Revalidation and AppraisalRevalidation and AppraisalUpdate October 2008Update October 2008

What’s happeningWhat’s happening

Appraisee stuffAppraisee stuff

Appraiser stuffAppraiser stuff

Handouts and www.starpace.co.uk Handouts and www.starpace.co.uk

The Three “R”sThe Three “R”s

Relicensing Relicensing GMC GMC

RecertificationRecertification RCGP RCGP

RemediationRemediation (only tiny minority (only tiny minority

expected to require GMC referral)expected to require GMC referral)

The Real NewsThe Real News

Revalidation WILL happenRevalidation WILL happen Licensing starts in 2009 (autumn)Licensing starts in 2009 (autumn)

(no assessment for this but…) (no assessment for this but…) Once you are licensed the clock is tickingOnce you are licensed the clock is ticking ReRelicensing 5 years from thenlicensing 5 years from then You must start methodically collecting your You must start methodically collecting your

evidence (portfolio) straight away if you evidence (portfolio) straight away if you are not already doing so….are not already doing so….

Good newsGood news

Incremental piloted approachIncremental piloted approach Being rolled out first in areas that are Being rolled out first in areas that are

better developed, NOT randomly by GMC better developed, NOT randomly by GMC numbernumber

? DOH still scarred by MTAS debacle? DOH still scarred by MTAS debacle The Three to watch:The Three to watch:

DOH proceeding cautiouslyDOH proceeding cautiouslyGMCGMCRCGPRCGP

Appraisal and assessmentAppraisal and assessment

Appraisal remains formative and Appraisal remains formative and developmentaldevelopmental

New framework against which to New framework against which to objectively assess Drs evidenceobjectively assess Drs evidence

Appraiser is not asked to make a Appraiser is not asked to make a judgementjudgement

Judgement made via clinical governance Judgement made via clinical governance pathway, appraisal evidence feeds in as a pathway, appraisal evidence feeds in as a part of thispart of this

Local and NationalLocal and National

Relicensing –GMCRelicensing –GMC for most Drs a local process: WILL BE PILOTED for most Drs a local process: WILL BE PILOTEDAppraiser and Responsible Officer (local)Appraiser and Responsible Officer (local)GMC affiliate-> GMC rubber stamp-Regional/NationalGMC affiliate-> GMC rubber stamp-Regional/National

Recertification - RCGPRecertification - RCGP Avoid duplication – same portfolio, MSF, AppraisalAvoid duplication – same portfolio, MSF, AppraisalIn Addition: Probably a Knowledge test (AKT)In Addition: Probably a Knowledge test (AKT)

Possibly Simulated Surgery (?) Possibly Simulated Surgery (?)ALSO PILOTINGALSO PILOTING

Evidence and ProcessesEvidence and Processes The CONTINUOUS Process-portfolioThe CONTINUOUS Process-portfolio

The Episodic processes:The Episodic processes:Annual appraisalAnnual appraisalMulti-Source Feedback (MSF)Multi-Source Feedback (MSF)Patient feedbackPatient feedbackKnowledge testing (AKT)Knowledge testing (AKT)Possibly simulated surgeriesPossibly simulated surgeriesReport of Responsible Officer-Report of Responsible Officer- Performance and Clinical Governance Performance and Clinical Governance sent to GMC Affiliate sent to GMC Affiliate

Judgment Day- RecertificationJudgment Day- Recertification

Responsible officer collates all evidenceResponsible officer collates all evidenceFrom AppraisalFrom AppraisalFrom Clinical Governance channelsFrom Clinical Governance channelseg (lack of) complaints, performance markerseg (lack of) complaints, performance markers

RO’s main concern is to assure safety and “good RO’s main concern is to assure safety and “good enough” qualityenough” qualityThe challenge to GMC Nationally is to produceThe challenge to GMC Nationally is to producetools to measure these objectivelytools to measure these objectively

What happens if there are concerns What happens if there are concerns about a Drs performance?about a Drs performance?

Numbers to GMC (low) currrently ~350paNumbers to GMC (low) currrently ~350pa Numbers with concerns to be addressed Numbers with concerns to be addressed

not via current GMC mechanisms (much not via current GMC mechanisms (much more but still max 5% of Drs) 33,000 GPsmore but still max 5% of Drs) 33,000 GPs

How to decide thresholds for formal GMC How to decide thresholds for formal GMC referralreferral

New procedures for remediation/ support New procedures for remediation/ support for those not requiring GMC referralfor those not requiring GMC referral

Preparation for appraisalPreparation for appraisal

Each Dr will needEach Dr will need

A Responsible OfficerA Responsible Officer A Professional bodyA Professional body To produce the necessary evidence To produce the necessary evidence

regularlyregularly .. And to engage constructively with the .. And to engage constructively with the

processprocess

E-portfolio websitesE-portfolio websites

NHS Appraisals toolkitNHS Appraisals toolkitRCGP in development, running for registrarsRCGP in development, running for registrarsNHS e-portfolio site NHS e-portfolio site www.nhseportfolios.orgwww.nhseportfolios.orgBMJ learningBMJ learningGP notebookGP notebookDrs netDrs netEtc etcEtc etcAvoid duplication and if use more than one make Avoid duplication and if use more than one make

sure can upload data from one site to your sure can upload data from one site to your chosen core sitechosen core site

Web tools -outlineWeb tools -outline

NHS Appraisal toolkit: www.appraisals.nhs.uk NHS Appraisal toolkit: www.appraisals.nhs.uk

LMC: Leicester SRTS; MSF/ 360 degree samplesLMC: Leicester SRTS; MSF/ 360 degree samples www.bedshertslmcs.org.uk/APPRAISAL.htmwww.bedshertslmcs.org.uk/APPRAISAL.htm

GMC: realistically awkward interactive ScenariosGMC: realistically awkward interactive Scenarios RCGP EGP update distance learningRCGP EGP update distance learning

dummy e-portfolio site: Curriculum headings dummy e-portfolio site: Curriculum headings Clinical skills listClinical skills list

RCGP Scotland nPEP – Knowledge learning needs RCGP Scotland nPEP – Knowledge learning needs assessment: online MCQs for a feeassessment: online MCQs for a fee

http://www.appraisalsupport.nhs.ukhttp://www.appraisalsupport.nhs.uk http://www.revalidationsupport.nhs.ukhttp://www.revalidationsupport.nhs.uk

Doing the detailDoing the detail

DocumentationDocumentation

Written reflectionsWritten reflections

Amount?Amount?

Not too muchNot too much

Not too littleNot too little

……but just rightbut just right

The Goldilocks principle

Useful handouts and articlesUseful handouts and articles RST BMJ Careers article 20.9.2008RST BMJ Careers article 20.9.2008

(Maurice Conlon, GP and Director of RST)(Maurice Conlon, GP and Director of RST) GMC TodayGMC Today Good Medical Practice in action-flyerGood Medical Practice in action-flyer nPEP flyernPEP flyer RCGP EGP Update flyerRCGP EGP Update flyer 360/MSF flyer360/MSF flyer Examples of Structured Reflective Templates Examples of Structured Reflective Templates

(RSTs)(RSTs) GMC Framework for Appraisal and assessmentGMC Framework for Appraisal and assessment

Take home messageTake home message

Make sure you have an annual AppraisalMake sure you have an annual Appraisal Learn how to use an e-PortfolioLearn how to use an e-Portfolio Stay up to date with what’s happening in Stay up to date with what’s happening in

revalidation:revalidation:local events, the GMC newsletter, and local events, the GMC newsletter, and websites: websites: GMC website (www.gmc-uk.org) GMC website (www.gmc-uk.org)

Check out Check out

Multisource feedback (MSF)Multisource feedback (MSF)will be compulsorywill be compulsoryexamples atexamples atwww.bedshertslmcs.org.uk/APPRAISAL.htmwww.bedshertslmcs.org.uk/APPRAISAL.htm

Applied Knowledge testing (AKT)Applied Knowledge testing (AKT)eg Scottish RCGP nPEPeg Scottish RCGP nPEP

RCGP Essential GP Update ProgrammeRCGP Essential GP Update Programmepilot atpilot at

www.rcgp.org.uk/practising_as_a_gp/distance_learwww.rcgp.org.uk/practising_as_a_gp/distance_learning/egp_update.aspx ning/egp_update.aspx

KISS Keep It Simple StupidKISS Keep It Simple Stupid

The Goldilocks PrincipleThe Goldilocks Principle (Amount of evidence) (Amount of evidence)Not too much, not too little, but just rightNot too much, not too little, but just right

SMARTSMART (PDP goals) (PDP goals)Specific Measurable Achievable Realistic TimelySpecific Measurable Achievable Realistic Timely

The Good, the Less Good and The UglyThe Good, the Less Good and The UglyCompliments and successesCompliments and successesSignificant IncidentsSignificant IncidentsComplaintsComplaints

QUESTIONSQUESTIONS