healthcare update - issue 12
Time for a (performers list) spring clean…
With spring approaching, albeit slowly, PCTs have been directed to
review their performers lists before the 1 July 2010.
The NHS (Performers Lists) Directions 2010 (the 'Directions')
came into force on 1 April 2010 require PCTs to review their
performers list procedures with particular reference to
applications for inclusion on a performers list; notifications and
disclosure of information and keeping performers lists up to
date.
If there is no such policy in place, PCTs must draw up and
implement one by 31 March 2011. Where, following a review, PCTs
identify a need to amend their procedure with a view to reducing
any risks to the public, this must also be implemented by 31 March
2011.
It is important to note that the duty to comply with the
directions is the responsibility of the PCT regardless of whether
or not it has outsourced its list management administration to a
third party organisation. Therefore the legal responsibility for
warranting that the reviews are carried out and any follow up
actions are completed will rest with the PCT and it will need to
ensure that these obligations are passed down to any third party
organisation.
Whilst the directions are relatively short requiring reviews of
three specific areas; an effective performers list policy should
also provide the PCT, applicants and performers with clear
guidelines as to the role and requirements which each party has to
fulfil. The directions provide the ideal prompt for PCTs to review
(or draft) their policy in its entirety and to ensure that it is
fully up to date and compliant.
The main changes
The directions require three specific reviews:
1. Applications to the performers list
The procedure must allow the PCT to verify both the identity of the
applicant and that the information provided by them in support of
their application is correct. Further, the PCT must be satisfied
that the applicant intends to perform the services and also that
they have a sufficient knowledge of the English language to
effectively perform those services.
2. Notifications and disclosure of
information
PCTs must ensure that when they consider
applicants or existing performers they also consider whether or not
to notify other specific bodies where an application is refused or
where a performer is suspended, removed or contingently removed
from the list.
PCTs must also have a procedure for dealing with requests for
information from another PCT or UK health services body (local
health board) and upon receipt of information that an applicant or
performer is registered on another PCT’s list.
3. Keeping performers lists up to date
PCTs are placed under a duty to keep their lists up to date. In
particular, they need to ensure that their procedure covers the
removal of performers from the list who cannot demonstrate that
they have performed the services for which they are included in the
list in their area in the preceding 12 months. This is in line with
the greater emphasis on the quality of the clinical service (and
outcome) for services.
Top tips for managing your list effectively
1. Applicability to all performers
The National Health Service (Performers Lists) Regulations 2004
(the ‘Regulations’) originally only applied to general
practitioners. The regulations were amended to include dentists,
opticians and pharmacists in 2005 and PCTs should ensure that their
policies have been amended to include this addition. In any event,
it should be clear from reading the policy exactly who it applies
to so as to avoid any confusion.
2. Designated responsibility
Allocate a designated member of staff to take responsibility for
monitoring the PCTs policy, arranging periodic reviews and taking
the necessary steps to ensure that any amendments are made as soon
as possible.
3. Establish a clear review timetable
In a busy organisation such as a PCT, it is important that review
dates are set in advance so that reviews can be scheduled at
regular intervals and the policy remains up to date.
The PCT must, under the regulations, include a review mechanism
in the policy which allows amendments to be made following further
regulations coming into force.
4. Publish any amendments to the policy in a
consolidated version on the website
Publication of a consolidated version will allow performers to
reference the document and enable the PCT to remain transparent in
its processes.
This should also reduce the risk of any confusion between
respective versions in the event that the PCT seeks to rely on the
policy in order to take action against an applicant or
performer.
5. Delegated authority
The PCT’s performers list decision making group should have
delegated executive authority from the board to decide any
necessary amendments and implement them.
The primary objective behind periodic reviews of the policy is
to minimise any risks to patient safety caused by the conduct of a
performer. It is therefore vital that where the PCT identifies a
need to amend the policy, this is actioned as promptly as
possible.
6. Regular audits and interim reviews
PCTs should consider carrying out regular audits of its performers
lists files to ensure that any action taken in relation to a
specific applicant or performer is compliant with both the
regulations and these directions, with appropriate follow ups.
7. Audit trail
We have seen a rise in performers list hearings to decide
suspension, removal or contingent inclusion being treated
litigiously by performers and their representatives. Recent case
law has reinforced the trend towards hearings where both sides have
lawyers in support.
One of the effects of this has been to amplify the reliance on
evidence and it is therefore becoming increasingly important that
PCTs keep complete files of their correspondence (both written and
verbal) on each performer to guarantee that the PCT is able, in the
event of a hearing, to present the best case possible. The
intention of any documents will need to be consistent with data
processing principles so that historic data is managed
proportionately to the nature of the performer under review.
A clear audit trail will also assist when files are reviewed as
this will make it easier to ascertain the background and determine
whether appropriate action has been taken to date.
If you have any questions related to effective performers list
management and/or require advice in this area including the
provision of assistance reviewing or drafting performers policies,
we would be delighted to assist you.
talk to us
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The content of this update is provided for the purposes of
general interest and information. It contains only brief summaries
of aspects of the subject matter and does not provide comprehensive
statements of the law. It does not constitute legal advice and does
not provide a substitute for it.