1. All NCAS-staff update

2. Agenda Key activity data Update from NHS LA AGM (17/07/15) Next steps for NCAS and short-term priorities (including audit on data completeness and accuracy) Update on priorities for new starters Staff Engagement Group Focus on an NCAS product or service – Healthcare Professional Alert Notices (HPANs)

3. Key activity data (FY15/16 to 16/07/15) 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 Advice282 new referrals* (as of 27/07/15) (232) AssessmentsFull assessments 5 assessment reports issued and a further 2 being finalised (3 and 1) 4 clinical assessment visits confirmed (4) A further 6 clinical assessment visits being actively planned Assessment of behavioural concerns and standalone MSF 1 Assessment report issued and 3 further underway Support to cases proceeding to FtP hearings 7 cases are currently being supported in this activity (9) Back on Track15 Action Planning Frameworks completed and 16 Action Plans issued. (12 and 16) GDC Clinical Review Service 132 clinical reviews completed and delivered to the GDC (109) HPANs17 current active alert notices (no change) Education workshops 37 training workshops/events delivered (22)

4. Update from NHS LA AGM NCAS – pages 33-38 of Annual Review External Education and Learning – page 48 Other Corporate information Flexible and responsive Diversified portfolio of A&I products to resolve concern as quickly as possible (including change in A&I mix) Customer feedback for advisory service Reduction in number of working days for each stage of the assessment process Organisational change

5. Update from NHS LA AGM (2) Year ahead (pages 56-57): Use our NCAS expertise to help the NHS improve patient safety by working constructively with teams in difficulty, making the service much more responsive so that from the outset interventions are tailored to each individual case Recruit, select and train assessors and other specialists to deliver NCAS assessments and interventions. We will review how we plan for A&Is to ensure we meet customer expectations and work within our resources Review our strategy for research within NCAS and review and develop a publication list of NCAS publications and data Seek the view of those using the service and other key stakeholders in order to develop and improve, establishing an external stakeholder reference group to ensure that we are appropriately engaged and obtain feedback from those using our services Move towards appropriate integration for PLR, HPAN and the existing NCAS knowledge system.

6. Next steps for NCAS and short-term priorities

7. Our vision – ways of working Clear funding and business model Re-established national and international reputation Stakeholder engagement Regional alignment Partnership working Motivated, innovative and resilient skilled workforce Synergies with NHS LA developed

8. Delivering our vision Defining and market testing of services and products Business model development Customer and stakeholder engagement Impact evaluation Research and development Establishment and marketing of services and products Training/development/engagement for staff Ways of working with NHS LA

9. Update on priorities for new starters Priorities VickyBusiness model development Stakeholder engagement and Group Assessor contracting Leadership and governance including voice on Board and SMT LindaReview all A&I products, establish utility indexes and ensure fitness for purpose Define programme of research and development Establish A&I External Reference Group and re-establish external credibility for A&I services Sanjay PManage and revisit all SLAs Support business model development Lead A&I services procurement New product development and rollout: Mediation Richard C and HillDickinson Ensuring assessment consideration decision making process is fit for purpose and takes account of all A&I services Ensuring robustness and defensibility of agreement to assessment, responding and handling comments on assessment reports

10. Update on priorities for new starters Priorities JoLead GDC clinical review service delivery and quality assurance Development of A&I QA and QC framework Development of GDC assessment QA framework New product development and rollout: Clinical record reviews (primary care) YvonneDay-to-day delivery of GDC clinical review service Support A&I cases being utilised in legal proceedings Clara, Ren, Karen, Mark Programme management and marketing for individual services including customer evaluation Policy and Projects Manager Establish and deliver a programme for ongoing maintenance and development of templates/guidance/forms/SOPs across NCAS David (Responsible Officer) (interim) Decision making for HPANs, PLR notifications and other complex information sharing issues Representative on Data Reference Group All other legal responsibilities for RO role for NHS LA

11. 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.

12. Audit on data completeness and accuracy An audit of EKS will take place in August 2015 to consider our data in terms of completion, accuracy and adequacy The audit will be carried out by PriceWaterhouseCoopers (internal auditors) and may involve: Review of existing process documentation, if any Interviews with management and staff Review of systems and procedures Review of source documents and files Testing of controls, where appropriate.

13. Importance of data collection Example: referrals by specialty group Three categories are meaningless – ‘not applicable’, ‘not specified’ and ‘not known’ which skews any conclusions that could be formed from this data

14. Staff Engagement Group An update on the ‘investors in people’ (IIP) project was given to the staff engagement group (SEG). SEG representatives will be involved in the IIP project by seeking feedback from colleagues and peers about the culture of the organisation. Information provided to the IIP project groups from SEG members can be anonymous Dee asked for a representative from NCAS to be involved in the IIP group. If you would like to volunteer, please let Dee and Lisa know. Stephen Melville, Clara Cooper and Anna Manning are on the project group The all staff survey is being arranged to take place in September 2015. SEG representatives are meeting to discuss the format and questions; if you have any comments and/or ideas in relation to the staff survey, please let us know

15. Staff engagement group Enquiries are being made to determine the cost of providing staff with NHS passes so that staff can obtain NHS discounts and benefits without needing their payslip as evidence of being an NHS employee SEG representatives can attend your team meetings. Please let any of us know if you’d like us to attend SEG to be reviewed and a manifesto will be developed. We would be grateful for your feedback

16. Focus on and NCAS product or service: Healthcare Professional Alert Notices (HPANs) Dr David Scott, Assessment Adviser and Adviser with responsibility for Healthcare Professional Alert Notices (HPANs)

17. Overview Previously known as ‘Alert Notices’ System was operated by Regional Offices (Health Authorities) and SHAs until 31 March 2013 Responsibility transferred to NHSLA (NCAS) on 1 April 2013 Used for healthcare professionals in regulated professions. Issued if a practitioner is considered to be a risk to patient safety and is either actively seeking or thought to be actively seeking employment in the NHS or with a body that supplies services to the NHS. Usually used as temporary safeguard until the Regulator has taken a decision on the practitioner’s registration status. Currently 30-40 referrals a year from NHS bodies.

18. Purpose of an HPAN To enable NHS organisations to request the NHSLA to issue an Alert Notice when they consider a healthcare professional could pose a significant risk of harm to patients and there is a pressing need to alert other organisations; or When they have reason to believe that a person will falsely hold out themselves to be a healthcare professional. These arrangements apply to all regulated healthcare professions i.e. doctors, dentists, nurses and midwives, pharmacists, the optical professions, chiropractors and osteopaths and the healthcare professions regulated by the Health and Care Professions Council. Advises healthcare organisations proposing to appoint a healthcare professional that they may wish check against any current Alert Notices and, where appropriate, to contact the originating healthcare organisation for further details.

19. Guidance from NHS Employers

20. When do we consider issuing an HPAN? NCAS may issue an Alert Notice when requested to do so by an NHS body as per the Healthcare Professionals Alert Notices Directions 2006 and the Letter from Sir Bruce Keogh (2013): The NHS body has reasonable grounds to believe that the healthcare professional poses a significant risk of harm to patients, staff or the public and intends or may intend to continue in that employment or seek additional or other work in the NHS. Further indications include the risk that an individual may pose a threat to patients or staff because their conduct compromises the effective functions of a team or local primary care service. An NHS body may also request the issue of an alert notice where it has reasonable grounds to believe that a person may falsely hold themselves out to be a healthcare professional and may seek work, in the NHS in that capacity.

21. In practice To alert potential employers that a prospective employee has unresolved issues that are considered to be a potential significant risk to patient safety. To be a source of additional information until the ‘Regulator’ has taken action on a healthcare professional’s registration status and published their determination on their website.

22. Consideration of HPANs The information contained in the alert request is then considered by DS (or any other designated person). A review checklist is completed and a decision is made (i.e. HPAN issued or not issued). The decision to issue an HPAN is usually straightforward, but sometimes involves complex decisions requiring confidential discussions between colleagues. The reasons for the decisions taken are fully documented This process is currently subject to review.

23. Distribution of HPANs To: Healthcare organisations in England, Chief Medical Officers of Wales, Scotland and Northern Ireland, the NHS body which requested the Alert Notice, the relevant professional regulatory body. Nominated contacts (on NCAS’ distribution list) are then responsible for cascading the HPAN. We also send a letter to the person who is subject of the alert notice (explaining the reasons why the HPAN has been issued) and provide a copy of the alert notice.

24. Dissemination of HPANs Determined by the Directions 2006 Electronic (Paper-based ) System To Regional Medical Directors and Chief Medical Officers for onward distribution Web-based system in development Recent upload to FHSAU database (Performer’s List) database Electronic access only possible via N3 connection Parallel pilot electronic system (CSC) Crown Commercial Services (CCS) Framework suppliers are required to check the HPAN database as part of their pre-employment checks

25. Reviews and Cancelations Reviews – Each alert should be reviewed at intervals of no more than six months. Consideration is given as to whether the alert notice should be revoked or maintained once we receive an update. Cancellations – In cases where we no longer deem it necessary to keep the HPAN in place, it must be revoked by writing to all those to whom the original alert notice was sent.

26. Activity

27. Current Issues The Directions are out of date NHS Employers’ Guidance is out of date Information on NCAS website is out of date No web-based database Access to the FHSAU database will not be universal Distribution of HPANs to non-NHS bodies employing healthcare professionals is incomplete There are significant problems relating to information governance Historical HPANs are still being discovered by NHS England

28. Questions?