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National Responsible Officer
Conference - 4th June 2014
Durham, Darlington and Tees Area Team
Hilton Dixon Responsible OfficerFiona Thomson – Templars Revalidation Manager
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
-
NHS | Presentation GMC, 6th May 20143
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• 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 • 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?• 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• 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
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
Issues for Locum Agencies
NHS | Presentation to [XXXX Company] | [Type Date]10
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
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
Thank you