The College is committed to supporting employers in resolving concerns about the clinical performance of an individual surgeon or surgical unit. Through the Invited Review Mechanism (IRM), the College can provide a fair independent and professional review process to determine whether there is a cause for concern and make recommendations for improvement. The College believes that action should be taken locally at the earliest possible stage with the aim of remedying problems before they affect fitness to practice or impact on patient safety.
Concerns about performance may be highlighted from a number of sources including; local clinical governance process, the appraisal process, by other members of the surgical team or through surgical outcome data. The College recommends a staged and proportionate response to investigating concerns, considering both the individual and the environment within which they work.
Employers will already have pathways for dealing with performance concerns. The IRM is provided to support, but not replace existing procedures for dealing with such issues.
‘The IRM has an important role in maintaining standards and supporting surgeons. This role is likely to expand with issues caused by revalidation’. consultant ENT surgeon, clinical reviewer for the IRM
The IRM provides a service that covers all surgeons working in the NHS and private sector in England, Wales and Northern Ireland.
Managing performance concerns – the individual
The College has several services that are offered under the IRM to assist employers:
Working with employers and national clinical assessment service to provide advice and guidance on the development of . This service aims to facilitate surgeons in their return to unsupervised clinical practice safely and without unnecessary delay.
Through its commitment to supporting trusts and external agencies in dealing with performance concerns, the College will under certain circumstances identify an individual to act as
Managing performance concerns – the service
provide an independent expert opinion in relation to concerns about a specific surgical department/unit.
The review mechanism is a flexible one, and the College will work with the commissioning hospital to develop the appropriate terms of reference.