title: Implementing medical revalidation in the United Kingdom: Findings about organisational changes and impacts from a survey of Responsible Officers.
abstract: Objective To describe the implementation of medical revalidation in healthcare organisations in the United Kingdom and to examine reported changes and impacts on the quality of care. Design A cross-sectional online survey gathering both quantitative and qualitative data about structures and processes for medical revalidation and wider quality management in the organisations which employ or contract with doctors (termed 'designated bodies') from the senior doctor in each organisation with statutory responsibility for medical revalidation (termed the 'Responsible Officer'). Setting United Kingdom Participants Responsible Officers in designated bodies in the United Kingdom. Five hundred and ninety-five survey invitations were sent and 374 completed surveys were returned (63%). Main outcome measures The role of Responsible Officers, the development of organisational mechanisms for quality assurance or improvement, decision-making on revalidation recommendations, impact of revalidation and mechanisms for quality assurance or improvement on clinical practice and suggested improvements to revalidation arrangements. Results Responsible Officers report that revalidation has had some impacts on the way medical performance is assured and improved, particularly strengthening appraisal and oversight of quality within organisations and having some impact on clinical practice. They suggest changes to make revalidation less 'one size fits all' and more responsive to individual, organisational and professional contexts. Conclusions Revalidation appears primarily to have improved systems for quality improvement and the management of poor performance to date. There is more to be done to ensure it produces wider benefits, particularly in relation to doctors who already perform well.
authors.affiliation: 1 Alliance Manchester Business School, University of Manchester, Manchester M15 6PB, UK.
authors.forename: Kieran
authors.initials: K
authors.lastname: Walshe
authors.affiliation: 1 Alliance Manchester Business School, University of Manchester, Manchester M15 6PB, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Boyd
authors.affiliation: 2 Collaboration for the Advancement of Medical Education Research & Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth PL4 8AA, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Bryce
authors.affiliation: 2 Collaboration for the Advancement of Medical Education Research & Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth PL4 8AA, UK.
authors.forename: Kayleigh
authors.initials: K
authors.lastname: Luscombe
authors.affiliation: 1 Alliance Manchester Business School, University of Manchester, Manchester M15 6PB, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Tazzyman
authors.affiliation: 2 Collaboration for the Advancement of Medical Education Research & Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth PL4 8AA, UK.
authors.forename: John
authors.initials: J
authors.lastname: Tredinnick-Rowe
authors.affiliation: 2 Collaboration for the Advancement of Medical Education Research & Assessment (CAMERA), Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth PL4 8AA, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Archer
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D004650:Employee Performance Appraisal; D019538:Health Care Surveys; D006801:Humans; D009936:Organizational Innovation; D009938:Organizations; D010820:Physicians; D024382:Professional Role; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement; D011787:Quality of Health Care; D013222:State Medicine; D006113:United Kingdom
keywords: Professional regulation; appraisal; evaluation; medical revalidation; quality of care