This page provides simple guidance on how to prepare for revalidation with the FOM.
Appraisal
Licensed doctors must participate in an annual appraisal process as part of revalidation. The appraisal must cover all of your medical practice and be based on the General Medical Council (GMC) document Good Medical Practice [1]. All doctors relating to the Faculty of Occupational Medicine’s RO will be expected to undergo their appraisal for revalidation with the Society of Occupational Medicine, a well established and independently quality approved appraisal scheme (unless there are exceptional circumstances).
Please visit the SOM website for more information on the SOM’s appraisal scheme. [2]
Continuing Professional Development (CPD)
Please visit the Continuing Professional Development [3] page.
Quality Improvement Activity (QIA)
Historically QIA tended to be thought of solely as clinical audit. Clinical audit has however, been found by some to be difficult to engage with, cumbersome and time consuming. Recent thinking is that it is better to engage with a QIA that is relevant to the doctors practice, easier to undertake and which leads to prompt change or improvement.
It is appreciated that for some OHPs, formal clinical audit is within their capabilities, especially for those who work within a large organisation with IT or administrative support that would allow them to do it. For other OHPs who work in isolation, or those whose portfolio does not lend itself to such activities, a simpler form of QIA is acceptable.
When considering what QIA to undertake, doctors may find the following principles guide them to an appropriate activity:
- Do I know how my practice compares to other OHPs practice?
- How could I demonstrate any difference in my practice compared to others?
- How could I demonstrate I have changed my practice in light of a QIA?
- How am I going to monitor any changes I have made to my practice in the future after a QIA?
On this basis QIA could take a variety of forms, for example:
- Participation in a national clinical audit to measure the care with which an individual doctor has been directly involved.
- An audit of occupational heath reports. This is perhaps one of the most accessible QIA activities for OHPs. It can be especially valuable for doctors who work in isolation if they are able to compare their reports to a local peer group of OHPs.
- A Case review or discussion. This would take the form of a documented account of interesting or challenging cases that a doctor has discussed with a peer, another specialist or within a multi-disciplinary team.
- An audit or monitoring of the effectiveness of a teaching programme.
- An evaluation of the impact and effectiveness of a piece of health policy, or management practice, for instance.
Visit the GMC’s Quality Improvement Activity page [4] for further guidance.
Multi-source feedback
Once in each five year revalidation cycle, before revalidation – a doctor must collect feedback from colleagues and patients using standard questionnaires. As not all doctors have clinical work, the exact requirements of this can vary and this is something to be discussed with an appraiser and the Responsible Officer. Colleague feedback can include non-medical colleagues.
Colleague feedback
Several private companies offer a service where they will manage the process of distribution, collation and reporting of colleague feedback – e.g. Edgcumebe 360 and FourteenFish.
As a designated body, we are not recommending a specific tool. However, any tool you choose must meet the GMC criteria, as outlined on their website. [5]
Patient feedback
Patient (and colleague) feedback is just one of several elements to Revalidation however is perhaps one of the most important. Since the inception of revalidation the expectation has been of the collection of formal patient feedback using a GMC compliant process and validated questionnaire.
GMC thinking is however evolving. It is likely that the methods for the collection of feedback will be less rigid allowing the RO flexibility to decide whether a particular collection method or questionnaire is acceptable. OHPs will still be expected to undertake a structured feedback exercise at least once during the revalidation cycle however additional forms of feedback, such as unsolicited compliments from patients or clients will also be taken into account for revalidation
For those OHPs without any patent contact feedback by “proxy” is acceptable, for example, from a client to whom professional services are provided.
Any complaints from patients should also be reflected on and discussed at appraisal. The GMC has begun to recommend that complaints, which may not meet the threshold for formal investigation should be discussed at appraisal. OHPs should reflect, on a continuous basis, on any patient feedback collected during the year and present it at appraisal.
Significant events
A significant event is any unintended or unexpected event that could have led or did lead to harm of one or more patients.
You will need to provide details of any significant events in which you have been directly involved since your last appraisal. This includes information about the incident, a review of the data and your subsequent reflection, learning points and action taken.
If you have not been directly involved in any significant incidents since your last appraisal, you will need to present a self-declaration to this effect.
Visit the GMC’s ‘significant events’ page for further guidance [6]
Reflection
It is important that doctors demonstrate what they’ve learnt from participating in each of the activities listed above. Effective reflection is critical for all elements of the appraisal portfolio but is a skill which needs to be developed and practised as many may find it difficult.
Download the FOM’s ‘Tips on writing effective reflective notes’ [7]
Guidance for ‘The reflective practitioner’ is available on the GMC website. [8]
Checklist
The Faculty of Occupational Medicine and the Society of Occupational Medicine have created an Appraisal and Revalidation Checklist which can be used by appraisees to ensure that the necessary supporting information and evidence has been included in their portfolio ahead of their appraisal or, alternatively, by the appraiser to ensure that all the elements of the strengthened medical appraisal have been covered before finalising the appraisal and complete the Appraisal Output Form in PReP. Download here. [9]