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Assessment and intervention

Assessment and intervention

We are currently looking at how we can use technological solutions to enable the remote delivery of those services which have previously only been available in a face-to-face setting. Our assessments help to clarify and understand the performance of individual practitioners, and provide the healthcare organisation and practitioner with a sound basis upon which to bring the case towards a resolution.

Our assessments are aimed at:

  • supporting the local management and implementation of timely and fair management solutions to resolve concerns about performance
  • enabling practitioners to return to safe and effective practice, where appropriate
  • helping to ensure public protection and patient safety.

The exact type of assessment we carry out will be dependent on the circumstances of the case. The types of assessment we offer include the following:

Clinical performance assessment

The purpose of this assessment is to:

  • provide an independent view on the clinical performance of the practitioner, identifying both satisfactory practice and any areas of poor practice.
  • provide information to assist the referring organisation in decisions about the next steps in their management of the case.

The assessment is carried out through a clinical assessment visit by a trained team of assessors, supported by an Assessment and Intervention 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.

The assessors will have relevant clinical experience in the practitioner’s specialty, be familiar with the standards relating to that specialty and be able to apply them to assess the performance of a peer. Our assessments are underpinned by a range of quality assurance mechanisms to ensure that we continue to provide an expert and high quality service.  The result is a comprehensive report with fair, robust and evidence-based findings and conclusions in respect of the individual’s practice, which provide the basis for a clear way forward to bring the case towards a resolution.

It takes around 18 weeks to complete a clinical performance assessment – from the time we offer the assessment to the issue of the assessment report.  This can vary depending on the clinical specialty of the practitioner and the individual circumstances of the case but we always aim to deliver assessments as quickly as we can.

Behavioural assessment

The purpose of this assessment is to:

  • provide an independent view on the behavioural characteristics of the practitioner, including any areas which require consideration.
  • provide information to assist the referring organisation in decisions about the next steps in their management of the case.

Where the concerns about an individual practitioner primarily focus on their behaviours and relationships with colleagues, and where there is not misconduct requiring the use of disciplinary procedures, we may offer to undertake an assessment of the practitioner’s behaviours.

The assessment includes:

  • The practitioner completing two online psychometric questionnaires (the Revised NEO Personality Inventory and the Hogan Development Survey).
  • The practitioner attending an all-day appointment with a behavioural assessor (an occupational psychologist). The day involves  an in-depth interview, during which the assessor explores a range of aspects of 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. There is then a break (during which the psychologist reflects on the interview) and then gives initial feedback to the practitioner.

The whole process takes about 8 weeks to complete, from the time we offer the behavioural assessment to the issue of the report.

Professional support and remediation

We draft action plans for doctors, dentists and pharmacists who have been identified by their healthcare organisation as needing support to deliver sustained, safe and effective practice.

We provide two types of action plan, depending on the circumstances of the case:

Remediation action plans – where there is clear evidence identifying performance or behavioural concerns, such as a report from one of our assessments or another type of investigation. The focus of a remediation plan may be on knowledge, skills or behaviours, or a combination of these.
Return to work action plans – which support a practitioner’s reskilling and/or reintegration into clinical practice following a prolonged absence for any reason, usually in excess of three months.  In some cases, there may be pre-existing performance concerns so some elements of remediation are also included in the action plan.
Action plans are developed following a careful review of each case, taking into account service needs, the practitioner’s working environment and their areas for development, such as leadership, patient/colleague interaction or other behavioural issues. After local discussion of the plan, it becomes an agreement between the healthcare organisation and the practitioner.

We also use our experience to provide constructive feedback on action plans drafted by other NHS organisations. We give an informed view on the feasibility of the proposed action plan and identify potential aspects that could be improved, while also considering the protection of patient safety as a priority.

Assisted mediation

To help support the resolution of relationship difficulties between healthcare professionals, we also offer assisted mediation. Assisted mediation is an independent, voluntary and confidential process in which two accredited mediators work with the parties concerned to create a mutual understanding of the issues and to find a way forward that enables a more effective professional working relationship.

Our mediators, most of whom are also Advisers for the service, share their experience of what is realistically likely to work and can also signpost parties to other interventions, which may also be helpful.

The aim of the assisted mediation service is to enable a more professional working relationship between both parties, which leads to a positive impact on the immediate team and ultimately better patient care.

Where we have offered to undertake an assessment or other intervention, we will only proceed with the explicit agreement of both the practitioner and their healthcare organisation.

Team reviews

Where concerns relate to the functioning of a clinical team, we can undertake a team review to identify any barriers to resolving the issues which have been highlighted and to suggest a plan for improving professional relationships within the team.

The circumstances in which we carry out a team review usually involve the following: issues of concern are usually longstanding, complex and deeply rooted; and the situation would benefit significantly from a fair and impartial view to clarify and communicate the net effects of the difficulties, as well as an exploration of the broader organisational context to the issues.

Where we have undertaken a team review, we will continue to support the healthcare organisation to implement the actions in order to ensure that necessary change is embedded in the team to achieve a resolution of the concerns.

Consideration of assessment policy statement

Our consideration of assessment policy statement related to cases where we are asked by an NHS employer or contracting organisation to consider whether to offer an assessment of an individual doctor, dentist or pharmacist about whom there are concerns.

A copy of our policy statement for considering such requests can be found here.

If you would like to know more about the above services and how to request them, please contact us and ask to speak to an Adviser.

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