All NCAS-staff update

Agenda Key activity Introduction from Chairman Whistleblowing – introduction to new NCAS guidance as a support to the organisational policy and opportunity to test implementation through case study discussion Themes from assessments NCAS/NHS LA projects for FY15/16.

Activity data – Advice calls and education 01/04/14 – 22/05/14 = 141 referrals H&C: 110 Primary Care: 31 Number of those cases closed in that period: 40 01/04/15 – 22/05/15 = 122 referrals H&C: 96 Primary Care: 22 Others: 4 Number of those cases closed in that period: 56 External Education (public and in-house) April – 5 May – 5 June – 12 July – 10

Activity data – Assessments & interventions Assessments 5 assessment reports either issued or about to be issued 3 assessment cases in pipeline with assessors appointed and clinical visits dates confirmed Actively making arrangements for 10 assessments where the AtAs have been received 6 cases in pipeline approved suitable for assessment where the AtA has not yet been received 2 assessment cases currently on hold Supporting 8 post-assessment cases at FtP hearings Back on Track 9 action planning frameworks completed & 7 action plans published, all to expected timeframes GDC Clinical Review Service New 30 month contract commenced 11 April KPI at 100% for clinical reviews completed on time

Introduction from Chairman

DRAFT Guidance on contact with NCAS by whistleblowers NCAS receives a small number of unsolicited expressions of concerns from practitioners about their organisations We have built upon previous guidance in 2010 to set out steps for how NCAS deal with these concerns Our aim in supporting these matters is to protect public safety Any whistleblowing concerns received will initially be discussed with the Director of NCAS and RO via either a lead or senior adviser In some circumstances we will direct these concerns to the appropriate organisation who has the remit to deal with the matters raised All approaches about concerns should be documented as a letter of file note against a case number

Alison Budd & Sanjay Sekhri May 2015 Assessment referrals and outcomes Preliminary analysis

Introduction Initial review of demographic info and outcomes of 205 full performance assessments of doctors Data drawn from assessment reports covering 7 years (FY 07/08 to 13/14) NOTE OF CAUTION – WORK IN PROGRESS! Needs further work and consideration – e.g: Excludes other professions and types of assessment Categories of information captured in reports has evolved over time Small data sets in respect of some areas But highlights useful opportunities for future analysis

Demographics – Age range

Gender

Sector

Relative risk of referral by specialty, doctors – all referrals Data from Liam Donaldson et al, BMJ Quality & Safety, October 2013

Secondary care specialties

Relative risk of referral by place of qualification – all referrals Referrals ; workforce 2007; 95% confidence intervals

Place of qualification - assessments

Assessment outcomes - context Full performance assessment provides independent view on the overall standard of practice Is the practitioner’s standard of performance at the level reasonably expected? Covering the scope of the individual’s clinical practice – judgements made against all key domains of clinical practice Cases proceeding to full performance assessment can often feature concerns which have been presented as complex, multi-faceted and longstanding

Assessment outcomes – overall conclusion Level% At the level expected (of which 19% were satisfactory in all domains) 33% Below the level expected67%

Outcomes for selected areas of clinical practice

Findings compared with initiating concerns – Clinical Care 2011 analysis of 50 cases

Next steps – some thoughts Housekeeping – clarify precise data sets – ensure we are comparing like for like, ethnicity categorisation, referral by grade, findings re context of practice Opportunities for further analysis Sharing themes and trends to wider external audience The case story - compare assessment findings with initiating concerns Linking assessment outcomes with Back on Track activity and case outcomes – i.e. tracking referral to resolution Learning for NCAS?

NCAS/NHS LA projects for FY15/16 Organisational-wide projects are governed by the Programme Steering Group (chaired by Tom Fothergill) and report to the Board PSG provides an opportunity to influence and engage with all departments at NHS LA, to maximise efficiencies and share cross- organisational learning NCAS projects for FY15/16 include: NCAS Business model development NCAS Core system review [EKS] NCAS Case classification NCAS Assessor contracting and assessment services procurement.