1. All NCAS-staff update

2. Agenda Key activity data Findings from EKS audit Permanent governance arrangements for NCAS HPANs Staff Engagement Group Focus on an NCAS product or service – work programme for Linda 5-year business plan and consultation with staff and members

3. Key activity data (FY15/16 to 16/09/15) AreaActivity summary AdviceXX new referrals AssessmentsFull assessments X assessment reports issued and a further 4 being finalised X clinical assessment visits confirmed and in pipeline A further XX visits being planned Assessment of behavioural concerns X Assessment report to be issued shortly X Assessment being planned Assessments on hold X assessment cases continue to be monitored while currently on hold Support to cases proceeding to FtP hearings X cases are currently being supported in this activity Back on TrackXX Action Planning Frameworks completed and XX Action Plans issued GDC Clinical Review XXX clinical reviews delivered HPANsXX current active alert notices EducationXX delivered AreaActivity summary Advice 446 new referrals for advice (282 at last all staff briefing in July) – on track for 1000 in FY New system for proactive management of case support inbox Assessments Full performance assessments 5 reports issued and a further 3 being finalised (3 and 1 respectively) 10 clinical assessment visits confirmed / actively scheduled (10) Assessment of behavioural concerns and standalone MSF 2 reports issued and 2 further underway (1 and 3 respectively) Support to cases proceeding to FtP hearings 7 cases are currently being supported in this activity (9) Increased capacity + review of assessor appointment process Assessment referral mix: 75 / 25% full assessment vs other types Assessment specialty mix: 75 / 25% secondary care vs primary care Back on Track 35 Action Planning Frameworks completed and 33 Action Plans issued (15 and 16 respectively) – 77% of frameworks prepared without NCAS assessment Revised framework for assessment AND intervention decision making under development GDC Clinical Reviews 253 clinical reviews completed and delivered to the GDC (132) Recruitment of additional clinical reviewers 100% of reports delivered within target timeframe HPANs 16 active alert notices (17 – but note 48 live HPANs in March 2015) – 12 relate to doctors Education workshops 36 training workshops/events delivered (37 – two cancellations) 3 Responsible Officer Networks

4. Update EKS Audit Commissioned audit through Price Waterhouse Coopers to test accuracy, completeness and timeliness of information on EKS- The audit excluded all other NCAS based systems. Scope: Case management policies and procedures Training of all users of EKS Monitoring and checking of EKS data by NCAS. Excluded: Access controls and system security in EKS Document retention policies and procedures, and IT security policies and procedures. Method: Tested a sample of 25 recent referral cases on EKS to ensure that information is internally consistent and agrees to correspondence/source documentation for the following areas: The details of the practitioner, related organisation and referrer Key dates and case development Action taken by NCAS, and Case outcome.

5. Update: EKS Audit The headlines: EKS does not fulfil all our case management needs Weaknesses in available management information available from EKS – alongside a lack of knowledge about what is available- supported by manual spreadsheets make EKS largely a filing system From the sample of 25 cases evaluated for accuracy and completeness of information the auditors were unable to find one case which did not have an error. Error classed as incomplete, or inaccurate information, poor timeliness of input, or ineffective use of case numbers Poor functionality: for example it takes16 clicks and the completion of 11 mandatory fields to upload a single document. No internal quality checks, review or monitoring procedures exist to ensure that the information input into EKS is correct or complete No forum for staff and assessors to discuss issues with using EKS and share lessons learnt Distrust in information reports being produced from EKS

6. Update: EKS Audit The Positive: The audit has provided a clear diagnosis of EKS issues so plans can be developed to address those issues Case Support and others have been working to update and improve data on EKS and this work will go on while EKS is reviewed and built on. The Action: While a rebuilt, revised or replacement EKS is worked on we can help ourselves by making sure that data is as complete, accurate and as up to date as possible for new and just as importantly, existing cases There will be a project to look at the future of /replacement of EKS and staff will be able to contribute when that takes place While we wait for the new EKS; we need to develop some guidance and direction so we can aim for consistency in data capture, review and rebuild the management reports and build confidence in the system we have.

7. Permanent governance arrangements for NCAS COG Membership Director of NCASVicky Voller (Chair) Head of OperationsSanjay Sekhri (Co-Deputy) Lead AdviserKaren Wadman (Co-Deputy) Lead Assessment & Intervention AdviserLinda Prescott-Clements Senior Adviser (England)Alison Budd

8. Permanent governance arrangements for NCAS Purpose of COG Ensure NCAS provides an efficient and effective service Provide strategic direction and leadership to NCAS Oversee operational activities at NCAS within the NHS LA governance framework Ensure that NCAS meets its statutory obligations and achieves its business plan objectives Ensure NCAS is responsive to opportunities, threats and directions Report to the NHS LA Senior Management Team, Board and Department of Health Ensure staff are actively engaged and supported in the development of NCAS and its services

9. Permanent governance arrangements for NCAS Cases to note Provide strategic oversight of cases to note (cases to note defined as cases which are known to COG as: subject of current complaint or review high-profile or with media interest (actual or has the potential to be) subject to legal hearing by a Regulator being managed materially or substantially outside usual NCAS procedures where the NHS LA RO has been involved in the management of a case highly sensitive for some other reason)

10. Permanent governance arrangements for NCAS 8 weekly cycle of review Week no of rolling 8-weeks Functions to be reviewedPersonnel to be invited Week 1Case support; AdvisersCS Team Leader; Lead Adviser Week 3Assessment & intervention incl HPANs; ROA&I Team Leader; HPAN lead (RO); BoT Lead Week 5External Education; Corporate Governance, Communications Head of E&L; Head of CG; potentially Business Development Mgr if applicable; Communications Mgr Week 7Policy and Stakeholder Engagement; New Product Development; HR Policy & Project Mgr; Business Development Mgr; A&I Programme Mgr; Head of HR

11. Recent COG areas for consideration/decision making HPANs Notifications of exclusions in MHPS – policy position Learning from legal hearings Clinically-qualified adviser’s requirement to maintain fitness to practise/registration Income generation activity Communications and stakeholder engagement requirements Informatics requirements Assessment scheduling and assessor appointment (pilot) Primary care AMEE – feedback and areas for development

12. The National Clinical Assessment Service "Healthcare Professional Alert Notices (HPANs)”

13. Healthcare Professional Alert Notices (HPANs) Purpose – to make NHS bodies aware that a practitioner may pose a significant risk to patients, staff or the public Alert notice is considered following the request of an employer (or ex- employer) who believes a practitioner may be seeking work elsewhere within the NHS Can be issued in relation to any registered healthcare professional i.e. doctor, dentist, nurse, midwife, pharmacist, optometrist, ambulance paramedic etc… NCAS released 40 alert notices in the last FY end 31 March 2015 Currently about 15 – 20 active HPANs at any one time Includes notices issued in Northern Ireland, Scotland and Wales

14. Performers List and HPAN Web Check Service

16. HPANs Communication plan For RBs and key stakeholders, to include: Purpose of an alert How to apply for access to the web-based system Reminder of how to raise an alert Role of NCAS – in general and in responding to an alert What they should do with their “current” list of HPANs Closure of CSC database (users referred to web check service) Presentations at RO networks and central NHS England meetings

17. NHS LA Staff Engagement Group NCAS All Staff Briefing 22/09/15

18. Overview Why we have a Staff Engagement Group (SEG) Purpose of SEG Membership Commitment from SEG members Sharing issues raised with SEG

19. Why do we have a Staff Engagement Group (SEG)? The NHS Constitution includes the following pledge: The NHS commits … to engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements. All staff will be empowered to put forward ways to deliver better and safer services for patients and their families. Having a SEG helps the NHS LA to fulfil that pledge.

20. Purpose of SEG Promote staff engagement by providing an additional means through which staff members can raise issues about actions or decisions that affect them and the services they provide Facilitate communication between staff and Senior Management Team (SMT) Make constructive proposals with a view to improving staff engagement Help embed NHS LA and NCAS integration Promote engagement across all NHS LA offices and for home workers Support question development for the annual NHS LA staff survey Advise on and promote staff well-being events as requested Advise on and promote corporate and social events as requested e.g. fundraising

21. Purpose of SEG continued What SEG doesn’t do: deal with issues that are properly dealt with by Human Resources (HR). It is intended that SEG’s activities will supplement, rather than replace, interaction between individual managers and their teams act as a forum for formal collective bargaining; this is conducted through the Joint Negotiating Committee i.e. our Union committee.

22. Membership Anyone who wants to volunteer can join HR provide secretariat support and the PAs provide admin support – they attend meetings and can also contribute to discussion There is no maximum number of members – SEG can, however, consider holding elections if numbers go above 12 No quotas but staff from a variety of Teams Grades Groups (e.g. age, disability, race or ethnic origin, gender, religious beliefs, sexual orientation) are encouraged to join SEG.

23. Commitment from SEG members Providing staff with a route to raise issues with SMT that they feel unable to raise elsewhere Agreeing action on those issues and providing feedback to staff Providing views to SMT about communicating plans for organisational development or to managers seeking to implement change Ensuring engagement in an organisation undergoing change that is based across different sites and includes home workers Supporting the development of the annual staff survey – link here to NHS LA aspiration to be awarded the Investors in People accreditation Attending six meetings a year and taking part in monthly SEG surgeries on a rolling basis

24. Sharing issues raised with SEG SEG will keep the SMT apprised of its work and staff views Other staff at the NHS LA will be consulted on issues relevant to their role and kept informed about SEG’s work by: SEG meeting notes Monthly briefings in the Chief Executive’s update All staff update meetings All staff emails Free discussion by SEG members with colleagues The confidentiality of individuals will be respected.

25. Linda Prescott-Clements NCAS Work Programme

26. Background….. Originally a scientist…. ! Transferred into Medical Education 16 years ago Masters and PhD in Workplace-Based Assessment at Maastricht University Examples: Designed & evaluated competency assessment framework for PG Dentists in UK Developed bespoke WPBA tools, including observation of performance, MSF, Patient Questionnaires, online tests of knowledge, portfolios, cultural competence OSCE…. Training of assessors / examiners Publications and research.

27. NCAS Work Programme….. Review NCAS assessment methods, services & interventions against existing published evidence in medical education, to make sure they are evidence-based and represent international best practice Ensure assessment is robust, i.e. valid, reliable, feasible, and defendable (Re)establish NCAS as an international leader in the design and implementation of assessment and interventions for doctors, dentists and pharmacists with performance concerns

28. NCAS Work Programme….. NCAS assessments & interventions should be: Able to withstand personal (and legal) challenge Considered effective and useful to referral bodies, practitioners and other stakeholders, supporting case progression Represent value for money, in patients’ best interests.

29. NCAS Work Programme….. Reviews of: Remediation intervention (‘Back on Track’) Full performance assessment Assessment of behavioural concerns - Occupational health & psychometric questionnaires - Observation of performance (clinical assessment) - Case-based assessment - Multi-source feedback - Patient feedback

30. NCAS Work Programme….. Further development of: Clinical record review Assessment of communication effectiveness Interventions for the resolution of team concerns Mediation (working with Karen)… Ensure A&I services are fit for purpose: Bespoke approach?

31. NCAS Work Programme….. Research and publication… Quality assurance & evaluation Identifying key themes and outcomes from A&I’s Communication & marketing Enhance NCAS reputation – contribute to international WPBA agenda Collaborations with leading international experts Quality, not quantity.

32. A little bit about me….

33. A little bit about me…..

34. CNST Membership Deadline for leaving CNST of 31 st August 100% membership for 2016/17 Plans for membership engagement: – Customer survey – Stakeholder group – Publications – Consultation on our CNST pricing and our 5 year plan – ‘20 years’ of expertise – 2020 and beyond’

35. AOB: SLA to Wales (visit to CMO) Whistleblowing (meeting and follow-up) Utilising the underspend within FY15/16 Questions?