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Identify your position within the profession and how that may
influence how you will approach this module.
Are you an NHS Consultant with junior staff accountable
you? YES / NO
You have managerial authority for these junior
staff. It is your responsibility to identify and address any
performance concerns that may arise.
You will also need to consider your peers.
Lead consultants and clinical and
medical directors have similar responsibility for the consultants
in their ambit.
If not, are you an NHS consultant
working without junior staff?
You may need to guard against the risks
associated with professional isolation. Are there others in the
multidisciplinary team (MDT) who can tell you when you may be out
of line? Do you meet regularly with peers?
If you are a full-time medical
director/responsible officer then you already know that you fall
into an unusual category.
If not, do you work outside the NHS in
private practice or at a private hospital?
There are some different checks, balances and
procedures outside the NHS. While NHS colleagues will be concerned
that self-interest will lead to concealment, private hospitals can
be highly sensitive about risks to their reputation and tend to be
robust in dealing with poor performance.
If not, are you a specialist trainee
or GP vocational trainee?
Most performance issues will be dealt with as
aspects of your training. Your educational supervisor and clinical
tutor have key roles.
If not, are you a specialty doctor,
associate specialist, staff grade or locally employed ‘trust grade’
or similar (non-consultant career grade)?
Where do you get to review your performance?
Is there regular and comprehensive supervision? Is there a good
If necessary, would you be able to raise
concerns about the performance of your consultant?
If not, are you a clinical
Do you understand the requirements of research
Are you professionally isolated?
Have you allowed sufficient time for the
clinical aspects of your post and the information needed for
revalidation, e.g. where are you holding your case-based
If not, are you working intermittently
as a locum?
Are you employed by an agency? If so what are
their arrangements for appraisal and revalidation? Or are you
employed by a series of Trusts/Health Boards (HBs)? If so what are
your arrangements for appraisal and revalidation?
If you are none of the above, you are either
retired or you are a rare individual indeed. I hope you enjoy this
This module is written with medical managers in mind. This
includes all consultants, unless you are working in relative
isolation. It aims to provide an understanding of the nature of
performance concerns, as well as preliminary guidance on how to
approach such concerns.