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Views And Reviews No Holds Barred

Margaret McCartney: We must look at the whole impact of revalidation

BMJ 2018; 361 doi: (Published 29 May 2018) Cite this as: BMJ 2018;361:k2323

Re: Margaret McCartney: We must look at the whole impact of revalidation

Dear Dr McCartney

Despite retiring a year ago I read my BMJ more avidly than ever. More time to read it now I suppose. Always enjoy No Holds Barred and usually find myself in agreement. This week in particular you struck a chord and I felt I should take the liberty of sharing an email I recently sent to the Today programme following a short segment highlighting the GP crisis in Plymouth. All I got from them was an automated acknowledgement! Perhaps it may be of interest to you?


Tim Padley

Begin forwarded message:

From: Dr Tim Padley

Subject: General Practice in Plymouth

Date: 24 April 2018 at 07:06:56 BST


I listened to yesterday’s segment on General Practice with great interest. I have recently taken early retirement after 27 years as a Plymouth GP and am acquainted with a number of the local GPs who were interviewed. I retired mainly in order to help care for my infirm parents in Manchester. In the year since I retired they have now both sadly deceased. On the day I retired I was effectively forced to give up my license to practice medicine unless I was prepared to continue with the full cycle of annual appraisal and revalidation. The requirements of this are the same for a doctor who does one session a month as for one who works full time. My skills (such as they were) and experience have effectively been thrown on the scrap heap.

GPs are retiring in droves and faster than they are being replaced. The demands of the job are such that nothing will stop this, but many, like me, would be delighted to be able to help out in crises, as our colleagues used to be able to do, or even work very part time on a regular basis. Only this week I learned that one of my ex partners had a sudden family illness and I would have loved to help out by offering him locum cover for a week. I am no more qualified to do this now than the proverbial man on the Clapham omnibus - accountant, zoologist or anything in between. It would even potentially be an offence to offer to help out.

Mr Humphrys asked if there was “one thing” that could really make a difference and the answer from the RCGP person was a rather utopian “more doctors”. In my view there is one very specific thing the government could do that would make an enormous difference in Plymouth and all over the country, almost overnight. Why not consider changing the rules so that doctors aged 55 or more, who will have already been through one full five year revalidation cycle (and hence proved that they have maintained their fitness to practice over a long career), who are in current good standing and have never been investigated by the GMC, can continue to hold their licence to practice without further interference until say age 65? Exactly how things were until revalidation was introduced a few years ago. This would cost no money, would, at a stroke, dramatically increase the available pool of doctors, would mean that the NHS was no longer throwing away skills and experience it can ill afford to lose, and would, in my view be considerably safer than continuing with the levels of stress and overwork mentioned by the GPs you interviewed yesterday.

Why not ask Mr Hunt for his view on this specific “one thing" - unlike me you are in a position to do so. He will no doubt list all the many new medical school places the government is funding etc etc but that is jam in five or six years time. General Practice needs some jam today or else it simply might cease to exist in its current universal form.


Tim Padley

Competing interests: No competing interests

06 June 2018
Tim Padley
Retired GP