Posted by: Witch Doctor | February 15, 2010

“Frail and weak” appraisal system

witchround

Dr Shirine Boardman, a diabetic consultant, was sacked for sending a list of patients’ names and addresses from herself in one office to herself in another office. There was no question of private practice being involved i.e. no financial gain. Furthermore, the two establishments work together and both feature on the NHS website.

Why did she do this?

She wanted to invite patients within her own specialty to attend educational meetings to help them cope with their diabetes.

That’s right, she was sacked as a consequence of using her initiative to go the extra mile to help her patients.

It is possible she may have breached the Trust rules regarding “a fax protocol” but this is not entirely clear.

If this happens to be is the case, then raise your hand if you or your secretary has never, never ever, transmitted a fax containing patient details. Or an e-mail?

If you have breached any of these rules since your last appraisal, then I trust you will detail this in the Probity Section of your next Appraisal, and take the consequences.

If this was relevant in the case of Dr Boardman, then the precedent has now been set that you may be sacked and referred to the GMC.

How many doctors do you suppose would be left within the NHS, My Black Cat?

If anyone reading this is not at doctor, then you need to be aware that a Very Detailed Appraisal System exists for all members of the medical profession. This has been ongoing for many years. Initially it was not compulsory although it was impossible to achieve a wage increase if the annual appraisal was not up to date. Therefore appraisal carries with it some financial gain. In the early days it was a carrot. It will soon become a stick. Appraisal will be an important part of Revalidation. This will be a time consuming, intrusive, cumbersome exercise performed according to protocol and there is no evidence whatsoever that it will help either doctor or patient any more than the previously existing private, personal activities that individual doctors organised for themselves and involving, where required, other experts in their field. This is the way it was  in the days when medicine was considered to be a profession.

Revalidation certainly won’t identify another Shipman.

Now, if you are a patient, you need to know this. Your clinical details may find their way into an individual doctor’s appraisal folder. If you write a letter of thanks or complaint to a doctor this also may also go into the appraisal folder.

What exactly is an appraisal folder?

Well, it might be a real folder kept in a filing cabinet i.e. hard copy. However the NHS is encouraging doctors to record their information on-line. Only the naïve believe that any information that goes-on line does not eventually attract a hacker looking for titbits.

You would imagine then, that there would be no identifiable information uploaded on to an Appraisal Website.

Not so, according to The Register:

NHS APPRAISAL TOOLKIT YANKED OFFLINE

“The UK’s Department of Health has taken the highly unusual step of suddenly taking a doctors’ appraisal website offline for three weeks over concerns it was vulnerable to hacking attacks.”

“The site provides an online database that allowed NHS doctors to prepare for their annual appraisals. The database therefore contains confidential information about all GPs’ performance, along with a large amount of named patient data including near diagnosis misses, critical incidents and the like.”

Are doctors putting their own personal information on line?

So it seems.

Remember MTAS?

Are doctors putting identifiable patient information on-line to their appraisal site?

Hopefully not.

If they are, have they asked the patient for their permission to do so after full discussion?

If they are putting such information on line without permission do they risk the same fate that befell Dr Boardman?

After all, the precedent now is that misconduct can mean anything the establishment might want it to mean.

“This kind of behaviour and the lowering of the threshold of ” gross misconduct” is also viewed in Shirine Boardman’s case. Essentially, the term “Misconduct” is floated around the planet and given any definition the Trust or the GMC deems fit depending on the circumstances. If the Trust disapproves of a doctor, anything can be deemed “misconduct” and at present there is little defence against this now. Of course, while the Daily Mail reports the rising complaints against doctors, the profession has done nothing to protect themselves against this.”

No, the profession has done nothing to protect themselves, My Black Cat.

What is it about the word “no” they do not understand?

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Responses

  1. Excellent post!

    There may be one doctor who understands the word “No” – but I can’t for a moment think who that might be…

  2. Only the naïve believe that any information that goes-on line does not eventually attract a hacker looking for titbits.

    Alternatively, you’d have to be incredibly naïve to believe that the NHS is even remotely capable of ensuring the security of any of their online records. Laptops are lost like Smarties in most hospitals.

  3. […] He also did it because it was something he could put into his ridiculous “Appraisal Folder” along with nice letters from little old ladies and satisfied others. […]


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