NHS Resolution: Practitioner Performance Advice

Summary

Practitioner Performance Advice (formerly NCAS) provides impartial advice to healthcare organisations to effectively manage and resolve concerns raised about the practice of individual doctors, dentists and pharmacists.

Practitioner Performance Advice was established in 2001 and is now a service delivered by NHS Resolution under the common purpose, to provide expertise to the NHS on resolving concerns fairly, share learning for improvement and preserve resources for patient care.

Practitioner Performance Advice provide a range of core services to NHS organisations and other bodies in England, Wales and Northern Ireland such as advice, assessment and intervention, training courses and other expert services.

Content

Who we are

We are an advisory body. We provide guidance and advice as to best practice in relation to the application of the national frameworks.

We are not:

• a decision-making body – the healthcare organisation retains the responsibility for any decisions relating to the management of a performance concern;
• a trade union or medical defence organisation – we cannot provide case specific advice to a practitioner about how an organisation is managing a performance concern;
• an advocate – either for the healthcare organisation or the practitioner;
• a regulator.

What advice can do

For practitioners we:

• Provide general information to help a practitioner better understand some of the procedural requirements that may inform a healthcare organisation’s management decisions.
• Provide details of a range of organisations and other resources that can offer support to practitioners.
• Provide general advice where a practitioner may be concerned about some aspect of their own health or clinical practice or wants to access advice about rebuilding their skills after a career break.
• Respond to subject access requests from practitioners to check whether they are, or have been, the subject of a case.
• Where an assessment or other intervention (for example, an action plan) is being undertaken we will provide the practitioner with information about the process, what to expect and a named contact.

For organisations we:

• Provide advice and guidance about the management and resolution of performance concerns about practitioners (doctors, dentists and pharmacists) in accordance with the national guidance.
• We encourage healthcare organisations to share our correspondence and the advice we have given with the practitioner.
• Provide advice to healthcare organisations that are considering excluding, suspending (in the case of GPs) or restricting a practitioner’s practice (it is recommended that Practitioner Performance Advice be contacted when this is being considered.)
• Undertake behavioural or clinical performance assessments of individual practitioners. These assessments are informative and aim to clarify and understand the factors which may be impacting upon the performance of individual practitioners.
• Assessments can support the local implementation of timely and fair solutions to resolve concerns about performance and, where appropriate, can enable practitioners to return to safe and effective practice.
• We can only proceed with an assessment with the agreement of the practitioner concerned.
• Draft action plans for practitioners who have been identified as needing support to deliver sustained, safe and effective practice.
• The development of an action plan involves us having separate discussions with both the practitioner and the organisation. It is then up to the organisation and practitioner to discuss and agree the final plan.
• Where there are concerns about the functioning of a clinical team, we can carry out a team review to identify any barriers to resolving the issues which have been highlighted and to suggest a plan for improving professional relationships within the team.
• Through the management of the Healthcare Professional Alert Notice (HPAN) system we inform NHS bodies and others about health professionals who may pose a significant risk of harm to patients, staff or the public.
• Provide and discuss with healthcare organisations an organisational activity report to aid reflection and learning from their advice cases in the context of any locally held information. This will allow organisations to reflect on themes and trends over time and consider any improvement action in relation to managing and resolving performance concerns. If you are a healthcare manager who makes use of Advice’s services, or are interested in doing so, and would like to discuss an activity report for your organisation, please contact us at: [email protected]
• Deliver educational services to provide healthcare organisations with the knowledge and skills to identify and manage performance concerns locally.