Remediation: where does the responsibility lie?

Twelve years after it was first proposed by the General Medical Council (GMC), December 2012 sees the introduction of ‘revalidation’ for all doctors in the UK. This 5-yearly affirmation of fitness to practise builds on existing legislation assigning every doctor to a ‘responsible officer’ (RO) and laying out a set of expectations in relation to professional development and performance review. Revalidation is founded on a strengthened appraisal processes covering the full scope of work for which a doctor holds their licence to practise, and a closer link with clinical governance systems. For doctors in postgraduate training, the Annual Review of Competence Progression is also being enhanced to ensure it covers revalidation requirements. Inevitably, the evolving system has led to questions about how those that are falling short of the required professional standards can be helped to meet them. In other words, what in the way of remediation needs to be made available, how can it be provided efficiently and effectively, and where does the responsibility for such provision lie?