National Responsible Officer

Conference - 4th June 2014

Durham, Darlington and Tees Area Team

Hilton Dixon Responsible OfficerFiona Thomson – Templars Revalidation Manager

Structure and working arrangements • 2800 GPs across 2 area teams

• 200 appraisers

• 2 band 4 admin staff full time

• 1 appraisal lead

• 2 performance managers

• 2 ROs

• 2 Deputy MDs

• Electronic matching system for appraisers and appraisees

• Fortnightly operational group meeting

Confusion and complexity and clarity

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NHS | Presentation GMC, 6th May 20143

Confusion• Some locum agencies not DBs

• Who investigates performance concerns?

• NHS England is the default DB for locum doctors with no DB

• Do locums understand the appraisal and revalidation processes?

• Who pays for the appraisal?

• Are the fees consistent?

• Who does the appraisal?

Complexity• Locum medical consultant approaches the Area

Team

• NHS England is not their employer and they are not a GP

• Locum Agency not a DB therefore no RO but offers to appraise/pay

• The doctor lives nearest DDT Area Team and is the Designated Body

• Performance concerns arise on discussion with RO where the doctor works.

Collaborative approach • AT confirmed they were the DB and RO

• FT to investigate concerns

• FT to appraise as a locum

• AT to undertake formal whole of practice appraisal as DB

• Requested past appraisal documents

• Discussion with ELA

How to get clarity?• ELA advice?

• Are GMC decisions appropriate?

• NCAS advice?

• RO to RO communication?

• Why are some locum agencies are DBs some are not?

• What are the implications

• Processes for complaints/SUI investigations

• Information sharing

• Risk assessment as DBs and ROs?

• Need for locum agency RO forum?

Issues for Locum Doctors• Difficult to obtain feedback particularly for short

term locums

• Appraisers difficult to find

• Appraisers may be selected on commercial basis alone

• May not get sufficient support from Agency

• Pressure to work through agencies in return for support

• Easy to blame – unfairly discriminated

NHS | Presentation to [XXXX Company] | [Type Date]8

Issues for overseas Locums Doctors

• CPD carried out overseas

• May have overseas appraisal which doesn’t meet the UK requirements

• Difficulty in securing adequate UK locums to make UK appraisal appropriate or obtain 360 and patient feedback

• Many specialists come to the UK for a few weeks a year but may not return due to revalidation difficulties

NHS | Presentation to [XXXX Company] | [Type Date]9

Issues for Locum Agencies

NHS | Presentation to [XXXX Company] | [Type Date]10

Concerns Around Locum Agencies• Agency has no knowledge of previous

history/complaints when supplying a locum not connected to the Agency

• NHS Issues disregarded and locums moved to alternative NHS post

• No means of monitoring performance/ identifying trends

• Information may not be passed to NHS body

• Insufficient recruitment checks

• Conflict of Interest when revalidating locums

NHS | Presentation to [XXXX Company] | [Type Date]11

What are the key issues to address• For patients

• For the doctor

• For the service provider

• For the regulator

• For the Designated Body and RO

Thank you