Revalidation

1. Revalidation Adapted from ARCP CHAIR TRAINING

2. Background • Revalidation for Trainee Doctors began on 3rd December 2012 for any trainees applying for CCT. • The GMC will expect the Deanery/LETB to revalidate a minimum of 20% of Trainees in the first year (2013) and then ensure that all East Midlands Trainees are revalidated by the end of March 2016. • Revalidation will begin from FY2 (once trainees are registered with the GMC) and is a 5 yearly cycle or at CCT (whichever comes sooner).

3. The process to revalidate trainees will be delivered by enhancing the existing ARCP process. The ARCP process will begin with the collection of evidence that will assist the Responsible Officer. Additional information will be required from employers (SUIs and complaints, etc.) and will be reported to the panel. • The panel will then need to: a) decide on fitness to progress in training (ARCP) b) comment on whether they have identified any known concerns regarding fitness to practice, based on evidence viewed.

4. Process - 1 • The GMC have commented that the current ARCP process delivers 70% of the information that will be required by the Responsible Officer to revalidate trainees. This information will already be available within the Deanery/LETB, and is already viewed by panels, to inform the Responsible Officer. • The further 30% of the information required will be from employers and trainees. This will come from Employers who will need to highlight any complaints/ investigations/SUIs that have occurred for individual trainees or for Employers to confirm there are “No Known Concerns” with an individual trainee’s fitness to practice.

5. Process - 2 • The remaining information will come from trainees, who need to self-declare aspects of their practice via an Enhanced Form R, on an annual basis. The following diagram details: • How the process for Revalidation will operate and how the ARCP panel fits within that process. • How the connection between the work of the ARCP panel and the annual collation of evidence will inform the Responsible Officer’s recommendation to revalidate an individual trainee on a 5 year cycle. • N.B. The evidence will be held centrally within the Deanery/LETB office so it is available for the Responsible Officer at the trainee’s revalidation date.

6. REVALIDATION: THE ARCP PANEL’S COMMENT ON FITNESS TO PRACTICE Trainee Doctor ARCP Panel ENHANCED FORM R For Revalidation comment: Use if present, not yet essential* EMPLOYER EXIT REPORT For Revalidation comment: Use if present, not yet essential* EDUCATIONAL EVIDENCE (e-portfolio, ES reports, etc. – info currently collected) For Revalidation comment: Essential • Trainee completes an enhanced Form R (self-declaration) annually. • Form R identifies all work undertaken in last year, plus any SUI’s/ complaints/ outstanding investigations. • This form is sent to the Deanery/LETB • Panel gives an educational progression outcome (Outcomes 1-9) as before. • Panel now also commentson “fitness to practice”. The comment is based on the evidence presented at the ARCP panel only. Comment either: • No evidence of concerns presented to this panel today and… • …all expected evidence was seen by this panel, {or} • …the following expected evidence was not seen by this panel: • {PLEASE DETAIL EXPECTED EVIDENCE NOT SEEN, IF ANY} • OR • Yes, this panel has been presented with evidence of concern(s), the details of which are as follows: • {+ DETAIL CONCERNS} • NB: In the case of an adjournment (e.g. the two-week adjournment for an Outcome 5 to allow time for evidence to be gathered), any comment made in the original ARCP can be superceded by a comment made based on new evidence when the panel reconvenes. • NB: Any concerns raised or missing evidence identified will be reviewed/investigated by the APD and the Deanery’s Revalidation Coordinator. They will then be raised with the Responsible Officer or Deputy Dean (as appropriate) for further action if required. The panel can only comment on evidence presented to them, and can feel reassured that if they state ‘no concerns but _____ evidence not seen by panel’, this evidence will be pursued and assessed by the Responsible Officer and Deanery before the R.O. makes any decision about her recommendation to the GMC. • NB: In the case of a missing Educational Supervisor’s report, the R.O. will not make a Revalidation recommendation until an ES Report is acquired and reviewed by a subsequent panel. Trust/Practice (Employer) • Responsible Officer at employer base receives a spreadsheet from the Deanery/LETB detailing all trainees in employment at that time. • Responsible Officer (employer) indicates for each trainee whether there are “no known concerns” or any issues that need highlighting. This is done on the ‘Collective Exit Report’. • For trainees where there are issues or concerns, an ‘Exception Exit Report’ (known as a ‘Grey Form’) is completed. • This is completed by the employer’s Medical Director (or delegate) to highlight details of the concerns with a trainee’s “fitness to practice”. * Valid only for 2013 as introductory measure. Form R and Exit Report may become essential in 2014

7. What this means to a panel • There is a standard set of national documents that all Deaneries/LETB must use for both ARCPs and Revalidation. • A COPMED Trainee Revalidation Steering Group are nationally developing the process of transferring data between Responsible Officers, for trainees who move to a another Deanery/LETB, which the Deanery/LETB will be expected to adhere to once defined. • This group will also be responsible for collating feedback nationally that may further develop the process, systems or documents that we will be expected to use for Revalidation.

8. 2013 First time to try this………. Locally we will contact all East Midlands trainees on 1st April 2013 to request completion of an Enhanced Form R on their practice and we will be doing this routinely on an annual basis.

9. All Trust Chief Executives and Medical Directors within the East Midlands will also be contacted and asked to provide information on current trainee’s fitness to practice. N.B. Employers will be asked to confirm that there are “No Known Concerns” with an individual trainee or there are “Concerns”. Concerns may be due to current or pending investigations. This will be a twice yearly activity at pre-defined time periods. • Again information will be held within the Deanery/LETB and sent to panels when the trainee is to be assessed.

10. Within the Deanery/LETB we need to receive this data from trainees and employers by the end of April in order for us to deliver the requirements of revalidation. • The Deanery/LETB will filter this information which will then be passed on to the ARCP panels who will record any comments on the ARCP form. This will be the mechanism to then communicate information back to the Deanery/LETB. • ARCP Chairs can assist greatly with this process by completing the ARCP Request Form, ensuring that all trainees that they intend to assess at a panel are detailed and that this form is received well in advance of the panel.

11. Working with the GMC This is a new initiative and new teams have been established at the GMC to deliver this. The Deanery/LETB works with the GMC to ensure that all East Midlands trainees have been allocated revalidation dates. The GMC have determined the dates they wish a trainee revalidated by. The GMC has written to all East Midlands trainees to inform them if their revalidation date is this year.

12. Current Issues • Some Trusts have experienced difficulty in providing information requested on SUIs and complaints and have highlighted that they require time to develop their systems to deliver this. Current systems do not attribute SUIs to individuals. The exception to this is GMC referrals, which they are able to attribute to the individual. This will mean that there will be gaps in the information that Trusts hold and can send until they develop the mechanisms and systems to support recording this information.

13. Current Issues • Some Trusts are currently looking at recruiting dedicated roles to assist with delivering Revalidation on an organisation wide basis. The Deanery/LETB will need to link individuals in the LETB with these roles/teams in the future so information can be shared. This will assist in joining up Deanery/LETB and Trust activities for Revalidation.

14. Further work that will assist ARCP Chairs • Training and documentation is being developed to assist Educational Supervisors in ensuring that their reports now account for professional conduct and behaviour in addition to educational competence and skill. This will improve the reports and enhance the information submitted to the panel. • These tools will be launched in April 2013 and released to the Chairs of Panels and Heads of School to cascade to their Training Programme Directors and Educational Supervisors.

15. Questions • What evidence would help you complete the educational/academic supervisors reports to meet revalidation requirements? • Can you foresee any problems for trainees completing the Enhanced Form R?