Doctors to undergo regular performance reviews

Secretary of State for Health Jeremy Hunt has announced that beginning in 2013 doctors are to undergo annual performance appraisals and five-yearly “revalidation” checks if they wish to retain their licence to practice.

First mooted around thirty years ago, it was not until the inquiry into the high mortality rate of babies undergoing heart surgery Bristol Royal Infirmary in the late 1980s/early 1990s found that lives were put at risk because surgeons were operating beyond their competence, that the idea really took hold.

The introduction of the new scheme, a world first, follows 12 years of tough negotiations among the British Medical Association, General Medical Council and the Government and comes in the wake of a survey by the Department of Health’s Revalidation Support team in December 2011 that found that the performance of just over 4 per cent (around 6,800) of doctors in England gave cause for concern.

The majority of these (around 4,000) related to low-level concerns such as poor time management while around 1,600 were medium-level concerns such as rude behaviour towards patients. These problems will be dealt with by advice, monitoring and training. Those few doctors (around 1,400) with more serious high-level concerns such as lack of ability or alcoholism will be unable to practice while undergoing retraining or treatment.

GMC Chief Executive Niall Dickson has described the new scheme as being meaningful and robust without being overly bureaucratic but NHS Medical Director Professor Sir Bruce Keogh has warned that will have imperfections and be difficult to implement.

Overall, the scheme should help to identify those doctors who are not performing to an appropriate standard and to identify problems before they lead to major issues.

Skype could save on GP visits

Skype is a highly popular internet-based voice and video communications programme and now it has been suggested that it could be used for patient- GP consultations.

The Medical and Dental Defence Union of Scotland has recently advised doctors that Skype could be used to communicate with disabled patients or those in remote areas without the patients having to leave home. Not only will this benefit the patients but it will also reduce the number of missed appointments that GPs often contend with.

According to Dr Barry Parker, a Medical Adviser with the MDDUS, the concept of Skype consultations may have advantages in terms of convenience for both doctors and patients and may appeal to some patients. They may be better than telephone consultations as the doctor can actually see the patient and can therefore gain a better impression of the patient’s condition.

Dr Parker warned, however, that under some circumstances a video consultation would not be sufficient. Skin complaints, for example, were a case in point where face-to-face consultation and physical examination would be far superior to Skype notwithstanding the quality of the video picture.

There were also concerns with legal aspects. Dr Parker noted that Skype consultations would probably be dealt with in similar fashion to telephone consultations. Doctors would need to be aware of the limitations of video consultations and be prepared to arrange face-to-face consultations when necessary. Similarly, patients and doctors would need to be alert to confidentiality.

Secretary of State for Health Jeremy Hunt believes that ideas such as Skype could have a dramatic impact on the NHS, which is why better use of technology was a focus of the NHS mandate published on 13th November.

Hunt is Backing the Move to Skype Consultations