New GP revalidation system planned

The Royal College of General Practitioners (RCGP) has announced a new system of revalidation for GPs, including a revised system of continuing professional development (CPD) focusing on patient care. 

Speaking at the PM Society's 'General Practitioner CPD – Making an Impact' meeting, Professor Nigel Sparrow, chairman of the Professional Development Board at the RCGP, explained how GPs will have to complete a revalidation process every five years in order to continue practicing.

Revalidation will combine current General Medical Council (GMC) recertification processes with the recently implemented relicensing scheme. Relicensing is now the process that signifies a doctor has the legal authority to write prescriptions and sign death certificates. 

Although suggesting that "things will change" before the full revalidation process begins, Sparrow gave details of what the process will involve, with its aim of being "a simple and straightforward way of keeping doctors up to date and fit to practice".

 
Professor Nigel Sparrow

GPs and appraisers will use RCGP produced guidance, the Good Medical Practice for General Practitioners and the RCGP Guide to the Revalidation of General Practitioners to help produce 13 pieces of supporting information for each five year revalidation, 11 of which have already been approved by the GMC. These include the basics such as a description of roles, as well as an annual Personal Development Plan (PDP) agreed with the appraiser.

The pieces of supporting information awaiting final approval from the GMC are two pieces of multi-source feedback from colleagues as well as two patient surveys, with tests currently ongoing in Canada to validate their effectiveness.

The main area of supporting information though, and the central focus of Sparrow's talk, was GPs' self-accreditation of a minimum of 250 learning credits over the five years, with such self-assessment offering a flexible learning method that would "keep away from strict guidance".

This follows a consensus view from the Academy of Medical Royal Colleges (AoMRC) that all doctors should collect a minimum of 50 credits per year (250 over the five year revalidation cycle) from a learning based credit system to support their appraisal and revalidation needs.

Unlike other colleges which use only time spent in CPD to calculate credits, Sparrow talked of the RCGP's intention to use 'impact' to calculate credits.

For GPs, each hour spent on a learning activity, which can include planning and reflection, counts as one credit, but if a doctor can demonstrate the impact of this learning on practice and patient care, then these credits will be doubled. All credits will be verified by the appraiser at each annual appraisal.

He gave an example of a GP's treatment of a patient with an unclear prostate problem. Instead of referring the patient onwards as might usually happen, the doctor would consult an Essential Knowledge Update (EKU) produced by the RCGP and follow National Institute for Health and Clinical Excellence (NICE) guidance to hold further discussions and adopt a watchful waiting plan with the patient. The two hours reading would come to two credits, but because this reading had an impact on the patient, these credits would be doubled to four.

A variety of other ways to build up credits are detailed in the RCGP Guide to the Credit-Based System for CPD. These include auditing, attending meetings and developing practical skills, and all contain examples of demonstrable uses for impact.

"It's not difficult," said Sparrow "it's just showing what you've done is being used."

Sparrow also suggested that feedback for the process has been positive from doctors and that other members of the AoMRC have expressed an interest.

Pathfinder pilots are currently ongoing for the revalidation scheme in Dorset and London, with Early Adopter sites beginning in 2011.

A full news analysis on this topic will appear in the April 2010 issue of Pharmaceutical Marketing.