Revalidation – a trap for the unwary?
All doctors will be aware of the need to revalidate and the GMC’s responsibilities in this regard. Revalidation is the process by which doctors are required to demonstrate that they are up to date and fit to practise. Doctors must revalidate every five years, and in order to do so they must have annual appraisals based on the GMC’s guidance, Good Medical Practice.
For most doctors, appraisals and revalidation are straightforward. If you are employed by an NHS Trust (even if you also have a private practice), that Trust is likely to be your Designated Body (DB) and you will have a Responsible Officer (RO) – often the Medical Director of your employing Trust. If you are a GP on the Performers List, your DB will be NHS England and your RO will be based in your local Area Team. Purely private doctors have a number of other options for their DB, including the private hospital where they work or have practising privileges, the Independent Doctors Federation, and some of the Royal College Faculties.
However, there are doctors who have trouble identifying a DB and RO, perhaps because their practice is unusual in some way. This can lead to difficulties.
It is open to doctors in this situation to find a “Suitable Person” – someone who has been approved by the GMC and who can make a revalidation recommendation to the GMC about you. The GMC publishes a list of Suitable Persons (SPs) on their website. It is well worth exploring this option if you do not have a DB and RO, as your SP will be able to assess your fitness to practise in your chosen field, which may be unusual or very niche.
If you do not have a DB/RO or an SP, the final option is to submit an annual revalidation return to the GMC, which will include evidence about your practice and your annual appraisal (which can be done by an independent provider of medical appraisals). In addition, you will need to take an exam every five years. This assessment is provided by the GMC, and there is a fee, which is currently £1,100. There are 12 different assessments and you would need to choose the assessment most relevant to your area of practice. That is where the difficulty often lies – almost by definition, someone who does not have a DB/RO or an SP tends not to fit into a neat category or work in one of the more mainstream specialties. That may make it difficult for you to pass the GMC’s assessment in one of the 12 areas they offer (which are: Anaesthetics, Emergency medicine, General practice, Histopathology, Medicine, Obstetrics and gynaecology, Ophthalmology, Paediatrics, Psychiatry, Radiology, Surgery, and a Foundation paper for doctors who do not practice in a specialty area). If you fail the assessment, the GMC will take steps to withdraw your licence to practise and it will be stressful, time consuming and expensive to appeal that decision. If you are having difficulty finding a DB/RO, you may therefore want to explore the possibly of finding an SP, rather than submitting to the GMC’s revalidation return and assessment system.
Whatever option you choose, if your RO or SP makes a recommendation to the GMC that you should not be revalidated (a notification of non-engagement), you will face the prospect of the GMC taking steps to withdraw your licence to practise. The first step is that the GMC will send you a notice of their intention to withdraw your licence, and if you want to challenge this you must respond within 28 days and provide them with as much additional evidence as possible (the notice will tell you what’s required). It is essential that you do so within the time limit – you may be able to persuade the GMC to defer their decision and give you more time, or even to change their decision and revalidate you. The alternative is to accept withdrawal of your licence to practise, without which you cannot work as a doctor in the UK. If the GMC decide to withdraw your licence, even after you have provided additional information in response to their notice, you will have the right to appeal that decision (on the papers or at an oral hearing). There is a 28 day time limit to lodge that appeal.
There are often good grounds for challenging a decision by the GMC to withdraw a doctor’s license – it may be that the doctor has been unable to engage with revalidation because of illness or other mitigating circumstances, or it may be that they have done what was required but not provided the necessary information or presented it clearly enough. Sometimes, doctors are lulled into a false sense of security because they pass their annual appraisals, but they are not in fact doing all that they need to do to enable their RO to recommend revalidation. If that is the case, the RO (or someone else on their behalf) should contact the doctor and let them know that there is a problem. You should be proactive and ensure that before your revalidation date, you contact your RO (if you have not heard from them), and ensure that they are happy with the information you have provided. Make sure that the GMC have your up-to-date contact details – they will send you a formal notice four months before your revalidation date and this will serve as a useful reminder to you.
We hope that you sail through your five-yearly revalidations without difficulty – but if you should ever need any legal assistance, specialist lawyers such as the team at Hempsons will be able to assist.