New Insights publication: Specialties in performance cases

Date published:

Our Practitioner Performance Advice service (Advice) has published its latest Insights paper,  Specialties in Practitioner Performance Advice cases: Key themes and use of our services. In this Insights publication we draw from our unique position to share the range of concerns about practitioner performance across the NHS on which we provide support and provide focused analysis of our casework regarding secondary care specialties from 2018/19 to 2022/23, which make up the majority of our cases.

Key findings:

  • Surgery, obstetrics and gynaecology, psychiatry and emergency medicine are the secondary care specialties which have the highest proportion of Advice cases per 1,000 doctors in the workforce for each specialty from 2018/19 to 2022/23.
  • Surgery: Although research indicates that in the past five years sexual misconduct has been experienced widely in the UK surgical workforce, surgeons do not appear to differ significantly from other specialties in terms of the proportion of related behaviour concerns in our cases. This may represent under-reporting of behaviour concerns to the employer, and/or Advice not being contacted by the employer regarding these types of concerns.
  • Obstetrics and Gynaecology: A number of maternity service reviews have illustrated that culture in maternity services is directly related to the quality and outcomes of the service. These reviews have found evidence of team dysfunction across different professional groups. We reflect on this and provide information on our new maternity team review service.
  • Psychiatry: The profession with the highest rate of Advice cases with 37 cases per 1,000 is psychiatrists and there are higher rates of health concern cases involving psychiatrists at specialty and specialist doctors (SAS), trust grades and training grades.
  • Emergency medicine: There has been an increase in cases involving doctors in emergency medicine since the COVID-19 pandemic and higher proportions of cases for SAS and trust grades in this specialty than across secondary specialties as a whole.

Why are we sharing this?

By sharing this information, we aim to raise awareness of the comprehensive support we provide to the management and resolution of concerns within secondary care. Composite case studies for each of the four specialties we focus on are provided to illustrate the role that Advice can play in supporting the management of performance concerns in secondary care.

Our resources

You can access other publications in our Insights series which covers a wide range of subjects, from behavioural assessments to practitioner exclusions.

If you are interested in hearing more about our research and insights programme, please get in touch with us at nhsr.adviceresearchandevaluation@nhs.net  or sign-up to receive Insights publications by email: