These frequently asked questions are updated regularly. Here you will find answers to a range of common questions we are often asked about our organisation and the services we deliver.
We are part of NHS Resolution. We support the resolution of performance concerns about individual doctors, dentists and pharmacists.
Our assessment services are aimed at clarifying and understanding the performance of individual practitioners and providing healthcare organisations and practitioners with a sound basis upon which to bring the case towards a resolution. Assessments are not an end point in themselves, but are a valuable tool to support the effective management of cases locally.
Assessments are not an investigation of the incidents which may have led to the referral to us.
The employing/contracting organisation will normally have asked for, and received, advice from us on how to manage the concern with the practitioner. As part of that process they will have been told about the assessments and other interventions available and will have then decided to request an assessment.
Requests for assessment are considered by our Intervention Consideration Group in line with our published policy and a formal decision to approve or decline the request will then be issued. We need the agreement of both the employing/contracting organisation and the practitioner before we can consider such a request.
Clinical Performance Assessment
The Covid-19 pandemic has had an impact on the delivery of these on-site assessments. If we offer one of these assessments then we will work with the parties involved to assess the feasibility of the assessment and the best method of delivery, taking into account the specific circumstances of the case.
The purpose of a Clinical Performance Assessment is to provide an independent view on the clinical performance of the practitioner, identifying both satisfactory practice and any areas of poor practice.
The assessment is intended to provide information to assist the referring organisation in decisions about the next steps in their management of the case.
Local Assessment of Clinical Performance (LACP)
We have introduced LACP’s as a response to the COVID-19 pandemic and the difficulties this has caused to our delivery of Clinical Performance Assessments. We have developed the LACP to facilitate and support NHS organisations in undertaking clinical performance assessments locally during this period.
An LACP is a bespoke tool for use by healthcare organisations to assess aspects of a practitioner’s clinical performance about which there are concerns. When completed, the LACP provides additional assurance to the practitioner’s employer/contractor about the performance of the practitioner in specific clinical domains.
Behavioural Assessment
A Behavioural Assessment provides an independent view on the behavioural characteristics of the practitioner, including any areas which require consideration.
The assessment is intended to provide information to assist the referring organisation in decisions about the next steps in their management of the case.
Clinical Performance Assessment
The assessment is carried out through a clinical assessment visit by a trained team of two clinical assessors and a Senior Assessment and Remediation Manager. It includes:
Clinical record review: of a sample of patient records.
Direct observation of practice: the practitioner’s normal clinical work.
Case-based assessment: exploring clinical reasoning and decision-making about the practitioner’s own cases.
Clinical assessors will have relevant clinical experience in the practitioner’s speciality, be familiar with the standards relating to their clinical specialty and be able to apply them to assess the performance of a peer. We also ensure that they are in good standing with the relevant professional bodies and regulators.
Local Assessment of Clinical Performance
Practitioner Performance Advice drafts a framework for an LACP, based on information about the concerns relating to the clinical performance of a practitioner. It is essential that there is sufficient information to enable us to identify the clinical areas to be assessed and to define clearly the scope of the LACP. Therefore, in most cases, it will be necessary for the practitioner to complete an action plan before the LACP. The objectives in the action plan then form the basis of the LACP. (Practitioner Performance Advice can draft an action plan in these cases, if requested.)
The LACP consists of a range of tools and activities to assess the specific areas of clinical performance. The LACP is normally undertaken by clinicians who were not involved in the implementation of the action plan and are, therefore, independent of that process. The employing/contracting organisation identifies and sources the clinicians who undertake the LACP and who prepare a report with their findings.
Behavioural Assessment
The assessment includes:
The practitioner completing three online psychometric questionnaires (the Revised NEO Personality Inventory, the Hogan Development Survey and the Motives, Values, Preferences Inventory).
The practitioner attending an interview with a behavioural assessor (an occupational psychologist), during which the assessor asks a range of questions about the practitioner’s work, including: what they do in their job, which aspects they enjoy most and least, how they approach the different aspects and demands of their role etc. This typically lasts three to four hours. The interview is currently conducted remotely, via videoconference, in two sessions of around two to three hours each. After the first session, the psychologist usually gives initial feedback to the practitioner.
If the request for an assessment is approved then we draw up an ‘agreement to assessment’ which sets out the purpose of the assessment and explains how the assessment will be carried out. It also sets out the responsibilities of Practitioner Performance Advice, the practitioner and the employing/contracting organisation with regard to the assessment.
We will not be able to proceed with the assessment until the agreement to assessment has been signed by both the practitioner and employing/contracting organisation to confirm their commitment to the process.
Please note that if we offer a Local Assessment of Clinical Performance, the agreement to assessment (i.e. to arrange and participate in the assessment) is between the practitioner and their employing/contracting organisation.
Practitioner Performance Advice produces an assessment report which will provide the employing/contracting organisation with clear findings and conclusions about the practitioner’s level of performance (for clinical practice assessments) and with an independent view on the behavioural characteristics of the practitioner, including any areas which require consideration (behavioural assessments).
If a Local Assessment of Clinical Performance has taken place, the local assessors will produce the report. Practitioner Performance Advice is not involved in preparing the report.
We are available to offer advice and recommendations to employing/contracting organisations on next steps after the assessment. This can include asking our Professional Support and Remediation service to prepare an action plan to support a practitioner’s return to safe and effective practice (for Clinical Performance Assessments) and to help consideration of behavioural issues (for Behavioural Assessments).
We recognise that where questions have been raised about a practitioner’s work, this can be a very stressful experience for the individual concerned. We are committed to ensuring the services we offer and the way we deliver our services are sensitive to the impact on the individual about whom questions have been raised.
We always recommend that practitioners access appropriate and timely professional support through their defence organisation or other representative body. We would also encourage practitioners to draw on personal support that is available to them, for example, through friends or family.
The practitioner’s General Practitioner can also be an important source of support.
It also worth remembering that support is available through the healthcare organisation, for example, through its local occupational health and counselling services. More avenues of support may be available locally or accessed through the relevant Royal College.
Our website also contains details of organisations that may be of use to practitioners – please see the link below:
