Editor—With reference to the article by Esmail,1 the purpose of revalidation is to ensure that doctors provide safe, effective health care for patients. The quality of health care that the patient receives could therefore be the basis of revalidation, rather than a measure of the skills and knowledge of the doctor.
Clinical governance could be adapted for purposes of revalidation as the means by which a doctor is held responsible and assessed to ensure the provision of a high quality of health care and the maintenance of the means to achieve it. Revalidation could be granted for fulfilling the requirements of clinical governance.
The advisory committee on clinical excellence awards administers a tried and tested scheme for granting clinical excellence awards, and the trusts have committees responsible for the granting of discretionary points in an integrated scheme. Revalidation could be incorporated in this scheme avoiding a plethora of committees. Involvement of the advisory committee would inspire public confidence.
Revalidation and granting of awards could be a combined exercise. Criteria should be established for revalidation as for the awards. Revalidation may not be required in the first few years after appointment. This strategy could dramatically reduce the cost of the scheme.
Submission of evidence is best simplified as for the awards. Preparation of a folder of evidence would be more appropriate for appraisals.
Similar schemes could be envisaged for general practitioners, involving the primary care trusts.
Professor David Hatch in giving evidence to the Shipman inquiry made an illuminating contribution about revalidation, saying that nobody had given him the opportunity to demonstrate his fitness to practise.2 Every effort should be made to present revalidation as a process that benefits the doctor as well providing protection for the patient.
Competing interests: None declared.
References
- 1.Esmail A. Failure to act on good intentions. BMJ 2005;330: 1144-7. (14 May.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.The Shipman Inquiry. Reports. Fifth report—Safeguarding patients: lessons from the past—proposals for the future. www.the-shipman-inquiry.org.uk/fifthreport.asp (accessed 7 Jun 2005). (Section 26.12, p 1030.)