Advice and support
Back on Track services
Support for investigations
Suspension or exclusion from work
Supporting the development of local procedures
Revalidation and support for responsible officers
All cases start with advice and support – a phone call from one of our advisers. This will usually be within a day of your first call to us, though we can also arrange to call you on a different date if this would be more convenient. You tell the adviser what the problem is, the adviser asks questions, and you work out together what the options are for addressing a performance concern. We may suggest follow-up action, including discussion of the specialist services described below. But advice and support is a service in its own right and the adviser and caseworker allocated to the case are your contacts for further work with us. With each episode of phone advice you will receive a confirmation letter shortly afterwards, and a further contact from us will be scheduled unless it has been agreed that the case can be closed. We are here so long as you need us. Each year, about 600 referrals are brought to resolution in this way.
Since being set up in 2001, NCAS has developed and refined the design and delivery of leading edge models of performance assessment. Before offering these specialist services, our advisers and assessment experts will help you identify the intervention best suited to your needs. We carry out assessments mainly for NHS employing and contracting bodies but we can also undertake them for regulators or other organisations concerned with practitioner performance. All our assessments are designed to support the effective management of concerns about a practitioner’s work and to protect patients. We conduct 40-50 assessments each year and normally follow them up with Back on Track work. All our assessments are underpinned by a rigorous framework of quality assurance so that all parties can rely on the robustness and independence of the findings. More
We help referring bodies and practitioners to develop, implement and monitor further training action plans to address concerns identified through local processes or by NCAS assessment. We can also provide action planning advice and guidance for practitioners who are returning to work after a significant period of absence. Our NCAS Good Practice Guide - Back on Track - and its supporting templates provide a clear framework for providing practitioners the opportunity to return to safe practice. NCAS has been working in this area since 2008 and the 2011 Department of Health Report of the Steering group on Remediation (pdf 530kb) advocated services of this sort.
Above all, our advisers are independent, so they can bring the parties together without any baggage. Advisers start by talking to the referring manager, but we encourage managers to tell practitioners that we are involved and advisers can meet with practitioners and their representatives, as well as facilitating all party case conferences. When you refer a case to us, think about how the adviser can best be used.
Requests for advice about how to investigate performance concerns are amongst the most common coming to us. We don’t investigate ourselves but we regularly advise on how investigation should be approached and our Good Practice Guide – How to conduct a local performance investigation - deals with this topic in detail. We also run regular workshops on conducting investigations.
In England in 2012/13, approaching 200 practitioners were excluded or suspended from work using MHPS or Performers List Regulations. Both frameworks ask managers to discuss these measures with NCAS. Our aim is to ensure that exclusion and suspension are used only when necessary and that episodes last for the shortest time consistent with resolving the concern and protecting patients and services. By monitoring this area of casework, we have shown that exclusion episodes are getting steadily shorter, saving the NHS money and minimising loss of practitioner skills.
NCAS employs trained and accredited mediators who can help resolve conflict in the workplace and deal with a range of employment disputes. Mediation is a formal process governed by accepted rules and procedures. If all parties understand and sign up to the process then mediation can be a useful way forward, saving manager time and identifying new ways through problems.
Good management of health professionals rests on good local governance, with clear procedures to manage concerns about performance. Every case brought to NCAS is an opportunity for our advisers to explore with managers how local procedures are working and whether any improvements might be made. The NCAS education programme also provides valuable opportunities for sharing ideas and good practice.
NCAS wants the focus of activity in professional governance to be at the front line of services so far as possible. We work to support local governance systems so that national regulatory systems are involved only where absolutely necessary. In relation to medical revalidation specifically, NCAS supports the work of responsible officers by providing:
education programmes for ROs and senior clinicians to support them in their role, particularly in tackling performance concerns locally
See our 2011 position paper.