1. All NCAS-staff update

3. Agenda Welcome from Chief Executive Business as usual arrangements Organisational development plans Update on advisory service work Update on assessment service Update on back on track service Update on external education and learning Workstreams – overview and update Arrangements for future all NCAS-staff updates

4. Welcome from Chief Executive

5. Business as usual arrangements NCAS’ role: NCAS as an advisory function – supporting the resolution of concerns Interventions, that is the direct delivery of products delivered under the NCAS banner to intervene in a case to facilitate the direct resolution of a case, will be a secondary function of NCAS and contained to interventions with an evidence- base for resolving performance concerns

6. Business as usual arrangements COG (and reporting to SMT) Wider management group Programme management of services: Running the service (and ensuring it meets the specification) Reporting on activity Seeking and responding to customer feedback Modifying the service Evaluating the impact and value for money/ROI Training and supporting staff Business planning Increasing integration with wider NHS LA

7. Organisational development plans Slot-ins Recruitment (Phase 1 (wk beg 24/11/14) and Phase 2 (wk beg 22/12/14)) Training and support Organisational development Cultural development work

8. Update on advisory service work

9. Some referral information Total referrals for first half of 2014/5 (comparisons to previous year in brackets) Total referrals – 490 (545)  Primary care medical – 78 (74)  Secondary care medical – 366 (421)  Dentistry – 31(34)  Pharmacy – 6 (3)  General cases – 9 (13)

10. Work stream updates Development of assessment consideration (Chakrabarty) Reviews of open cases (8 months) HPAN NCAS Risk Register Transition following consultation

11. Questions? Thank you

12. Update on assessment service work

13. Update on: Assessment activity – overall picture Wales / NI assessment activity GDC clinical review service + training and consultancy services to MCI Key challenges and priorities

14. Assessment activity overview Clearing the backlog and reducing waiting times Started this calendar year with approx. 12 month backlog of full assessment work Currently planning visits to take place approx. 4 months ahead subject to availability and case circumstances Broadening range of interventions delivered Offering less full assessments, more modular-based interventions 53 assessments completed in FY14/15 to date: 43% included full clinical assessment visit component (compared with 59% in FY13/14) 32% assessment of behavioural concerns (16% in FY13/14) 25% other – e.g. OH only, record reviews (25% in FY13/14)

15. Assessment activity overview – cont’d Average number of days between assessment start (AtA received) to assessment completion (report issued) for routine full assessments YTD Average for FY14/15 – 119 days (Average for FY13/14 – 159 days) Average number of days between assessment start (AtA received) to assessment completion (report issued) for routine ABCs YTD Average for FY14/15 – 43 days (Average for FY13/14 – 83 days)

16. Wales / NI assessments and services to MCI Wales/NI assessments 12 assessments completed so far this FY (compare with 13 in FY13/14) – 8 of which were modular interventions (including 4 record reviews) Medical Council of Ireland – training and consultancy Since 2011, NCAS contracted to provide services to MCI NCAS’ support – from design to delivery We continue to provide advice on management of individual assessments handled by MCI In November we successfully delivered refresher training to MCI assessor panel to ensure maintenance of their skills and knowledge

17. GDC clinical review service Over 1,500 expert advice reports produced since inception of service in April 2012 – 440 reports this FY to date Outcomes of reviews in this FY: 32% - At the expected level 20% - Some aspects of care poor but did not materially affect overall care 30% - Below the expected standard 12% - Significantly below the expected standard 6% - No opinion possible Turnaround target for reports met in 100% of cases – normally 5 working days

18. Key challenges and priorities Maintaining business continuity – continue to ensure safe, effective service during period of change Managing demand against capacity – living within our means Staffing – recruitment and training Assessors – revisit requirements re. capacity, skills set for record reviews etc

19. Questions? Thank you

20. Update on Back on Track Service (BoT)

21. Service Data AprMayJunJulAugSepOctNovDecJanFebMar Total Action plans drafted or reviewed (revised) 2013-14 18106 835498 9100 2014- to date 141012419 769 Action plan frameworks drafted 2013-14 36660123524745 2014- to date 45452810644 External Back on Track Meetings attended 2013-14 310871425252756 2014- to date 3510110112

22. Service Data Back on Track contributed to Assessment report recommendations in : 50 cases in 2013-14 1 case 2014- to date 2014- to date: There have been 94 cases with BoT involvement: 14 GP cases 6 Dental 70 Secondary care 2 Public Health 2 Pharmacy

23. Key challenges Reduced resource versus increasing demand - More selective in offering assessments appears to have led to greater demand for Back on Track plans as an alternative (29 requests for action plans received between 16 October 2014 and 30 November 2014) - Modular assessments create action plans that are as resource dependent as those for full assessment or non-assessment cases. Weaker evidence base to support action planning-: - No assessment recommendations, modular assessments, change in report format - Often less clear reports from external sources - Less clarity about practitioner concerns - Lack of direct contact with stakeholders

24. Four communication wishes: Use the BoT email address alongside personal accounts and please make your requests early We need evidence to build a plan – please involve us in the evidence gathering Have a conversation with us about realistic timescales for action plans before meeting stakeholders Keep us up to date on feedback received.

25. Service Development –Temporary recruitment –Widen the skills base for Action Planning –Revise our processes to fit developments in NCAS assessments and report Longer term: –Our templates and guidance –Resource directory of educational and supportive interventions Ongoing process and service development - keep ahead of the game including revisions of: –Stakeholder engagement –Career counselling forum –External review

26. Questions? Thank you

27. Update on external education and learning

28. Workshop programmes Managing concerns about performance of doctors, dentists and pharmacists Case investigator training workshop Case manager training workshop Understanding and using MHPS effectively MHPS and the Trust Board masterclass Custom presentations

29. Activities to date No of events YTD:83 No of scheduled events (Dec 14 – Mar 15):27 New and TBC (dates not yet confirmed):15 Two delivery models: In-house (in a RB/area bespoke to customer need) Public (at NCAS offices; mix of delegates).

30. Testimonials and feedback Overall, I found this course very useful and although it covered 2 days it probably required this level of time/commitment. Both trainers were excellent and their knowledge and experience of the subject matter and course content very much enhanced the overall learning experience The days did treat us like adults and must be commended for that Thank you for providing this excellent course. Please can I commend the XX and XX for their presentation style and the knowledge that they imparted during the course which has clearly been gleaned from years of working in this challenging field I enjoyed the training and feel that I now have a sense of what is expected of me and how important it is for me to investigate a case to the best of my ability

31. Questions? Thank you

32. Workstreams Programme/projectLead Non-NHS work (consideration of active/expiring contracts and exploration of next steps with cost models) SBoyle/CF with input from COS Record review (development of service)NB Consideration of establishment of Assessment and Remediation External Reference Group NB Review of reports (consideration of methods to ensure quality)NB Assessment consideration (criteria)NB Capacity planning for assessmentAB with SS Stakeholder engagement including establishing a Stakeholder Reference Group PD MOUs (review/extension)PD/TM Implications of Chakrabarty/MHPS Part IV Para 14SP Assessor contractingVV Case investigation serviceVV KPIs (development of)VV/KW Team reviewsKW MediationKW