A key aspect of clinical governance is dealing with poorly performing clinicians.
The National Clinical Assessment Service (NCAS) has published the largest study of medical and dental performance concerns ever carried out in the UK. The publication – NCAS casework: The first eight years – analyses nearly 5000 cases referred to NCAS since 2001.
The report identifies which groups of practitioners are more likely to be referred to NCAS and what can be learnt from these referral patterns. The report also examines episodes of suspension and exclusion of individual practitioners. And, for more than 1,400 cases dealt with by NCAS since the end of 2007, it analyses the nature of concerns which led to referral.
Some of the main findings are:
• NCAS referrals come from all parts of the UK and across all sectors, whether in hospital or in general practice;
• Two referrals in three are about clinical skills but behavioural concerns are also common, seen in more than half the cases analysed;
• The average duration of exclusions of doctors in the hospital and community sector has fallen by over a third since 2003, which directly addresses concerns raised over the past two decades about prolonged exclusion from work;
• Amongst 144 of cases where the most serious concerns had been raised, two thirds were back in work after remediation – rather than being lost to the service;
• Certain groups of practitioners are more likely than others to be referred to NCAS, for example men and older practitioners. The same groups are also more likely to experience exclusion or suspension from work.
The report also examines the part played by ethnicity and place of qualification in the likelihood of referral of practitioners in hospital and community services. It shows that non-white practitioners qualifying outside the UK are more likely to be referred to NCAS, but that neither referral nor suspension or exclusion from practice is any higher among non-white practitioners qualifying within the UK.
The report can be downloaded here.