A new opinion survey of 203 GPs has found that half of the respondents think that the new revalidation process now coming into effect will belittle their professionalism – and 65% fear it will reduce morale.
The revalidation proposals from the Chief Medical Officer have been widely called for since the Bristol Royal Infirmary inquiry into excess deaths in paediatric heart surgery of the 1990s, and were given added impetus by the revelation of the activities of the serial killer and GP Harold Shipman. Interestingly, 84% of respondents replied that revalidation would not be successful in identifying another Harold Shipman – not quite the main aim of the proposals.
The new revalidation process (being piloted over the next 18 months) includes a system to re-license the UK’s 150,000 doctors to test their basic competence as medics. It will apply to all doctors, and will be based on a strengthened annual review process. Doctors on the GP and specialist registers also will face specific testing to confirm they can continue in their specialties.
The survey, by market research consultancy TNS Healthcare, found little support for the new procedure, with 71% of respondents believing it will reduce their time spent with patients and over 60% anticipating that it will be simply a ‘tick-box’ exercise.
Colleague feedback good, patient feedback bad
Over half of the doctors surveyed agreed that feedback from colleagues will enhance the revalidation process. However, 41% of respondents agreed that including patient feedback will improve the revalidation process, and just 27% reported seeing value in including caregiver feedback.
Yet contradictorily, three-quarters of respondents said they recognised that their ability to communicate with patients and caregivers is critical, and that assessing doctors’ communication skills was just as important as considering prescribing behaviors.
Weeding out the unco-operative and hard-to-manage?
Almost half are concerned revalidation will serve as a tool to weed out doctors viewed as difficult to manage or uncooperative.
“Doctors clearly are not convinced that the new revalidation process will provide the benefits the government is citing,” says Adam Harris, UK Managing Director of TNS Healthcare. “Less than half agree that revalidation will enhance public confidence in the medical profession or ensure physicians keep more up to date. In addition, only about a third believe that revalidation will raise the standards of practice, and less than half think it will lead to consistent standards of practice across the UK.
“Overall, only about half of GPs see any good in the revalidation process, and even fewer—just 28%—think it is long overdue,” says Harris. “One of our respondents summed up what seems to be the predominant feeling, calling the new process ‘a shallow political gesture [with] no cost benefit evidence to support it.’ Another called it ‘another costly exercise based on an unsound premise that pulls yet more time away from our patients.’ Still others spoke about potentially resigning or moving overseas.”
