The appraisal and revalidation of GPs must be fair, evidence-based and supported by robust mechanisms for doctors to challenge decisions that may affect their ability to practise medicine, medicolegal experts have said in response to yesterday’s (23 July 2008) Chief Medical Officer’s report.
The report, which outlined plans to improve patient safety by evidence-based annual assessments of doctors, was also given a cautious backing by the chairman of the British Medical Association (BMA), who said “it is vital that the new system is good for patients and fair to doctors”.
Dr Hugh Stewart, Head of Case Decisions at the Medical Defence Union (MDU), said: “We are pleased that the Chief Medical Officer has said the primary focus of revalidation must be to support doctors to develop their own talents, rather than solely to detect the small proportion of doctors who cause concern.
Dr Stewart said: “The vast majority of doctors are extremely hard-working professionals and already held accountable in more ways than other UK professions.
“We agree that the revalidation process must be efficient, fair, free from discrimination, command the confidence of patients, employers and the profession and draw on the expertise of different stakeholder groups.
“To this end we strongly support the CMO’s statement that decisions about doctors’ ability to practice are not taken by individuals in isolation or based on informal discussion and agreements and that clear accountability for these individuals must be in place.
“There must also be robust mechanisms for a doctor to challenge any decision that may affect his or her ability to practice medicine.
“The CMO says that ‘the sense of urgency and desire to make progress must be balanced with the need to get it right’. There is no need for urgency and doctors’ rights must not be compromised by artificial deadlines. We wholly support this sentiment and the need for a careful, incremental approach to rolling out the new system.”
Chairman of the BMA, Dr Hamish Meldrum, said: “The BMA is supportive of plans to appraise doctors in order to develop and improve their skills. However, it is essential that the Chief Medical Officer’s proposals are not unduly burdensome for doctors and result in them having to spend less time with patients.”
Dr Meldrum added: “The vast majority of doctors are dedicated to providing high-quality care to their patients. It is important that these proposals are not used to weed out the minority of doctors who are under-performing – there are other processes in place to do this.”