Revalidation and anaesthesia

Report
Revalidation update and the
new CPD matrix
Andy Tomlinson
Revalidation Lead
Royal College of Anaesthetists
AAGBI Congress
Edinburgh 2011
Revalidation: Why?
Revalidation update and the CPD matrix

What is revalidation?

Medical appraisal

Supporting Information

Continuing professional development and the matrix

What should you be doing now?
What is Revalidation?
“A new process to assure patients, the public,
employers and other healthcare practitioners that
licensed doctors are up to date and fit to practise.”
Revalidation:The Way Ahead
GMC Consultation Paper
March 2010
Revalidation…..is a continuing cycle
One
revalidation
cycle
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Strengthened
appraisal
Another
revalidation
cycle
…..for each/every professional lifetime
Revalidation model
Portfolio of Supporting Information
Five x yearly appraisals
Responsible Officer
Recommend
revalidation
Query
Cannot recommend
revalidation
RCoA adviser and/or
GMC ELA review and
support
General Medical Council
Revalidation….is coming to us all
In 2012 provided:
 Responsible
Officers appointed
 Effective clinical governance systems in place
 Effective annual medical appraisal
 Agreed core supporting information
 Agreed strategy for remediation
Revalidation for Doctors: Health Committee

Must ensure:

Implemented by 2012

Consistency of appraisal

Administrative burden placed on doctors not excessive

Patient and colleague feedback is embedded
HC 557
8th February 2011
Appraisal

Discussion/constructive dialogue at the heart of
appraisal

Key appraiser skills

Support, guide, challenge (constructively)


Balance



Based on supporting information
Assessment (Revalidation)
Support (Personal development)
Recognise/respond to patient safety concerns
Appraisal
Current best practice

Clinical and non-clinical aspects
mapped to GMP

CPD reviewed against


Core topics
Job plan

Matching of job plan to Trust
needs

Increased use of MSF

PDP taking account of the above
Appraisal
Current best practice
Appraisal for revalidation

Clinical and non-clinical aspects
mapped to GMP


CPD reviewed against




Core topics
Job plan

Match job plan to Trust needs

Increased use of MSF

PDP taking account of the above
‘Whole practice’ referenced to
four domains of GMP
Judgements on:




Adequacy of supporting
information including:
 CPD
 Quality of practice
 Learning from complaints
 MSF
Clinical risks/safety
Progress towards revalidation
Match job plan to Trust needs
PDP taking account of the above
GMC Good Medical Practice Framework
www.gmcuk.org/GMP_framework_for_appraisa
l_and_revalidation.pdf_41326960.pdf
Good Medical Practice Framework

Must be used by individual doctors to:

Reflect on practice/approach to medicine

Reflect on Supporting Information and what it demonstrates

Identify areas for improvement/further development

Demonstrate they are ‘up to date and fit to practise’
Supporting information
www.gmcuk.org/Supporting_information__2_.pdf_39
974163.pdf
Core supporting information

Information that all doctors should provide
Core supporting information

Information that all doctors should provide

General information


Keeping up to date


Maintaining/enhancing quality of professional work
Review of practice


Providing context about your ‘whole’ practice
Evaluating the quality of your practice
Feedback on professional practice

How quality of professional practice is perceived by others
Core supporting information

Information that all doctors should provide

General information


Keeping up to date


Maintaining/enhancing quality of professional work
Review of practice


Providing context about your ‘whole’ practice
Evaluating the quality of your practice
Feedback on professional practice

How quality of professional practice is perceived by others
Specialty specific advice added
Specialty specific supporting information
Supporting Information:
Feedback on professional practice
www.gmcuk.org/Colleague_and_patient_question
naires.pdf_41683779.pdf
Specialty feedback on professional practice
www.rcoa.ac.uk/docs/peer_
patFeedback2011.pdf
Supporting Information: CPD
www.rcoa.ac.uk/docs/
CPD_2010.pdf
CPD Matrix (Clinical)

Three levels:

Level One
 Restricted area of essential knowledge

Level Two (Knowledge and skills)
 Directly related to on-call activity

Level Three (Knowledge and skills)
 Directly related to special interest clinical activity
www.rcoa.ac.uk/docs/CPD_2010.pdf
(New) CPD Matrix: level one (L1)
Level 1 covers the core knowledge areas expected of all those
who have trained as anaesthetists. The CPD evidence for this
level will be largely ‘internal’ and may be obtained from
reviews/reflection of personal clinical practice utilising records of
clinical activity, e-learning material, reading and local hospital
departmental meetings.
(New) CPD Matrix: level one (L1)
A. Scientific
principles
Physiology and
biochemistry
B. Emergency
Mx and
resuscitation
Anaphylaxis
Pharmacology
and
therapeutics
Can’t intubate
can’t ventilate
Physics and
clinical
measurement
BLS (all ages and
special
situations)
ALS relevant to
practice
C. Airway
Mx
Airway
assessment
Basic airway
Mx
D. Pain
medicine
E. Patient
safety
G. IT skills
H. Education &
I. Health Mx
training
Consent
Use of patient
record systems
Roles and
responsibilities
of clinical
supervisors
Level 2 child
protection
training
Mental capacity
& deprivation
of liberty
safeguards
Basic search
methodology
Personal
education and
learning
Protection of
vulnerable adults
Data
protection
Human factors
in anaesthetic
practice
Blood product
checking [to
comply with
local
requirements]
Equality and
diversity
Understanding
the process of
dealing with
complaints
Prophylaxis &
management of
VTE
Ethics
Quality
improvement
Assessment
Infection control
of acute pain
Mx of acute
pain
F. Legal
aspects
Critical
incident
reporting
Team
leadership &
resource Mx
(New) CPD Matrix: level two (L2)
Level 2 CPD topics should reflect the whole of the individual’s
clinical practice including on-call responsibilities in non-specialist
centres. The CPD evidence for this level may be provided, in part,
by updates from local experts but it will also include the need for
more ‘external’ CPD activity through attendance at courses and
meetings.
(New) CPD Matrix: level two (L2)
A. General
B. ICM
Advanced airway Mx
Assess of the
critically ill pt
Assess & initial Mx
of major trauma
(and burns)
C. Neuro
D. Obs
Initial Mx of
Analgesia for
brain injury
labour
[traumatic or
Initiation and Mx
GA for
intracranial
of ventilatory
elective/emerge
haemorrhage]
support
ncy LSCS
Pre-op assess and
preparation for
surgery
Support of
threatened and
failing organs
Initial Mx of
RA for
pts with spinal elective/emerge
injuries
ncy LSCS
Peri-op emergencies
Diagnosis & Mx
of shock, inf &
sepsis
Mx of pts with
neuro trauma
for imaging
Advanced pt
monitoring
techniques
E. Pain medicine
F. Paeds
Advanced Mx of
peri-op pain
Assess & Mx of the
critically ill child
Mx of acute nonsurgical pain
Perioperative care
of children
Basic assess & Mx
of chronic pain
Vascular access
techniques
Complications
of RA in obs
Fluid Mx for
children
Sedation in ICU
Mx of obs
emergencies
Analgesia for
children
Fluid Mx/blood
product usage
End of life issues
& organ donation
Assessment of
critically ill
parturient
Sedation techniques
for children
Sedation for adults
Mx of the ICU
Principles of
newborn resus
Team working with
retrieval teams
+others
G. Regional
anaes
Indications,
benefits and risks
of RA
Principles of
performing local,
regional and
neuraxial
techniques
Use of
nerve/plexus
location
techniques
Recognition & Mx
of side effects and
complications of
RA
H. Education &
training
Work-place based
assess
Educational
supervisor training
CPD credits and activities

Minimum of 50 credits per year with some
flexibility

Internal

Minimum 20 credits


External


Minimum of 10 from local clinical governance meetings
Minimum 20 credits
RCoA encourages wide range of activities
Revalidation:
What should I be doing now?
Revalidation: What should I be doing now?
Ask the following of your Trust

Is there a robust appraisal process?


Sufficient “Trained” appraisers
A hospital-wide appraisal development process?
Revalidation: What should I be doing now?
Ask the following of your Trust

Is there a robust appraisal process?



Sufficient “Trained” appraisers
A hospital-wide appraisal development process?
Is there robust Clinical Governance?
Revalidation: What should I be doing now?
Ask the following for yourself


Am I:

collating/organising relevant supporting information?

developing a CPD portfolio mapped to professional
guidance?
How am I involved in Quality Assurance and
Improvement?
Further advice or guidance?
[email protected]
Or
[email protected]

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