This week the Department of Health launched a landmark policy, first recommended 30 years ago, to regularly assess the skills of medical practitioners in the UK. The system, called medical revalidation, will require every doctor (including those practicing in the private sector) to undergo an annual appraisal. The outcome of each doctor’s appraisal will feed into a recommendation – made every 5 years – as to whether they are fit to practice. The scheme is designed to monitor if the UK’s doctors are keeping up-to-date with the latest medical technologies and techniques, as well as addressing any concerns surrounding patient trust and communication.
Health Secretary Jeremy Hunt said:
“We want to have the best survival rates in Europe for the major killer diseases. Doctors save lives every day and making sure they are up to speed with the latest treatments and technologies will help them save even more. This is why a proper system of revalidation is so important.”
As you will know if you’ve been keeping up to date with our blog, survival rates can be greatly improved through early diagnosis. A key recommendation, made by the All Party Parliamentary Group on Cancer in it’s 2009 report on cancer inequalities, was to promote early presentation and diagnosis because although cancer survival rates are improving, our five-year survival rates are still way behind the European average.
In vitro diagnostic (IVD) technology is at the forefront of this battle – and not just in terms of beating cancer. 70% of all clinical decision-making is based on information gained from the use of an IVD. However, cutting edge diagnostic techniques cannot be used to the benefit of patients if doctors do not keep their finger on the pulse and maintain an awareness of all the latest developments. This is one of the reasons BIVDA is happy to welcome this week’s announcement about medical revalidation. Placing the requirement to keep up-to-date with the latest medical developments firmly within the doctor’s remit will help to foster a culture of innovation that will take new treatments straight to patient’s bedsides. At this early stage, however, BIVDA looks forward to further clarity and information after the initial medical revalidation pilot exercises. These pilots look set to identify the best models of implementation as there are still some questions surrounding impleemntation of this policy.
DH Press Release - New checks for doctors in world first patient safety boost
The General Medical Council - revalidation
Medical revalidation - principles and next steps: the Report of the Chief Medical Officer for England's Working Group 2008
BIVDA sees an increased role for organizations such as ours, and patient representative groups, in the future of the NHS. Innovative, cutting edge technologies and techniques need to be communicated directly to the health service and patients. In the new NHS, with already busy doctors playing a much bigger role in deciding commissioning priorities, it is important to identify the roles and responsibilities of those working in Clinical Commissioning Groups. Doctors deciding commissioning priorities will feed directly into (or starve!) their colleague’s knowledge base – after all the commissioning process is often a significant hurdle when seeking the adoption of a new test, treatment or technology. You can learn more by reading a recent blog which outlines challenges faced by those seeking adoption of the Breast Lymph Node Assay .
There is also a ‘NICE-shaped’ question mark hanging over the revalidation announcement. With an increase from 151 PCTs to 212 CCGs, there is the potential for even greater variation in service provision. While BIVDA would never advocate the penalization of individual doctors for failures at a commissioning level, the demarcation between these roles are becoming increasingly blurred and we are left asking whether there are plans to include the failure to carry out recommendations by NICE in any element of the assessment criteria? After all, keeping abreast of NICE recommendations is also a good way of keeping up-to-date with the latest approved technologies.
Once these challenges are overcome the IVD industry can offer the NHS a great deal. Not just in terms of the manufacture and supply of new technologies, but also in training and expertise. By fostering partnerships with the IVD industry the NHS could gain so much more than a product with each transaction. For example, manufacturers of point-of-care tests understand that not all primary care practitioners feel confident administering near patient tests, so training and education can come as an attractive part of the package. Medical revalidation might lead to a new era of collaboration with doctors, with knowledge transfer at the heart of it. However, with the NHS in a state of flux, it is hard to identify who will be making what decisions and it can be hard to identify who to collaborate with.