Licensing, Revalidation and Registration

Paul Philip – Deputy Chief ExecutiveGeneral Medical Council

The main reason a doctor remains on the medical register in the UK is because no-one makes a sufficiently serious complaint about them that is proved to impair their fitness to practise.

There is

● No formal CPD

● No regular formal assessment or competence or performance.

But that is about to change…

New Architecture

● Registered Doctor.

● Licensed Doctor.

What is the difference?

Registered Doctor

● No privileges to practise.

● But keeps formal link with regulator.

● May be involved in work affiliated to medicine (possibly sitting on tribunals or boards etc.)

N.B. Not able to practise medicine as we presently understand the concept

Licensed Practitioner

● All privileges of present registered doctors. ● But with added obligation of needing to

provide evidence of being up to date and fit to practise.

● Will need to undertake revalidation to maintain a licence.

How will this be done?

Relicensing

Revalidation is the process by which doctors will prove they are fit to be relicensed.

‘This licence to practise will have to be renewed every five years…to bring objective assurance of continuing fitness to practise, the appraisal will include ‘summative’ elements which confirm that a doctor has objectively met the standards expected.’

White Paper Chapter 2

Relicensing

● Agreed generic standards of practice set by the GMC

● Revised system of appraisal with a judgement

● 360 degree multi source feedback

● Resolution of any known concerns

● Positive affirmation of a doctor’s fitness to practise by a Responsible Officer

Relicensing

● The function of relicensing is to help drive quality improvements in the delivery of good care for patients

● Appraisal: helping to identify developmental skills needs for delivering better care for patients

● Linked to the needs of the service

● Resources required to support quality improvements

Licence to Practise

● GMC to issue licences (as a first step towards re-licensing) ‘as soon as it is practicable to do so’.

● Legislation will be in place by early 2009 to enable the GMC to introduce licensing – summer/autumn 2009

● All registered doctors will be entitled to a licence to practise but some may choose to maintain registration only

● Only licensed doctors will be subject to revalidation

● 240,000 registered doctors/150,000 in active practice

Recertification

● Standards will be drawn up for each area of specialist recertification by the RCs and specialist associations

● Standards will be agreed by the GMC to ensure that they are sufficient to meet the requirements for remaining on the appropriate part of the medical register

Recertification

‘The evidence that provides the basis for specialist recertification will vary between specialties….Evidence may be drawn from a range of sources and activities, including employer appraisal, clinical audit, simulator tests, knowledge tests, patients’ feedback, continuing professional development or observation of practice’

White Paper Paragraph 2.20

Any Questions?