[Skip to content]

Search our Site
National Patient Safety Agency

NCAS calls for better support for doctors qualifying outside the UK

15 February 2011


Statistics released today by the National Clinical Assessment Service (NCAS) show that doctors qualifying outside the UK are more likely to be referred to NCAS or be excluded or suspended from work than UK medical graduates.


NCAS is calling on the NHS to strengthen induction and support systems for international medical graduates so that levels of concern about professional practice can be reduced.


Professor Alastair Scotland, Director of NCAS, said:  “We are not generalising. Most doctors from outside the UK do excellent work for the NHS and the service depends a great deal on them and the skills they bring.  But these statistics show clearly that there is a greater likelihood of concerns being raised in some groups than others”.


Rates of concern are higher amongst doctors who qualified elsewhere in the European Economic Area as well as outside Europe, with the highest rates seen amongst non-white doctors. However, NCAS attributes these differences to place of qualification and training factors at undergraduate level rather than to ethnicity.  Levels of concern amongst doctors qualifying in the UK do not differ between white and non-white groups.


The analyses also show a strong association between concerns about professional practice and the gender and age of doctors being referred.

Approximately 5,600 NCAS referrals were examined altogether, including 900 in the most recent year, 2009/10.  The latest year’s figures show patterns very close to those reported in earlier years, reinforcing the picture being presented.


Professor Alastair Scotland, Director of NCAS, added: “NCAS is in a unique position to hold up a mirror to the NHS and show patterns which might not be apparent to individual trusts or GP practices. We consistently find higher levels of concern in older age groups, which might be telling us something about the educational needs of doctors at the later stages of their careers.  We also find fewer concerns amongst women at all ages. The reasons for that are less clear and it is therefore important we see more research in that area.


"There has been a great deal of discussion in recent years about the influence of ethnicity and place of qualification on concerns about professional practice.   NCAS' statistics have shown consistently that place of primary qualification has a more powerful influence on referral to our services.   We believe this consistent picture should help colleagues within health services focus their work on induction and staff development to greatest effect”.


Today’s report, Concerns about professional practice and associations with age, gender, place of qualification and ethnicity – 2009/10, can be found at www.ncas.nhs.uk/publications/statistics.





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 1631/07500 224240 or e-mail simon.morgan@ncas.npsa.nhs.uk