Overseas doctors who qualified abroad are more likely to have complaints made about their professional conduct, clinical skills or behaviour, a report reveals.
Questions are also more likely to be raised about the competence of men, older doctors and consultants than about younger medics and trainees.
The referral rate for doctors over 50 is about five times the rate for those under 40. Women doctors are two thirds less likely to be referred than men.
The analysis of over 5,000 doctors and dentists referred to the National Clinical Assessment Service, since 2001, found that half the hospital doctors whose performances give rise to complaints qualified abroad though they account for only a third of the workforce.
Non-white doctors who qualified in the UK were not more likely to be referred, suggesting that complaints were not being made on the grounds of race.
Above average numbers of psychiatrists were referred for assessment but the report says this may be partly explained by the fact that higher numbers of ethnic minority doctors who trained overseas work in the specialty. Referrals were also ‘significantly higher’ from surgery, obstetrics and gynaecology and general practice.
In 2008/09, three quarters of NHS organisations referred at least one health professional to the assessment service.
The report gives a detailed analysis of 1,472 cases it has dealt with since 2007. Two thirds of these featured concerns about clinical skills but behavioural problems were also common, seen in more than half the cases. Communication with colleagues was the most common behavioural difficulty, a problem in one in five complaints.
The NCAS was set up in 2001 to resolve disputes between doctors and their employers following a series of high-profile scandals. It receives referrals from hospitals and primary care trusts and even from individuals referring themselves.
Among 144 cases where the most serious concerns had been raised two thirds of the doctors were back in work after remediation. The report also records that the average duration of exclusions of hospital doctors has fallen by over third since 2003.
Dr Umesh Prabhu, a consultant paediatrician at Fairfield Hospital, Bury, and a GMC and NCAS adviser, said the NHS did not have a good track record of supporting doctors when they ran into difficulties. The NCAS was now working to remedy this.
They had already held five meetings with the GMC to see how doctors needing help could be identified early and training was being given to human resources and medical directors.
“The aim is to help and support these doctors, to retrain them and get them back into the workforce. But I would like to see still more being done with medical directors taking leadership in revalidation and appraisals and using them in a supportive way.
“We need to remove the blame culture and deal with issues early and effectively so that patients can be protected and doctors supported,” said Prabhu.
Dr Michael Devlin, MDU medico-legal adviser, said: “It is notable that communication with colleagues and patients features in the referrals seen by the NCAS. In the MDU’s experience, breakdowns in communication are often at the heart of concerns raised about doctors’ conduct and performance.”
Dr Peter Old, NCAS associate medical director, who led the work of producing the report, said: “Our latest analyses of some of our most difficult cases show that most of the practitioners whose performance caused concern were able to resume safe and valued practice. That has to be the best outcome we can aim for.”
Tags: Overseas doctors, Suspended
