Revalidation and appraisal are essential processes for medical doctors in the UK in order to demonstrate that they are up-to-date and fit to practise.
The process of regular assessment through revalidation, which usually takes place every five years, was introduced by the General Medical Council (GMC) in 2012 to provide a greater assurance to patients, the public, employers and other healthcare professionals that licensed doctors are meeting the professional standards set out in the principles of Good Medical Practice.
“The purpose of revalidation is to provide greater assurance to patients and the public, employers and other healthcare professionals that licensed doctors are up-to-date and fit to practise. It is a key component of a range of measures designed to improve the quality of care for patients.”
These are challenging times but the GMC still requires doctors to collect patient feedback
Patient and colleague feedback have always been required as part of the revalidation process. However, medical professionals are currently under extreme pressure and are finding it harder than ever perform tasks beyond patient care due to unmanageable workloads coupled with a rapidly shrinking and exhausted workforce. This has resulted in increased pressures on a system that is already at breaking point. Recent figures from the British Medical Association (2023) show that the average number of patients each GP is responsible for has increased by nearly 17% to 2,260 since 2015. Consequently, as fewer GPs are providing care for a larger number of patients, there is a greater risk of GPs becoming burned out and struggling to offer the best care.
A recent article published from the Chair of the GMC, Dame Carrie MacEwen, has highlighted the current pressures that the health services are facing, including staff shortages, lack of space and patient delays. In this article, Dame MacEwen explains that the GMC’s aim is to support the medical profession in giving the best possible care, even though there will be no instant fix to the problems. This support includes:
- helping to implement workplace cultures that allow every doctor to thrive;
- sharing the GMC’s extensive data with employers to pinpoint how to make the most out of the existing and future workforce
- making revalidation as supportive, flexible and meaningful as it can be.
In 2020 (during the height of the Covid pandemic), the GMC relaxed requirements around appraisal in response to the decision on the part of four UK Departments of Health to pause the contractual obligation to undergo medical appraisal for organisations or individuals that wished to do so. In practice, many organisations continued to offer appraisal throughout, and the Departments of Health gradually re-instated the contractual obligation to carry out appraisal activities between October 2020 and April 2021. During the pause in contractual obligation, the GMC accepted recommendations for doctors to revalidate if they met all other requirements (including patient and colleague feedback) regardless of whether they met the appraisal requirement. With this in mind, the GMC expected doctors to collect and reflect on colleague and patient feedback consistently (and they continue to do so).
The practical requirement is low (i.e., once every five years) and, in practice, many doctors undertake feedback exercises more often than this, either because their employer expects it or because their Royal College of General Practitioners (RCGP) recommends it as good practice. In 2020, the GMC also introduced flexibilities around the mechanism used to collect patient feedback, recognising that online methods would be far more practical for some patients, as well as much more efficient for doctors to collect and review their feedback.
The importance of patient feedback within revalidation (and doing it the right way)
The UK has led the world in the use of patient surveys, but staff are not always aware of them. The National Institute for Health and Care Research’s study on Improving Care by Using Patient Feedback (2020), highlights that patient experience feedback:
- can shape services to better meet patient needs, and that better patient experience is associated with the efficient use of services;
- results in patients being better able to use the clinical advice given, and to use primary care more effectively;
- can affect hospital length of stay (Doyle et al 2013).
This study suggests that learning from patients’ views on the care they have received is widely accepted as key to improving healthcare services. Evidence of the use and usefulness of patient experience feedback shows that whilst there is a growing interest in using feedback for both accountability and service improvement, there are gaps in healthcare providers’ capacity to analyse and use it. Organisations should embrace all forms of feedback (including complaints and unsolicited feedback) as an opportunity to review and improve care.
Furthermore, a study from BMC (BioMed Central) Medical Education on the Impact of Patient Feedback on Medical Performance (2018), also suggests that patient feedback is considered integral to quality improvement and professional development, and can have an impact on medical performance. BMC includes however, that actionable change is influenced by several contextual factors and cannot simply be guaranteed. BMC suggests that the feedback obtained should be fed back in a way that facilitates reflective discussion and encourages the formulation of actionable behaviour change.
To strengthen patient feedback as an educational tool, the initiatives should:
- be specific;
- be collected through credible methods;
- contain narrative comments;
- involve facilitated reflective discussions where initial emotional reactions are processed into specific behavioural change, quality improvement initiatives or educational tasks.
So patient feedback is an essential element in a doctor’s development process – but why use our Doctor 360?
With the NHS under more pressure than ever before, our aim is to help make the process of revalidating as quick and efficient as possible for doctors, revalidation managers and responsible officers:
Trust in the quality of the process and the output
At Edgecumbe, professional self-development is central to our work. Our intention is to provide efficient ways of collecting feedback that remain robust and compliant, so that an insightful report is gained, from which identify actionable development points can be taken, and in which no additional intervention is needed from the designated body. We have been heavily involved in medical appraisal and revalidation, serving on advisory groups and committees, and training thousands of consultants and GPs in medical appraisal since 2000. We also work closely with the National Clinical Assessment Service and have maintained the position as their behavioural assessors since their formation in 2002. In fact, we were the first organisation to launch a 360-feedback tool for doctors in the 1990s – Edgecumbe Doctor 360°.
Save on time and administrative costs
Our colleague and patient questionnaires require a significantly lower minimum threshold of responses than others. The minimum number of feedback responses required to generate a patient report (17) with the Doctor 360 questionnaire is half of that required when using the GMC questionnaire (34). This enables an easier process for collating feedback, which is particularly beneficial for doctors and their teams who want to spend less time on the feedback process, but also brings huge cost savings with regards to the organisation’s administrative overheads.
An online system that is fully automated and user-friendly
Plenty of reminders are issued to colleagues who may have forgotten to give feedback, and the feedback process is quick and easy for them, when they do. Settings can be tailored to the requirements of the organisation.
Service users are supported by a friendly team who go the extra mile to ensure that reports are ready on time
We treat each doctor as a client, rather than a purchaser of our product, and our small, personable team works one-to-one with doctors to troubleshoot issues and ensure they meet their deadlines. Revalidation managers and responsible officers can be assured that there is a proficient account manager to pick up the phone to at any time.
No tie to an appraisal portfolio package
Organisations and doctors are able to stick with their existing appraisal portfolio solution whilst getting the best colleague and patient feedback reports to upload to it.
An easy ordering and re-ordering process
For individual doctors, our exercises can be purchased easily via our Doctor 360° website. Organisations can get in touch to set up a flexible payment plan.
If you would like to know more about our services, please visit our website to find out the various packages that we have to offer. Alternatively, if you would like to have a chat with a member of our brilliant team, please contact us via firstname.lastname@example.org, or call 0117 332 8277 and we look forward to speaking with you.