22 September 2009
The largest
study of medical and dental performance
concerns ever carried out in the UK has
today been released by the National Clinical
Assessment Service (NCAS).
NCAS
casework – The first eight years
report
analyses cases referred to NCAS since 2001
(a total of almost 5,000). It identifies
which groups of practitioners are more
likely to be referred to NCAS and what can
be learnt from these referral patterns. It
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, the report analyses
in depth the nature of concerns which led to
referral.
Professor
Alastair Scotland, Medical Director of NCAS,
said: “The first eight years is a
central part of our work in supporting the
highest standards of patient care. The great
majority of practitioners work hard to
provide excellent care, but in those
uncommon situations where concerns do arise
about individual practice, we work closely
with health services and with practitioners
to ensure not only that those concerns are
understood and resolved as quickly and as
fairly as they can be, but also that this
meets our paramount duty of protecting
patients and the public.
“The heart
of NCAS’ service is its case work with
health services, the insights this gives us
to the reasons that we are contacted for
help and what lies behind those concerns. We
use these insights to share what we learn
with healthcare professions and with health
services, so concerns can be identified much
earlier and more accurately, and can be
resolved more quickly and more fairly,
enabling us to meet our first priority of
protecting patients and the public.”
Dr Peter Old
and Ms Diana Scarrott, who led the work of
producing this report said “The first
eight years report shows some striking
findings and some consistent differences
between groups.
- 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 our cases where the most serious
concerns have 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.”
Dr Old and
Ms Scarrott added: “We want this report to
be used by health services and the
professions that look to NCAS for a service
to think about the arrangements they have in
place to predict, to prevent, to identify
and to manage performance concerns. And we
want to work with them to understand more
about the patterns of referral and what lies
behind them. Our latest analyses of some of
our most difficult cases show that most of
the practitioners whose performance caused
concern were able to resume safe and valued
practice. That has to be the best outcome we
can aim for.”
The full
report (60 pages) and a 12 page summary can
be viewed at:
www.ncas.npsa.nhs.uk/resources/publications/caseworkanalyses/
