1. National Responsible Officer Conference - 4th June 2014 Durham, Darlington and Tees Area Team Hilton Dixon Responsible Officer Fiona Thomson – Templars Revalidation Manager

2. Structure and working arrangements 2800 GPs across 2 area teams 200 appraisers 2 band 4 admin staff full time 1 appraisal lead 2 performance managers 2 ROs 2 Deputy MDs Electronic matching system for appraisers and appraisees Fortnightly operational group meeting

3. Confusion and complexity and clarity - NHS | Presentation GMC, 6 th May 20143

4. Confusion Some locum agencies not DBs Who investigates performance concerns? NHS England is the default DB for locum doctors with no DB Do locums understand the appraisal and revalidation processes? Who pays for the appraisal? Are the fees consistent? Who does the appraisal?

5. Complexity Locum medical consultant approaches the Area Team NHS England is not their employer and they are not a GP Locum Agency not a DB therefore no RO but offers to appraise/pay The doctor lives nearest DDT Area Team and is the Designated Body Performance concerns arise on discussion with RO where the doctor works.

6. Collaborative approach AT confirmed they were the DB and RO FT to investigate concerns FT to appraise as a locum AT to undertake formal whole of practice appraisal as DB Requested past appraisal documents Discussion with ELA

7. How to get clarity? ELA advice? Are GMC decisions appropriate? NCAS advice? RO to RO communication? Why are some locum agencies are DBs some are not? What are the implications Processes for complaints/SUI investigations Information sharing Risk assessment as DBs and ROs? Need for locum agency RO forum?

8. Issues for Locum Doctors Difficult to obtain feedback particularly for short term locums Appraisers difficult to find Appraisers may be selected on commercial basis alone May not get sufficient support from Agency Pressure to work through agencies in return for support Easy to blame – unfairly discriminated NHS | Presentation to [XXXX Company] | [Type Date]8

9. Issues for overseas Locums Doctors CPD carried out overseas May have overseas appraisal which doesn’t meet the UK requirements Difficulty in securing adequate UK locums to make UK appraisal appropriate or obtain 360 and patient feedback Many specialists come to the UK for a few weeks a year but may not return due to revalidation difficulties NHS | Presentation to [XXXX Company] | [Type Date]9

10. Issues for Locum Agencies Validating overseas evidence Cost Locums move designated bodies Inappropriate connections Inability to support certain doctors No remediation Communication with NHS Trusts/health Boards Loss of supply – many take retirement option Need for communication with NHS Trust/Health Boards. NHS | Presentation to [XXXX Company] | [Type Date]10

11. Concerns Around Locum Agencies Agency has no knowledge of previous history/complaints when supplying a locum not connected to the Agency NHS Issues disregarded and locums moved to alternative NHS post No means of monitoring performance/ identifying trends Information may not be passed to NHS body Insufficient recruitment checks Conflict of Interest when revalidating locums NHS | Presentation to [XXXX Company] | [Type Date]11

12. What are the key issues to address For patients For the doctor For the service provider For the regulator For the Designated Body and RO

13. Thank you