Purpose – In light of the recent report on regulation by the CMO of England and Wales and the subsequent Department of Health White Paper, this paper aims to consider the nexus between revalidation, appraisal and clinical governance. It provides a summary of the history of revalidation in the UK and explores how revalidation is linked to annual appraisal. It further considers the implications of this relationship and its potential impact on clinical governance and practise. Design/methodology/approach – This is a policy review related to revalidation and appraisal including primary sources from the Department of Health, the GMC, Fifth report of the Shipman Inquiry and published journal articles. Findings – Local clinical governance will be a significant part of the route to re‐licensing for the vast majority of doctors working in the NHS and many of the larger private sector hospitals. Although it will be used for two different purposes, it is generally accepted that the information collected by doctors for their annual appraisal will also form the basis of evidence for revalidation. If appraisal is to be effective, robust and consistent, it is important that the clinical governance framework within which it operates is appropriately designed for its increased role within the regulatory system. Originality/value – This paper is a valuable summary and introduction to the concept of revalidation in the UK, its history and its impact on clinical governance and regulation. It provides a timely review and analysis of the proposed changes to clinical governance at the local, SHA level and the strengthened connection between consultant appraisal and revalidation, contained in both the Department of Health White Paper – Trust, Assurance and Safety and the report – Good Doctors, Safer Patients, by the Chief Medical Officer for England and Wales.