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Is it Time We Questioned the Validity of GMC Revalidation?

23 October 2023

The NHS needs to save money. That is a fact. Doctors are striking for higher pay, and litigation costs are at almost £3 billion per annum, a combination that might break the back of our struggling system. Doctors and surgeons are disenfranchised, and we need to improve their working lot without jeopardising patient care. But how so? The answer, if there is one, would be a complex combination of many factors.

Should we begin with a review of the current General Medical Council (GMC) revalidation process? This system uses many hours of supervisors’ time whilst costing the NHS money. Some would argue it’s a necessary and valid process, whilst others feel the money would be better spent elsewhere, and revalidation is arbitrary and needless.

The camp is split in two, with little room for manoeuvre on either side. Those against the revalidation process argue that the projected £97 million cost (plus the cost of training responsible officers) would be better placed elsewhere in the rapidly diminishing pot, that the revalidation bar is set too low, and the process would not have stopped the likes of Harold Shipman and Lucy Letby. Those in favour of the process would counterpoint that revalidation was never intended to catch murderers; that if revalidation was designed to do this, they might be working for five years (the time gap between fitness to practice revalidation) before being caught and struck off. They might argue that we must have faith in other processes more robustly designed to catch dangerous individuals and other wrongdoings. The argument is that revalidation has its place, providing formal evidence of good practice, a focus point, and a sense of value. 

Statistics from the GMC show that, out of the 271,379 revalidations carried out in England since its implementation in 2012, just 0.32% had recommendations of non-engagement.[1] A British Medical Association (BMA) poll as far back as 2016 identified excessive regulation among the top five factors pushing doctors towards early retirement, with revalidation cited as one of those processes.[2]

Does it work in its current form? This is a question that needs answering. Over the past decade, there have been changes implemented to many other NHS structures and procedures. These include modifications to the death certification system; complaints handling; management of controlled drugs; the coroner system; monitoring of prescribing data, mortality rates and unexpected deaths; GP practice inspections; and police guidance, all of which make for an increasingly robust system for highlighting concerns and malpractice, and identifying unfit doctors. Is it time to also tweak the revalidation process?

We leave the answer to this entirely up to you! Should we disengage from revalidation, change its format and parameters, or is it a valuable process and fit-for-purpose? Let us know your thoughts!

 

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