Revalidation in the United Kingdom

To the Editor: Recent discussions about revalidation for doctors in Australia highlight the need for doctors to be aware of developments in countries such as the United Kingdom.1,2

The UK regulatory body for medical practitioners, the General Medical Council (GMC), has introduced a licensing system for medical practitioners. By law, doctors practising in the UK have to be both registered and licensed to practise in order to be able to work as a doctor. Implementation of a licence to practise was the first step towards revalidation. Revalidation in the UK then started in December 2012. The requirements for doctors to be revalidated are in accordance with the GMC good medical practice guidance. The revalidation cycle for the individual doctor is completed every 5 years. Annual professional appraisals are compulsory for doctors practising in the UK and form the basis of revalidation.3

Appraisal needs to cover six areas: continuing professional development, quality improvement activities, significant events, feedback from colleagues, feedback from patients, and complaints and compliments. Appraisals also need to include a portfolio about the work the doctor does, including maintenance of professional standards. During appraisal, a qualified appraiser has a discussion with the doctor who is to be appraised. The principles of good medical practice apply.4 The appraiser then makes a recommendation to a responsible officer. The responsible officer makes a recommendation to the GMC, which then decides if the doctor is granted revalidation. Doctors working clinically or non-clinically both need to revalidate in the UK. Doctors working clinically need to work a minimum of 200 sessions during a 5-year cycle.5

The revalidation process for doctors working in the UK is complex, and its implications on the workforce remain to be seen. An introduction of revalidation in Australia should ensure professional standards, but could also cause a reduction of existing numbers of working doctors. It would be wise to monitor the impacts of revalidation in the UK, before implementing a similar system in Australia.