Assessing Competence of NHS Consultants: Challenges and Possible Solutions

Even a mention of formal assessment of senior clinicians can be a contentious issue, to say least, when revalidation is said to be frmly in place in NHS-UK for almost half a decade. Since revalidation is accepted as a standard modality of assessment of performance, some colleagues in NHS wonder ‘stir up a hornets’ nest,’ when the authors allude to limitations of revalidation because poorly performing senior NHS clinicians may ‘slip through the net.’ NHS consultants have
clinical as well as training roles. Fundamentally, this assessment (revalidation) is meant to ensure the safety of the public and mitigates the risk of disciplinary action by the GMC. Unfortunately, a disciplinary action is often the frst sign of underperformance. In fact, the Bristol and Shipman inquiries have underscored the importance of the non-clinical and behavioural skills like communication, teamworking, personal organization and leadership are as important as
clinical skills. Rather than considered an assessment tool, an annual appraisal is aimed to facilitate and improve the way NHS consultants work and provide services. The authors have to wait for five years, to assess the efficacy of the system that was introduced with much ‘fanfare’ since it was projected as a panacea for poor performance by ’bad doctors.’ The objectives of this article are to contextualize the issue of the underperformance among senior clinicians in the current NHS environment and to conceptualize the idea that their performance
as trainers is directly related to their performance as clinicians. It is worth identifying the underlying factors of that are related to, or even better, can predict underperformance and will help evolve a strategy to help those consultants who are underperforming.