Guidance for managing a candidate whose performance raises serious concerns for patient safety

This guidance describes the actions that should be taken only in relation to a candidate on an ALSG course who is considered to present a serious potential concern to patient safety.This situation is likely to be extremely rare and must be distinguished from a candidate’s mere failure either to qualify or re-qualify. It pays due regard to:

  • The General Medical Council guidelines: in particular the duty to raise concerns about patients’ safety.
  • The General DentalCouncil guidelines: in particular acting to protect patients’ interests by observing relevant guidelines used by other organisations.
  • The Nursing and Midwifery Council guidelines: in particular acting without delay if a colleague or anyone else may be putting someone at risk.
  • The Health Professions Council guidelines: in particularnot to do anything or allow someone else to do anything that will put the health or safety of a service user in danger.

Where it becomes apparent during a course that a candidate by his/her actions and/or answers presents a potential danger to patients’ safety the following procedure should be followed:

  1. The Course Director should be informed immediately of the circumstances giving rise to serious concern.
  1. The candidate should be made aware of the concern and offered further support and mentoring to help them, if possible, to complete the course successfully. The Course Director must be involved in this mentoring. Taking into account a candidate's previous clinical experience, appropriate support should be provided with the aim of gaining improvement and resolving the situation locally if at all possible. Remedial teaching can be offered during the course where possible and must be delivered by two (or more) members of faculty.
  1. In weighing the candidate's response to subsequent assessments, due regard should be paid to what are artificial circumstances, involving as they do the use of manikins and role-play, and to any other mitigating circumstances.
  1. If in spite of these interventions the candidate's performance is such that in the opinion of the Course Director and those members of faculty who have directly worked with the candidate, that patientswould be at potential risk of harm then the following action must be taken:
  • The candidate must be informed by the Course Director and another senior member of the faculty (ideally their mentor) of the decision and the potential steps that may be taken. If they have left the course then this should be done as soon as is practicable in conjunction with their local employer.
  • The Course Director should contact theALSG office and asked to be put into contact withChair of the appropriate ALSG Working Group, at the earliest possible opportunity, to discuss the circumstances and concerns. The Chair will offer objective advice and ensure that the right procedures have been followed.
  • The decision as to whether to notify the candidate's employer (and if appropriate educational supervisor or equivalent) should be made by the Course Director and members of faculty who have directly worked with the candidate, but no contact should be made unless the ALSG Working Group Chair authorises this. If the matter is subsequently reported to the candidate's employer (and if appropriate educational supervisor or equivalent), then it falls to that employer to be satisfied as to the candidate's clinical competence.
  • In the case of a self-employed person a decision will be taken whether to notify the Course Director’s and faculty’s concerns to the appropriate professional body.

By exception
Only if the Course Director is unable to speak to the Chair of the appropriate ALSG Working Group, before the candidate’s next working shift, the following action may be taken:
  • Contact another local Course Director, who is not involved with the course concerned, for advice. If after discussion it is agreed that the candidate presents a serious potential concern to patient safety, the candidate’s employer should be informed through a Medical Director or their deputy. The telephone call should be followed up with an email including a copy of the completed Record of Serious Concern (at the rear of this document).
  • In addition the Course Director should email ALSG stating the action that has been taken. The Course Director’s contact number should be given for further discussion.

  • The candidate must be kept informed of the course of action.
  1. It is essential that detailednotesare made at the time to record the evidence that has given rise to concern. This evidence and explanation of how the decision is reached must be clearly documented on the “Record of Serious Concern”. One copy of this must be given to the candidate, one copy sent to the Chair of the appropriate ALSG Working Group and one copy retained by the course centre.

REFERENCES

  • General Medical Council – Good medical Practice (2006)
  • Nursing and Midwifery Council – The Code: Standards of conduct, performance and ethics for nurses and midwives (2008)
  • Health Professional Council – Standards of conduct, performance and ethics (2008)
  • General Dental Council – Standards for Dental Professionals (2009)

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Record of Serious Concern
Candidate Details
Full Name:
Professional Title:
Work Address:
Home Address:
Email:
GMC/NMC/HPC/GDC registration number:
Course Details
Course name
Date of Course
Course Director
Mentor(s)
Faculty members involved:
Details of concerns raised:
Details of discussion with (and response of) the candidate:

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Remedial action taken(include when, where and by whom)
Course Medical Director contact with the Working Group Chair
Date: Time:
Details of the Course Director discussions with the Working Group Chair (include outcome)
Date and details of contact with Clinical Director / Line Manager(if none please state)
Date: Time:
Details of contact with the professional regulatory body if appropriate(include dates and names)
Date: Time:
Any other observations

PLEASE ENSURE THIS FORM IS SIGNED – SEE NEXT PAGE

CANDIDATE SIGNATURE

Candidate signature:Date:
Print Name:
RELEVANT FACULTY SIGNATURES(e.g. mentors, instructors on relevant teaching stations)
Signature:Date:
Print name:
Course Director:
Signature:Date:
Print name:
Faculty position:
Signature:Date:
Print name:
Faculty position:
Signature:Date:
Print name:
Faculty position:
Signature:Date:
Print name:
Faculty position:

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