly CPD cycle will be set when the user logs in to the system for the 1st time. The day and month can then be selected to start the cycle from. • All data backed up automatically • Consultants can register online on the RCoA website.
AAGBI learn@AAGBI Personal CPD Record Reflection Certificate
30. It is your responsibility to do enough appropriate CPD to remain up to date and fit to practice in your work. This applies whether you are full time or part time Most medical royal colleges and faculties have developed CPD systems or guidance to support doctors ....... participating in these schemes to obtain a specific number of CPD credits over 5 years. We don’t require you to be a member of a college or faculty CPD scheme to undertake a specific number of hours of CPD each year or acquire a particular number of CPD credits. However you may find that participating in such a scheme is helpful........
GMC - Reflection 16 Reflection drives change in performance and is key to effective CPD. GMP requires you to reflect regularly on your standards of medical practice 18 You must also reflect on what you have learnt from your CPD activity......record whether your CPD has had any impact....on your performance and practice
Reflection CPD Reflective Note Guidance and Template www.aomrc.org.uk/component/docman/doc_download/9335- reflective-practice-template.html?Itemid=33
Quality improvement activity Audit cycle • Audit recipe book RCoA Review of clinical outcomes • National standards • Individual and team practice Case review or discussion • 2 per year • Reflect against national standards or guidelines • Evidence of discussion with peers/presentation at audit
Quality Improvement Activity Can be done!
Significant events • Clinical incidents • SUI Details based on data logged on local systems or national reporting systems Up to 2 incidents per year All SUIs or root cause analyses involved in
Feedback • Colleague • Patient / carer • On practice e.g. teaching
Feedback on practice Clinical supervision, teaching and training • Evidence of performance as clinical supervisor at least once in cycle • Evidence that you meet the minimum training requirements of the GMC ( accreditation of trainers) • Feedback on any formal teaching done • Deanery QA process
Feedback on practice Formal complaints • All complaints • All areas of work not just patient complaints • Summary of issues raised AND reflection • Reflection will be the focus • Self declaration if none Compliments and thanks!
Feedback Patient and /or carers feedback comply with GMC requirements can take a while can use departmental information e.g. satisfaction survey Colleague feedback Min 1 in 5 year cycle Year 2 Can take a while
RCoA feedback • Piloting in 4 sites • Adults and children • User guide • Logistics guide • Facility for departments to collate feedback
Revalidation • 6 months: check designated body information is correct • 4 months: formal notice that GMC requires a recommendation by your revalidation date • 10 days: if the GMC haven’t got a recommendation they tell you • Let you know the decision • Next date 5yrs minus one day from date the decision is made
The first cycle • Revalidation date If you haven’t: • Register for GMC online account • Find you designated body RO • Contact the GMC
The first cycle You should be: • be participating in an annual appraisal process • have completed at least one appraisal with Good medical practice as its focus • have collected and reflected on all six types of supporting information. ***minimum***
Read relevant documents GMC Good Medical Practice Framework for Revalidation and Appraisal GMC Supporting Information RST Medical Appraisal Guide v3 MAG form v3 RCoA Supporting Information RCoA Continuing Professional Development
The First Cycle READ!!
Don’t Leave it to the last minute! “It is not a point in time assessment of knowledge and skills .It is a five year process not a fifth year event.”