Revalidation is time consuming, “clunky,” and poorly supported

Most doctors in revalidation pathfinder pilots spent at least a day on the process and had considerable problems with the “absolutely dreadful” toolkit software, a new survey from the BMA has shown.

Almost 80% of the 258 general practitioners and consultants surveyed who were in pathfinder pilots needed more than eight hours to complete the revalidation process, whereas less than half (47%) of the 3863 doctors who had completed the standard appraisal procedure took this long.

The revalidation toolkit in particular was condemned, with respondents finding the software difficult to navigate, time consuming, not user friendly, unreliable, and prone to losing data.

“The IT computer software system is very time consuming and cumbersome to use,” said one respondent. “It has taken longer to prepare so far than the previous paper based assessments.” One respondent even reported completing private computer training so as to be able to use the toolkit.

“We recognise that if revalidation is to work the systems that support it must be easy to access, simple, and straightforward to use,” said Niall Dickson, chief executive of the General Medical Council. “The findings from the pilots suggest that some of the IT support was clunky, and that does need to be addressed.”

When asked about the current appraisals system two thirds of the doctors surveyed said that they were not able to get hold of enough supporting data from their trusts, and a similar proportion said they did not have enough work time or funding to complete the process, raising concerns as to how the extra information and time required for the more detailed process of revalidation will be provided for.

“This [survey] is a useful snapshot of where the NHS has got to with appraisals, and it shows there is still work to do,” said Niall Dickson. “It is also timely: with revalidation due to come in before the end of 2012, this is a wake-up call. We are going to work closely with the four UK health departments and with responsible officers to make sure doctors have what they need by the time revalidation is introduced.”

The BMA sent surveys to all 47 688 of its consultant and GP members in November 2010, 3863 of whom responded (8% response rate). Nearly all respondents (89%) reported having had an appraisal since April 2009, with GPs slightly more likely to have been appraised than consultants (92% versus 86%).

Two thirds (68%) reported that their trust was not able to generate sufficient data relevant to their performance for their appraisal, however. Respondents said that they had difficulties getting hold of individual level and outcomes related data and that the information provided was of poor quality.

Revalidation also came under fire at the BMA’s consultants conference earlier this week, with speakers calling the 10 years spent developing the process an “embarrassment.”

However, a motion on whether five satisfactory appraisals should be sufficient for revalidation was defeated after the chairman of the Central Consultants and Specialists Committee, Mark Porter, raised concerns that doctors who have an unsatisfactory appraisal would not have access to remediation and could lose their licence to practise.

• Read the full results of the survey at www.bma.org.uk/images/revalidationappraisalsurveyresultsmarch2011_tcm41-205054.pdf.