As I was researching to write this article, I was disappointed to see that much of the readily available information for locums was so unconstructive. Many articles and interviews I have done on this topic complain at the ‘box-ticking’ nature of the process and did little to advise locums on how to actually get through it. This entry aims to be a little more helpful than that, providing advice and thoughts on how locums can prepare.
In general our top tips are:
- Be organised (as usual!) – keep track of where you have worked and who the contact is
- Push hard to make practices support you and collecting patient feedback
- Make use of sessional GP groups and / or your peers
What is Revalidation?
Revalidation is in short, showing how you met your professional goals so that you can show to employers, patients and professional bodies that you are up to date and fit to practise so that you can retain your license in the UK. You should have a Responsible Officer (RO) from the trust whose performers list you are on and they make a recommendation the GMC to pass or fail you.
“We are typically isolated in the workplace, so identifying which goals to fulfil can be difficult, notwithstanding the difficulty in collecting evidence to show goal achievement” Locum Manchester
Nevertheless, the process has to be completed, we hope we have compiled a list of practical tips on how to approach the process.
How do I identify the right goals?
The process starts by you identifying your goals. It is more important for locums that you identify the goals which have demonstrable outcomes. (For example, if you are only spending the odd sessions in practices it is unlikely that you have changed the way a certain process is done within the practice, make sure you choose goals that are within your sphere of influence).
Not only do you need to demonstrate the outcome of filling these needs but you should be able to quantify the outcome in terms of the impact that the learning exercise will have.
Although there is no set number of goals you should pick, most pick between 3-5 goals. A good way to identify these is by noting down each time each time patients have had an unmet need and areas where you needed to do further research. From this, make your selection on which are the right goals to focus on. Don’t be afraid to ask for help on selecting the goals, Sessional GP groups can be helpful here, and there will be many sessional GPs who are going through the same thing. There are also online questionnaires which help you.
You will need to have 250 learning credits or more over 5 years with a minimum of 50 credits each year and you will need to show that the educational activity covers a broad range. The market here is flooded with training providers offering courses, conferences and materials to help you with this. Locums don’t have protected learning time which can make this a more of a pain to organise but there are workarounds. For example, Edge Hill University have developed an iPhone app which allows you to collect CPD credits on the move and is definitely something locums should look into.
Get multi-source feedback
At least once every 5 years, you will need to find a variety of people willing to complete a brief online questionnaire about what you are like to work with. This will mainly be from GPs but it can include practice managers, Nurse, Receptionists etc.. This is probably easier for locums than other GPs given the dynamism of the job you do. A tip though, push practices to give you some feedback as soon as you have completed work there.
James, A practice manager from London recalls
“When a locum calls me up 2 years after doing a few sessions for us and asks for feedback I honestly can’t provide anything helpful as I probably can’t remember”
Significant event audit
Significant events don’t have to be critical incidents, they can also be things that have gone well. If it was a positive event, recall what went well and plan how you can repeat this with another patient.
We encourage you to write this up and present it at a meeting, for example, a practice meeting or to your peers at sessional GP groups- Explain how the event has changed your personal practice.
List your complaints
Any formal complaints about you will need to be listed in your eportfolio.* Be sure to document the handling of the complaint, refection and the change in practice at the end. Often, complaints about a locum might not reach you – we urge you however, to be stringent about collecting feedback at the end of a job, that way, any complaints about you will be picked up and you will be able to deal with and learn from them.
You will be required to do two clinical audits during the revalidation phase, one by year 3 and the second in year 4 or 5. The idea is that your second audit includes your initial audit, the change implemented and a re-audit to demonstrate the improvement.
This is one of the most difficult things for locums to do but suggested areas to focus on include:
- Antibiotic prescribing
- Investigation and imaging
- Prescribing for pain
- Hypertension management
Note that In order to audit prescribing, you will need to be issued individual prescribing numbers by the NASGP
You will need to complete two of these during the 5 year cycle. This can be a valuable source of feedback. Some locums have issues where the patient is feeding back on the practice and not the locum – try to avoid this by making clear to the patient what the form is for.
Have a consistent approach to this because this will be compared to previous results. Make sure you have action points relating to the feedback too.
*Collating it all
There are a number of tools you can use if you want to keep all of this information in one place, for example the NHS appraisers Toolkit (which costs c.£60/year) or perhaps your sessional GP group has software such as Premier IT’s Revalidation software which you could be added onto http://revalidation.premierit.com/
There is also the RCGP’s revalidation eportfolio which is free to PCOs, GP appraisers and RCGP members, those who are not one of the above can still use it, but for a fee.
Any questions or comments please contact Melissa Morris
Useful links for more advice