MPS Head of Medical Services, Dr Nick Clements, looks at how early remediation can play an important role in helping doctors with health problems to get back on the road to recovery
At MPS, we feel there is an urgent need to invest in supporting doctors with health problems or whose clinical capability is in question.
Recent reports in the media have questioned the competence of NHS doctors facing health problems.1 There are many contributing factors that can influence the impact this has on the care provided to patients.
One of the main factors, in our experience, is the significant difference in the way doctors are treated depending on who is their employing trust. Some trusts are helpful, resourceful and accommodating, actively seeking ways to support the doctor, recognising the benefits this has for their patients. However, others are less helpful and this is often down to a lack of resources. There is currently no central funding to meet the costs involved and local arrangements vary widely.
The BMA has reported that it can cost more than £300,000 to train an NHS doctor.2 Effective, targeted and well organised remediation costs a fraction of that sum. Where the trust has good procedures in place, doctors requiring remediation are often identified early and we are aware of many cases where early remediation and support has enabled the doctor to return to work quickly and provide effective and valuable treatment for their patients. Where procedures or organisational will is lacking the outcome can be very different and this benefits neither doctor nor patient.
Wherever possible, concerns should be dealt with locally but too often, doctors who encounter health or other problems find it impossible to get the local support and training they need to get their careers back on track.
In most cases both the individual and the wider community benefit if the doctor is helped back into active practice
Every year MPS provides help and support to members in this predicament. There will be circumstances where concerns for patient safety will override the case for remediation, but in most cases both the individual and the wider community benefit if the doctor is helped back into active practice.
The most sensible way of getting doctors back on track and into the workplace quickly and efficiently is to have adequate resources and centrally-controlled and co-ordinated funding. Ensuring a single source of advice and, where necessary, a co-ordinated remediation process, as recommended by the Department of Health’s Steering Group on Remediation, would also go a long way to improving the current patchwork of approaches. This will be particularly important with the introduction of revalidation next year.
References
- “Inquiry questions competence of 3,000 NHS doctors”, The Times, 19 December 2011
- See BMA press release for summary, or view full report: Unit Costs of Health and Social Care 2010