Revalidation: still work in progress
Even the most ardent opponents of revalidation are likely to admit that one day it will become a reality. Personally I think the principle of revalidation is a good idea - it is what the public expects and encourages openness, learning and continuing professional development. The downsides are that it can take time, costs money and will require a robust IT infrastructure to make the whole project work properly. I suspect these are key reasons why it is taking time to bring the revalidation project to the frontline.
I am sure it will eventually arrive and become part and parcel of everyday life. But even then it will need to constantly evolve, so that it is a fair and transparent system that can achieve its goals. A recent article in the univadis GP News service reported on the progress of pathfinder pilots of revalidation (click here). The pilot scheme was a reasonable size - according to the article it consisted of "10 sites across England and involved over 3000 doctors, including 923 GPs".
This article reports that "96% of NHS managers were in agreement that revalidation would improve the quality of care". But an article published in BMJ Careers(click here) states that "less than half of the doctors who took part expect that revalidation will improve the quality of care (43%) or patient safety (44%)". These different perspectives do not surprise me and yet it is the clinicians that we have to get on board with the idea of revalidation.
Of particular interest to GPs was the statement in the univadis GP News report that "the median time spent on collating information and preparing for appraisals by appraisees in primary care went up from 10 to 15 hours". Obviously this will have a significant impact on workloads - where will this time be found within the working day? I suspect that a lot of this work will have to be completed outside work hours.
Of course, one of the benefits of carrying out pilot schemes is that such issues are highlighted. In the meantime, we need to continue to refine how we carry out revalidation and make it easier for end users to participate. More importantly, many clinicians remain to be persuaded on the positive aspects of revalidation and there is still much work to be done on this.
Dr Harry Brown, editor-in-chief Univadis
Dr Harry Brown