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New era of five-yearly doctor checks starts | New era of five-yearly doctor checks starts |
(about 4 hours later) | |
By Nick Triggle Health correspondent, BBC News | By Nick Triggle Health correspondent, BBC News |
Regular checks on doctors' skills will start from December, heralding the biggest shake-up in medical regulation for more than 150 years. | Regular checks on doctors' skills will start from December, heralding the biggest shake-up in medical regulation for more than 150 years. |
The UK's 220,000 doctors will have annual appraisals, with a decision taken every five years on whether they are fit to continue working. | The UK's 220,000 doctors will have annual appraisals, with a decision taken every five years on whether they are fit to continue working. |
But it will be April 2016 before the vast majority of the first round of checks have been done. | But it will be April 2016 before the vast majority of the first round of checks have been done. |
The health secretary said it was about addressing "deficiencies" in skills. | |
Jeremy Hunt said that if doctors failed to satisfy the standards of the General Medical Council (GMC) they would be prevented from practising. | |
But he said the new system was about identifying where there were "gaps" in knowledge or skills and giving doctors a "chance to put those issues right". | |
He said the vast majority of doctors "do a brilliant job" but when the government carried out a survey last year of 300 health bodies there were "serious concerns" with 0.7% of doctors - a figure Mr Hunt described as "significant". | |
"At the end of the day if the GMC is not satisfied that someone is up to speed then, yes, they will be prevented from practising," he told BBC Breakfast. | |
He said this would give the public confidence that the UK had the most thorough regulatory process for its 175,000 doctors. | |
'Improve quality' | |
The move comes after years of discussions about the way doctors are monitored. | |
At the moment there are no mandatory checks on the performance of individual doctors, a situation which has been compared unfavourably to the airline industry where pilots face regular, on-going assessment. | At the moment there are no mandatory checks on the performance of individual doctors, a situation which has been compared unfavourably to the airline industry where pilots face regular, on-going assessment. |
Annual appraisals do happen in some places - particularly for medics in training - but they are by no means routine. | Annual appraisals do happen in some places - particularly for medics in training - but they are by no means routine. |
There is, of course, a system of registration which the GMC is in charge of. | There is, of course, a system of registration which the GMC is in charge of. |
When serious complaints are made about performance, the GMC can start disciplinary procedures. | When serious complaints are made about performance, the GMC can start disciplinary procedures. |
But this system essentially only picks up problems when things have gone wrong. | But this system essentially only picks up problems when things have gone wrong. |
Revalidation has been designed to ensure issues are dealt with before they reach that stage. | Revalidation has been designed to ensure issues are dealt with before they reach that stage. |
GMC chief executive Niall Dickson said: "This is an historic moment. It is the biggest change in medical regulation for 150 years [since the creation of the GMC]." | GMC chief executive Niall Dickson said: "This is an historic moment. It is the biggest change in medical regulation for 150 years [since the creation of the GMC]." |
He said the system should help improve quality, but he admitted the health industry had been "slow to recognise" the importance of such checks. | He said the system should help improve quality, but he admitted the health industry had been "slow to recognise" the importance of such checks. |
The introduction of regular checks - dubbed a medical MOT - has been talked about for more than 30 years. | The introduction of regular checks - dubbed a medical MOT - has been talked about for more than 30 years. |
Serious consideration started being given to the issue in the mid-1990s. | Serious consideration started being given to the issue in the mid-1990s. |
But over subsequent years scandals like that of the family GP and serial killer Harold Shipman and the deaths of the Bristol heart babies led to reviews and re-evaluations about what the process was intended to do. | But over subsequent years scandals like that of the family GP and serial killer Harold Shipman and the deaths of the Bristol heart babies led to reviews and re-evaluations about what the process was intended to do. |
Government and GMC officials have also had to have detailed discussions with the British Medical Association (BMA). | Government and GMC officials have also had to have detailed discussions with the British Medical Association (BMA). |
Dr Mark Porter, chair of the BMA's Council said it supported revalidation. | Dr Mark Porter, chair of the BMA's Council said it supported revalidation. |
He added: "It is important to recognise, that while revalidation will undoubtedly enhance the rigorous testing that doctors undergo, clinicians are already offering patients a very high quality service and robust systems are currently in place to deal with any concerns. | He added: "It is important to recognise, that while revalidation will undoubtedly enhance the rigorous testing that doctors undergo, clinicians are already offering patients a very high quality service and robust systems are currently in place to deal with any concerns. |
"There is too much bureaucracy in the NHS and so we have to be careful that revalidation does not add to this unnecessarily." | "There is too much bureaucracy in the NHS and so we have to be careful that revalidation does not add to this unnecessarily." |
Dean Royles, director of NHS Employers, said: "It is a very positive step forward and should herald greater patient safety and build confidence. | Dean Royles, director of NHS Employers, said: "It is a very positive step forward and should herald greater patient safety and build confidence. |
"Patients need and expect this. It has been a long time coming." | "Patients need and expect this. It has been a long time coming." |
NHS medical director Professor Sir Bruce Keogh added it was a "powerful opportunity" to ensure standards of quality and professionalism are kept to across the country. | NHS medical director Professor Sir Bruce Keogh added it was a "powerful opportunity" to ensure standards of quality and professionalism are kept to across the country. |
'4% concerns' | '4% concerns' |
Each NHS organisation from hospitals to local networks of GP practices will have a responsible officer, such as a medical director, in charge of revalidation. | Each NHS organisation from hospitals to local networks of GP practices will have a responsible officer, such as a medical director, in charge of revalidation. |
They will assess the annual appraisals along with feedback from patients and colleagues to make a recommendation about revalidation to the GMC every five years. | They will assess the annual appraisals along with feedback from patients and colleagues to make a recommendation about revalidation to the GMC every five years. |
Minor issues that do not constitute a risk to safety may lead to revalidation being deferred for a short period, but major problems will result in the doctor not having their licence to practise revalidated. | Minor issues that do not constitute a risk to safety may lead to revalidation being deferred for a short period, but major problems will result in the doctor not having their licence to practise revalidated. |
Such a scenario could also lead to disciplinary procedures being started by the GMC, the ultimate sanction of which is being struck off the medical register. | Such a scenario could also lead to disciplinary procedures being started by the GMC, the ultimate sanction of which is being struck off the medical register. |
During piloting and testing of the new system, concerns were raised over the performance of 4.1% of doctors. | During piloting and testing of the new system, concerns were raised over the performance of 4.1% of doctors. |
In 2.4% of cases the issues were judged to be lower level, such as lateness, in 1% they were medium level, which included problems with behaviour including rudeness to patients, while in 0.7% the problems were serious and would have had an impact on safety. | In 2.4% of cases the issues were judged to be lower level, such as lateness, in 1% they were medium level, which included problems with behaviour including rudeness to patients, while in 0.7% the problems were serious and would have had an impact on safety. |