Revalidation began with doctors in the UK in 2012, nurses in 2016, and now it’s pharmacy’s turn to step up to the plate. Each of these events marked a huge change for its respective profession and the process that will see pharmacists and pharmacy technicians annually verify their fitness to practise officially began on 30 March 2018.
It has been a long time coming. The notion of healthcare professionals renewing licence to practise was first suggested in the 1970s by the Merrison Committee, which was set up to modernise medical regulation, when it proposed what it called ‘relicensure’. A number of high-profile medical scandals provided the momentum for the idea to move forward. The most notorious of these — the case of GP Harold Shipman, who was found guilty of the murders of 15 patients — inadvertently delayed revalidation’s introduction after the judge leading an inquiry into Shipman’s actions, Dame Janet Smith, criticised proposals as inadequate for identifying bad or dangerous doctors.
But as the British Medical Association pointed out at the time, revalidation is not intended to identify serious malpractice, but instead to act as a kind of ‘MOT’ for clinicians — a process which now includes pharmacists. A Department of Health white paper, published in 2007, proposed that all registered healthcare professionals should be required to demonstrate their continuing competence and fitness to practise at intervals throughout their career. That same year, the Royal Pharmaceutical Society established an advisory group to develop proposals for revalidation for pharmacists.
Just over a decade later, the introduction of the revalidation system will be phased in, with pharmacists and technicians revalidating by 31 October 2018 asked to submit four continuing professional development (CPD) records to the General Pharmaceutical Council (GPhC). In 2019, registrants will have to provide four CPD records as well as a peer discussion and a reflective review of their practice. No submissions will be reviewed until January 2019 and reflective account and peer discussion records will not be reviewed until the year after that.
Getting to this point has not been plain sailing. More than a third of voters in a 2013 online poll for The Pharmaceutical Journal said the introduction of revalidation would influence whether they would stay on the GPhC register. And the GPhC’s consultation on its revalidation proposals drew criticism from pharmacy bodies that the system would not be robust enough to improve patient safety, that it was, in effect, another form of CPD, and that it would prove costly, both financially and in terms of pharmacists’ time.
Pharmacists should be encouraged that a wide-ranging review of doctors’ revalidation commissioned by the General Medical Council did conclude that four years after its introduction, it was making a positive impact on clinical practice and patient safety, and that it was now more likely that another Shipman could be caught. However, many doctors still say that revalidation could be made much simpler and less time consuming, pointing to the low proportion (4%) of doctors which have have not had their licence renewed because of real concerns over their fitness to practise.
There will inevitably be teething problems, but the real crux of the revalidation process is that pharmacists are up to date with their professional development, that they remain fit to practise, and that the public is assured that this is the case. While it is encumbent on everyone across the profession to engage with the new requirements and give pharmacy revalidation the best chance of succeeding, regular and thorough reviews of its implementation must check whether the process is working, and vitally, how it can be improved.