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FAQs on Revalidation


REVALIDATION
WHO NEEDS TO REVALIDATE
RETIRED DOCTORS
WORKING OVERSEAS AND THE GMC UK LICENCE TO PRACTICE
YOUR DESIGNATED BODY
PREPARING FOR REVALIDATION
APPRAISALS FOR REVALIDATION
BREAKS IN PRACTICE
SUPPORTING INFORMATION FOR APPRAISAL & REVALIDATION
RESPONSIBLE OFFICER RECOMMENDATIONS
NON ENGAGEMENT
RESPONDING TO CONCERNS 
REVALIDATION DEFERRALS

 

REVALIDATION

Q: What is revalidation?

Revalidation began on 3 December 2012. Revalidation is the process by which doctors will have to demonstrate to the General Medical Council (GMC), normally every five years, that they are up to date and fit to practise.

Q: What is the purpose of revalidation?

The purpose of revalidation is to assure patients and the public, employers and other healthcare professionals that licensed doctors are up to date and fit to practise.

WHO NEEDS TO REVALIDATE

Q: Who will need to revalidate?

All doctors registered with the GMC with a licence to practise will be legally required to revalidate. 

Q: I only work part time. How will this affect my revalidation?

You will be expected to revalidate in the same way as full-time doctors, including participating in annual appraisal and collecting supporting information in relation to the practice that you do.

Q: I work exclusively in a non-clinical role. How do I revalidate?

If you hold a licence to practise, you will revalidate in the same way as doctors in clinical roles, and the supporting information you bring to appraisal will reflect your non-clinical role.

The GMC states that if you want to continue to hold a licence to practise, then you will need to revalidate like every other doctor who is licensed. However, you may not need a licence to practise if you don’t carry out any clinical practice. If this is the case, you have the option of giving up your licence but maintaining your registration with the GMC. 

If the type of activity that you are involved in could be 'related to patient care', you will need to confirm with your employing organisation whether you require a licence to practise. The term ‘practice’ refers to your professional work, clinical or non-clinical. This may include work with little or no patient contact; for example:

  • Interaction by correspondence, such as giving advice by telephone, email or letter 
  • Requests for insurance medicals 
  • Medico-legal work 
  • Review of articles for a medical/specialty journal 
  • Clinical-skills lecturing.

Q: What happens if I don’t work in the NHS?

Revalidation is based on maintaining your licence to practice, not your employing organisation. Regardless of employer, if you wish to retain your licence to practise, you will still be required to revalidate. Please refer to the Prescribed Connections Algorithm to find your designated body for GMC revalidation.

Q: I work for a local authority. Who will I revalidate through?

It is likely that Public Health England will be your designated body and you will revalidate through that organisation.

Q: What if I am not in active public health practice, but maintain professional registration?

If you wish to maintain your licence to practise, the requirements are the same as for any other doctor.

Q: I only work part time. What are the requirements for revalidation?

You will be expected to revalidate in the same way as full-time doctors, including participating in annual appraisal and collecting supporting information in relation to the practice that you do.

RETIRED DOCTORS

Q: I have retired from the NHS but continue to work in an independent/or voluntary capacity. Do I need to revalidate?

Retired doctors may continue to work in many different capacities, and it depends upon whether you require a licence to practise to undertake any or all of the work that you do. You should speak to the organisation that you are working or volunteering for to ascertain whether that organisation requires you to hold a licence to practise. If you continue to treat patients you will require a licence.

If you do require a licence then you will have to revalidate in the same way as all doctors, linking to a designated body and RO, participating in annual appraisal and collating a portfolio of supporting information in relation to the work that you do.

Q: I have retired from active medical practice. If I continue to maintain CPD will that be sufficient for revalidation?

No. If you choose to hold a licence to practise, the GMC requires you to revalidate in the same way as every other doctor by participating in annual appraisal and maintaining a portfolio of supporting information.

If you are retired from clinical practice, it may be that you would wish to relinquish your licence to practise but maintain your registration with the GMC. This means that you do not have to revalidate, and it will show that you remain in good standing with the GMC. This will depend on whether you undertake any activity post-retirement which requires a licence to practise (eg. if you work directly with patients).

Q: I am retiring in less than five years. Do I have to revalidate?

Yes. If you hold a licence to practice in the years leading up to your retirement you will need to revalidate in what you are currently doing, up until the point you retire and relinquish your licence to practice. You should discuss the management of your appraisal and supporting information with your RO if you are retiring before a full five-year cycle.

If you choose to retain your licence to practice in order to undertake practice post-retirement, you will still need to revalidate according to that activity.

WORKING OVERSEAS AND THE GMC UK LICENCE TO PRACTICE

Q: Does revalidation affect my specialist registration or GMC registration?

No. Revalidation is required to maintain a licence to practise in the UK only. It is not required to maintain GMC registration or specialist registration. 

There is an option for doctors in some situations (eg. working abroad) to relinqush the Licence to Practice  (and therefore not revalidate), but remain registered with the GMC and maintain their entry on the specialist register. This provides confirmation that their qualifications have been recognised and that they are in good standing with the GMC. Licences can be reinstated if circumstances change.   

The specialist register is a historical document recording the specialties in which you have trained. If you no longer work in the specialty for which you were originally listed on the register you will not lose your registration if your revalidation is based on supporting information from practice in another field. Revalidation is not about demonstrating that you are up to date in that registered specialty (in which you trained), but that you are up to date and fit to practise in your current fields and across your scope of work.

As a specialist, you will need to continue to meet the existing requirements, and this will be evident through the detail of the supporting information that you provide at appraisal.

Q: What if I work overseas?

We have confirmed with the GMC that doctors who are based exclusively overseas do not need a licence to practise in the UK. The licence to practise gives doctors legal rights and privileges in the UK that do not apply in any overseas country. Doctors who are based overseas must abide by whatever regulatory requirements exist in the country in which they practise.

Non-UK organisations should therefore not require their doctors to hold a UK licence to practise. You can remain registered with the GMC and maintain your entry on the specialist register without a licence. This provides confirmation that your qualifications have been recognised and that you are considered in good standing with the UK regulator. You can relinquish your licence to practise whilst working abroad and reinstate it on return to the UK. Once your licence is restored, you would need to link to a designated body, participate in annual appraisal in the UK and provide supporting information in line with guidance. Any relevant information gathered while working abroad, as well as evidence of on-going CPD, should be brought to your first appraisal on return to the UK. More information about giving up and restoring your licence is available from the GMC website.

If you choose to continue to hold your licence while practising abroad, you will have to revalidate in the same way as doctors practising in the UK and link to a UK designated body. If your employer or contractor is based within the UK it may be that they will be able to provide you with a link to a RO, and you should discuss your revalidation with them at the earliest opportunity.

If you have not already done so, you should confirm your current circumstances with the GMC through your GMC online account, so that the GMC can provide you with appropriate advice.

YOUR DESIGNATED BODY

Q: I do not have a connection to a designated body. What should I do?

If you are in this situation, you should make the GMC aware of your circumstances by updating your details using your GMC online account and stating that you do not have a designated body.

Q: Who is my Responsible Officer?

The GMC has developed a tool to aid doctors in identifying their Responsible Officer.

Q: I don’t have a Prescribed Connection. Can I get a Suitable Person via the GMC?

If you have fully explored the Prescribed Connection algorithm as provided on the GMC website and cannot connect to a Designated Body it is important to let the GMC know. Further information on the Suitable Person route can be found on the GMC website.

Q: I work for a number of organisations, how is it decided who my designated body should be?

Typically where the majority of practice occurs. This is only applicable when comparing two + employment contracts or two + practising privilege arrangements. An employment contract is a ‘higher’ prescribed connection than practising privileges, irrespective of majority of practice. 

Locums – with the agency where the majority of work was undertaken in the previous calendar year (Jan-Dec). 

If a doctor’s practice is evenly split – the organisation that is closest to the doctor’s GMC-registered address will be the designated body.

Q: All my work is performed for NHS bodies but not as an employee, to what extend could one of these bodies become my Designated Body?

A doctor working within NHS Trusts can only connect to that Trust, with it acting as its Designated Body, through a contract of employment. This is typically where the organisation pays the employers PAYE. The other option is through an honorary NHS contract which is afforded the same status as an employment contract.

PREPARING FOR REVALIDATION

Q: How can I meet the requirements in my first revalidation cycle?

You must be participating in an annual appraisal process which has Good Medical Practice as its focus and which covers all of your medical practice. You must have completed at least one appraisal, with Good Medical Practice as its focus, which has been signed off by you and your appraiser.

You must have demonstrated, through appraisal, that you have collected and reflected on the following information as outlined in the GMC’s guidance Supporting information for appraisal and revalidation:

Continuing professional development 

Quality improvement activity 

Significant events 

Feedback from colleagues 

Feedback from patients 

Review of complaints and compliments.

Please also read the guidance provided by the GMC.

Q: When will I be revalidated?

The GMC will give a minimum of three months' notice of when a revalidation recommendation should be submitted but will let doctors know earlier if it can.

The current timeline is:

Year 0: 2012/13. All responsible officers (ROs) and some medical leaders revalidated 

Year 1: 2013/14. 20% of licensed doctors at each designated body revalidated 

Year 2: 2014/15. 60% of licensed doctors at each designated body revalidated 

Year 3: 2015/16. 100% of licensed doctors at each designated body revalidated 

Years 4 and 5. All remaining licensed doctors revalidated by the end of March 2018.

APPRAISALS FOR REVALIDATION

Q: How will revalidation appraisals work? 

Revalidation will be based on a local evaluation of doctors' performance through appraisal. Doctors will be expected to participate in annual appraisal in the workplace and will need to maintain a folder or portfolio of supporting information to bring to their appraisals as a basis for discussion. 

There will be some types of supporting information that all doctors will be expected to provide at appraisal over a revalidation cycle. However, doctors can take any other additional information to demonstrate their practice at appraisal.

Revalidation is an on-going process. The GMC is responsible for revalidating doctors and will require assurance that a doctor is up to date and fit to practise.

For non-training grades, revalidation will be based on a local evaluation of your practice through appraisal. You will be expected to participate in annual appraisal in the workplace over a five-year revalidation cycle and will need to collate a portfolio of required supporting information to bring to your appraisal as a basis for discussion. The supporting information will demonstrate that you are keeping up to date and have met the requirements for Good Medical Practice.

The GMC has set out its generic requirements for medical practice and appraisal in three main documents. These are supported by guidance from FPH which gives the specialty context for the supporting information required for appraisal. You should therefore ensure that you are familiar with the following documents:

Good Medical Practice 

Good Medical Practice Framework for appraisal and revalidation 

Supporting information for appraisal and revalidation 

The revalidation pages of the FPH website.

Information from the appraisal will be provided to a Responsible Officer who will make a recommendation to the GMC, normally every five years, on whether to revalidate a doctor.

Q: I’m an academic. How do I revalidate?

The process for academics is the same as for any doctor with a licence to practise. The key difference for academics is that appraisals should follow the Follett principles, and you may be required to undergo a joint appraisal with your university and your designated body. Different arrangements are in place around the UK so you are advised to discuss with these two organisations how your appraisal will work. The BMA has further information about medical academic appraisals on its website.

Q: How do I get an appraisal? 

Once you have confirmed your prescribed connection with your designated body you will be given information on how to access an appraisal.

ROs are obliged to ensure that there are sufficient numbers of trained appraisers in place in their organisations, your RO/Designated Body will also ensure you are allocated an appraiser who has been through the necessary training. This fits with their obligations and responsibilities to quality-assure appraisal within their organisation. You should speak to your Designated Body if you wish to enquire whether you can keep an existing appraiser. It is recommended that doctors have two different appraisers during the five-year cycle. 

If your designated body does not offer appraisal, there are external organisations who offer appraisal services. It is the responsibility of each doctor to arrange their appraisal. Independent organisations may not conduct appraisals.

The Independent Doctors Federation has appointed an RO for doctors without a prescribed connection to an NHS RO. The Federation of Independent Practitioner Organisations also offers an appraisal service.

Q: Should appraisers be of the same specialty as the person being appraised?

In general, it would be advisable for an appraiser to be of the same specialty (for example at the level of physician/surgeon/ophthalmologist, but not sub-specialty) if at all possible. However, this is not mandatory and will largely be dependent upon the decisions of the employer and the availability of trained appraisers within that specialty. Please speak to your Responsible Officer; all appraisers will need to have received the appropriate training.

Any appraiser should ensure that they have sufficient information about you, your specialty and specialty standards to complete the appraisal. Specialty information and advice is available to appraisers and appraisees, including the specialty-specific guidance.

Q: Where can I find an appraiser if I do not have a Designated Body or a Responsible Officer?

Commercial organisations such as Miad and Edgecombe offer appraisal at a cost. Other options may include a local trust appraiser or a trained appraiser within the professional community known to the doctor.

Medical appraisers must be formally trained and understand revalidation and good medical practice. Appraisals must be quality assured. Every appraisal from Year 1 onwards must be a revalidation-ready appraisal covering the full scope of practice, all elements of Good Medical Practice and conforming to GMC guidance regarding medical appraisals

BREAKS IN PRACTICE

Q: How will a short career break (for example maternity leave) affect my ability to revalidate?

Your ability to revalidate should not be affected if you take a short career break within a five-year revalidation cycle. Our understanding from the GMC is that you will be expected to revalidate at the usual point in your five-year cycle on the basis of the supporting information you have collected and appraisals that you have attended within this time period. If you have been unable to collect sufficient supporting information for your appraisal, your RO may recommend a deferment of your revalidation to the GMC, in order to allow you to collect additional information.

It is expected that doctors will want to take career breaks within their revalidation cycle, and there is flexibility in the process to manage this. If you do plan a break you should manage your appraisals around that break as far as possible, so that you do not miss an appraisal prior to going on leave. A 'return to work' appraisal may also be required by your employer. Some of the supporting information is required over the five-year cycle, not annually, so again this may be able to be managed around the career break. You should speak to your appraiser and RO to develop an agreed approach. It is advisable to try to keep your CPD in your clinical areas up to date even if you are not actively practising, ie. by attending specialist meetings or using distance learning.

The Academy of Medical Royal Colleges has now drawn on various sources to produce guidance on return to practice.

Q: I work for periods of time outside the UK. How will this affect my ability to revalidate?

It should be possible for you to collect supporting information, participate in appraisals and link to a RO through your practice in the UK. You should discuss management of your appraisal and supporting information (including additional supporting information to demonstrate your practice abroad) whilst in the UK with your RO and appraiser.

Q: I have been retired from the NHS for a few years and have not had an annual appraisal. Where would I stand with regard to revalidation?

Revalidation legislation came into force on 3 December 2012. As a result all doctors should be engaging with annual appraisal from that point through their designated body. Where a doctor currently has no Prescribed Connection it would be advisable to source an appraisal that meets GMC requirements.

SUPPORTING INFORMATION FOR APPRAISAL & REVALIDATION

Q: I work across different specialties. Do I need to be revalidated twice?

No, revalidation is based on the entire scope of your practice. Ideally, you will have one appraisal to cover all of your roles. You will only have one RO who will make a recommendation to the GMC about your entire practice. 

Your supporting information should reflect your entire scope of practice. Some elements of supporting information will be common to your entire scope of practice and will not need to be duplicated. If in doubt, talk with your appraiser.

Q: What forms do I have to fill in for appraisal?

It is very important that the inputs and outputs of your appraisal are accurately and effectively recorded over the revalidation cycle. In the first instance, you should speak to your appraiser or RO about your organisation’s forms or procedures for recording your supporting information and/or the appraisal discussion. Some trusts may have an electronic integrated appraisal and revalidation system and these systems will include appraisal forms. The RO is responsible for providing an effective appraisal system – please confirm with him or her as to what is expect of you. NHS England also has forms available on its website, and there will be different support in the devolved nations. It is important to establish what systems your RO will expect you to use.

Q: What multi-source feedback (MSF) should I use?

The multi-source feedback (MSF, as it is also known) is a mandatory element of revalidation. However, which MSF questionnaire to use is the decision of the Responsible Officer (RO) to which a doctor is connected and it is expected that doctors follow the local process as determined by the RO. 

GMC guidance on multi source feedback can be found on its website.

Q: Do I need to gather patient feedback?

The need for this type of feedback will be dictated by your scope of practice, not your specialty; if you treat patients, you must collect this type of feedback.

The GMC guidance states: "One of the principles of revalidation is that patient feedback should be at the heart of doctors' professional development. You should assume that you do have to collect patient feedback and consider how you can do this. We recommend that you think creatively about who can give you this sort of feedback. For instance, you might want to collect views from people who are not conventional patients but have a similar role, like families and carers, students or even suppliers or customers. 

"However, we recognise that, in some settings, a doctor will not have any relationships like this and will not be able to collect this information. If you are not sure what to do about patient feedback, you should talk to your appraiser about what to do."

FPH guidance supports and supplements this: "The expectation is that all doctors should be able to provide something which can serve a similar purpose to patient feedback, this being some kind of feedback about the doctor's interpersonal skills which the doctor can reflect on at appraisal. Where there are no patients, a doctor should consider who else might be able to provide such feedback eg. students or other stakeholders. The doctor will then be able to discuss with their appraiser and/or RO whether the alternative arrangements are feasible. 

"For some doctors there just will not be anybody, and, as long as that is clearly agreed, that is fine. However the principle is that doctors should think creatively and actively about who can provide the same kind of useful feedback that they would get from patients if they had them. The aim is to obtain useful developmental feedback which can aid reflection on skills and practice."

RESPONSIBLE OFFICER RECOMMENDATIONS

How am I revalidated?

A doctor will be recommended for revalidation to the GMC by their Responsible Officer (RO), normally every five years, based on:

information provided from the five annual appraisals 

a completed portfolio of supporting information 

an absence of concerns about their practice raised through local clinical governance routes.

An RO will be able to make one of three statements to the GMC:

1. That the doctor is up to date, fit to practise and should be revalidated

2. That the recommendation should be deferred while more information is obtained - for example where a doctor has taken a career break

3. That the doctor has failed to engage with any of the local systems or processes (such as appraisal) that support revalidation.

In the last case the doctor will be referred to a fitness to practise (FtP) panel of the GMC for consideration as to whether the licence to practise should be revoked. It is only the GMC that can give or remove the licence to practise.

Please note that if there are concerns arising about the doctor’s fitness to practice at any time preceding the revalidation date, those concerns should be raised with the GMC formally or informally – this should take place at the time concerns arise and not be left until the revalidation date.

Revalidation is not about ‘pass or fail’; it is a supportive and developmental process designed to provide assurance about a doctor’s fitness to practice and will enable doctors to identify areas for improvement at an early stage within a structured approach to personal development. These areas should be addressed at appraisal through the Personal Development Plan each year.

Q: How often must I revalidate?

For most doctors, revalidation will be a five-year cycle. Every five years the GMC will require confirmation from a doctor's Responsible Officer that they are up to date and fit to practise and that there are no significant unresolved concerns about their practice. 

The GMC may vary the frequency of this cycle where the circumstances of the individual doctor require it. One example is where a doctor has taken a career break and their revalidation may be postponed for a period of time to allow them time to gather sufficient supporting information for the appraisal and revalidation.

Whilst a revalidation recommendation occurs once every five years, appraisal is an annual requirement.

NON ENGAGEMENT

Q: What will happen if I do not engage in appraisal and revalidation?

We expect that the majority of doctors will have no problem meeting the requirements for revalidation if they engage with the appraisal and local clinical governance processes.

If you choose not to engage, by not providing evidence to support your revalidation or failing to participate in an annual appraisal process, you cannot be revalidated and you risk having your licence to practise withdrawn.

RESPONDING TO CONCERNS 

Q: If serious concerns are raised about a doctor's practice what will be the consequences for their revalidation?

If concerns are identified about a doctor's practice that are sufficiently serious to raise questions about whether they should have a licence to practise and the Responsible Officer (RO) is therefore unable to recommend them for revalidation, the doctor will be referred to their regulator's Fitness to Practise processes.

Where concerns about a doctor's practice exist, these should be identified early and, where possible, addressed through relevant local clinical governance processes including appraisal. The identification of, and action on, concerns should not wait until a doctor is due to be revalidated but be dealt with through usual day-to-day systems or at appraisal. The RO might also want to immediately engage with the National Clinical Assessment Service or refer the doctor to the GMC if the concerns raised are sufficiently serious. 

Where a doctor is referred to the regulator’s Fitness to Practise department for investigation, their revalidation will be deferred until the outcome of that investigation is known.

REVALIDATION DEFERRALS

Q: If I have not been working due to ill health and not employed, what is the situation regarding my revalidation?

Doctors with prolonged periods of ill health are likely to have their revalidation dates deferred by the RO or Suitable Person to allow them sufficient time to regain good health and obtain the required supporting information. The deferral process does not affect the doctor’s licence to practise although they may be currently unfit for work due to ill health. The doctor will be deferred for a defined period of time, providing that doctor has engaged with the appraisal and revalidation process. Deferral is a neutral act and is not publicly available information.

Q: Can a doctor defer only once?

There is not a one-time deferral rule. An RO can typically recommend deferral of a doctor for a maximum period of 12 months. If the situation is such that a further deferral is required, the GMC will seek to fully understand the reason for this.

Q. Will a doctor’s revalidation date be moved when the connection to a Designated Body is dropped?

A doctor’s revalidation date will not be moved when the connection to a Designated Body is dropped. It is up to the doctor to discuss this with their RO at the time that their revalidation date is due. If a doctor does not have connection at the time that their revalidation date is due they can write to the GMC to request a deferral and this will be considered by the GMC.

 


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