Consultants should face annual review of practice

The critical inquiry report into disgraced gynaecologist Rodney Ledward has called for annual appraisals of all hospital consultants following a series of blunders by senior managers.

The Government said last week that following the Ritchie report it intends to press forward as quickly as possible with plans for an assessment and support service to make sure problems in an NHS doctor’s performance are picked up at a much earlier stage.

The report highlights the distress and misery caused to women who said they were maimed by Ledward’s surgery.

John Adsett, National Secretary of the Association of Health Service HR Managers and head of personnel at Basildon and Thurrock General Hospital, called for clearer guidelines on disciplining doctors following the Ledward case.

He said, “We are working on guidance set out in 1990 which is difficult, costly and time-consuming. The procedure requires a barrister, who will have to be paid the appropriate rate.”

He added, “We need to get the procedure out of the arena and in front of an independent assessor – this protects doctors from someone within the organisation who may have an axe to grind.”

He said the NHS lacked HR managers with the necessary experience of disciplining incompetent doctors. “The NHS is short on HR people with experience of investigating doctors. They will be particularly important because the new EU Human Rights Act could have quite serious implications on disciplinary procedures.”

The Ritchie report recommendations on appraisals back proposals first put forward last November by Professor Liam Donaldson, chief medical officer for England, in his consultation paper on policing poorly performing doctors, Supporting Doctors, Protecting Patients.

This proposed setting up a network of independent assessment and support centres to provide a link between trusts and the GMC, the doctors’ regulatory body. He also proposed a system of compulsory regular annual appraisals for doctors, and the requirement that trusts conduct more rigorous employment history checks before hiring new staff.

The proposals are expected to be implemented by the end of next year, with legislation being introduced to Parliament this autumn.

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