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National Patient Safety Agency

Less time being lost through suspension and exclusion – new NCAS statistics

15 March 2011


New statistics from the National Clinical Assessment Service (NCAS) show that over the past five years, suspension and exclusion episodes amongst GP and hospital and community doctors have been getting steadily shorter (1, 2).


However, GP suspensions still average about twice the length of exclusions in the Hospital and Community (H&C) sector – 39 weeks against 21 weeks in the year to September 2010.


Findings also show two-thirds of GP suspensions involve the regulator (General Medical or General Dental Council), compared with only a quarter of H&C exclusions.  The nature of regulatory processes is such that their involvement in any case is likely to lengthen the time to resolution (3).


Professor Alastair Scotland, Director of NCAS, said: “The overwhelming majority of doctors and dentists work hard to provide an excellent service.  This report is about a small group of practitioners, some of whom get into great difficulty.  Those difficulties have a great impact on patient and public confidence.


“The cost of exclusions to the NHS and to the public has been well recognised for many years and led to the National Audit Office’s report in 2003.  However there has been much less scrutiny of suspension in primary care.


“Our figures suggest that concerns about professional practice are late in coming forward in primary care.  Late recognition increases the likelihood of regulatory action and therefore lengthens the time for resolution.  This is too late to assist the practitioner and means that patients are at greater risk of harm. 


“Performance concerns are best dealt with as early as possible - not only to identify those cases that must involve the regulator, but also to focus on helping those cases where safe practice can be restored effectively.  This will underpin patient and public protection. Our experience has shown that the earlier concerns come forward and NCAS can be involved, the more readily safe practice can be restored”.


NCAS was established 10 years ago to work with health services to resolve concerns about individual professional practice.  It now works across the country, covering doctors, dentists and pharmacists, and deals with more than 1,000 requests for help each year.


For a copy of the report, called Use of NHS exclusion and suspension from work amongst doctors and dentists, please visit www.ncas.nhs.uk/publications/statistics




Notes to editors


(1)  ‘Suspension’ is a general practice term while ‘exclusion’ is used amongst employed hospital and community practitioners.  Both mean that the practitioner is separated from work.


(2)  Please see table 4 and chart C on page 5 for the trends in both sectors.  The average duration of GP suspension episodes concluded in the year to September 2010 was 39 weeks, compared with 43 weeks in the previous year and 49 weeks the year to September 2006.  For H&C exclusion episodes, the average duration was 21 weeks, compared with 24 weeks in the previous year and 34 weeks in the year to September 2006.


(3) Regulators respond to concerns about: 

·        conduct, after a criminal conviction or where serious professional misconduct is alleged;

·        performance, where there is repeated failure to meet expected standards;

·        health, where illness makes a practitioner a potential danger to patients or colleagues.


1.   NCAS provides general and specialist advice to help organisations address concerns about the practice of individual dentists, doctors or pharmacists or, in some cases, of practice teams. NCAS also undertakes formal assessment of practitioners.


2.   NCAS is currently a division of the National Patient Safety Agency (NPSA). In July 2010, the Department of Health published its review of Arm’s Length Bodies – Liberating the NHS: Report of the arms-length bodies review. Although the report announced abolition of NPSA, it did stipulate that NCAS functions are to continue. NCAS services will continue to remain free to NHS organisations until the service becomes self funding – expected within two-three years.


3.   Certain statistics produced by NPSA and NCAS are designated ‘official’ (by the Official Statistics Order 2009 – SI2001 no 753). This report is one of three NCAS official statistics products and NCAS was guided in its production by the requirements of the Code of Practice for Official Statistics published in 2009 by the UK Statistics Authority. For more information about the current report or other NCAS statistics, contact the Information and Knowledge Management Team on 0207 062 1655.


4.  For other information about this press release, please contact Simon Morgan, Senior Communications Manager, on 0207 062 1631 or e-mail simon.morgan@ncas.npsa.nhs.uk