19 Oct 2012

Doctors face an annual skills assessment for the first time

Doctors’ skills will be reassessed every year to ensure they are fit to practise, in a move the General Medical Council describes as the biggest change in medical regulation for more than 150 years.

At present, doctors can go for their entire career without facing any formal assessment of their competence.

But the Health Secretary Jeremy Hunt has announced that from December 2012 doctors will be assessed to see if they are fit to stay on the medical register.

The assessment will take the form of an annual appraisal and a more comprehensive meeting every five years.

The General Medical Council (GMC) has said the new system will mean that problems with doctors are flagged earlier.

Doctors will be expected to demonstrate that they meet clinical standards and have kept up to speed with the latest developments in their field. Appraisals will include feedback from patients and colleagues.

Mr Hunt said: “We want to have the best survival rates in Europe for the major killer diseases.

“Doctors save lives every day and making sure they are up to speed with the latest treatments and technologies will help them save even more. This is why a proper system of revalidation is so important.”

Four options

All doctors in the UK with a licence to practise will be linked to a “designated body” which will be responsible for conducting the appraisal.

Every five years a “responsible officer” – who is in charge of the appraisals – will send a recommendation to the GMC on whether each doctor should be revalidated.

The GMC said there are four options for those being revalidated ranging from no action if their skills are up-to-date, to the “worst case scenario” of a doctor’s licence being suspended temporarily.

But the GMC told Channel 4 News that it would not result in doctors being struck off.

Health officials have been considering revalidation for many years.

The GMC began creating a revalidation model after the 2001 public inquiry into failings in the children’s heart surgery service at Bristol Royal Infirmary.

Every doctor has a duty to be able to describe what they do and to define how well they do it NHS medical director Professor Sir Bruce Keogh

But the 2005 Shipman Inquiry, which looked into the case of serial killer and GP Harold Shipman, was heavily critical of the initial proposals so health officials created a new model and organised pilots.

In one, conducted on 3,000 doctors, concerns were raised about 1 per cent of the medics.

Another survey of 320 of the designated bodies in England found concerns about 4.1 per cent of doctors. Worries raised ranged from tardiness to more serious concerns about clinical competency.

Niall Dickson, chief executive of the GMC, said: “This is an historic moment, it is the biggest change in medical regulation for more than 150 years.

Regular checks

“The decision to press ahead with revalidation after many years of preparation and planning means that we’ll be able to have a comprehensive system of regular checks for all doctors registered in the UK.

“Every NHS doctor is already supposed to have an annual appraisal but until revalidation appeared on the horizon many organisations were simply not achieving this. Now both the NHS and private healthcare organisations have begun to get their act together.

But Mr Dickson admitted that revalidation was “not a panacea” and would not guarantee that care is safe or that every doctor is perfect.

“It will take time to settle in,” he added “we will need to evaluate and improve the model.”

NHS medical director Professor Sir Bruce Keogh admitted that implementation will be “initially quite difficult” and that the system would not be immediately perfect, but added: “My personal view is that it is better to start than wait for perfection.”

He added: “I think that every doctor has a duty to be able to describe what they do and to define how well they do it – if you can’t do that you forfeit some of your professionalism.”

The process will start in December with the revalidation of medical leaders and from April 2013 it will start to assess mainstream doctors.

By then, every doctor will have been told when their revalidation is due, with the vast majority likely to have gone through the process by April 2016.

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