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National Clinical Assessment Service: A guide for health practitioners – frequently asked questions. 

This guide is aimed at healthcare practitioners whose employer or contracting body has made contact with NCAS for advice about an individual doctor, dentist or pharmacist about whom there are performance concerns.  The guide is intended to provide clear and helpful information about our role and to address some of the most frequently asked questions about our services.  

Advice for practitioners

If your performance is challenged, here are some tips for dealing with the situation. They come from The savvy doctor, by Steven Preece and Peter Old, published in BMJ Career Focus(2006; 332:gp35-gp36). But they apply just as much to dentists and pharmacists and they are timeless:


  • Try to keep in close touch with colleagues, professional and managerial.  If you have a good dialogue they will feel able to tell you early on if they think you are going adrift and support you in difficulties. Professionals who become isolated struggle most – both in understanding what is happening and dealing with it.

  • Don’t panic or over-react. An immediate overstated denial may cause you more trouble (by appearing dishonest) than the original concerns.

  • Try to see things from the perspective of others. Firstly patients – if concerns are well-founded, consider limiting aspects of you practice while the concerns are looked at. Secondly colleagues and your Trust/Commissioner – can you reasonably and properly reassure them? If you can facilitate an investigation and resolve concerns it is likely to be greatly appreciated.

  • Don’t ‘treat’ yourself. You can’t be objective and you will probably be far more critical of yourself than others are. Acknowledge expressed concerns; say you would like time to consider them. Take good advice and act on it.  Don’t procrastinate - that only puts you on the back foot. And don’t keep it all to yourself which is a recipe for panic and isolation.

  • Do talk privately to someone wise and trusted who understands something of the processes involved but stands apart from it – it will give you a better view, probably a lot of reassurance. 
    At least you will have talked it through and having the discussion may help you later if you need to demonstrate insight. Just watch you don’t breach confidentiality in that discussion.

  • Do consult your defence organisation or trade union.  Remember to be clear (and realistic) in your instructions and preferred outcome. You don’t want to find yourself in the middle of a long running dispute.

  • Do remember there is a lot of support out there - professional and NHS bodies (including your Trust/ Commissioning Group) locally and also nationally, including NCAS whose advisers can advise individual doctors as well as NHS bodies.

  • Do respond rationally and constructively. Be as objective as you can about your own practice and constructive about resolutions - show insight.

Also remember: if you have concerns about your own performance - perhaps you are returning to work after a period of absence, or you have health problems which may be impacting on your performance  - you can self-refer to NCAS through our advice numbers. We will provide expert advice about the steps you can take and where you can go for help. However, please be aware that we will only consider an assessment or other intervention with the involvement of the practitioner's employing or contracting organisation.

Some practitioners may be concerned about whether or not they have been referred to NCAS by their employer. NCAS always encourages organisations to be open with practitioners about their contact with us and we would encourage you to do the same. You can also make a subject access request under the Data Protection Act 1998. 

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