Abstract
Aims and methodRelative to workforce numbers, the National Clinical Assessment Service (NCAS) has reported high rates of referrals for performance concerns in psychiatrists. Our aim was to see how these concerns would be distributed across good medical practice (GMP) domains. Such specification would help identify appropriate training and development interventions. Concerns were obtained from consecutive case reports (anonymised) of psychiatrists referred to NCAS between October 2004 and April 2006.ResultsThe proportion of psychiatrists with concerns in any domain was highest (just over 50%) in the domains of good clinical care and working with colleagues. Two-thirds had concerns across multiple domains.Clinical implicationsTraining and development needs of psychiatrists referred to NCAS are more complex and more prevalent in the GMP domain of good clinical care than previously reported.
Highlights
It is retrospective and restricted to those working in the National Health Service (NHS)
In the absence of recent NHS data, it is difficult to know whether the sample is representative of psychiatrists in the NHS workforce
Existing National Clinical Assessment Service (NCAS) data for all specialties show that male gender, consultant grade, ethnicity, older age and primary medical qualification outside the UK are associated with increased risk of referral.[5,6]
Summary
A consecutive series of 123 cases was recruited. Complete data were available for all the employer and referral source characteristics and for gender and grade. None of the baseline characteristics were associated with increased numbers of concerns in the NCAS domains or the GMP domains of good clinical practice and patient relationships. More than half had concerns in the domains of good clinical care (56%) and colleague relationships (55%); about a third had concerns in the probity and patient relationship domains (40% and 34% respectively). The nature of the relationships between the four most frequently presenting domains (good clinical practice, colleague relationships, probity and patient relationships) was explored. In the colleague relationships domain, concerns about team working (including communication skills) and respect for colleagues (including bullying and harassment) were present in about a third of practitioners. Most of the concerns pertained to conduct with staff and/or patients that undermined trust. This is as yet unknown; the present findings can be compared with previous NCAS data on psychiatrists.[3,4,5,6]
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