Annex A: 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. Section 29A, part 5 states that '"revalidation" means 'the evaluation of a medical practitioner’s fitness to practise''.
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.
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 (as amended)
The General Medical Council (Licence to Practise and Revalidation) Regulations 2012 (as amended) were made by the GMC and agreed by the Department of Health 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 Officers) Regulations 2013 (as amended)
The RO role was introduced in the UK by the Medical Profession (Responsible Officers) Regulations 2010 and the Medical Profession (Responsible Officers) (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.
What the regulations describe
The RO regulations and accompanying guidance:
- create a 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 to make recommendations to the GMC ‘about medical practitioners’ fitness to practise.
You can only make recommendations about those doctors who have a prescribed connection to your designated body, as described by the RO regulations. If you are a suitable person, you can only make recommendations about doctors linked to you.
A set of amendments to the regulations, principally reflecting changes to the structure of the NHS in England in 2012 and adding new designated bodies, was published as the Medical Profession (Responsible Officers) (Amendment) Regulations 2013.
Annex B: What do we mean by public interest concerns?
The term public interest concern is used to refer to instances where a doctor has raised concerns in the public interest, usually relating to patient safety, rather than for personal reasons (this is also sometimes referred to as ‘whistleblowing’). This type of concern is distinct from a grievance or private complaint, for example a dispute about the employee’s own employment position that has no public interest element.
Doctors have a duty to act when they believe patients’ safety is at risk, or that patients’ care or dignity are being compromised by the practice of colleagues or the systems, policies and procedures of the organisation in which they work. Our guidance for doctors Raising and acting on concerns about patient safety (2012) sets out our expectation that all doctors will, whatever their role, take appropriate action to raise and act on concerns about patient care, dignity and safety.
Further information about public interest concerns, including the relevant legislation that confers protection on workers who raise concerns, may be found on the website of the whistleblowing charity Protect.
Frequently asked questions
1. Why should I contact my GMC Employer Liaison Adviser before submitting a recommendation for a doctor who has raised public interest concerns?
Sir Anthony Hooper’s report into the experience of whistleblowing doctors highlighted the potential for revalidation systems and processes to be used in a punitive or retaliatory fashion against doctors who have raised public interest concerns. As a safeguard against your role as an RO, or our role as a regulator, being used inappropriately in response to a doctor raising concerns, we require you to discuss any cases where you are aware that public interest concerns have been raised by the doctor, and you do not plan to submit a recommendation to revalidate the doctor.
Discussing such cases with your Employer Liaison Adviser (ELA) provides an opportunity to share information and gain advice and support on issues relating to GMC requirements for revalidation. It will also help to demonstrate that you have taken steps to be open and transparent should any issues later arise. You can discuss this issue with your ELA at any time and don’t need to wait until you are due to submit a recommendation for the doctor.
You may also find it helpful to discuss public interest concern cases with your ELA where you plan to submit a recommendation to revalidate. This will help build up a picture across the board of how doctors who have raised public interest concerns are participating in revalidation.
2. What if I am unaware that a doctor has raised a public interest concern?
Of course, you can only discuss cases that you are aware of - and in many instances, we understand that concerns raised by a doctor, which are dealt with entirely separately from their revalidation, will not be bought to the attention of their RO. We don’t expect you to create any extra systems for obtaining this information. However, if we become aware that a doctor has raised public interest concerns via another avenue (for example, they tell us as part of their written representations in response to a recommendation of non-engagement) we may ask you for further information to help inform our decision.
3. What information will you ask for and how will this be used?
In a small number of cases we may ask for information that can help us to establish the context of the PIC and whether this has any relationship to the circumstances giving rise to the doctor’s revalidation recommendation.
4. What happens if new information comes to light after the recommendation has been made? For example, if I become aware that the doctor has raised concerns, but I wasn’t aware of this when I made the recommendation?
You should contact the Revalidation team or your ELA to discuss any new information.
Telephone: 0161 923 6277