Advanced General Medical Conference : The Royal College of Physicians (London), The Ministry of Health, Oman, and Sultan Qaboos University: 22–23 February 2012

The purpose of revalidation is to provide greater assurance that licensed doctors are up-to-date and fit to practise. The introduction of medical revalidation throughout the UK means doctors who wish to retain their licences to practice in the UK will need to demonstrate they fit these criteria. Revalidation is a new way of regulating the medical profession, providing a focus for doctors’ efforts to maintain and improve their practice; facilitate medical organisations in supporting doctors in keeping their practice up to date, and encourage patients and the public to provide feedback about the medical care they receive from doctors. In these ways, revalidation will contribute to the ongoing improvement in the quality of medical care delivered to patients throughout the UK. The successful introduction of revalidation is a shared responsibility involving the General Medical Council, the health departments in England, Northern Ireland, Scotland and Wales, the medical Royal Colleges, the medical profession and the revalidation support team (RST) working with the National Health Service and other employers in the UK. This group of interested parties should work together to develop, test, and implement a system of revalidation throughout the UK that is feasible, flexible, proportionate, cost effective, and provides the necessary level of assurance to the public. Revalidation will be based on a local evaluation of doctors’ performance through appraisal, which will be conducted annually in the workplace. The responsible officer, informed by the appraisal and appraiser, will make a recommendation to the GMC concerning the doctor’s fitness to practise. This presentations by the medical director for the Department of Health England Revalidation Support, will give an overview of the design and implementation of this programme, with particular reference to the implications for and improvements offered to integrated clinical governance. Developing targeted treatment for haematological cancers is a key aim of current research. These stratified cancer medicine strategies are being developed in colon cancer and sarcoma, and offer improvements in patient outcomes and the value of novel therapies. The key concept underlying this approach is to identify a specific molecular lesion found within the tumour cells which can be switched off using a targeted treatment. The access to tumour tissue in haematological cancers has allowed the generation of many years of clinical data which. These data provide insights into how these approaches can work in the clinic. The disease that has exemplified the role of targeted treatment best is chronic myeloid leukaemia. This disease is characterised by a chromosomal translocation BCR/ABL, which leads to the over-expression of a tyrosine kinase. This tyrosine kinase can be targeted using imatinib, a specific inhibitor. This use of this drug in the clinic results in patients achieving complete remissions. This tolerable treatment strategy has lead to a rapid decline in allogeneic transplantation, which was previously the key clinical treatment for this disease. A surprising result of the treatment has been the emergence of treatment resistance mediated via tumour specific mutations, affecting the ability of the targeted treatment to inhibit its target. This emerging treatment resistance has led to the development of a range of different kinase inhibitors which have different characteristics and abilities to overcome resistance. Targeted treatment is also relevant to other haematological diseases, including B-cell lymphomas and acute leukaemias. Overall, we have made big strides in the application of targeted treatments strategies in haematological cancers and it is expected this will form the basis of improved outcomes in other haematological conditions over the next years.