Health secretary Jeremy Hunt has given the green light for revalidation of doctors to begin, removing the final barrier to the introduction of a system first recommended more than a decade ago.
However, senior NHS figures remain sceptical it will tackle poorly performing doctors.
From December doctors across the UK will begin to receive letters notifying them of their revalidation date. In England designated responsible officers, who will be responsible for the revalidation of medical colleagues within their organisation, will go through the process first.
They will be followed by around 20 per cent of the medical workforce during 2013-14, with the vast majority expected to have been revalidated by 2016.
After that doctors will be revalidated every five years when they will be required to collect feedback from colleagues and around 35 patients to feed into a “super-appraisal”.
Announcing the rollout of the system Mr Hunt said revalidation would help make sure doctors are “up to speed with the latest treatments and technologies” and improve survival rates.
NHS medical director Sir Bruce Keogh said revalidation was one of the “most powerful quality levers we have put into the system for a long time” and would be invaluable to boards.
He said the level of resource to be provided to support organisations to carry out revalidation was still being worked out.
“I simply do not accept the argument that compiling evidence you’re doing a decent job is outside the jurisdiction of your medical responsibilities,” he said. “If you don’t know what you’re doing you have no right to be doing it.”
Asked how they would make sure revalidation happened, in light of the poor record of appraisal in the NHS, General Medical Council chief executive Niall Dickson said the fact that responsible officers were “answerable” to the GMC would provide a powerful driver as would doctors themselves who would not be able to practice if they had not been revalidated.
He said he hoped revalidation and the accompanying annual appraisal process would lead to problems being identified earlier rather than being allowed to “fester” without the doctor involved developing any insight, as often happened at the moment.
However, medical directors and chief executives told HSJ it was unclear how revalidation would work where the existing system of job planning and appraisal had failed. Although they felt ready for implementation they cautioned against the risk of creating another layer of bureaucracy.
One senior doctor with experience working at the Department of Health said it was a question of will. “It’s up to the profession to police themselves and they have never done that before. Most doctors are perfectly safe; every hospital knows the few exceptions. It’s how those exceptions will be managed that everyone’s going to watch.”
An acute trust chief executive said revalidation did not address the difficulty and expense of tackling poor performance for the small percentage of doctors who did not want to co-operate.
She said: “If people have been waiting for revalidation [to tackle poorly performing doctors] then frankly the board [in question] should be ashamed of themselves.”
Assistant medical director at Plymouth Hospitals Trust Steve Allder told HSJ it could be a positive way of making sure doctors stayed up to date on training and procedure but there was no objective definition to judge doctors against.
He added: “It will become a tick box exercise; most of the people will pass, rightly so. No-one will have the balls to do anything about the people you’re really worried about.”
However, Peter Homa, chief executive of Nottingham University Hospitals Trust, told HSJ revalidation would be a way of recognising good practice and identifying difficulties early on in their practice.
“It’s clearly an important and significant undertaking but we would see it as an investment and not a cost,” he said.