GPs condemn GMC’s lack of leadership over revalidation

Authors: Helen Jaques 

Publication date:  26 May 2012

GP leaders have slammed the General Medical Council for failing to spell out how GPs in need of remediation should be supported in the process of revalidation and for “opening the door” to local variation in appraisal.

But a GMC council member, Malcolm Lewis, told the conference of local medical committees this week that the lack of guidance on remediation shouldn’t delay the introduction of revalidation.

“I know a concern about remediation is the patchy approach to delivery across the UK and across specialties,” he said. “I think revalidation has brought attention to that issue, but don’t let it stop revalidation, because otherwise it will never happen. I don’t think we can wait for [remediation] to be in place to start revalidation: we have to get the ball rolling on this.”

However, Andrew Green, a GP in Hull and a member of the BMA’s General Practitioners Committee, accused the GMC of “shocking complacency” in not acknowledging remediation’s integral role in revalidation.

“I’m sure I’m not the only GP here who has been shaken by the total lack of leadership the GMC has shown recently regarding its own plans for revalidation,” he told the conference. “In our professional lives we all walk a tightrope where one slip, one moment of inattention, can lead to disaster. If the GMC are going to sit in the comfort of their offices shaking the rope under our feet, they have a clear and pressing duty to fix the safety net.”

The introduction of “enhanced appraisal” by deaneries, strategic health authorities, primary care organisations and other NHS authorities in advance of revalidation also came under fire. Rachel Tinker, a GP from Derby and Derbyshire Local Medical Committee, told the conference how some primary care trusts are requiring GPs to bring extra information to their annual appraisal, such as audits and details of any serious untoward incidents.

Beth McCarron-Nash, a negotiator for the General Practitioners Committee, argued that it was completely unacceptable to have different levels of appraisal across the UK. “We have to have consistency for appraisal and standards of training for appraisers across England in particular, where this is a problem,” she said. “This is a building block towards revalidation, and unless those blocks are equitable and fair then this process is not going to go ahead.”

However, Lewis stated that what was included in appraisal was an issue for practices to sort out locally with their primary care trust or health board and was not an area in which the GMC should interfere.

Delegates passed a motion calling on the BMA, in partnership with the GMC, to develop a national system of appraisal that could be used as an alternative to local appraisal.

Delegates also discussed the potential for conflict of interest in revalidation should primary care commissioning managers also act as responsible officers. Such individuals would have a conflict between implementing commissioning policies and making revalidation recommendations, said Paddy Glackin, a representative for Camden Local Medical Committee, London.

GPs passed a motion insisting that the role of responsible officer be separated from any role that involves performance management of GPs.

Helen Jaques news reporter BMJ Careers

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