The General Medical Council has set out the most comprehensive statement yet on revalidation, with proposals on how it will work, when it will be rolled out, and what doctors and employers need to do.

The consultation poses 20 key questions for those who will be affected in order to help shape the process.

Revalidation is about providing further assurance that the 218,000 doctors with a licence to practise medicine in the UK are up to date and fit to practise. The proposals set out a system which is designed to be flexible and relevant to doctors’ day-to-day practice and builds on systems that already exist, or should exist, to support high quality care.

The statement makes clear that revalidation is on its way but there will be no big bang approach to its introduction – instead there will be a phased implementation following extensive piloting to ensure that it is proportionate and practicable.

Revalidation will not involve a point-in-time assessment of a doctor’s knowledge and skills. It will be based on a continuing evaluation of their practice in the context of their everyday working environment. Revalidation will focus on affirming good practice for the vast majority of doctors but will depend on good clinical governance arrangements that should also detect poor practice.

The proposals in the consultation have been developed by the GMC in close collaboration with the Academy of Medical Royal Colleges, the four health departments, the NHS and other healthcare employers, the medical profession, and input from patients and patient groups.

The consultation has four main themes:

• How revalidation will work. This covers the approach to revalidation, including the process by which a final recommendation will be made to the GMC by a designated ‘Responsible Officer’, likely to be the medical director in a doctor’s employing organisation. More specific issues, such as how revalidation will work for doctors in non-mainstream roles, will also be considered.
• What doctors and employers will need to do. The consultation will consider aspects of appraisal and assessment, the specialty standards developed by the Medical Royal Colleges and Faculties, the role of continuing professional development in revalidation and the use of questionnaires to test the views of patients and colleagues.
• How patients will be involved. This section explains how patients will provide feedback to doctors on their performance and how this will be included in the revalidation process.
• How and when revalidation will be introduced. This section sets out the plans for implementation across the four parts of the UK.

The Chair of the General Medical Council, Professor Peter Rubin, said:

“As doctors, we are among the most trusted of all professionals. We have to ensure that this trust in doctors continues to be justified. For the past 150 years, the GMC has sought to provide assurance through the register of medical practitioners. It remains one of the most robust and well used registers anywhere in the world. But it has always been a historical record of exams and qualifications earned, not of competence or performance. As such, it offers a limited assurance about whether each of us is maintaining the high standards expected of us throughout our careers.

“Revalidation will plug this gap. In one sense, what is being proposed is no more than what should be happening in every doctor’s practice – it is based on local systems of annual appraisal over five years and affirms what has already been demonstrated through that appraisal process.

“We want to hear from doctors, employers and patients across the UK in response to the consultation – we need to know the views of all of those affected to ensure that revalidation works, and is proportionate and flexible to meet the needs of a busy and diverse workforce.”

Chief Medical Officer, Sir Liam Donaldson, said:

“Revalidation is starting to take shape and all doctors who hold a licence to practise will be required to demonstrate, on a regular basis, that they are up to date and fit to practise. This consultation is an opportunity for all doctors to have their say in how the process will work – I would encourage as many as possible to take part.

“For the vast majority of doctors in this country, revalidation will confirm what they already do: keep their skills and knowledge up to date and demonstrate high levels of professionalism every day of their working lives. This new system will also help us to give appropriate support to those few professionals who are struggling to keep pace.”