Doctors will undergo annual assessments from next year to ensure they are up to the job- but patients will not find out if concerns were raised.The system, called revalidation, will involve an annual ‘beefed-up’ appraisal with a senior colleague going over complaints, compliments, clinical data, complications and mistakes as well as any management and research work they have undertaken.
Every five years this will have to include feedback from at least 35 patients and colleagues before the doctor can be recommended to the General Medical Council to continue to practice.
The aim is to detect low level poor practice that would not currently warrant a referral to the GMC so action can be taken early to rectify the situation with extra training or supervision.
It should also allow doctors to ensure they stay up to date with their skills and knowledge, although it will not involve formal exams or tests.
In a survey concerns were raised in 4.1 per cent of cases, the equivalent to 6,800 doctors in England. That includes 2.4 per cent, or 4,000 nationally, with low level concerns such as lateness that would be addressed within the organisation.
One per cent, or 1,600 doctors nationally, had medium level concerns raised which could include rudeness and other behaviour issues that may need further training or a ‘contract agreement’ to change.
The remaining 0.7 per cent or 1,200 doctors in England had high level concerns raised which could include problems such as alcoholism as well as patient safety issues. These concerns could be enough to trigger a referral to the current GMC fitness to practice panels, which remains unchanged.
Of the concerns raised, one quarter were about the doctor’s health, one quarter were about their conduct and 60 per cent were about competency or a combination of those factors.
Officials at the GMC and Department of Health admitted that patients would not know of any concerns raised about their doctor unless they were referred to fitness to practice and there was considered to be a case to answer.
Niall Dickson, chief executive of the GMC, said no other profession published the results of appraisals and patients should be reassured that all doctors would now undergo annual checks in the first such national system anywhere in the world.
He said it was a ‘historic movement’ and the biggest change in medical regulation for 150 years.
Medicine was a ‘safety critical’ industry, he said and added: “Doctors’ capacity to do good is greater than it has ever been but so to is the capacity to do harm.”
Katherine Murphy, chief executive of the Patients Association said patients wanted to be in a position to see the best doctor no matter what their condition and needed good information to do that.
She said: “When a serious clinical matter has been raised in the revalidation process then patients have a right to know. The GMC must make sure that their first priority is protecting the public.”
However she added that where concerns raised were of a managerial or human resources nature then that should stay between the doctor and their employer.
The first wave will be revalidated using one appraisal and a feedback questionnaire instead of the usual five years’ worth of appraisals in future.
There should be no additional cost to the NHS as responsible officers are already in post, and annual appraisals and preparation for them should already have been happening, officials said.