Picker warmly welcomes Sir Keith’s important and thorough report ‘Taking revalidation forward: Improving the process of relicensing for doctors‘. We also welcome the General Medical Council’s endorsement of the report and especially the key priority being given to patient feedback mechanisms.
The overall direction of travel signalled by the report is right and it will be important in assuring patients and the public that the medical profession is well regulated and fit for purpose. It provides a timely opportunity to modernise revalidation and give patient voice a central role. As Sir Keith notes, “any contact that a patient has with a doctor should offer itself as an opportunity for the patient to be able to feedback on that doctor, and for that to go into the portfolio of that doctor”.
This focus on collecting better and more useful patient feedback is key. For too long doctors have had to rely on the infrequent use of unvalidated questionnaires, and this has limited opportunities for the data collected to support positive change. What is needed in future is both more variety in the collection of feedback so that both quantitative and qualitative data, including near real-time, are collected. This needs to be done in ways that are acceptable to patient and follow best practice both scientifically and in terms of patient involvement. It is also critical that feedback is in a form that can be built into service improvement work both for individual clinicians and for services as a whole including becoming an integral part of doctors’ appraisals / professional development.
Working with partners, Picker developed an Individual Clinician Feedback survey. It is one of the few instruments for measuring patient experience of individual doctors – with a particular focus on communication skills – that has been rigorously developed and piloted in a variety of settings. The instrument uses Good Medical Practice as the basis and questions were carefully mapped onto the different attributes within the guide, relevant to patient-doctor communication. It has undergone a substantial process of development and piloting and was implemented with doctors in two NHS Trusts and in a primary care setting and found to be statistically robust and capable of differentiating consultant’s communication skills.
Progress now needs to be rapid. Inadequate revalidation processes with poor quality patient feedback have been allowed to go on for too long, damaging the reputation of the regulatory process, and all parties are hungry for change. Picker stands ready to support these changes because patients and doctors alike deserve better.