Panels of doctors and lay people will assess all registered doctors in the United Kingdom every five years to satisfy themselves that members of the profession are fit to continue to practise, according to a consultation document discussed by the General Medical Council this week. The council approved the document and it will now be sent out for consultation.
The GMC agreed in November 1998 that specialists and GPs must be able to show—on a regular basis—that they are keeping up to date and remain fit to practise. It set up a steering group to propose appropriate mechanisms (BMJ 1998;317:1406). The GMC defines revalidation as “making registration, which is currently largely a historical record of medical qualifications, into a contemporary record of a doctor's fitness to practise.”
Before the five year assessments can start every doctor will be required to maintain a folder, which will describe what the doctor does and include evidence to show how well he or she is practising. The evidence is likely to reflect the results of audit, educational activity, and the views of patients.
At regular intervals, perhaps annually, another registered doctor will review the folder, identify any deficiencies, and suggest opportunities for development or remedial action. This is likely to be done through appraisal systems.
If serious concerns about the doctor's fitness to practise are raised at any stage or if the revalidating panel does not feel able to certify to the GMC that the doctor is fit to remain registered the doctor will be referred to the GMC.
The GMC held a special conference in February, and the education, fitness to practise, and registration committees have considered how revalidation will affect their responsibilities. The GMC's president, Sir Donald Irvine, told a press conference this week that “because we have consulted many bodies and organisations already . . . we are confident that there will not be any major surprises for most doctors and patient organisations and that the system will not be too bureaucratic.”
The GMC points out in its consultation document that revalidation is part of wider reform in medicine and health care. “Creating a professional culture in which conscientious doctors can pursue quality improvement and work in effective teams, and can admit to error and find support in putting things right promptly before patients come to harm, is critical to success,” it says.
The consultation document will be launched in June, after which an executive summary of the document will be sent to all doctors on the register. Responses have been requested by 25 September. The GMC will consider the responses in November, and draft proposals for a revalidation model will be discussed by the council in February 2001, with a view to reaching agreement in May 2001. New legislation will be needed to make participation in revalidation mandatory.
Revalidation: The Consultation Document will be available on the revalidation section of the GMC's website: www.gmc-uk.org after it is launched.