What do all GPs need to know About revalidation and commissioning Autumn 2012

Background  Years of delay may have led to complacency  “maybe I’ll retire first”  We are now assured it will happen from December 2012, subject to government approval  Ground rules and advice changed under GMC direction  Essential to be up to date!

Revalidation  Responsible officers will be revalidated in first four months  April 2013 roll out to all doctors- expected all revalidated by march 2016  If you are on the performers list the RO is responsible for recommending you to the GMC for revalidation  From December 2012 you will know the year you will be revalidated

Revalidation  The RO needs to be satisfied that you have participated in an annual appraisal that covers all of your medical practice, and that your appraiser has signed off at least one appraisal that has good medical practice as its focus  You have brought to your appraisals appropriate supporting information  There are no unresolved concerns about your performance as a doctor

Revalidation  “Minimum supporting information” applies to the 12 month period prior to your last appraisal before your revalidation date  Ie for some of us that means information gathered this year:  Revalidation is a continuous process, not a high stakes exam at a fixed point in time- the RO should give you time to put things right  Part timers, retainers,and locums all expected to submit a full standard portfolio

Minimum supporting information  Personal details, scope of your work, record of annual appraisals, PDPs, probity and health declarations  At least 50 CPD credits in the 12 months prior to your last appraisal before your revalidation date  At least 2 significant event reviews in 12 months – must include any serious incident

Minimum supporting information  Audit –evidence of regular participation in in quality improvement activity relevant to your scope of work, and discussed at appraisal  Colleague feedback and patient feedback- one of each in 5 years before your revalidation recommendation  Description of any formal complaints

MSF and PSQ  Various tools approved by GMC – their own tools are simple; require 40 patients and 15 colleagues  Can use GP-SPRAT, CFET, 2Q MSF, Edgecumbe 360  Initially other non validated tools will be acceptable if they focus on what you do, but suggest data externally collated

MSF and PSQ  Feedback and reflection essential  Can be challenging  RCGP faculties will be providing support  Means if you haven’t done a personal PSQ or MSF in the past 3 years, do one soon

Extended roles  Any activity beyond the scope of GP training and the MRCGP, or with a separate contract eg GPwSI or receiving fees outside of care to registered practice population eg teaching, medico-legal work, occ health  Must demonstrate fit for these roles- eg trainer approval from deanery, review of appraisers practice, statement from OOH provider

PDPs  Must be SMART, no max or min number of items  Must contain statement of development need, how this will be addressed, date by which it will be achieved, intended outcome, and review by appraiser  If not achieved, explanation as to why not  Need to consider more than just clinical learning, eg leadership and management

CPD credits  250 in 5 year cycle required  In essence 1 credit = 1 hour if accompanied by reflective record; a certificate alone is no credit  Claim 2 credits per hour if can demonstrate impact eg leading to a change in practice  Self allocated and approved by appraiser  Should reflect broad range of activity over 5 yrs- ie not just diabetes courses for diabetes GPwSI

Significant events  Need to include description of event, who was involved and who it was discussed with  What went well?  What could have been done differently?  Reflections in terms of knowledge, skills, safety, partnership and communication  Agreed changes,and their effect

Significant events  Ideally discuss in team, but may be difficult for locums  Encourage practitioner groups, locum chambers  Can do serial case review -10 consecutive cases, or 10 cases with a specific condition

Audit  At least one full cycle audit that you have taken part in ie not just the medical student audit!  Audit is a systematic analysis of the quality of care  Needs to be relevant to your practice, amenable to change, and appropriately actioned

Audit  Criterion – statement of best practice, preferably evidence based  Standards set- how you think you will measure up to best practice, bearing in mind reality of GP  Data collection 1  Compare to standards, discuss changes needed

Audit  Changes put into action  Compare to standards and discuss whether quality improvement resulted, and if not why not – and repeat as required  Topics could include antibiotic prescribing, use of investigations, prescribing, hypertension management etc

Audit  Can submit a quality improvement project eg reviewing use of care pathways in a particular group of patients  Action audit – reviewing care of cases of a defined nature with a colleague, matching performance to preset criteria- my be suitable for locums / OOH doctors

Commissioning  New responsibility for GPs to be cost aware and make efficient use of resources  We are all involved in commissioning through referral and prescription  Links to QIPP agenda and QOF ongoing  Suggestion that PDPs take local and national priorities into account,as well as personal needs