The Royal College of Pathologists welcomes Sir Keith Pearson’s review of revalidation, particularly the focus on how the process can support doctors’ personal development and continuous improvement in their practice. We already provide clear and detailed guidance on revalidation to our members and will review our documents in light of Sir Keith’s recommendations.
We strongly support the need to improve the quality of appraisals, while reducing the burden they impose. All doctors will benefit from an appraisal process that helps improve their practice. Concentrating on identifying poorly performing doctors risks making the process irrelevant to the majority.
Patient feedback is rightly highlighted as vitally important for those doctors who work directly with patients. We agree that more could be done to explain to patients how their constructive feedback can help doctors reflect on their practice. We endorse the report’s call for improvements in the collection of patient feedback.
The recommendation that it should be made easier for all doctors, in whatever sector they work, to have a connection to a Responsible Officer is welcome. The Responsible Officer model should be applied consistently to help ensure the process is robust and the same standards apply to all. However, it is currently unclear how this could be achieved given the broad spectrum of types of medical employment. This proposal needs further discussion and development.
Sir Keith rightly points out that revalidation should not be expected to ’catch another Shipman’. He identifies the array of changes that have been put in place to the death certification process and coroners’ system, which alongside revalidation, make it likely that Shipman’s behaviour would have been detected earlier.
However, one vital element, the role of medical examiners, is yet to be implemented. Extensive pilot schemes have shown that medical examiners improve patient safety and increase the accuracy of death certification. The Royal College of Pathologists is the lead College for medical examiners and has long campaigned for their introduction. In March 2016 the Secretary of State announced that a system of medical examiners would be introduced in England and Wales in 2018.
Notes to editors
Introduced in the Coroners and Justice Act 2009, medical examiners will seek out and consider any serious, adverse or untoward incidents relating to the care of the person who has died. They will also ensure that all circumstances are taken into account whether or not they are recorded in the medical records.
Harold Shipman was a GP who was convicted of murdering 15 of his patients. However, it is likely that he killed over 200. Harold Shipman signed the death certificates of the patients he murdered.