01.12.12
Fall in GP suspensions
Source: National Health Executive Nov/Dec 2012
The upward trend in GP suspensions has come to a halt, new figures show. Adam Hewitt reports.
Far fewer GPs were suspended from work by the NHS in 2011/12 compared to the previous year.
New figures on suspensions and exclusions published by the National Clinical Assessment Service (NCAS) show that there were 45 GPs suspended in England in 2011/12, compared to 84 in 2010/11.
NCAS said a similar fall in suspensions of GPs was reported by the Family Health Services Appeals Unit (FHSAU), a division of the NHS Litigation Authority.
NCAS and FHSAU have shared their trend data for the first time.
In secondary care, ‘exclusion’ of doctors (the equivalent process to suspension in primary care) is stable, at about 130 new episodes a year in England, and there is a trend towards shorter exclusion periods. Doctor exclusions concluded in 2011/12 lasted an average of 19 weeks. The NCAS report, ‘Use of NHS exclusion and suspension from work amongst doctors and dentists in England in 2011/12’, notes: “With an H&C (hospital and community) medical workforce of about 102,000 in 2011 (headcount) the one year risk of exclusion for doctors is about one in 800.”
The trend for GPs coincides with changes in the management of primary care, NCAS says, adding that it expects the level of suspensions to return to more ‘normal’ levels as new commissioning arrangements become established. The GP workforce stood at around 41,000 in 2011, meaning the ‘risk of suspension’ rate was about 1 practitioner in 900.
Both suspension and exclusion mean the practitioner ceases clinical work while usually, but not always, remaining on full pay. Such measures involve extra spending if locum or other arrangements are needed to maintain patient services. But since suspension or exclusion may be necessary to protect patient safety, cost must be balanced against safety benefit, NCAS says. NHS suspension is distinct from suspension for regulatory purposes by the General Medical Council or General Dental Council.
On the issue of cost, the NCAS report says: “Since 2010 we have used estimates of the amount of working time lost as a result of exclusion and suspension from work to suggest that the NHS has been making cost savings through better management of these measures.
“In the H&C sector this is still happening, given the latest information on new exclusions and the duration of recently-closed episodes.
“For GP suspensions, cost in lost working time is also falling but to an extent which may indicate temporary underuse during a period of service reorganisation. Having said that, working weeks lost through GP suspension are approximately equal to weeks lost through exclusion in the H&C sector, despite the large difference in workforce size.”
NCAS director Lynn Hugo said of the trend in GP suspensions: “We will be monitoring this over the next 12 months to see if this is an ongoing trend. It’s important for NHS managers and their colleagues who have concerns about a GP’s practice to call us as soon as possible.
“If they are unsure of who is responsible for managing the concern, we will point them in the right direction.”
NCAS receives around 900 referrals a year from across the NHS. Since the abolition of the National Patient Safety Agency, it has been hosted by the National Institute for Health and Clinical Excellence (NICE), but from 1 April 2013 it will become an operating division within the NHS Litigation Authority.