Revalidation Guidance, RCGP
The RCGP has approved a new Guide to Supporting Information for Appraisal and Revalidation (March 2016) that aims to reduce inconsistencies in interpretation and simplify and streamline the recommendations. It is designed to ensure that any areas where there has been a lack of clarity are better understood. The guide confirms that:

• all time spent on learning activities associated with demonstrating the impact of learning on patient care, or other aspects of practice, can be credited as continuing professional development (CPD)
• Quality over quantity – GPs should provide a few high quality examples that demonstrate how they keep up to date, review what they do, and reflect on their feedback, across the whole of their scope of work over the five year cycle
• Only incidents that reach the GMC level of harm need to be recorded as Significant Events in the portfolio. Reflection on all such Significant Events is a GMC requirement and must be included whenever they occur
• GPs only need to do a formal GMC compliant colleague survey once in the revalidation cycle (like all doctors)
• there are many forms of quality improvement activity and they are all acceptable to demonstrate how you review the quality of what you do, and evaluate changes that you make. There is no requirement for GPs to do a formal two cycle clinical audit once in the five year cycle.

Standards for Communication Patient Diagnostic Test Results on Discharge from Hospital
NHS England has developed a set of standards for the communication of patient diagnostic test results when they are discharged from hospital. The standards describe acceptable safe practice around how diagnostic test results should be communicated between secondary, primary and social care and also with patients. The intention is to ensure that hospitals take responsibility for their own tests, and this is specified in the first key principle, which states ‘the clinician who orders the test is responsible for reviewing, acting and communicating the result and actions taken to the General Practitioner and patient even if the patient has been discharged’.

Following concerns raised about other statements within the guidance, please see the following clarification.

The standard stating that ‘Where a consultant delegates responsibility for any tasks around the communication of diagnostic test results to general practitioners, they should ensure clinicians given the task understand and fulfill that responsibility’ raised concerns from LMCs that this might refer to the inappropriate delegation of tasks to GPs.

NHS England has agreed to amend the statement to ‘Where a consultant delegates responsibility to another team member for any tasks around the communication of diagnostic test results to general practitioners, they should ensure that person understands and fulfils the responsibility’. For clarity, the statement was never intended to suggest consultants can ‘delegate’ these tasks to GPs.

The stated principle that ‘every test result received by a GP practice for a patient should be reviewed and where necessary acted on by a responsible clinician even if this clinician did not order the test’ is not a new obligation. Please note that ‘acted on’ in many cases will mean ensuring the responsible secondary care clinician who ordered the test has taken, or will take, the appropriate action, in cases where patient care will be affected. If safe systems are in place to enforce the first principle, even this action should rarely be required. The BMA previously issued its own statement regarding the duty of care regarding communication of investigation results, which also confirms ultimate responsibility for ensuring that results are acted upon rests with the person requesting the test. GPC will be writing to CCGs proposing that this principle is written into local service specifications with Trusts, as well as ending any unnecessary copying of hospital initiated test results to practices.

General Practice Nursing (GPN) Resource
The Queen’s Nursing Institute (QNI) GPN Transition resource is for nurses new to general practice. It might also be used to support revalidation, since it has a cloud based portfolio, and student nurses in GP placements. Over 1200 people have already accessed the resource since it was launched on 18 January. The QNI is committed to updating this as required and plan a full review in two years.

Sessional GP Newsletter
The March edition of the sessional GP E-newsletter focuses on the NHS England’s proposal to introduce maximum indicative locum rate for locum doctors’ pay. It also highlights the value of sessional GPs getting involved with their Local Medical Committees, provides guidance on managing clinical risk for locum GPs, diagnosing scarlet fever and provides a useful update on the GP campaign – Urgent Prescription for General Practice, as well as personal accounts of why one medical student is considering a career in general practice and another on coming through the other side of a GMC investigation.

GP Complaint Handling Report
The Parliamentary and Health Service Ombudsman has been working in partnership with the Care Quality Commission, Healthwatch England, and NHS England to examine how well GP practices in England are handling concerns and complaints; resulting in this joint report on GP complaint-handling. The key recommendations from the report include providing training and education to GPs and staff around complaint-handling; providing help for practices so they can share learning locally from NHS England, clinical commissioning groups, and local medical committees; and clarification from medical defence unions to GPs that an apology is not an admission of liability. As a result of the positive collaboration, there are also clear commitments resulting from the project from a range of organisations; these include:

• NHS England will continue work with Health Education England and others to ensure that complaint-handlers have access to high quality training
• Care Quality Commission will publish a ‘myth-buster’ and provide additional guidance to inspectors on complaints handling in GP practices
• Healthwatch England will continue their work to develop a complaints toolkit for local Healthwatch representatives to help suggest improvements to CCGs, GPs and Practice Managers
• The Parliamentary and Health Service Ombudsman will produce guidance for practices on working with the Ombudsman