Intended for healthcare professionals


Dealing with poor clinical performance

BMJ 2001; 322 doi: (Published 13 January 2001) Cite this as: BMJ 2001;322:66

New proposals are ill thought out and more about politics than policy

  1. Steve Dewar, fellow (,
  2. Belinda Finlayson, research officer
  1. Health Care Policy Programme, King's Fund, London W1G 0AN

    This week the British government announced a new agency, the National Clinical Assessment Authority, to work with doctors and employers to address underperformance and incompetence.1 The announcement was hasty, following a report that concluded that a British general practitioner, already convicted of 15 murders, might have committed up to 300. Moreover, and despite being in the offing for some time, the report describing the new authority, Assuring the Quality of Medical Practice, reads like an end of term report from a government seeking re-election.2 It was supposed to add flesh to the bones of a consultation document produced by England's chief medical officer 14 months ago, Supporting Doctors, Protecting Patients,3 and tell us how “a system for preventing, recognising and dealing with the poor clinical performance of doctors”3 would work in practice. In fact, it rehearses a lot about what we already know and tells us little more about how it will all work together.

    The diagnosis is not contentious. The current systems in the NHS for dealing with potential poor performance are ad hoc, fragmented, …

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