This paper, commissioned by the NHS Revalidation Support Team, presents the findings from focus group discussions with doctors and interviews with wider staff. It provides analysis from interviewees’ perspectives and offers commentary on how leaders at all levels can use revalidation to help create a culture of excellence in patient care.
- The study identified different assumptions about the overarching purpose of revalidation to assure the public of doctors' fitness to practise. Responsible officers felt the focus should be on using effective appraisal to engender a reflective workforce. For CEOs and chairs, revalidation could help in achieving their organisational goals.
- Among doctors, there was confusion and some cynicism about the purpose of revalidation, with various messages being heard. However, all participants could identify possible benefits, particularly the developmental potential for doctors.
- Most impacts in the case study organisations were being driven by the need for compliance to regulation on revalidation and clinical governance.
- But there was evidence of greater commitment to using revalidation as a tool for quality improvement at all levels, with individuals interpreting revalidation as a force for developing and reflecting on their practice, which underpins innovation and creating culture change.
- The study found evidence that the culture pre-dating revalidation contributed to how it was received, used or implemented.
- Positive and sustained changes to behaviours and culture will require engagement with the benefits and intent of revalidation from frontline doctor to executive colleague.
- Moving revalidation from compliance to commitment will require action by leaders at system, organisational and individual levels. This will engage doctors in contributing to a shared vision in which revalidation fosters a culture where excellence in patient care and professional practice are interdependently linked.
- The stability post-implementation can be used to refine the process and clarify the purpose of revalidation, with leaders ensuring consistent messaging on the purpose at a national and organisational level.
- Implementing change processes at scale requires leaders to encourage a learning culture in which a drive for continuous quality improvement becomes the norm.
More on revalidation
- Read Vijaya Nath's blog: Medical revalidation: trauma, trivia, triumph
- Watch our interviews with clinicians who are preparing for, or have completed, the revalidation process
- Read the press release for this report: Revalidation is adding value but there is more to do, report reveals
- Catch up with our medical leadership work