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National Responsible Officer Conference - 4th June 2 01 4. Hilton Dixon Responsible Officer Fiona Thomson – Templars Revalidation Manager. Durham, Darlington and Tees Area Team. Structure and working arrangements. 2800 GPs across 2 area teams 200 appraisers

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national responsible officer conference 4th june 2 01 4

National Responsible OfficerConference - 4th June 2014

Hilton Dixon

Responsible Officer

Fiona Thomson – Templars

Revalidation Manager

Durham, Darlington and Tees Area Team

structure and working arrangements
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
confusion and complexity and clarity
Confusion and complexity and clarity

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NHS | Presentation GMC, 6th May 2014

confusion
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?
complexity
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.
collaborative approach
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
how to get clarity
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?
issues for locum doctors
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]

issues for overseas locums doctors
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]

issues for locum agencies
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]

concerns around locum agencies
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]

what are the key issues to address
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