South East

PERFORMERS LIST DECISION PANEL – GP

Thursday 27 July2017, 12.00 noon

Board Room, York House, Massetts Road,

Horley, RH6 7DE

MINUTES - Henrik BEERSTECHER (3434110)

Attendees:

Name / Core role
Clive Powell / Independent Lay Chair
Alison Taylor / Medical Director
Demenica Basini / Senior Manager/ Director - Patient Experience
Tom Scanlon / Discipline Specific Practitioner
Linden Rakestrow / Programme Manager - presenting
Ffion Jones Hutchings / Observer
John Allingham - Kent LMC / Observer
Jane Godden / Admin Support - minutes
Declarations of Conflict of Interest
  • None

Tabled Documents, Discussion, Decision, Actions
Tabled documents:
Document 1: (DOCX) Annex 1 AB CA REVIEW - 08.06.2017
Document 2: 6.2 Annex 1 Dr Beerstecher comments - AB CA REVIEW June 20172
Document 3: (DOC) Clinical Review Form - Dr Beerstecher comments
Document 4: (DOCX) CA REVIEW final draft - 08.06.2017
Document 5: (PDF) 12 GMC to NHS E re audio recordings 11 May 2017 - 18.04.2017
Document 6: (PDF) 11.0 NHS E to DR Beerstecher re VU - 04.01.2017
Document 7: (DOCX) 11.1 Dr H Beerstecher - VU - 4 Jan 2017
Document 8: (PDF) 11.3 Dr Beerstecheer to NHS E re VU - 21 Feb 2017
Document 9: Communication with patients HB PDP (2) 16-01-24 - revised
Document 10: Maintaining prof perf and clinical management PDP comments 16-01-24 - revised
Document 11: obtaining consent HB PDP (2) 16-01-24 - revised
Document 12: record keeping HB PDP 16-01-24 -revised
Document 13: Working with colleagues HB PDP 16-01-16 - revised
Document 14: assessment of patients condition HB PDP (2) revised 16-01-16
Document 15: infection control HB PDP (2) 16-01-24 - revised
Document 16: (PDF) 4.0 letter from GMC to Dr Thallon - 13.11.2015
Document 17: (PDF) 2 NCAS FINAL REPORT LTR - 14.01.15
Document 18: (PDF) 2.1 NCAS final report - 14.01.2015
Document 19: (PDF) 3. GMC Performance Assessment
Discussion:
  • The Panel reviewed the papers, and discussed the Dr’s choice to audio record consultations .
  • The Dr does not use a Smartcard, and uses System One clinically
  • Referrals are made by email or fax.
  • Review from CA shows some progress against PDP, but there are still concerns about the continued use of audio records, especially as it would be a time-consuming process for another GP to review
  • The Panel discussed whether a record review was required. At present there is no evidence as to the quality of the current written records - there has been no independent evidence regarding record quality since 2015[h1], hence the reason for a proposed new review.
  • The GP has self-audited, but there was concern that there is no evidence of the quality of this process either.[h2]
  • Details of the level of consent the Dr explains and receives from the patients when audio recording is required. [h3]The panel decded that they would like evidence of protocol used by the GP . They noted that there is a notice on the surgery wall to declare the intention to record, but it is it’s unknown whether this is explained and whether he obtains fresh consent from repeat visitors to the surgery at the beginning of each consultation, and how this is documented on the patient record.[h4] The Panel asked if the patients were aware of how the discs are stored, the retention period, and who has access to the recordings as part of informed consent.
  • The Panel is unable to establish if all the concerns have been remediated. The Panel discussed having a Senior Appraiser to review, as a decision cannot be made without all the relevant information, but decided that a 30 record audit should be undertaken, and an additional audit of 10 recent referrals.
  • The Panel also wishes to be informed if the GP refuses to comply with the new review within a timely manner.

Decision:
  • It decided that an audit should be carried out by a Senior Clinical Advisor with no conflicts in the case, to review 30 records and10 recent referrals. Any refusal to comply with the request for a review by the performer in a timely manner should be referred to PLDP.
  • Enquiries should be made as to the details of the level of patient consent to audio recordings requested by the Dr, and whether this permission is gained at the start of each consultation and if the protocol fulfils the requirement for informed consent.
  • Findings to be presented at PLDP in September 2017 for review.

Actions:
  • New RCR review, as per Decision above.
  • Enquiries as to the level of consent obtained from patients should be investigated, and whether this consent has been obtained afresh at each consultation.
  • Findings to be presented to PLDP in September.

PLDP Minutes 27 July 2017Page 1

[h1]1 Dr Hall and Dr Shum reviewed the records since 2015, Dr Reed carried out a record review in 2016. Dr Moore carried out an appraisal in 2016 over the work. See comments on

[h2]1The audit was agreed in advance by NHS England and reviewed by the appraiser in November 2016, it was sent to the NHS and to the GMC. See

[h3]1 This is set out in the GMC report, in possession of the NHS since November 2015.

[h4]1 Anoher incorrect statement, this was discussed with the NHS and the CQC and in the GMC report in possession of NHS since 2015. See audio file on