Revalidation of Trainees Implications for Trainees, Trainers and Trusts

1. Revalidation of TraineesImplications for Trainees, Trainers and Trusts Dr Alistair Thomson Vice-Chairman NACT UK 14th September 2012

4. http://www.flickr.com/photos/brizzlebornandbred/with/5047423154/http://www.flickr.com/photos/brizzlebornandbred/with/5047423154/

7. A Different World 1956 • NHS 8 years old • Free healthcare for all • Paternalistic 2005 • Dame Janet Smith report • 6th report of Shipman enquiry • Revalidation slow to come

8. Another Era • Dr John Bodkin Adams • HS in BRI, 1921; GP 1922 • Eastbourne 1957 • Found not guilty of murder • Trial established principle of double-effect • Changes to Dangerous Drugs Act • Probably killed >160 over 30 years • Establishment cover-up • A model for Shipman?

9. Need for Revalidation 1991-1995 1999 2001 2000 1998

11. GMC - Revalidation for Drs in Training How doctors in training can meet the GMC’s requirements for revalidation in the first cycle • To be ready for a revalidation recommendation • Must have discussed and be participating in • Curriculum requirements of training programme • Assessments • i.e. appraisals, WPBAs, exams, etc • Already tested at ARCP

12. Revalidation for Trainees • Postgraduate Deans are Responsible Officers • Based on ARCP • Probably more robust than career Dr revalidation • Pilots Autumn 2011 • Led by KSS Deanery • Volunteers • Declaration of probity • Declaration of health • Information about Serious Untoward Incidents

13. When Will Trainees Revalidate? If CCT Dec 2012-Mar 2013 = ‘transition group’ • From April 2013, before March 2016 CCT from April 2013 • With CCT, starting a 5-yearly cycle • At 5 years after December 2012, if no CCT yet • Then every 5 years, if no CCT Otherwise • At registration (end of F1) • Starting a 5 yearly cycle (or <5y if CCT)

14. Use of SUIs - Concerns • SUIs should be formative • If SUI raises FTP issues, Trust should report to • Deanery • GMC • If SUI raises no concerns about FTP it is not relevant to recommendation • Inclusion might flout blame free culture • Data not retained or accessible once local investigation complete

15. Only Serious Untoward Incidents? “Only SUIs to be notified, then?” “Yes” “So not the 17 complaints of rudeness reported?” “Oh, well, yes, we want those too…” “But not one complaint of rudeness?” “No, we don’t want that…” “So the threshold is how many – 5, 6, 7 complaints?” “Er…”

16. Ergo Collect it all Integrate Clinical Governance Complaints Legal PGMC information DiD information Then PGMC to filter for RO

17. Data collection spreadsheet (NACT UK)

18. Advantages of Revalidation for PGMC Revalidation of Trainees Committee Task and Finish Group? Requires formal links with Clinical Governance Bypass no longer possible Allows pro-active approach to trainees Support for SUI involvement Trainee problem identification Early warning for DiD

19. National Association of Clinical Tutors UK (Revised 2012)

20. Identification of Problems in PGMC Failure to Book appraisals Complete WPBAs Spread WPBAs throughout post Collect sufficient evidence for year Complete eportfolio Undertake mandatory training Produce a PDP

21. Summary • Revalidation of Trainees starts April 2013 • Based on ARCP • SUI and complaint info from Trusts • Implies • Linkage of PGME with Clinical Governance • PGMC role complementing Deanery Schools • Earlier identification of problems, DiDs, etc • Evolution of ‘Educational Governance’ • More work for MEMs!

22. Where to Get the Information • General Medical Council www.gmc-org.uk • Revalidation Support Team www.revalidationsupport.co.uk • Academy of Medical Royal Colleges www.aomrc.org.uk • CoPMeD • Via KSS website

25. 17 December 1903