Regulating doctors, ensuring good medical practice

Background to revalidation

This page is in Section 1: Introduction - part of the GMC's guide for responsible officers on making revalidation recommendations.

What is revalidation?

The Medical Act 1983 (Section 29A, part 5) states that ‘“revalidation” means ‘the evaluation of a medical practitioner’s fitness to practise.’

Revalidation is the process through which the GMC confirms that a doctor’s licence to practise will continue. It is a GMC process based upon licensed doctors working within governed environments that have, at their core, regular appraisal of their practice that reflect the values and principles of Good medical practice (GMP).

Revalidation confirms that the doctor continues to practise in accordance with those values and principles and the processes that underpin revalidation should provide a regular opportunity for doctors to reflect on their own performance and practice. More information on revalidation is available in the revalidation section of the GMC’s website.

Revalidation and the GMC’s fitness to practise procedures

Doctors’ fitness to practise is the focus of both revalidation and the GMC’s fitness to practise processes. Nevertheless they are separate processes with different aims:

  • Revalidation is the process through which a doctor’s fitness to practise is positively affirmed.
  • The GMC’s fitness to practise procedures, as described in Section 29 of the Medical Act, focus on dealing with concerns that are raised about a doctor’s fitness to practise.
  • Revalidation affects a doctor's licence to practise, whereas the GMC's fitness to practise processes affect a doctor's GMC registration. 

Importantly revalidation does not replace or override the GMC’s existing procedures for dealing with concerns about doctors’ fitness to practise.

Your recommendations about doctors’ revalidation are not a route for raising concerns about their fitness to practise with the GMC. Concerns about doctors’ fitness to practise must be referred to the GMC, through our existing processes for dealing with concerns about doctors, as soon as those concerns arise.

If, for example, you wish to request the deferral of your recommendation, this should not be because you have identified a concern about the doctor’s fitness to practise that should be referred to the GMC.

Further information about the GMC’s fitness to practise procedures is available at the GMC’s web pages on ‘concerns about doctors.’

The purpose and effect of revalidation

The purpose of revalidation is to provide assurance for patients and the public, employers and other healthcare professionals that licensed doctors are up to date and fit to practise.

Revalidation should contribute to the provision of high quality healthcare in the UK by:

  • providing a focus for doctors’ efforts to maintain and improve their practice
  • enabling the organisations in which doctors work to provide support to doctors in keeping their practice up to date
  • identifying concerns about doctors at an early stage so that these cases are more actively managed locally or, where required, referred to the GMC’s fitness to practise process for investigation
  • encouraging patients and the public to provide feedback about the medical care they receive from doctors
  • acting as a driver for improving clinical governance at the local level, and ultimately, improving standards of patient care.

How revalidation works

Revalidation is based on the local evaluation of a doctor’s practice through annual appraisals that consider the whole of their practice.

For revalidation doctors must:

What ROs will need to do

As a doctor’s responsible officer (RO) you are responsible for making a recommendation to the GMC about his or her revalidation, when it is due.

Your recommendation must be one of the three recommendation categories described in Section 3 and must align with the relevant statements and criteria.

To ensure that you can make recommendations that are fair, consistent and robust you will need to:

  • ensure doctors are supported in revalidation by, for example, providing access to supporting information about their practice and to systems of annual appraisal
  • seek assurance about the doctor’s fitness to practise from the systems of clinical and corporate governance that govern the doctor's workplace or workplaces (for example, clinical audits, board review and other systems of internal and external audit) 
  • understand the outcomes of a doctor’s appraisals, where they have presented and discussed information collected from the whole of their practice 
  • be satisfied that, where appropriate, a doctor has collected information about their practice from all other settings in which they practise, and that it is of sufficient quality 
  • reinforce the doctor’s statutory responsibility to engage in the systems and processes that support revalidation.

Your recommendation will be submitted to the GMC via GMC Connect or via an Application Programming Interface (API).

The GMC will use your recommendation as the basis for its decision about the doctor’s revalidation.

The legislation that supports revalidation 

The Medical Act 1983

The Act is the primary UK legislation that provides the legal basis for everything that the GMC does.

The Act gives the GMC specific powers and functions. Under the Act the GMC is able to make additional regulations that govern the way that the GMC works. These include the General Medical Council (Licence to Practise and Revalidation) Regulations 2012.

The General Medical Council (Licence to Practise and Revalidation) Regulations 2012

The Licence to Practise and Revalidation Regulations 2012 were made by the GMC and agreed by the Department of Health (England) and Privy Council. They include:

  • the GMC’s powers to grant, withdraw, restore, or refuse to restore licences in a range of different circumstances
  • additional powers that the GMC needs in order to maintain, withdraw, restore, or refuse to restore licences in the context of revalidation.

The Medical Profession (Responsible Officer) Regulations 2010

The RO role was introduced in the UK by the Medical Profession (Responsible Officer) Regulations 2010 and the Medical Profession (Responsible Officer) (Northern Ireland) Regulations 2010.

The RO regulations that apply to England, Scotland and Wales were made by the Department of Health (England). The RO regulations (Northern Ireland) were made by the Department of Health, Social Services and Public Safety (Northern Ireland). 

What the regulations describe

The RO regulations and accompanying guidance:

  • create a new statutory role in UK healthcare
  • create relationships that overlay and transcend the existing structures and reporting arrangements within healthcare organisations
  • describe the duties of ROs
  • clarify who is eligible to undertake the RO role
  • require you, as an RO, to make recommendations to the GMC ‘about medical practitioners’ fitness to practise’.

As an RO you can only make recommendations about those doctors who have a prescribed connection to your designated body, as described by the RO regulations.

Your duties that complement revalidation

The statutory responsibility of ROs to make revalidation recommendations is distinct from their other duties as described in the RO regulations.

Nevertheless, the legislation dictates a number of duties that complement the RO's role in making revalidation recommendations. These include:

  • ensuring that your designated body or bodies carries out robust and regular appraisals
  • establishing and implementing procedures to investigate concerns about a medical practitioner’s fitness to practise
  • where appropriate, referring concerns about the doctor to the GMC
  • where appropriate, monitoring a doctor’s compliance with conditions imposed by, or undertakings agreed with, the GMC
  • maintaining records of doctors’ fitness to practise evaluations, including appraisals and any other investigations or assessments.

The designated body (or bodies) for whom you are the RO is obliged to provide you with sufficient resources to carry out your role.