Information for Doctors in Training (including LATs) about the Local Revalidation Process

Information for Doctors in Training (including LATs) about the Local Revalidation Process 1. What is Revalidation? Medical revalidation is the process by which the General Medical Council (GMC) confirms the continuation of a doctor s licence to practise in the UK. The aim is to support doctors in their professional development, helping to improve quality, patient safety and public confidence in the profession. It ensures that doctors are up to date and maintaining their fitness to practise. Every fully registered doctor needs to revalidate every 5 years, and this includes doctors in foundation year two and specialty training, up to and including their grace period. Revalidation is based on the evidence you are providing every year at your ARCP/RITA process. Revalidation encompasses the full scope of a doctor s work, for trained as well as training doctors, which includes any other medical work you are carrying out, including locum work, voluntary work as a doctor etc. For an explanation of what Fitness to Practise actually means, see further information by the GMC here 2. When you will revalidate The point at which you revalidate will depend on how long your training lasts. Until 31 st March 2018, trainees will ONLY revalidate at the time of CCT (although please remember that you still have to complete the revalidation paperwork for each ARCP/RITA in the years prior to your CCT). Doctors who exit their training programme prior to obtaining CCT will retain their allocated revalidation date, and their next Responsible Officer (RO) will need to make a recommendation by that date. Only when trainees start after 31 st March 2013 will they also need to revalidate at 5 years after full registration. You can view your revalidation date by logging into your GMC Online account. It is important to note that if you relinquish your training number before the Dean has an opportunity to submit a revalidation recommendation, you will not be able to revalidate as a doctor in training. The responsibility will fall to the Responsible Officer of your new employer. Four months before your recommendation is due from the RO, the GMC will send you a formal revalidation notice. Your RO can make their recommendation to the GMC at any time during the four month formal notice period but if you leave the programme, they will not be able to do so. Your first revalidation Expected CCT between 1 April 2013 and 31 March 2018 Expected CCT after 31 March 2018, and those trainees who do not currently have an expected CCT date At point of eligibility for CCT Between 1 April 2016 and 31 March 2018. (Your responsible officer can bring forward your revalidation to align with your expected CCT date where necessary.) For queries about CCT dates moving and what will happen to the revalidation date, please see the GMC guidance here. We are the Local Education and Training Board for Thames Valley Developing people for health and www.hee.nhs.uk hee.enquiries@nhs.net @NHS_HealthEdEng

3. The Evidence you will need to supply As the revalidation recommendation is based on your Annual Assessment process, this means you need to be engaged in and meeting the assessments and curriculum requirements of your training programme. You will already be in regular discussion about your progress and outstanding learning needs with your supervisors, including reflection on any adverse events and complaints. The documentation you will need to provide to the ARCP/RITA panel will encompass all of the evidence you need for revalidation. This will include: Form R - This now includes a self-declaration covering your extended scope of practice and asks about health, probity, significant events, serious untoward incidents, complaints and compliments received. It does not need to be signed by the school until your ARCP. Instructions on completion of the Form R can be found in Appendix 1. Wider scope of practice form this needs to be completed if you have listed any other medical work on your Form R apart from locum in your own specialty in your own trust. This needs to be signed by your Educational Supervisor so that they are aware that you are doing other work and can check that you are providing evidence about that work, see Appendix 2. This wider work also needs to be reflected upon in your portfolio. Examples are: Locum work carried out in different trust/specialty Editor of a medical journal Overseas expedition ALS/ALERT instructor Section 12 (Psychiatry) Educational Supervisor annual training report (either on your e-portfolio or in a paper portfolio). If you are using a paper portfolio or your college does not have the revalidation questions on the e-portfolio, you also need to ask your supervisors to complete the form in Appendix 3. Your full portfolio (this will be electronic for ARCP, but does require you to bring along the full paper portfolio for the year for RITAs). Where your training programme does not require you to routinely collect items of supporting information, you are not expected to collect this, for example patient feedback. The ARCP/RITA panel will request that all evidence is provided at least 2 weeks before the panel takes place. If you do not provide the evidence in time, you will be given an outcome 5 at ARCP or RITA D, requiring that you provide the evidence promptly in order to complete the ARCP process. If you fail to submit evidence within this extended deadline, you risk being given an outcome 3 or RITA E. Page 2 of 12

4. How the process works At the ARCP/RITA, as well as the evidence you supply (see 3 above) the Trust / Area Team in which you are working will also be asked to supply any information they have about significant events, complaints etc that you have been involved in, particularly ones which remain unresolved. This is done in a Collective Exit Report which Details your Trust employment Identifies any complaints or serious untoward incidents in which you have been involved, and any trust investigations arising from these. The trust completes an Exception Exit report if a concern is noted in the collective report and a copy of the report must be shared with the trainee. All this evidence is then examined by the panel to confirm that there are no concerns likely to affect your revalidation. Your Designated Body (DB) is Health Education Thames Valley. Your Responsible Officer (RO) is the Postgraduate Dean, Dr Michael Bannon. The Dean (as RO) will make a revalidation recommendation to the GMC during a period of four months around your revalidation date. He will base his recommendation on your participation in the ARCP or RITA process. He is asked to confirm that there are no unaddressed concerns about your fitness to practise, and this information will come either from employers (the trust) or the ARCP/RITA process. The RO will then make one of three possible recommendations to the GMC for the purposes of revalidation: Positive Defer Non-engagement 5. Information for other types of trainee or training - 5.1 Academic Trainees Trainees in such programmes have both an Academic and an Educational Supervisor, and are assessed each year as to their progress both academically and clinically, preferably through a joint academic/clinical ARCP/RITA process. Revalidation will therefore encompass both the academic work, and the clinical work of the trainee, as well as any wider scope of medical work that they are undertaking. Such trainees will therefore be required to produce evidence of their progress at ARCP/RITA and also address and reflect on any critical incidents, complaints and other concerns in both their clinical and their academic training. You will need to complete both the Form R as well as the Wider Scope of Practice form. Your Academic Supervisor is required to complete the Report on Academic Progress form as agreed by the OUCAGS ARCP/RITA guidelines, and this needs to be agreed and signed by you for submission to the annual panel. Your Educational Supervisor is required to complete your e-portfolio or other evidence of the clinical work you have undertaken and to confirm that you are progressing through the relevant training programme. Both supervisors will be expected to discuss with you any Page 3 of 12

adverse events, complaints etc as with other trainees and to confirm that you have reflected on any incidents. 5.2 Trainees who are Out of Programme Trainees who are Out of Programme are generally still doing work that requires them to have a licence to practise on the GMC s medical register. Therefore they still need to provide evidence each year that they are working towards revalidation. The only exception is OOPC, where doctors may not be carrying out any medical work at all. For all types of OOP work, please see the information on the Revalidation pages of the Oxford PGMDE website which provides more information about the supporting evidence you need to supply. You should retain your Licence to Practise to remain on the training programme even when you are out of programme. If you re considering giving up your licence, you should contact the Associate Dean for Revalidation, for further advice to help you make an informed decision. 5.3 Maternity Leave Your RO will recommend deferral of your revalidation to the GMC if you are on maternity leave at the time of your revalidation date. This will only be until you are back at work and again able to provide the appropriate evidence to support your ARCP/RITA. You should not give up your Licence to Practise, as this is required for you to remain on the training programme and continue to be employed. If you re considering giving up your licence, you should contact the Associate Dean for Revalidation, for further advice to help you make an informed decision. 6. What if you don t agree with the revalidation recommendation? The RO only makes a recommendation to the GMC. The GMC decides about any doctor s revalidation. It is important to remember that revalidation is separate to fitness to practise (FtP) and any concerns about FtP would already have been referred to the GMC. Deferral is a neutral process. This will generally be recommended because there is an investigation of an incident or complaint in progress, which has not yet been completed. Rarely it may be used if a trainee is on a career break or long-term sick leave. In either case, it merely provides the trainee with some extra time to be supported by the training programme in collecting the right evidence. Non-engagement is a very unlikely recommendation and would only be made by the RO if a trainee has not engaged at all in the training and revalidation process. This would also result in an adverse ARCP/RITA outcome. There is no appeal process, but you will be involved in the process at every step; this will not be done TO you, but WITH you. Any appeal against an ARCP/RITA outcome can be taken ahead through the usual processes. Page 4 of 12

7. After you complete your training Please ensure that for your final ARCP/RITA, particularly before your outcome 6, you provide all the revalidation paperwork so that your revalidation can be completed before you leave the training programme. If you have already left and given up your National Training Number, the Dean will no longer be your RO and will not be able to make a revalidation recommendation for you. When you complete your training, your designated body will change to the organisation in which you spend most or all of your practice and the Dean will cease to be your RO. You will need to tell the GMC when your designated body changes by using GMC Online. It is important to share your final ARCP/ RITA as this is your evidence that you have engaged in revalidation. After this, you will need to have a regular appraisal that is based on the GMC s core guidance for the profession, Good medical practice, and collect supporting information to show how you are meeting the professional standards. Click to read more information about how licensed doctors will revalidate. If you would like further information, please email HETVRevalidation@thamesvalley.hee.nhs.uk Page 5 of 12

Appendix 1 Form R (Part A) Trainee registration for Postgraduate Specialty Training This has been pre-populated as an example on how to complete the form. Both Part A and Part B must be completed Forename Joe GMC-registered surname Bloggs GMC Number 123456 Deanery / LETB Health Education Thames Valley Date of Birth: 01.01.1991 Gender: Male Primary Qualification and date awarded: add details of your medical degree and date awarded??? Medical School awarding primary qualification (name and country):???? {If newly registering, attach passport-sized photo of face here} Current Home Address: It is important you complete these fields so we can be sure our records are up to date Home Phone / Mobile: Current Work Address: Add details of current employer (e.g. trust or GP practice) Work Phone / Mobile: Preferred email address for all communications: This is important so we can be sure our records are up to date Immigration Status: (e.g. resident, settled, work permit required) Choose from above examples or add information about other categories Programme Specialty: e.g. Paediatrics GMC Programme Approval Number: (to be completed by Postgraduate Dean) Deanery Reference Number: (to be completed by Postgraduate Dean) (this will start with a number) Specialty 1 for Award of CCT (if applicable): e.g. Paediatrics Specialty 2 for Award of CCT (if applicable): (complete for dual CCT) Provisional CCT Date (or CESR/CEGPR where applicable), if known: If you are not sure check with your TPD and College Post Type or Appointment: (e.g. LAT, Run Through, core trainee, FTSTA etc.) Choose from above examples or information about other post types National Training Number: (to be completed by Postgraduate Dean on first registration) OXF/... (your NTN number will start with OXF and can be found in your portfolio) Please tick only one of these three options : I confirm I have been appointed to a programme leading to award of CCT I confirm that I will be seeking specialist registration by application for a CESR I confirm that I will be seeking specialist registration by application for a CEGPR Royal College/Faculty assessing training for the award of CCT (if undertaking full prospectively approved programme): e.g. Royal College of Paediatrics and Child Health Initial Appointment to Programme (Full time or % of Full time Training): e.g. Full time (at point of training not now) Date of Entry to Grade/Programme (Substantive date started in Programme of appointment): e.g. 6 August 2009 I confirm that the information above is correct. Trainee Signature : Sign here Date: Signature of Postgraduate Dean or representative of PGD: (*for Deanery/LETB use only upon return) Date: Page 6 of 12

Form R (Part B) Self-declaration for the Revalidation of Doctors in Training IMPORTANT: If this form has been pre-populated by your Deanery/LETB, please check all details, cross out errors and write on amendments. By signing this document you are confirming that ALL details (pre-populated or entered by you) are correct. Section 1 only the highlighted questions need to be answered; sections 2 7 must be completed Section 1: Doctor s details Forename GMC-registered surname GMC Number Deanery / LETB Date of Birth: Gender: Date of previous Revalidation (if applicable): Name of previous Designated Body for Revalidation (if applicable): e.g. Health Education Wessex Specialty (e.g. Foundation, Core Medical Training, Anaesthetics, General Practice, Rheumatology, etc.): If dual specialty, second specialty: Current Home Address: Home Phone / Mobile: Preferred email address for all communications: Section 2: Whole Scope of Practice Read these instructions carefully! Please list all placements in your capacity as a registered medical practitioner since your last ARCP/RITA or appraisal. This includes: (1) each of your training posts if you are or were in a training programme; (2) any time out of programme, e.g. OOP, mat leave, career break, etc.; (3) any voluntary or advisory work, work in non-nhs bodies, or self-employment; (4) any work as a locum. For locum work, please group shifts with one employer within an unbroken period as one employer-entry. Include the number of shifts worked during each employer-period. Please add more rows if required, or attach additional sheets for printed copy and entitle Appendix to Scope of Practice. Name and location of Employing/ Hosting Type of Work (e.g. name and Was this a Organisation/GP Practice (Please use full name of grade of specialty rotation, Start Date End date training organisation/site and town/city, rather than OOP, maternity leave, etc.) post? Y/N acronyms) ST3 Paediatrics 01.08.13 31.01.14 Y Add name of first trust Voluntary Medic, Kilimanjaro Expedition 07.12.13 22.12.14 N VSO ST3 Paediatrics 03.02.14 31.07.13 Y Add name of second trust if different Locum work (name specialty) 5 shifts 05.04.14 27.04.14 N Add name of trust / locum agency Time out of training: Trainee self-reported absence since last ARCP/RITA as mandated by the GMC: Time out of training includes all forms of absence such as sickness, maternity, compassionate paid/unpaid leave, jury service, etc. You do not need to include study or annual leave or prospectively approved Out of Programme Training/ Research. 10 days (Sickness) Page 7 of 12

Section 3: Declarations relating to Good Medical Practice These declarations are compulsory and relate to the Good Medical Practice guidance issued by the GMC. Honesty & Integrity are at the heart of medical professionalism. This means being honest and trustworthy and acting with integrity in all areas of your practice, and is covered in Good Medical Practice. A statement of health is a declaration that you accept the professional obligations placed on you in Good Medical Practice about your personal health. Doctors must not allow their own health to endanger patients. Health is covered in Good Medical Practice. 1) I declare that I accept the professional obligations placed on me in Good Medical Practice in relation to honesty & integrity. Please tick/cross here to confirm your acceptance * If you wish to make any declarations in relation to honesty & integrity, please do this in Section 6. 2) I declare that I accept the professional obligations placed on me in Good Medical Practice about my personal health. Please tick/cross here to confirm your acceptance 3a) Do you have any GMC conditions or undertakings placed on you by the GMC, employing Trust or other organisation? Yes No - Go to Q3b - Go to Q4 Tick as appropriate 3b) If YES, are you complying with these conditions/undertakings? Yes Tick as appropriate No 4) Health statement Writing something in this section below is not compulsory. If you wish to declare anything in relation to your health for which you feel it would be beneficial that the ARCP/RITA panel or Responsible Officer knew about, please do so below. Section 4: Significant Events - The GMC state that a significant event (also known as an untoward or critical incident) is any unintended or unexpected event, which could or did lead to harm of one or more patients. This includes incidents which did not cause harm but could have done, or where the event should have been prevented. All doctors as part of revalidation are required to record and reflect on Significant events in their work with the focus on what you have learnt as a result of the event/s. Use nonidentifiable patient data only. Please continue on a separate sheet if required and attach and entitle Appendix to Significant Events. **REMINDER: DO NOT INCLUDE ANY PATIENT-IDENTIFIABLE INFORMATION ON THIS FORM 1) Please tick/cross ONE of the following only: I am NOT aware of any significant event investigations since my last ARCP/RITA/Appraisal I am aware of significant event investigations since my last ARCP/RITA/Appraisal 2) If you know of any RESOLVED significant event investigations since your last ARCP/RITA/Appraisal, you are required to have written a reflection on these in your Portfolio. Please identify where in your Portfolio the reflection(s) can be found. (Add additional lines if required). Date of entry in Portfolio 12.12.2013 Title/Topic of Reflection/Event _Drug error Location of entry in Portfolio Development Log ** 3) If you know of any UNRESOLVED significant event investigations since your last ARCP/RITA/Appraisal, please provide below a brief summary, including where you were working, the date of the event, and your reflection where appropriate. If known, please identify what investigations are pending relating to the event and which organisation is undertaking this investigation. N/A Page 8 of 12

Section 5: Complaints - A complaint is a formal expression of dissatisfaction or grievance. It can be about an individual doctor, the team or about the care of patients where a doctor could be expected to have had influence or responsibility. As a matter of honesty & integrity you are obliged to include all complaints, even when you are the only person aware of them. All doctors should reflect on how complaints influence their practice. Use non-identifiable patient data only. **REMINDER: DO NOT INCLUDE ANY PATIENT-IDENTIFIABLE INFORMATION ON THIS FORM 1) Please tick/cross ONE of the following only: I am NOT aware of any complaints since my last ARCP/RITA/Appraisal I am aware of complaints since my last ARCP/RITA/Appraisal 2) If you know of any RESOLVED complaints since your last ARCP/RITA/Appraisal, you are required to have written a reflection on these in your Portfolio. Please identify where in your Portfolio the reflection(s) can be found. (Add additional lines if required). Date of entry in Portfolio Title/Topic of Complaint Location of entry in Portfolio ** 3) If you know of any UNRESOLVED complaints since your last ARCP/RITA/Appraisal, please provide below a brief summary, including where you were working, the date of the complaint/incident, and your reflection where appropriate. If known, please identify what investigations are pending relating to the complaint and which organisation is undertaking this investigation. I have been named in a complaint by a family member of a patient. I am currently awaiting further details on the nature of the complaint. My educational supervisor is aware, and I will discuss this further with her and reflect on the incident once I have more information. Section 6: Other investigations - In this section you should declare any on-going investigations, such as honesty, integrity, conduct, or any other matters that you feel the ARCP/RITA/Appraisal panel or Responsible Officer should be made aware of. Use nonidentifiable patient data only. 1) In relation to being subject to any other investigation of any kind since my last ARCP/RITA /Appraisal, please tick/cross ONE of the following only: I have nothing to declare I have something to declare 2) If you know of any other RESOLVED investigations since your last ARCP/RITA/Appraisal, you are required to have written a reflection on these in your Portfolio. Please identify where in your Portfolio the reflection(s) can be found. (Add additional lines if required). Date of entry in Portfolio Title/Topic of Issue Location of entry in Portfolio 3) If you know of any other UNRESOLVED investigations since your last ARCP/RITA/Appraisal, please provide below a brief summary, including where you were working, the date of the incident/investigation, and your reflection where appropriate. If known, please identify what investigations are pending relating to the matter and which organisation is undertaking this investigation. Unauthorised absence at previous rotation which is being discussed with the employing Trust and School. Full reflection can be found in entry dated 5 January 2014, named Absence in the development log. Page 9 of 12

Section 7: Compliments - Compliments are another important piece of feedback. You may wish to detail here any compliments that you have received which are not already recorded in your portfolio, to help give a better picture of your practice as a whole. Please use a separate sheet if required. This section is not compulsory. Use non-identifiable patient data only I confirm this is a true and accurate declaration at this point in time and will immediately notify the Deanery/LETB and my employer if I am aware of any changes to the information provided. I give permission for my past and present ARCP/RITA portfolios and / or appraisal documentation to be viewed by my Responsible Officer and any appropriate person nominated by the Responsible Officer. Additionally if my Responsible Officer or Designated Body changes during my training period, I give permission for my current Responsible Officer to share this information with my new Responsible Officer for the purposes of Revalidation. Trainee Signature : Sign here Date: Page 10 of 12

Appendix 2 Wider scope of practice form You do not need to complete this form if you carry out locum work in your own specialty through your own employing organisation, but you will need to declare this work on your Form R. All doctors in training who carry out clinical work outside of a training programme (voluntary or paid) should declare this information on the Form R and complete the below information to share with the Educational Supervisor. Any work carried out as a health professional should be declared below. Examples are locum work carried out at another organisation/specialty; editor of a medical journal; section 12 if you are a doctor in training in Psychiatry; private practice; Territorial Army etc Type of Work (locum; expedition; editor of medical journal) Start Date End date Details of Employing / Hosting Organisation / GP Practice (name and address) To be completed by the doctor in training: Reflection on practice noted above: (e.g. are you up to date with CPD; what have you learnt / experienced which will change your every day practice) Are you involved in any incidents/complaints/investigations in these roles that are not already declared in the Form R? Yes* / No (delete as appropriate) If Yes, please add further information: To be completed by the Educational Supervisor: Comments / developments for the doctor in training (e.g does this doctor have sufficient training / experience for this role, CME requirements etc). Name of Doctor in training: Signature: Date: Name of Educational Supervisor: Signature: Date: This completed, signed form should be returned with your ARCP/RITA paperwork to Oxford PGMDE at least 2 weeks prior to the ARCP/RITA. Page 11 of 12

Appendix 3 Additional question added to ES report Details of concerns/investigations: Are you aware if this trainee has been involved in any conduct, capability or Serious Untoward Incidents/ Significant Event Investigation or named in any complaint? Yes/ No If so are you aware if it has/ these have been resolved satisfactorily with no unresolved concerns about a trainee s fitness to practice or conduct? Yes/No Comments, if any: Page 12 of 12