Doctors to face regular checks as performance fears are raised
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Friday 19 October 2012
More than 1,000 doctors in England could be putting patients at risk after serious concerns about their competence were raised by their NHS Trust, private hospital or employer.
Nearly 7,000 doctors – one in 25 of all those practising – gave cause for concern for reasons ranging from being late for clinics to lacking the skills to do their job, according to a government-commissioned survey.
The figures were disclosed as Jeremy Hunt, the Health Secretary, announced the launch of the first scheme in the world to impose regular checks on doctors to ensure they are up to the job.
As a condition of retaining their licence to practice all doctors will be subject, from next year, to annual appraisals of their performance, dubbed MOTs for the medical profession. These will be backed by five-yearly checks, called "revalidation".
The checks will supplement existing measures for identifying poorly performing doctors through complaints to the NHS. The idea is to catch problems early before they cause harm.
The survey of all 650 NHS trusts, locum agencies, private health organisations and other bodies, conducted by the Department of Health's Revalidation Support Team in December 2011, found there were concerns about the performance of 6,800, or 4.1 per cent, of doctors in England.
Of these, most of the doctors (4,000, or 2.4 per cent) had prompted low-level concerns over issues such as lateness; 1,600 (1 per cent) had prompted medium-level concerns relating to behaviour such as rudeness to patients; and 1,200 (0.7 per cent) had prompted high-level concerns over problems such as alcoholism or a lack of skills.
Most cases could be dealt with through advice, extra training and monitoring. Doctors giving rise to high-level concerns would be stopped from working while being treated, or retrained. Niall Dickson, chief executive of the General Medical Council, which will run the scheme, said it was a "historic moment" and the "biggest change in medical regulation for 150 years." He added: "Most patients probably think we have a system like this already. They would not board an aircraft where the last check on the pilot was 20 years ago but that is the level of assurance we have in medicine."
It has taken 12 years of hard negotiating between doctors' leaders, the GMC and the Government to agree the scheme. BMA leaders protested that it was unfair, bureaucratic and would neglect those who fell short.
Regular checks for doctors were first recommended three decades ago but it was the Bristol children's heart surgery scandal in 2000 that gave impetus to the idea. The report of the inquiry into the worst scandal in the NHS's history described how babies died because surgeons were operating beyond their competence.
The plans were derailed in 2005 by Dame Janet Smith, chair of the Shipman inquiry, who said they were based on "expediency rather than principle" after they were watered down to meet the BMA's objections.
Mr Dickson called the new scheme "meaningful and robust and not over-bureaucratic". Professor Sir Bruce Keogh, NHS medical director, admitted it would not be perfect and would be difficult to implement, but he said: "It is the job of every doctor to describe what they do and define how well they do it.
Mr Hunt said: "Making sure [doctors] are up to speed with the latest treatments and technologies will help them save [more lives]."
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